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2021 Plan Information for Colorado
Choose a Location, Employee Type, & Payment Period
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South Carolina
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Texas
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Virgin Islands
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Wyoming
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
262.6
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
515.62
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
578.72
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
153.96
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
388.27
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
337.64
Aetna Direct
Z24
Non-Postal
Advantage Self
Monthly
125
Aetna Direct
Z25
Non-Postal
Advantage Self & Family
Monthly
331.25
Aetna Direct
Z26
Non-Postal
Advantage Self Plus One
Monthly
275
Aetna HealthFund CDHP and Aetna Value Plan
G51
Non-Postal
CDHP Self
Monthly
535.34
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
1196.87
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
1270.04
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
193.62
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
424.06
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
488.93
BlueAdvantage HMO
WW1
Non-Postal
High Self
Monthly
159.09
BlueAdvantage HMO
WW2
Non-Postal
High Self & Family
Monthly
387.37
BlueAdvantage HMO
WW3
Non-Postal
High Self Plus One
Monthly
361.91
Humana Health Plan, Inc.
NR1
Non-Postal
High Self
Monthly
437.76
Humana Health Plan, Inc.
NR2
Non-Postal
High Self & Family
Monthly
944.43
Humana Health Plan, Inc.
NR3
Non-Postal
High Self Plus One
Monthly
945.36
Humana Health Plan, Inc.
NR4
Non-Postal
Standard Self
Monthly
166.52
Humana Health Plan, Inc.
NR5
Non-Postal
Standard Self & Family
Monthly
374.68
Humana Health Plan, Inc.
NR6
Non-Postal
Standard Self Plus One
Monthly
358.02
Humana Health Plan, Inc.
NT1
Non-Postal
High Self
Monthly
310.18
Humana Health Plan, Inc.
NT2
Non-Postal
High Self & Family
Monthly
657.45
Humana Health Plan, Inc.
NT3
Non-Postal
High Self Plus One
Monthly
671.11
Humana Health Plan, Inc.
NT4
Non-Postal
Standard Self
Monthly
147.57
Humana Health Plan, Inc.
NT5
Non-Postal
Standard Self & Family
Monthly
332.03
Humana Health Plan, Inc.
NT6
Non-Postal
Standard Self Plus One
Monthly
317.28
Humana Health Plan, Inc.
R21
Non-Postal
Basic Self
Monthly
155.35
Humana Health Plan, Inc.
R22
Non-Postal
Basic Self & Family
Monthly
349.54
Humana Health Plan, Inc.
R23
Non-Postal
Basic Self Plus One
Monthly
334.01
Humana Health Plan, Inc.
RZ1
Non-Postal
Basic Self
Monthly
133.06
Humana Health Plan, Inc.
RZ2
Non-Postal
Basic Self & Family
Monthly
299.38
Humana Health Plan, Inc.
RZ3
Non-Postal
Basic Self Plus One
Monthly
286.08
Kaiser Permanente - Colorado
651
Non-Postal
High Self
Monthly
249.47
Kaiser Permanente - Colorado
652
Non-Postal
High Self & Family
Monthly
528.54
Kaiser Permanente - Colorado
653
Non-Postal
High Self Plus One
Monthly
625.59
Kaiser Permanente - Colorado
654
Non-Postal
Standard Self
Monthly
165.21
Kaiser Permanente - Colorado
655
Non-Postal
Standard Self & Family
Monthly
373.36
Kaiser Permanente - Colorado
656
Non-Postal
Standard Self Plus One
Monthly
373.36
Kaiser Permanente - Colorado
N41
Non-Postal
Basic Self
Monthly
111.38
Kaiser Permanente - Colorado
N42
Non-Postal
Basic Self & Family
Monthly
273.98
Kaiser Permanente - Colorado
N43
Non-Postal
Basic Self Plus One
Monthly
251.71
UnitedHealthcare Advantage Plan
Y51
Non-Postal
High Self
Monthly
102.93
UnitedHealthcare Advantage Plan
Y52
Non-Postal
High Self & Family
Monthly
272.77
UnitedHealthcare Advantage Plan
Y53
Non-Postal
High Self Plus One
Monthly
226.45
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU1
Non-Postal
HDHP Self
Monthly
132.04
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU2
Non-Postal
HDHP Self & Family
Monthly
303.69
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU3
Non-Postal
HDHP Self Plus One
Monthly
283.89
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT1
Non-Postal
High Self
Monthly
258.7
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT2
Non-Postal
High Self & Family
Monthly
737.14
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT3
Non-Postal
High Self Plus One
Monthly
560.41
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service