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2018 Plan Information for Illinois
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
H41
Non-Postal
CDHP Self
Monthly
326.13
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
745.55
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
793.24
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Value Self
Monthly
143.93
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Value Self & Family
Monthly
330.34
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Value Self Plus One
Monthly
323.86
Blue Preferred
9G1
Non-Postal
High Self
Monthly
237.21
Blue Preferred
9G2
Non-Postal
High Self & Family
Monthly
458.84
Blue Preferred
9G3
Non-Postal
High Self Plus One
Monthly
440.7
Blue Preferred
9G4
Non-Postal
Standard Self
Monthly
133.03
Blue Preferred
9G5
Non-Postal
Standard Self & Family
Monthly
399.69
Blue Preferred
9G6
Non-Postal
Standard Self Plus One
Monthly
345.86
Health Alliance HMO/POS
K84
Non-Postal
Standard Self
Monthly
156.7
Health Alliance HMO/POS
K85
Non-Postal
Standard Self & Family
Monthly
788.52
Health Alliance HMO/POS
K86
Non-Postal
Standard Self Plus One
Monthly
388.1
Humana CoverageFirst and Humana Value Plan
GB1
Non-Postal
CDHP Self
Monthly
376.46
Humana CoverageFirst and Humana Value Plan
GB2
Non-Postal
CDHP Self & Family
Monthly
834.51
Humana CoverageFirst and Humana Value Plan
GB3
Non-Postal
CDHP Self Plus One
Monthly
813.46
Humana CoverageFirst and Humana Value Plan
GB4
Non-Postal
Value Self
Monthly
129.13
Humana CoverageFirst and Humana Value Plan
GB5
Non-Postal
Value Self & Family
Monthly
290.53
Humana CoverageFirst and Humana Value Plan
GB6
Non-Postal
Value Self Plus One
Monthly
277.63
Humana CoverageFirst and Humana Value Plan
MW1
Non-Postal
CDHP Self
Monthly
215.5
Humana CoverageFirst and Humana Value Plan
MW2
Non-Postal
CDHP Self & Family
Monthly
472.42
Humana CoverageFirst and Humana Value Plan
MW3
Non-Postal
CDHP Self Plus One
Monthly
467.44
Humana CoverageFirst and Humana Value Plan
MW4
Non-Postal
Value Self
Monthly
139.25
Humana CoverageFirst and Humana Value Plan
MW5
Non-Postal
Value Self & Family
Monthly
313.29
Humana CoverageFirst and Humana Value Plan
MW6
Non-Postal
Value Self Plus One
Monthly
299.37
Humana Health Plan, Inc.
751
Non-Postal
High Self
Monthly
764.96
Humana Health Plan, Inc.
752
Non-Postal
High Self & Family
Monthly
1708.63
Humana Health Plan, Inc.
753
Non-Postal
High Self Plus One
Monthly
1648.73
Humana Health Plan, Inc.
754
Non-Postal
Standard Self
Monthly
384.78
Humana Health Plan, Inc.
755
Non-Postal
Standard Self & Family
Monthly
853.26
Humana Health Plan, Inc.
756
Non-Postal
Standard Self Plus One
Monthly
831.33
Humana Health Plan, Inc.
9F1
Non-Postal
High Self
Monthly
1073.67
Humana Health Plan, Inc.
9F2
Non-Postal
High Self & Family
Monthly
2403.29
Humana Health Plan, Inc.
9F3
Non-Postal
High Self Plus One
Monthly
2312.49
Humana Health Plan, Inc.
AB1
Non-Postal
Basic Self
Monthly
146.02
Humana Health Plan, Inc.
AB2
Non-Postal
Basic Self & Family
Monthly
328.54
Humana Health Plan, Inc.
AB3
Non-Postal
Basic Self Plus One
Monthly
313.93
Humana Health Plan, Inc.
AB4
Non-Postal
Standard Self
Monthly
523.9
Humana Health Plan, Inc.
AB5
Non-Postal
Standard Self & Family
Monthly
1166.3
Humana Health Plan, Inc.
AB6
Non-Postal
Standard Self Plus One
Monthly
1130.48
Humana Health Plan, Inc.
RW1
Non-Postal
Basic Self
Monthly
148
Humana Health Plan, Inc.
RW2
Non-Postal
Basic Self & Family
Monthly
333.01
Humana Health Plan, Inc.
RW3
Non-Postal
Basic Self Plus One
Monthly
318.21
MercyCare Health Plans
EY1
Non-Postal
High Self
Monthly
269.77
MercyCare Health Plans
EY2
Non-Postal
High Self & Family
Monthly
870.18
MercyCare Health Plans
EY3
Non-Postal
High Self Plus One
Monthly
584.12
Union Health Service
761
Non-Postal
High Self
Monthly
174.39
Union Health Service
762
Non-Postal
High Self & Family
Monthly
550.88
Union Health Service
763
Non-Postal
High Self Plus One
Monthly
410.33
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
115.83
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
324.79
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
226.22
UnitedHealthcare Plan of the River Valley Inc.
YH1
Non-Postal
High Self
Monthly
209.41
UnitedHealthcare Plan of the River Valley Inc.
YH2
Non-Postal
High Self & Family
Monthly
849.9
UnitedHealthcare Plan of the River Valley Inc.
YH3
Non-Postal
High Self Plus One
Monthly
344.77
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service