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2017 Plan Information for Indiana
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
138.7
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
305.95
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
299.95
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
120.05
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
302.77
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
263.29
Aetna HealthFund CDHP and Aetna Value Plan
JS1
Non-Postal
CDHP Self
Monthly
485.2
Aetna HealthFund CDHP and Aetna Value Plan
JS2
Non-Postal
CDHP Self & Family
Monthly
1106.22
Aetna HealthFund CDHP and Aetna Value Plan
JS3
Non-Postal
CDHP Self Plus One
Monthly
1148.2
Aetna HealthFund CDHP and Aetna Value Plan
JS4
Non-Postal
Value Self
Monthly
218.24
Aetna HealthFund CDHP and Aetna Value Plan
JS5
Non-Postal
Value Self & Family
Monthly
500.05
Aetna HealthFund CDHP and Aetna Value Plan
JS6
Non-Postal
Value Self Plus One
Monthly
548.01
Health Alliance HMO/POS
K84
Non-Postal
Standard Self
Monthly
151.54
Health Alliance HMO/POS
K85
Non-Postal
Standard Self & Family
Monthly
587.45
Health Alliance HMO/POS
K86
Non-Postal
Standard Self Plus One
Monthly
318.24
Humana CoverageFirst and Humana Value Plan
MW1
Non-Postal
CDHP Self
Monthly
217.94
Humana CoverageFirst and Humana Value Plan
MW2
Non-Postal
CDHP Self & Family
Monthly
476.39
Humana CoverageFirst and Humana Value Plan
MW3
Non-Postal
CDHP Self Plus One
Monthly
470.32
Humana CoverageFirst and Humana Value Plan
MW4
Non-Postal
Value Self
Monthly
122.14
Humana CoverageFirst and Humana Value Plan
MW5
Non-Postal
Value Self & Family
Monthly
274.82
Humana CoverageFirst and Humana Value Plan
MW6
Non-Postal
Value Self Plus One
Monthly
262.61
Humana Health Plan of Ohio, Inc.
A61
Non-Postal
High Self
Monthly
504.94
Humana Health Plan of Ohio, Inc.
A62
Non-Postal
High Self & Family
Monthly
1122.12
Humana Health Plan of Ohio, Inc.
A63
Non-Postal
High Self Plus One
Monthly
1087.36
Humana Health Plan of Ohio, Inc.
A64
Non-Postal
Standard Self
Monthly
296.42
Humana Health Plan of Ohio, Inc.
A65
Non-Postal
Standard Self & Family
Monthly
652.91
Humana Health Plan of Ohio, Inc.
A66
Non-Postal
Standard Self Plus One
Monthly
638.99
Humana Health Plan, Inc.
751
Non-Postal
High Self
Monthly
777.53
Humana Health Plan, Inc.
752
Non-Postal
High Self & Family
Monthly
1735.42
Humana Health Plan, Inc.
753
Non-Postal
High Self Plus One
Monthly
1673.38
Humana Health Plan, Inc.
754
Non-Postal
Standard Self
Monthly
399.4
Humana Health Plan, Inc.
755
Non-Postal
Standard Self & Family
Monthly
884.65
Humana Health Plan, Inc.
756
Non-Postal
Standard Self Plus One
Monthly
860.43
Humana Health Plan, Inc.
MH1
Non-Postal
High Self
Monthly
235.45
Humana Health Plan, Inc.
MH2
Non-Postal
High Self & Family
Monthly
515.78
Humana Health Plan, Inc.
MH3
Non-Postal
High Self Plus One
Monthly
507.97
Humana Health Plan, Inc.
MH4
Non-Postal
Standard Self
Monthly
173.16
Humana Health Plan, Inc.
MH5
Non-Postal
Standard Self & Family
Monthly
375.62
Humana Health Plan, Inc.
MH6
Non-Postal
Standard Self Plus One
Monthly
374.03
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
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