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2017 Plan Information for Texas
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
Aetna Whole Health
ES1
Non-Postal
Basic Self
Monthly
153.22
Aetna Whole Health
ES2
Non-Postal
Basic Self & Family
Monthly
527.96
Aetna Whole Health
ES3
Non-Postal
Basic Self Plus One
Monthly
575.68
Baylor Scott and White Health Plan
A84
Non-Postal
Standard Self
Monthly
198.18
Baylor Scott and White Health Plan
A85
Non-Postal
Standard Self & Family
Monthly
495.26
Baylor Scott and White Health Plan
A86
Non-Postal
Standard Self Plus One
Monthly
390.24
Baylor Scott and White Health Plan
P84
Non-Postal
Standard Self
Monthly
279.21
Baylor Scott and White Health Plan
P85
Non-Postal
Standard Self & Family
Monthly
685.65
Baylor Scott and White Health Plan
P86
Non-Postal
Standard Self Plus One
Monthly
560.39
Firstcare
CK0
Non-Postal
High Self
Monthly
Firstcare
CK1
Non-Postal
High Self & Family
Monthly
Firstcare
CK2
Non-Postal
High Self Plus One
Monthly
Humana CoverageFirst and Humana Value Plan
TP1
Non-Postal
CDHP Self
Monthly
175.04
Humana CoverageFirst and Humana Value Plan
TP2
Non-Postal
CDHP Self & Family
Monthly
379.86
Humana CoverageFirst and Humana Value Plan
TP3
Non-Postal
CDHP Self Plus One
Monthly
378.08
Humana CoverageFirst and Humana Value Plan
TP4
Non-Postal
Value Self
Monthly
116.33
Humana CoverageFirst and Humana Value Plan
TP5
Non-Postal
Value Self & Family
Monthly
261.73
Humana CoverageFirst and Humana Value Plan
TP6
Non-Postal
Value Self Plus One
Monthly
250.1
Humana CoverageFirst and Humana Value Plan
TU1
Non-Postal
CDHP Self
Monthly
159.4
Humana CoverageFirst and Humana Value Plan
TU2
Non-Postal
CDHP Self & Family
Monthly
358.66
Humana CoverageFirst and Humana Value Plan
TU3
Non-Postal
CDHP Self Plus One
Monthly
342.71
Humana CoverageFirst and Humana Value Plan
TU4
Non-Postal
Value Self
Monthly
116.33
Humana CoverageFirst and Humana Value Plan
TU5
Non-Postal
Value Self & Family
Monthly
261.73
Humana CoverageFirst and Humana Value Plan
TU6
Non-Postal
Value Self Plus One
Monthly
250.1
Humana CoverageFirst and Humana Value Plan
TV1
Non-Postal
CDHP Self
Monthly
172.31
Humana CoverageFirst and Humana Value Plan
TV2
Non-Postal
CDHP Self & Family
Monthly
373.73
Humana CoverageFirst and Humana Value Plan
TV3
Non-Postal
CDHP Self Plus One
Monthly
372.23
Humana CoverageFirst and Humana Value Plan
TV4
Non-Postal
Value Self
Monthly
116.33
Humana CoverageFirst and Humana Value Plan
TV5
Non-Postal
Value Self & Family
Monthly
261.73
Humana CoverageFirst and Humana Value Plan
TV6
Non-Postal
Value Self Plus One
Monthly
250.1
Humana Health Plan of Texas, Inc.
EW1
Non-Postal
High Self
Monthly
297.05
Humana Health Plan of Texas, Inc.
EW2
Non-Postal
High Self & Family
Monthly
654.36
Humana Health Plan of Texas, Inc.
EW3
Non-Postal
High Self Plus One
Monthly
640.38
Humana Health Plan of Texas, Inc.
EW4
Non-Postal
Standard Self
Monthly
188.13
Humana Health Plan of Texas, Inc.
EW5
Non-Postal
Standard Self & Family
Monthly
409.29
Humana Health Plan of Texas, Inc.
EW6
Non-Postal
Standard Self Plus One
Monthly
406.18
Humana Health Plan of Texas, Inc.
UC1
Non-Postal
High Self
Monthly
313.77
Humana Health Plan of Texas, Inc.
UC2
Non-Postal
High Self & Family
Monthly
691.99
Humana Health Plan of Texas, Inc.
UC3
Non-Postal
High Self Plus One
Monthly
676.35
Humana Health Plan of Texas, Inc.
UC4
Non-Postal
Standard Self
Monthly
162.13
Humana Health Plan of Texas, Inc.
UC5
Non-Postal
Standard Self & Family
Monthly
361.38
Humana Health Plan of Texas, Inc.
UC6
Non-Postal
Standard Self Plus One
Monthly
350.37
Humana Health Plan of Texas, Inc.
UR1
Non-Postal
High Self
Monthly
850.61
Humana Health Plan of Texas, Inc.
UR2
Non-Postal
High Self & Family
Monthly
1899.89
Humana Health Plan of Texas, Inc.
UR3
Non-Postal
High Self Plus One
Monthly
1830.53
Humana Health Plan of Texas, Inc.
UR4
Non-Postal
Standard Self
Monthly
266.04
Humana Health Plan of Texas, Inc.
UR5
Non-Postal
Standard Self & Family
Monthly
584.61
Humana Health Plan of Texas, Inc.
UR6
Non-Postal
Standard Self Plus One
Monthly
573.71
Humana Health Plan of Texas, Inc.
UU1
Non-Postal
High Self
Monthly
691.47
Humana Health Plan of Texas, Inc.
UU2
Non-Postal
High Self & Family
Monthly
1541.8
Humana Health Plan of Texas, Inc.
UU3
Non-Postal
High Self Plus One
Monthly
1488.39
Humana Health Plan of Texas, Inc.
UU4
Non-Postal
Standard Self
Monthly
492.39
Humana Health Plan of Texas, Inc.
UU5
Non-Postal
Standard Self & Family
Monthly
1093.87
Humana Health Plan of Texas, Inc.
UU6
Non-Postal
Standard Self Plus One
Monthly
1060.34
UnitedHealthcare Benefits of Texas, Inc.
GF1
Non-Postal
High Self
Monthly
465.44
UnitedHealthcare Benefits of Texas, Inc.
GF2
Non-Postal
High Self & Family
Monthly
1557.17
UnitedHealthcare Benefits of Texas, Inc.
GF3
Non-Postal
High Self Plus One
Monthly
816.12
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
108.27
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
303.59
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
211.44
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service