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2018 Plan Information for Georgia
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
151.86
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
334.98
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
328.41
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
131.92
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
332.67
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
289.29
Aetna HealthFund CDHP and Aetna Value Plan
F51
Non-Postal
CDHP Self
Monthly
309.25
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
707.57
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
755.63
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
145.75
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
333.75
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
327.2
Aetna Open Access
2U1
Non-Postal
High Self
Monthly
714.72
Aetna Open Access
2U2
Non-Postal
High Self & Family
Monthly
1660.4
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Monthly
1699.02
Blue Open Access POS
QM1
Non-Postal
High Self
Monthly
143.12
Blue Open Access POS
QM2
Non-Postal
High Self & Family
Monthly
401.35
Blue Open Access POS
QM3
Non-Postal
High Self Plus One
Monthly
318.45
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Monthly
220.05
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Monthly
482.63
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Monthly
477.23
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Monthly
136.8
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Monthly
307.81
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Monthly
294.12
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Monthly
149.99
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Monthly
337.48
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Monthly
322.49
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Monthly
118.66
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Monthly
266.98
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Monthly
255.11
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Monthly
158.27
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Monthly
356.12
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Monthly
340.28
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Monthly
126.02
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Monthly
283.54
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Monthly
270.94
Humana Employers Health Plan of Georgia, Inc.
CB1
Non-Postal
High Self
Monthly
408.68
Humana Employers Health Plan of Georgia, Inc.
CB2
Non-Postal
High Self & Family
Monthly
907.05
Humana Employers Health Plan of Georgia, Inc.
CB3
Non-Postal
High Self Plus One
Monthly
882.79
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Monthly
337.76
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Monthly
747.48
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Monthly
730.3
Humana Employers Health Plan of Georgia, Inc.
DG1
Non-Postal
High Self
Monthly
711.06
Humana Employers Health Plan of Georgia, Inc.
DG2
Non-Postal
High Self & Family
Monthly
1587.37
Humana Employers Health Plan of Georgia, Inc.
DG3
Non-Postal
High Self Plus One
Monthly
1532.88
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Monthly
337.5
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Monthly
746.83
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Monthly
729.67
Humana Employers Health Plan of Georgia, Inc.
DN1
Non-Postal
High Self
Monthly
216.47
Humana Employers Health Plan of Georgia, Inc.
DN2
Non-Postal
High Self & Family
Monthly
474.54
Humana Employers Health Plan of Georgia, Inc.
DN3
Non-Postal
High Self Plus One
Monthly
469.5
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Monthly
186.09
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Monthly
406.23
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Monthly
404.2
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Monthly
147.2
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Monthly
331.21
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Monthly
316.49
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Monthly
136.53
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Monthly
307.19
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Monthly
293.53
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Monthly
142.59
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Monthly
320.83
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Monthly
306.57
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Monthly
185.4
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Monthly
411.52
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Monthly
477.78
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Monthly
128.24
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Monthly
289.83
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Monthly
289.83
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Monthly
157.51
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Monthly
636.63
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Monthly
307.63
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service