HUMUNA 2016 GROUP AND BENEFIT NUMBERS AGENT USE ONLY PLAN NAME STATE SERVICE AREA

Transcription

1 HUMUNA 2016 AND BENEFIT NUMBERS AGENT USE ONLY NAME STATE SERVICE AREA BSN PREM IOWA ENHANCED S PDP ND SD MT WY PDP $61.00 IOWA PREFERRED S PDP ND SD MT WY PDP $27.40 IOWA WALMART S PDP ND SD MT WY PDP $18.40 WISCONSIN ENHANCED S PDP WI WI PDP $66.90 WISCONSIN PREFERRED S PDP WI WI PDP $34.50 WISCONSIN WALMART S PDP WI WI PDP $18.40 NAME STATE SERVICE AREA MINNESOTA GC H PFFS MINNESOTA HC H LPPO Blue Earth, Brown, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Jackson, Martin, Mower, Nicollet, Olmsted, PFFS MAPD $97.00 Redwood, Rice, Sibley, Steele, Wabasha, Waseca, Winona Aitkin, Anoka, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass, Chippewa, Chisago, Cottonwood, Crow Wing, Dakota, Douglas, Faribault, Goodhue, Grant, Hennepin, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Lac qui Parle, Lake, Lincoln, Lyon, McLeod, Martin, Meeker, LPPO Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Otter Tail, Pine, Pipestone, Pope, Ramsey, Redwood, Renville, Rice, Rock, Scott, Sherburne, Sibley, St. Louis, Stearns, Swift, Todd, Wadena, Waseca, Washington, Watonwan, Wilkin, Wright Hubbard, Kittson, Lake of the Woods, Le LPPO Sueur, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake, Roseau LPPO Aitkin, Anoka, Benton, Carlton, Carver, Cass, Chisago, Crow Wing, Dakota, Douglas, Hennepin, Isanti, Itasca, Kanabec, Lake, McLeod, Meeker, Mille Lacs, Morrison, Otter Tail, Pine, Ramsey, LPPO MAPD $69.00 Redwood, Scott, Sherburne, St. Louis, Stearns, Todd, Wadena, Washington, Wilkin, Wright

2 MINNESOTA HC H LPPO MINNESOTA HC H LPPO MINNESOTA HC H LPPO Hubbard, Lake of the Woods, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake, Roseau Blue Earth, Brown, Cottonwood, Faribault, Goodhue, Jackson, Martin, Mower, Nicollet, Rice, Sibley, Waseca, Watonwan LPPO MAPD $69.00 LPPO MAPD $71.00 LPPO MAPD $71.00 MINNESOTA HC H LPPO Le Sueur LPPO MAPD $71.00 Aitkin, Anoka, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass, Chippewa, Chisago, Cottonwood, Crow Wing, Dakota, Douglas, Faribault, Goodhue, Grant, Hennepin, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Lac qui Parle, Lake, Lincoln, Lyon, McLeod, Martin, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Otter Tail, Pine, Pipestone, Pope, Ramsey, Redwood, Renville, Rice, Rock, Scott, Sherburne, Sibley, St. Louis, Stearns, Swift, Todd, Wadena, Waseca, Washington, Watonwan, Wilkin, Wright LPPO MAPD $27.50 LPPO MAPD $27.50 Hubbard, Kittson, Lake of the Woods, Le LPPO MAPD $27.50 Sueur, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake, Roseau IOWA CHA GP H HMO Clinton, Delaware, Iowa, Johnson, Jones, HMO MAPD $0.00 Linn, Muscatine, Scott, Washington IOWA CHA GP H HMO Lyon, Plymouth, Sioux, Woodbury HMO MAPD $0.00

3 IOWA GP H HMO Mills, Montgomery, Pottawattamie HMO MAPD $0.00 Boone, Dallas, Jasper, Madison, Marion, IOWA GP H HMO Marshall, Story, Warren HMO MAPD $0.00 IOWA GP H HMO Polk HMO MAPD $0.00 IOWA HC H LPPO Scott LPPO MAPD $51.00 IOWA HC H LPPO Pottawattamie LPPO MAPD $ Pottawattamie LPPO Adair, Allamakee, Appanoose, Audubon, Butler, Calhoun, Carroll, Cass, Cerro Gordo, Cherokee, Clayton, Crawford, Davis, Decatur, Dickinson, Emmet, Floyd, Franklin, Fremont, Grundy, Hamilton, Hancock, Hardin, Henry, Humboldt, Ida, Jackson, Jefferson, Kossuth, Lee, Lucas, Lyon, Mahaska, Mills, Monona, Monroe, O'Brien, Osceola, Page, Palo Alto, Plymouth, Pocahontas, Polk, Poweshiek, Ringgold, Sac, Sioux, Tama, Union, Van Buren, Wapello, Wayne, Webster, Winnebago, Winneshiek, Woodbury, Worth, Wright LPPO Boone, Buena Vista, Dallas, Harrison, Jasper, Keokuk, Madison, Marion, Marshall, LPPO Story, Warren Clinton, Delaware, Iowa, Johnson, Jones, LPPO Linn, Muscatine Washington LPPO Boone, Dallas, Jasper, Madison, Marion, IOWA HC H LPPO LPPO MAPD $51.00 Marshall, Story, Warren IOWA HC H LPPO Delaware, Iowa, Johnson, Jones, Linn, LPPO MAPD $51.00 Muscatine, Polk IOWA HC H LPPO Washington LPPO MAPD $51.00

4 IOWA HC H LPPO Adair, Allamakee, Appanoose, Audubon, Butler, Calhoun, Carroll, Cass, Cerro Gordo, Cherokee, Clayton, Crawford, Davis, Decatur, Dickinson, Emmet, Floyd, Franklin, Fremont, Grundy, Hamilton, Hancock, Hardin, Henry, Humboldt, Ida, Jackson, Jefferson, Kossuth, Lee, Lucas, Lyon, LPPO MAPD $63.00 Mahaska, Mills, Monona, Monroe, O'Brien, Osceola, Page, Palo Alto, Plymouth, Pocahontas, Poweshiek, Ringgold, Sac, Sioux, Tama, Union, Van Buren, Wapello, Wayne, Webster, Winnebago, Winneshiek, Woodbury, Worth, Wright IOWA HC H LPPO Buena Vista, Harrison, Keokuk LPPO MAPD $63.00 IOWA HC H LPPO Clinton LPPO MAPD $63.00 IOWA GC H PFFS Adair, Adams, Audubon, Buena Vista, Calhoun, Carroll, Cherokee, Dickinson, Emmet, Harrison, Humboldt, Ida, Louisa, Lyon, Madison, Pocahontas, Sac, Sioux, Union, Van Buren, Washington, Webster PFFS MAPD $97.00 IOWA GC H PFFS Adair, Adams, Audubon, Buena Vista, Calhoun, Carroll, Cherokee, Dickinson, Emmet, Harrison, Humboldt, Ida, Louisa, Lyon, Madison, Pocahontas, Sac, Sioux, Union, Van Buren, Washington, Webster PFFS Brown, Calumet, Fond du Lac, Green Lake, WISCONSIN GP H HMO WI Manitowoc, Marathon, Marquette, Oconto, HMO MAPD $0.00 Outagamie, Shawano, Waupaca, Milwaukee, Ozaukee, Racine, Sheboygan, WISCONSIN GP H HMO WI HMO MAPD $31.00 Washington, Waukesha Dodge, Kenosha, Milwaukee, Ozaukee, WISCONSIN HC H LPPO WI Racine, Washington, Waukesha LPPO MAPD $91.00 Brown, Calumet, Door, Fond du Lac, Forest, Green Lake, Kewaunee, Manitowoc, Marathon, Marinette, Marquette, WISCONSIN HC H LPPO WI LPPO MAPD $81.00 Menominee, Oconto, Outagamie, Portage, Sheboygan, Waupaca, Waushara, Winnebago Columbia, Crawford, Dane, Green, Iowa, WISCONSIN HC H LPPO WI LPPO MAPD $61.00 Jefferson, Lafayette, Richland, Rock, Sauk WISCONSIN HC R RPPO WI State Wide RPPO MAPD $127.00

5 WISCONSIN HC R RPPO WI State Wide RPPO Adams, Barron, Brown, Burnett, Calumet, Clark, Dane, Dodge, Dunn, Eau Claire, Fond du Lac, Forest, Green Lake, Jackson, Jefferson, Juneau, Kenosha, La Crosse, Lafayette, Langlade, Lincoln, Manitowoc, Marathon, Marquette, Menominee, WISCONSIN GC H PFFS WI PFFS MAPD $99.00 Milwaukee, Oneida, Outagamie, Ozaukee, Pepin, Portage, Racine, Richland, Rusk, Sauk, Shawano, Sheboygan, Taylor, Trempealeau, Vernon, Vilas, Walworth, Washburn, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood SOUTH DAKOTA CHA GP H HMO SD Lincoln, Union HMO MAPD $0.00 Butte, Custer, Fall River, Lawrence, Meade, SOUTH DAKOTA HC H LPPO SD LPPO MAPD $69.00 Pennington Beadle, Bon Homme, Brookings, Brown, Butte, Clark, Clay, Codington, Custer, Davison, Day, Deuel, Fall River, Grant, Hamlin, Hanson, Hutchinson, Kingsbury, SOUTH DAKOTA HC H LPPO SD LPPO Lake, Lawrence, Lincoln, McCook, Marshall, Meade, Miner, Minnehaha, Moody, Pennington, Roberts, Sanborn, Spink, Turner, Union, Yankton Beadle, Bon Homme, Brookings, Brown, Clark, Clay, Codington, Davison, Day, Deuel, Grant, Hamlin, Hanson, Hutchinson, SOUTH DAKOTA HC H LPPO SD Kingsbury, Lake, Lincoln, McCook, Marshall, Miner, Minnehaha, Moody, Roberts, Sanborn, Spink, Turner, Union, Yankton Bennett, Bon Homme, Brule, Campbell, Codington, Corson, Davison, Deuel, Dewey, Edmunds, Faulk, Haakon, Hanson, Hughes, LPPO MAPD $57.00 SOUTH DAKOTA GC H PFFS SD Hyde, Jones, Lyman, McPherson, Mellette, PFFS MAPD $97.00 Pennington, Perkins, Potter, Shannon, Spink, Stanley, Sully, Tripp, Turner, Union, Walworth, Yankton Barnes, Burleigh, Cass, Grand Forks, NORTH DAKOTA HC H LPPO ND LPPO Kidder, Morton, Richland, Stutsman, Traill Barnes, Burleigh, Cass, Grand Forks, NORTH DAKOTA HC H LPPO ND LPPO MAPD $71.00 Kidder, Morton, Richland, Stutsman, Traill NORTH DAKOTA GC H PFFS ND Burleigh PFFS MAPD $97.00