1. Healthcare

University of Wisconsin
Health Insurance Premium
Employee Contribution Rates for the 2015 Plan Year
Tier 1 :
Health Maintenance Organization (HMO) and
Preferred Provider Organization (PPO) Plans
Tier 2 :
Out-of-state residents assigned to work out of state receive
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
HMO and PPO Plans
2015 Monthly Employee Contribution Rates for
Classified and Unclassified Employees
Single
Tier 1
Tier 2
Tier 3
$92.00
$136.00
$267.00
Family
$230.00
$341.00
$666.00
High Deductible Health Plan (HDHP) Option
2015 Monthly Employee Contribution Rates for
Classified and Unclassified Employees
Single
Tier 1
Tier 2
Tier 3
$32.00
$76.00
$207.00
Family
$81.00
$192.00
$517.00
HMO and PPO Plans
2015 Monthly Contribution Rates for
UW Graduate Assistants
Single
Tier 1
Tier 2
Tier 3
$46.00
$68.00
$133.50
Family
$115.00
$170.50
$333.00
UW Graduate Assistants and Teaching Assistants
are not eligible for HDHP coverage.
Rev. 09/2014
University of Wisconsin
Health Insurance Premium
Employee Contribution Rates for the 2015 Plan Year
Tier 1 :
Health Maintenance Organization (HMO) and
Preferred Provider Organization (PPO) Plans
Tier 2 :
Out-of-state residents assigned to work out of state receive
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
HMO and PPO Plans
2015 Monthly Premiums for
Crafts Employees
Plan Name
Anthem Blue Preferred Northeast
Anthem Blue Preferred Southeast
Arise Health Plan Northern
Arise Health Plan Southeast
Dean Health Insurance
Dean Health Insurance-Prevea360
GHC of Eau Claire
GHC of South Central Wisconsin
Gundersen Health Plan
Health Tradition Health Plan
HealthPartners Health Plan
Humana-Eastern
Humana-Western
Medical Associates Health Plans
MercyCare Health Plans
Network Health
Physicians Plus
Security Health Plan
Standard Plan (PPP)
Standard Plan-Out of State
State Maintenance Plan (SMP)
UnitedHealthcare of Wisconsin
Unity Health Insurance-Community
Unity Health Insurance-UW Health
WEA Trust-East
WEA Trust-Northwest Chippewa Valley
WEA Trust-Northwest Mayo Clinic Hlth Sys
WEA Trust-South Central
Tier
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
2
1
1
1
1
1
1
1
1
Single
$731.90
$814.50
$774.10
$798.30
$676.00
$810.40
$851.80
$648.60
$793.40
$813.80
$725.20
$834.40
$834.40
$675.20
$602.10
$799.30
$683.00
$814.50
$1,392.80
$1,392.80
$862.00
$795.00
$774.80
$694.20
$794.90
$831.20
$831.20
$665.60
Family
$1,822.30
$2,028.80
$1,927.80
$1,988.30
$1,682.60
$2,018.60
$2,122.10
$1,614.10
$1,976.10
$2,027.10
$1,805.60
$2,078.60
$2,078.60
$1,680.60
$1,497.80
$1,990.80
$1,700.10
$2,028.80
$3,477.80
$3,477.80
$2,150.20
$1,980.10
$1,929.60
$1,728.10
$1,979.80
$2,070.60
$2,070.60
$1,656.60
All represented and nonrepresented employees in craft-related classifications pay all of the total monthly
premium.
Rev. 09/2014
University of Wisconsin
Health Insurance Premium
Employee Contribution Rates for the 2015 Plan Year
Tier 1 :
Health Maintenance Organization (HMO) and
Preferred Provider Organization (PPO) Plans
Tier 2 :
Out-of-state residents assigned to work out of state receive
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
High Deductible Health Plan (HDHP) Option
2015 Monthly Premiums for
Crafts Employees
Plan Name
Anthem Blue Preferred Northeast
Anthem Blue Preferred Southeast
Arise Health Plan Northern
Arise Health Plan Southeast
Dean Health Insurance
Dean Health Insurance-Prevea360
GHC of Eau Claire
GHC of South Central Wisconsin
Gundersen Health Plan
Health Tradition Health Plan
HealthPartners Health Plan
Humana-Eastern
Humana-Western
Medical Associates Health Plans
MercyCare Health Plans
Network Health
Physicians Plus
Security Health Plan
Standard Plan (PPP)
Standard Plan-Out of State
State Maintenance Plan (SMP)
UnitedHealthcare of Wisconsin
Unity Health Insurance-Community
Unity Health Insurance-UW Health
WEA Trust-East
WEA Trust-Northwest Chippewa Valley
WEA Trust-Northwest Mayo Clinic Hlth Sys
WEA Trust-South Central
Tier
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
2
1
1
1
1
1
1
1
1
Single
$641.10
$713.30
$678.00
$699.20
$592.10
$709.70
$746.00
$568.20
$694.90
$712.70
$635.20
$730.70
$730.70
$591.40
$527.50
$700.00
$598.30
$713.30
$1,222.40
$1,222.40
$757.40
$696.30
$678.60
$608.10
$696.20
$727.90
$727.90
$583.00
Family
$1,595.30
$1,775.80
$1,687.50
$1,740.50
$1,472.80
$1,766.80
$1,857.50
$1,413.00
$1,729.80
$1,774.30
$1,580.50
$1,819.30
$1,819.30
$1,471.00
$1,311.30
$1,742.50
$1,488.30
$1,775.80
$3,049.70
$3,049.70
$1,887.30
$1,733.30
$1,689.00
$1,512.80
$1,733.00
$1,812.30
$1,812.30
$1,450.00
All represented and nonrepresented employees in craft-related classifications pay 100% of the total
monthly HDHP premium and do not receive a State HSA contribution.
Rev. 09/2014
University of Wisconsin
Health Insurance Premium
Employee Contribution Rates for the 2015 Plan Year
Tier 1 :
Health Maintenance Organization (HMO) and
Preferred Provider Organization (PPO) Plans
Tier 2 :
Out-of-state residents assigned to work out of state receive
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
HMO and PPO Plans
2015 Monthly Employee Contribution Rates for
Non-Represented and Represented Employees employed less than half-time
Plan Name
Anthem Blue Preferred Northeast
Anthem Blue Preferred Southeast
Arise Health Plan Northern
Arise Health Plan Southeast
Dean Health Insurance
Dean Health Insurance-Prevea360
GHC of Eau Claire
GHC of South Central Wisconsin
Gundersen Health Plan
Health Tradition Health Plan
HealthPartners Health Plan
Humana-Eastern
Humana-Western
Medical Associates Health Plans
MercyCare Health Plans
Network Health
Physicians Plus
Security Health Plan
Standard Plan (PPP)
Standard Plan-Out of State
State Maintenance Plan (SMP)
UnitedHealthcare of Wisconsin
Unity Health Insurance-Community
Unity Health Insurance-UW Health
WEA Trust-East
WEA Trust-Northwest Chippewa Valley
WEA Trust-Northwest Mayo Clinic Hlth Sys
WEA Trust-South Central
Tier
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
2
1
1
1
1
1
1
1
1
Single
$365.95
$407.25
$387.05
$399.15
$338.00
$405.20
$425.90
$324.30
$396.70
$406.90
$362.60
$417.20
$417.20
$337.60
$301.05
$399.65
$341.50
$407.25
$696.40
$696.40
$431.00
$397.50
$387.40
$347.10
$397.45
$415.60
$415.60
$332.80
Family
$911.15
$1,014.40
$963.90
$994.15
$841.30
$1,009.30
$1,061.05
$807.05
$988.05
$1,013.55
$902.80
$1,039.30
$1,039.30
$840.30
$748.90
$995.40
$850.05
$1,014.40
$1,738.90
$1,738.90
$1,075.10
$990.05
$964.80
$864.05
$989.90
$1,035.30
$1,035.30
$828.30
This table shows premium contribution amounts for part time employees with appointments of less than
1044 hours; employees working less than half-time pay 50% of the total monthly premium. These rates
apply to represented and non-represented employees. These rates also apply to faculty and academic
staff as established by their respective compensation plans.
Rev. 09/2014
University of Wisconsin
Health Insurance Premium
Employee Contribution Rates for the 2015 Plan Year
Tier 1 :
Health Maintenance Organization (HMO) and
Preferred Provider Organization (PPO) Plans
Tier 2 :
Out-of-state residents assigned to work out of state receive
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
High Deductible Health Plan (HDHP) Option
2015 Monthly Employee Contribution Rates for
Non-Represented and Represented Employees employed less than half-time
Plan Name
Anthem Blue Preferred Northeast
Anthem Blue Preferred Southeast
Arise Health Plan Northern
Arise Health Plan Southeast
Dean Health Insurance
Dean Health Insurance-Prevea360
GHC of Eau Claire
GHC of South Central Wisconsin
Gundersen Health Plan
Health Tradition Health Plan
HealthPartners Health Plan
Humana-Eastern
Humana-Western
Medical Associates Health Plans
MercyCare Health Plans
Network Health
Physicians Plus
Security Health Plan
Standard Plan (PPP)
Standard Plan-Out of State
State Maintenance Plan (SMP)
UnitedHealthcare of Wisconsin
Unity Health Insurance-Community
Unity Health Insurance-UW Health
WEA Trust-East
WEA Trust-Northwest Chippewa Valley
WEA Trust-Northwest Mayo Clinic Hlth Sys
WEA Trust-South Central
Tier
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
2
1
1
1
1
1
1
1
1
Single
$320.55
$356.65
$339.00
$349.60
$296.05
$354.85
$373.00
$284.10
$347.45
$356.35
$317.60
$365.35
$365.35
$295.70
$263.75
$350.00
$299.15
$356.65
$611.20
$611.20
$378.70
$348.15
$339.30
$304.05
$348.10
$363.95
$363.95
$291.50
Family
$797.65
$887.90
$843.75
$870.25
$736.40
$883.40
$928.75
$706.50
$864.90
$887.15
$790.25
$909.65
$909.65
$735.50
$655.65
$871.25
$744.15
$887.90
$1,524.85
$1,524.85
$943.65
$866.65
$844.50
$756.40
$866.50
$906.15
$906.15
$725.00
This table shows premium contribution amounts for part time employees with appointments of less than
1044 hours; employees working less than half-time pay 50% of the total monthly HDHP premium and will
receive 50% of the State HSA contribution. These rates apply to represented and non-represented
employees. These rates also apply to faculty and academic staff as established by their respective
compensation plans.
Rev. 09/2014