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2020 Plan Information for Tennessee
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
UB1
Non-Postal
High Self
Monthly
550.35
Aetna Open Access
UB2
Non-Postal
High Self & Family
Monthly
1535.28
Aetna Open Access
UB3
Non-Postal
High Self Plus One
Monthly
1600.15
Humana CoverageFirst and Humana Value Plan
TT1
Non-Postal
CDHP Self
Monthly
234.47
Humana CoverageFirst and Humana Value Plan
TT2
Non-Postal
CDHP Self & Family
Monthly
492.96
Humana CoverageFirst and Humana Value Plan
TT3
Non-Postal
CDHP Self Plus One
Monthly
510.19
Humana CoverageFirst and Humana Value Plan
TT4
Non-Postal
Value Self
Monthly
172.12
Humana CoverageFirst and Humana Value Plan
TT5
Non-Postal
Value Self & Family
Monthly
384.15
Humana CoverageFirst and Humana Value Plan
TT6
Non-Postal
Value Self Plus One
Monthly
376.05
Humana Health Plan, Inc.
GJ1
Non-Postal
High Self
Monthly
664.95
Humana Health Plan, Inc.
GJ2
Non-Postal
High Self & Family
Monthly
1461.42
Humana Health Plan, Inc.
GJ3
Non-Postal
High Self Plus One
Monthly
1435.59
Humana Health Plan, Inc.
GJ4
Non-Postal
Standard Self
Monthly
359.29
Humana Health Plan, Inc.
GJ5
Non-Postal
Standard Self & Family
Monthly
773.76
Humana Health Plan, Inc.
GJ6
Non-Postal
Standard Self Plus One
Monthly
778.51
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LS1
Non-Postal
HDHP Self
Monthly
113.68
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LS2
Non-Postal
HDHP Self & Family
Monthly
261.48
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LS3
Non-Postal
HDHP Self Plus One
Monthly
244.43
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KK1
Non-Postal
High Self
Monthly
203.03
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KK2
Non-Postal
High Self & Family
Monthly
600.69
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KK3
Non-Postal
High Self Plus One
Monthly
442.61
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