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2020 Plan Information for Illinois
Choose a Location, Employee Type, & Payment Period
Alabama
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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
H41
Non-Postal
CDHP Self
Monthly
317.63
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
704.43
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
777.66
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Value Self
Monthly
296.2
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Value Self & Family
Monthly
668.16
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Value Self Plus One
Monthly
723.6
Blue Preferred
9G1
Non-Postal
High Self
Monthly
322.37
Blue Preferred
9G2
Non-Postal
High Self & Family
Monthly
674.85
Blue Preferred
9G3
Non-Postal
High Self Plus One
Monthly
668.33
Blue Preferred
9G4
Non-Postal
Standard Self
Monthly
150.15
Blue Preferred
9G5
Non-Postal
Standard Self & Family
Monthly
522.99
Blue Preferred
9G6
Non-Postal
Standard Self Plus One
Monthly
451.45
Health Alliance HMO/POS
K84
Non-Postal
Standard Self
Monthly
167.03
Health Alliance HMO/POS
K85
Non-Postal
Standard Self & Family
Monthly
619.97
Health Alliance HMO/POS
K86
Non-Postal
Standard Self Plus One
Monthly
455.52
Humana CoverageFirst and Humana Value Plan
GB1
Non-Postal
CDHP Self
Monthly
669.69
Humana CoverageFirst and Humana Value Plan
GB2
Non-Postal
CDHP Self & Family
Monthly
1472.12
Humana CoverageFirst and Humana Value Plan
GB3
Non-Postal
CDHP Self Plus One
Monthly
1445.86
Humana CoverageFirst and Humana Value Plan
GB4
Non-Postal
Value Self
Monthly
247.3
Humana CoverageFirst and Humana Value Plan
GB5
Non-Postal
Value Self & Family
Monthly
521.75
Humana CoverageFirst and Humana Value Plan
GB6
Non-Postal
Value Self Plus One
Monthly
537.7
Humana CoverageFirst and Humana Value Plan
MW1
Non-Postal
CDHP Self
Monthly
405.18
Humana CoverageFirst and Humana Value Plan
MW2
Non-Postal
CDHP Self & Family
Monthly
877.13
Humana CoverageFirst and Humana Value Plan
MW3
Non-Postal
CDHP Self Plus One
Monthly
877.24
Humana CoverageFirst and Humana Value Plan
MW4
Non-Postal
Value Self
Monthly
244.07
Humana CoverageFirst and Humana Value Plan
MW5
Non-Postal
Value Self & Family
Monthly
514.5
Humana CoverageFirst and Humana Value Plan
MW6
Non-Postal
Value Self Plus One
Monthly
530.79
Humana Health Plan, Inc.
751
Non-Postal
High Self
Monthly
728.1
Humana Health Plan, Inc.
752
Non-Postal
High Self & Family
Monthly
1603.59
Humana Health Plan, Inc.
753
Non-Postal
High Self Plus One
Monthly
1571.48
Humana Health Plan, Inc.
754
Non-Postal
Standard Self
Monthly
441.06
Humana Health Plan, Inc.
755
Non-Postal
Standard Self & Family
Monthly
957.75
Humana Health Plan, Inc.
756
Non-Postal
Standard Self Plus One
Monthly
954.33
Humana Health Plan, Inc.
9F1
Non-Postal
High Self
Monthly
1427.48
Humana Health Plan, Inc.
9F2
Non-Postal
High Self & Family
Monthly
3177.18
Humana Health Plan, Inc.
9F3
Non-Postal
High Self Plus One
Monthly
3075.09
Humana Health Plan, Inc.
AB1
Non-Postal
Basic Self
Monthly
245.8
Humana Health Plan, Inc.
AB2
Non-Postal
Basic Self & Family
Monthly
518.48
Humana Health Plan, Inc.
AB3
Non-Postal
Basic Self Plus One
Monthly
534.58
Humana Health Plan, Inc.
AB4
Non-Postal
Standard Self
Monthly
638.69
Humana Health Plan, Inc.
AB5
Non-Postal
Standard Self & Family
Monthly
1402.42
Humana Health Plan, Inc.
AB6
Non-Postal
Standard Self Plus One
Monthly
1379.24
Humana Health Plan, Inc.
RW1
Non-Postal
Basic Self
Monthly
237.4
Humana Health Plan, Inc.
RW2
Non-Postal
Basic Self & Family
Monthly
499.52
Humana Health Plan, Inc.
RW3
Non-Postal
Basic Self Plus One
Monthly
516.47
MercyCare Health Plans
EY1
Non-Postal
High Self
Monthly
275.08
MercyCare Health Plans
EY2
Non-Postal
High Self & Family
Monthly
866.97
MercyCare Health Plans
EY3
Non-Postal
High Self Plus One
Monthly
597.52
MercyCare Health Plans
EY4
Non-Postal
Standard Self
Monthly
152.4
MercyCare Health Plans
EY5
Non-Postal
Standard Self & Family
Monthly
406.83
MercyCare Health Plans
EY6
Non-Postal
Standard Self Plus One
Monthly
327.67
Union Health Service
761
Non-Postal
High Self
Monthly
233.24
Union Health Service
762
Non-Postal
High Self & Family
Monthly
717.62
Union Health Service
763
Non-Postal
High Self Plus One
Monthly
576.07
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
130.37
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
365.56
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
254.61
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