2016 Plan Information for District of Columbia
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Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 130.08 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 286.94 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 281.31 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 118.33 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 298.42 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 259.5 |
| Aetna HealthFund CDHP and Aetna Value Plan | F51 | Non-Postal | CDHP Self | Monthly | 185.27 |
| Aetna HealthFund CDHP and Aetna Value Plan | F52 | Non-Postal | CDHP Self & Family | Monthly | 418.1 |
| Aetna HealthFund CDHP and Aetna Value Plan | F53 | Non-Postal | CDHP Self Plus One | Monthly | 463.01 |
| Aetna HealthFund CDHP and Aetna Value Plan | F54 | Non-Postal | Basic Self | Monthly | 135.76 |
| Aetna HealthFund CDHP and Aetna Value Plan | F55 | Non-Postal | Basic Self & Family | Monthly | 310.88 |
| Aetna HealthFund CDHP and Aetna Value Plan | F56 | Non-Postal | Basic Self Plus One | Monthly | 304.78 |
| Aetna Open Access | JN1 | Non-Postal | High Self | Monthly | 497.21 |
| Aetna Open Access | JN2 | Non-Postal | High Self & Family | Monthly | 1098.71 |
| Aetna Open Access | JN3 | Non-Postal | High Self Plus One | Monthly | 1136.91 |
| Aetna Open Access | JN4 | Non-Postal | Basic Self | Monthly | 149.48 |
| Aetna Open Access | JN5 | Non-Postal | Basic Self & Family | Monthly | 336.46 |
| Aetna Open Access | JN6 | Non-Postal | Basic Self Plus One | Monthly | 329.86 |
| CareFirst BlueChoice | 2G1 | Non-Postal | High Self | Monthly | 234.87 |
| CareFirst BlueChoice | 2G2 | Non-Postal | High Self & Family | Monthly | 598 |
| CareFirst BlueChoice | 2G3 | Non-Postal | High Self Plus One | Monthly | 395.44 |
| CareFirst BlueChoice | 2G4 | Non-Postal | Standard Self | Monthly | 160.9 |
| CareFirst BlueChoice | 2G5 | Non-Postal | Standard Self & Family | Monthly | 422.28 |
| CareFirst BlueChoice | 2G6 | Non-Postal | Standard Self Plus One | Monthly | 311.6 |
| CareFirst BlueChoice | B61 | Non-Postal | HDHP Self | Monthly | 147.99 |
| CareFirst BlueChoice | B62 | Non-Postal | HDHP Self & Family | Monthly | 351.62 |
| CareFirst BlueChoice | B63 | Non-Postal | HDHP Self Plus One | Monthly | 295.98 |
| Kaiser Permanente - Mid-Atlantic States | E31 | Non-Postal | High Self | Monthly | 156.24 |
| Kaiser Permanente - Mid-Atlantic States | E32 | Non-Postal | High Self & Family | Monthly | 388.94 |
| Kaiser Permanente - Mid-Atlantic States | E33 | Non-Postal | High Self Plus One | Monthly | 398.99 |
| Kaiser Permanente - Mid-Atlantic States | E34 | Non-Postal | Standard Self | Monthly | 116.44 |
| Kaiser Permanente - Mid-Atlantic States | E35 | Non-Postal | Standard Self & Family | Monthly | 272.46 |
| Kaiser Permanente - Mid-Atlantic States | E36 | Non-Postal | Standard Self Plus One | Monthly | 263.14 |
| M.D. IPA | JP1 | Non-Postal | High Self | Monthly | 178.75 |
| M.D. IPA | JP2 | Non-Postal | High Self & Family | Monthly | 739.09 |
| M.D. IPA | JP3 | Non-Postal | High Self Plus One | Monthly | 312.99 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 132.78 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 430.84 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 259.32 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L91 | Non-Postal | Value Self | Monthly | 115.22 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L92 | Non-Postal | Value Self & Family | Monthly | 323.08 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L93 | Non-Postal | Value Self Plus One | Monthly | 225.02 |