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2021 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
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
F51
Non-Postal
CDHP Self
Monthly
328.32
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
723.82
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
801.65
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
298.4
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
663.67
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
723.8
Aetna Open Access
2U1
Non-Postal
High Self
Monthly
1282.43
Aetna Open Access
2U2
Non-Postal
High Self & Family
Monthly
2941.51
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Monthly
2997.37
Blue Open Access POS
QM1
Non-Postal
High Self
Monthly
164.1
Blue Open Access POS
QM2
Non-Postal
High Self & Family
Monthly
471.47
Blue Open Access POS
QM3
Non-Postal
High Self Plus One
Monthly
361.65
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Monthly
566.76
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Monthly
1234.65
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Monthly
1222.7
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Monthly
302.62
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Monthly
640.31
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Monthly
654.79
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Monthly
223.71
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Monthly
462.91
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Monthly
485.25
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Monthly
183.39
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Monthly
397.57
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Monthly
398.48
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Monthly
245.99
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Monthly
512.94
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Monthly
533.05
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Monthly
153.15
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Monthly
344.59
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Monthly
329.27
Humana Employers Health Plan of Georgia, Inc.
CB1
Non-Postal
High Self
Monthly
751.47
Humana Employers Health Plan of Georgia, Inc.
CB2
Non-Postal
High Self & Family
Monthly
1650.46
Humana Employers Health Plan of Georgia, Inc.
CB3
Non-Postal
High Self Plus One
Monthly
1620.11
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Monthly
614.47
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Monthly
1342.1
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Monthly
1325.35
Humana Employers Health Plan of Georgia, Inc.
DG1
Non-Postal
High Self
Monthly
864.61
Humana Employers Health Plan of Georgia, Inc.
DG2
Non-Postal
High Self & Family
Monthly
1904.85
Humana Employers Health Plan of Georgia, Inc.
DG3
Non-Postal
High Self Plus One
Monthly
1863.14
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Monthly
777.34
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Monthly
1708.5
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Monthly
1675.55
Humana Employers Health Plan of Georgia, Inc.
DN1
Non-Postal
High Self
Monthly
350.85
Humana Employers Health Plan of Georgia, Inc.
DN2
Non-Postal
High Self & Family
Monthly
748.91
Humana Employers Health Plan of Georgia, Inc.
DN3
Non-Postal
High Self Plus One
Monthly
758.55
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Monthly
289.73
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Monthly
611.32
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Monthly
627.08
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Monthly
323.29
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Monthly
686.9
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Monthly
699.27
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Monthly
167.46
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Monthly
376.8
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Monthly
360.06
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Monthly
196.46
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Monthly
404.93
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Monthly
426.58
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Monthly
227.68
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Monthly
479.29
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Monthly
576.34
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Monthly
145.27
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Monthly
328.31
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Monthly
328.31
Kaiser Permanente - Georgia
LA1
Non-Postal
Basic Self
Monthly
104.72
Kaiser Permanente - Georgia
LA2
Non-Postal
Basic Self & Family
Monthly
236.66
Kaiser Permanente - Georgia
LA3
Non-Postal
Basic Self Plus One
Monthly
236.66
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. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Monthly
227.2
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Monthly
1033.69
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Monthly
492.73
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
149.87
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
354.44
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
322.22
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
144.18
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
340.98
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
309.98
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service