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2019 Plan Information for Arizona
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
164.93
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
363.8
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
360.1
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
139.33
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
351.38
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
305.56
Aetna HealthFund CDHP and Aetna Value Plan
G51
Non-Postal
CDHP Self
Monthly
286.42
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
652.69
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
706.59
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
171.86
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
397.67
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
439.18
Aetna Open Access
WQ1
Non-Postal
High Self
Monthly
626.3
Aetna Open Access
WQ2
Non-Postal
High Self & Family
Monthly
1593.33
Aetna Open Access
WQ3
Non-Postal
High Self Plus One
Monthly
1637.87
Humana CoverageFirst and Humana Value Plan
R61
Non-Postal
CDHP Self
Monthly
179.38
Humana CoverageFirst and Humana Value Plan
R62
Non-Postal
CDHP Self & Family
Monthly
387.51
Humana CoverageFirst and Humana Value Plan
R63
Non-Postal
CDHP Self Plus One
Monthly
391.32
Humana CoverageFirst and Humana Value Plan
R64
Non-Postal
Value Self
Monthly
135.5
Humana CoverageFirst and Humana Value Plan
R65
Non-Postal
Value Self & Family
Monthly
304.88
Humana CoverageFirst and Humana Value Plan
R66
Non-Postal
Value Self Plus One
Monthly
291.33
Humana CoverageFirst and Humana Value Plan
R91
Non-Postal
CDHP Self
Monthly
155.16
Humana CoverageFirst and Humana Value Plan
R92
Non-Postal
CDHP Self & Family
Monthly
349.1
Humana CoverageFirst and Humana Value Plan
R93
Non-Postal
CDHP Self Plus One
Monthly
333.58
Humana CoverageFirst and Humana Value Plan
R94
Non-Postal
Value Self
Monthly
123.54
Humana CoverageFirst and Humana Value Plan
R95
Non-Postal
Value Self & Family
Monthly
277.96
Humana CoverageFirst and Humana Value Plan
R96
Non-Postal
Value Self Plus One
Monthly
265.61
Humana Health Plan, Inc.
BF1
Non-Postal
High Self
Monthly
862.71
Humana Health Plan, Inc.
BF2
Non-Postal
High Self & Family
Monthly
1924.96
Humana Health Plan, Inc.
BF3
Non-Postal
High Self Plus One
Monthly
1860.4
Humana Health Plan, Inc.
BF4
Non-Postal
Standard Self
Monthly
417.35
Humana Health Plan, Inc.
BF5
Non-Postal
Standard Self & Family
Monthly
922.98
Humana Health Plan, Inc.
BF6
Non-Postal
Standard Self Plus One
Monthly
902.98
Humana Health Plan, Inc.
C71
Non-Postal
High Self
Monthly
363.87
Humana Health Plan, Inc.
C72
Non-Postal
High Self & Family
Monthly
802.65
Humana Health Plan, Inc.
C73
Non-Postal
High Self Plus One
Monthly
787.99
Humana Health Plan, Inc.
C74
Non-Postal
Standard Self
Monthly
227.85
Humana Health Plan, Inc.
C75
Non-Postal
Standard Self & Family
Monthly
496.54
Humana Health Plan, Inc.
C76
Non-Postal
Standard Self Plus One
Monthly
495.47
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU1
Non-Postal
HDHP Self
Monthly
112.58
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU2
Non-Postal
HDHP Self & Family
Monthly
258.93
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU3
Non-Postal
HDHP Self Plus One
Monthly
242.05
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT1
Non-Postal
High Self
Monthly
180.47
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT2
Non-Postal
High Self & Family
Monthly
559.76
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT3
Non-Postal
High Self Plus One
Monthly
393.64
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service