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2020 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
217.96
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
423.58
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
483.84
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
153.16
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
386.25
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
335.89
Aetna Direct
Z24
Non-Postal
Advantage Self
Monthly
115.96
Aetna Direct
Z25
Non-Postal
Advantage Self & Family
Monthly
307.29
Aetna Direct
Z26
Non-Postal
Advantage Self Plus One
Monthly
255.11
Aetna HealthFund CDHP and Aetna Value Plan
F51
Non-Postal
CDHP Self
Monthly
318.39
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
706.7
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
779.74
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
309.14
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
693.59
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
748.52
Aetna Open Access
2U1
Non-Postal
High Self
Monthly
1222.52
Aetna Open Access
2U2
Non-Postal
High Self & Family
Monthly
2808.67
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Monthly
2860.89
Blue Open Access POS
QM1
Non-Postal
High Self
Monthly
156.29
Blue Open Access POS
QM2
Non-Postal
High Self & Family
Monthly
456.45
Blue Open Access POS
QM3
Non-Postal
High Self Plus One
Monthly
344.43
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Monthly
462.54
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Monthly
1006.05
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Monthly
1000.48
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Monthly
226.69
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Monthly
475.39
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Monthly
493.42
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Monthly
169.81
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Monthly
382.07
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Monthly
368.1
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Monthly
160.64
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Monthly
361.43
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Monthly
345.37
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Monthly
182.3
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Monthly
389.9
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Monthly
398.02
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Monthly
137.97
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Monthly
310.43
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Monthly
296.64
Humana Employers Health Plan of Georgia, Inc.
CB1
Non-Postal
High Self
Monthly
637.73
Humana Employers Health Plan of Georgia, Inc.
CB2
Non-Postal
High Self & Family
Monthly
1400.38
Humana Employers Health Plan of Georgia, Inc.
CB3
Non-Postal
High Self Plus One
Monthly
1377.35
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Monthly
739.61
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Monthly
1629.48
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Monthly
1596.21
Humana Employers Health Plan of Georgia, Inc.
DG1
Non-Postal
High Self
Monthly
811.09
Humana Employers Health Plan of Georgia, Inc.
DG2
Non-Postal
High Self & Family
Monthly
1790.32
Humana Employers Health Plan of Georgia, Inc.
DG3
Non-Postal
High Self Plus One
Monthly
1749.93
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Monthly
661
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Monthly
1452.68
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Monthly
1427.31
Humana Employers Health Plan of Georgia, Inc.
DN1
Non-Postal
High Self
Monthly
269.77
Humana Employers Health Plan of Georgia, Inc.
DN2
Non-Postal
High Self & Family
Monthly
572.35
Humana Employers Health Plan of Georgia, Inc.
DN3
Non-Postal
High Self Plus One
Monthly
586.04
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Monthly
215.19
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Monthly
449.5
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Monthly
468.67
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Monthly
251.96
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Monthly
532.31
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Monthly
547.76
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Monthly
149.52
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Monthly
336.43
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Monthly
321.48
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Monthly
162.13
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Monthly
364.81
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Monthly
348.59
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Monthly
219.2
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Monthly
465.85
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Monthly
557.61
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Monthly
138.08
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Monthly
312.06
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Monthly
312.06
Kaiser Permanente - Georgia
LA1
Non-Postal
Basic Self
Monthly
98.34
Kaiser Permanente - Georgia
LA2
Non-Postal
Basic Self & Family
Monthly
222.24
Kaiser Permanente - Georgia
LA3
Non-Postal
Basic Self Plus One
Monthly
222.24
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Monthly
190.6
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Monthly
920.27
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Monthly
415.81
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
131.45
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
310.84
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
282.6
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
126.68
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
299.56
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
272.34
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service