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2016 Plan Information for Utah
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
G51
Non-Postal
CDHP Self
Monthly
234.89
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
531.83
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
575.62
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
133.71
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
306.25
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
300.24
Altius Health Plans
9K1
Non-Postal
High Self
Monthly
219.75
Altius Health Plans
9K2
Non-Postal
High Self & Family
Monthly
449.88
Altius Health Plans
9K3
Non-Postal
High Self Plus One
Monthly
494.5
Altius Health Plans
9K4
Non-Postal
HDHP Self
Monthly
92.23
Altius Health Plans
9K5
Non-Postal
HDHP Self & Family
Monthly
192.77
Altius Health Plans
9K6
Non-Postal
HDHP Self Plus One
Monthly
188.99
Altius Health Plans
DK4
Non-Postal
Standard Self
Monthly
124.57
Altius Health Plans
DK5
Non-Postal
Standard Self & Family
Monthly
275.08
Altius Health Plans
DK6
Non-Postal
Standard Self Plus One
Monthly
272.37
SelectHealth, Inc.
SF1
Non-Postal
High Self
Monthly
225.47
SelectHealth, Inc.
SF2
Non-Postal
High Self & Family
Monthly
475.71
SelectHealth, Inc.
SF3
Non-Postal
High Self Plus One
Monthly
535.25
SelectHealth, Inc.
SF4
Non-Postal
Standard Self
Monthly
128.08
SelectHealth, Inc.
SF5
Non-Postal
Standard Self & Family
Monthly
284.42
SelectHealth, Inc.
SF6
Non-Postal
Standard Self Plus One
Monthly
284.42
SelectHealth, Inc.
SF1
Non-Postal
High Self
Monthly
225.47
SelectHealth, Inc.
SF2
Non-Postal
High Self & Family
Monthly
475.71
SelectHealth, Inc.
SF3
Non-Postal
High Self Plus One
Monthly
535.25
SelectHealth, Inc.
SF4
Non-Postal
Standard Self
Monthly
128.08
SelectHealth, Inc.
SF5
Non-Postal
Standard Self & Family
Monthly
284.42
SelectHealth, Inc.
SF6
Non-Postal
Standard Self Plus One
Monthly
284.42
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service