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2019 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
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
F51
Non-Postal
CDHP Self
Monthly
312.07
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
710.52
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
763.81
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
209.72
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
484.06
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
523.83
Aetna Open Access
2U1
Non-Postal
High Self
Monthly
1085.57
Aetna Open Access
2U2
Non-Postal
High Self & Family
Monthly
2511.17
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Monthly
2546.63
Blue Open Access POS
QM1
Non-Postal
High Self
Monthly
148.85
Blue Open Access POS
QM2
Non-Postal
High Self & Family
Monthly
439.19
Blue Open Access POS
QM3
Non-Postal
High Self Plus One
Monthly
329.6
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Monthly
299.11
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Monthly
656.94
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Monthly
648.76
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Monthly
164.63
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Monthly
370.4
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Monthly
353.94
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Monthly
157.93
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Monthly
355.35
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Monthly
339.56
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Monthly
128.5
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Monthly
289.14
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Monthly
276.29
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Monthly
163.48
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Monthly
367.83
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Monthly
351.48
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Monthly
130.16
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Monthly
292.87
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Monthly
279.85
Humana Employers Health Plan of Georgia, Inc.
CB1
Non-Postal
High Self
Monthly
491.64
Humana Employers Health Plan of Georgia, Inc.
CB2
Non-Postal
High Self & Family
Monthly
1090.23
Humana Employers Health Plan of Georgia, Inc.
CB3
Non-Postal
High Self Plus One
Monthly
1062.75
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Monthly
478.19
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Monthly
1059.87
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Monthly
1033.78
Humana Employers Health Plan of Georgia, Inc.
DG1
Non-Postal
High Self
Monthly
784.71
Humana Employers Health Plan of Georgia, Inc.
DG2
Non-Postal
High Self & Family
Monthly
1749.52
Humana Employers Health Plan of Georgia, Inc.
DG3
Non-Postal
High Self Plus One
Monthly
1692.81
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Monthly
439.19
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Monthly
972.1
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Monthly
949.91
Humana Employers Health Plan of Georgia, Inc.
DN1
Non-Postal
High Self
Monthly
237.69
Humana Employers Health Plan of Georgia, Inc.
DN2
Non-Postal
High Self & Family
Monthly
518.75
Humana Employers Health Plan of Georgia, Inc.
DN3
Non-Postal
High Self Plus One
Monthly
516.72
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Monthly
186.21
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Monthly
402.87
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Monthly
405.99
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Monthly
155.04
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Monthly
348.84
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Monthly
333.34
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Monthly
141.06
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Monthly
317.39
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Monthly
303.28
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Monthly
148.75
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Monthly
334.68
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Monthly
319.81
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Monthly
197.37
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Monthly
434.96
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Monthly
506.56
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Monthly
131.55
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Monthly
297.3
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Monthly
297.3
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Monthly
165.51
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Monthly
847.91
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Monthly
356.78
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service