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2016 Plan Information for Kentucky
Choose a Location, Employee Type, & Payment Period
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Nationwide
Non-Postal
Certain Temporary Employees
Annuitant
U.S. Postal Service (Category 1)
Former Spouse Enrollee
Federal Deposit Insurance Corporation
Temporary Continuation of Coverage (TCC)
U.S. Postal Service (Category 2)
Tribal Employee
Biweekly
Every Four Weeks
Semi-Monthly
Monthly
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
H41
Non-Postal
CDHP Self
Monthly
215.17
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
485.89
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
530.14
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Basic Self
Monthly
134.18
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Basic Self & Family
Monthly
307.96
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Basic Self Plus One
Monthly
301.92
Humana CoverageFirst and Humana Value Plan
6N1
Non-Postal
CDHP Self
Monthly
138.48
Humana CoverageFirst and Humana Value Plan
6N2
Non-Postal
CDHP Self & Family
Monthly
311.57
Humana CoverageFirst and Humana Value Plan
6N3
Non-Postal
CDHP Self Plus One
Monthly
297.73
Humana Health Plan of Ohio, Inc.
A61
Non-Postal
High Self
Monthly
293.91
Humana Health Plan of Ohio, Inc.
A62
Non-Postal
High Self & Family
Monthly
643.06
Humana Health Plan of Ohio, Inc.
A63
Non-Postal
High Self Plus One
Monthly
626.99
Humana Health Plan of Ohio, Inc.
A64
Non-Postal
Standard Self
Monthly
176.28
Humana Health Plan of Ohio, Inc.
A65
Non-Postal
Standard Self & Family
Monthly
378.38
Humana Health Plan of Ohio, Inc.
A66
Non-Postal
Standard Self Plus One
Monthly
374.05
Humana Health Plan, Inc.
MH1
Non-Postal
High Self
Monthly
227.83
Humana Health Plan, Inc.
MH2
Non-Postal
High Self & Family
Monthly
494.37
Humana Health Plan, Inc.
MH3
Non-Postal
High Self Plus One
Monthly
484.92
Humana Health Plan, Inc.
MH4
Non-Postal
Standard Self
Monthly
164.86
Humana Health Plan, Inc.
MH5
Non-Postal
Standard Self & Family
Monthly
352.79
Humana Health Plan, Inc.
MH6
Non-Postal
Standard Self Plus One
Monthly
349.55
Humana Health Plan, Inc.
MI1
Non-Postal
High Self
Monthly
220.24
Humana Health Plan, Inc.
MI2
Non-Postal
High Self & Family
Monthly
477.29
Humana Health Plan, Inc.
MI3
Non-Postal
High Self Plus One
Monthly
468.58
Humana Health Plan, Inc.
MI4
Non-Postal
Standard Self
Monthly
185.88
Humana Health Plan, Inc.
MI5
Non-Postal
Standard Self & Family
Monthly
399.99
Humana Health Plan, Inc.
MI6
Non-Postal
Standard Self Plus One
Monthly
394.7
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N71
Non-Postal
HDHP Self
Monthly
128.17
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N72
Non-Postal
HDHP Self & Family
Monthly
379.21
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N73
Non-Postal
HDHP Self Plus One
Monthly
250.32
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ1
Non-Postal
High Self
Monthly
132.83
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ2
Non-Postal
High Self & Family
Monthly
431.45
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ3
Non-Postal
High Self Plus One
Monthly
259.42
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
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