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2021 Plan Information for Kentucky
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
H41
Non-Postal
CDHP Self
Monthly
303.42
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
666.53
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
745.27
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Value Self
Monthly
294.06
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Value Self & Family
Monthly
657.95
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Value Self Plus One
Monthly
718.23
Humana CoverageFirst and Humana Value Plan
6N1
Non-Postal
CDHP Self
Monthly
304.62
Humana CoverageFirst and Humana Value Plan
6N2
Non-Postal
CDHP Self & Family
Monthly
644.86
Humana CoverageFirst and Humana Value Plan
6N3
Non-Postal
CDHP Self Plus One
Monthly
659.13
Humana CoverageFirst and Humana Value Plan
TC1
Non-Postal
CDHP Self
Monthly
215.15
Humana CoverageFirst and Humana Value Plan
TC2
Non-Postal
CDHP Self & Family
Monthly
443.58
Humana CoverageFirst and Humana Value Plan
TC3
Non-Postal
CDHP Self Plus One
Monthly
466.79
Humana CoverageFirst and Humana Value Plan
X31
Non-Postal
CDHP Self
Monthly
315.99
Humana CoverageFirst and Humana Value Plan
X32
Non-Postal
CDHP Self & Family
Monthly
670.5
Humana CoverageFirst and Humana Value Plan
X33
Non-Postal
CDHP Self Plus One
Monthly
683.61
Humana CoverageFirst and Humana Value Plan
X34
Non-Postal
Value Self
Monthly
161.47
Humana CoverageFirst and Humana Value Plan
X35
Non-Postal
Value Self & Family
Monthly
363.31
Humana CoverageFirst and Humana Value Plan
X36
Non-Postal
Value Self Plus One
Monthly
347.16
Humana Health Plan of Ohio, Inc.
A61
Non-Postal
High Self
Monthly
1052.61
Humana Health Plan of Ohio, Inc.
A62
Non-Postal
High Self & Family
Monthly
2327.89
Humana Health Plan of Ohio, Inc.
A63
Non-Postal
High Self Plus One
Monthly
2267.33
Humana Health Plan of Ohio, Inc.
A64
Non-Postal
Standard Self
Monthly
707.36
Humana Health Plan of Ohio, Inc.
A65
Non-Postal
Standard Self & Family
Monthly
1551.09
Humana Health Plan of Ohio, Inc.
A66
Non-Postal
Standard Self Plus One
Monthly
1525.03
Humana Health Plan of Ohio, Inc.
W61
Non-Postal
Basic Self
Monthly
159.76
Humana Health Plan of Ohio, Inc.
W62
Non-Postal
Basic Self & Family
Monthly
359.48
Humana Health Plan of Ohio, Inc.
W63
Non-Postal
Basic Self Plus One
Monthly
343.5
Humana Health Plan, Inc.
MH1
Non-Postal
High Self
Monthly
692.06
Humana Health Plan, Inc.
MH2
Non-Postal
High Self & Family
Monthly
1516.62
Humana Health Plan, Inc.
MH3
Non-Postal
High Self Plus One
Monthly
1492.1
Humana Health Plan, Inc.
MH4
Non-Postal
Standard Self
Monthly
422.2
Humana Health Plan, Inc.
MH5
Non-Postal
Standard Self & Family
Monthly
909.41
Humana Health Plan, Inc.
MH6
Non-Postal
Standard Self Plus One
Monthly
911.89
Humana Health Plan, Inc.
MI1
Non-Postal
High Self
Monthly
913.3
Humana Health Plan, Inc.
MI2
Non-Postal
High Self & Family
Monthly
2014.33
Humana Health Plan, Inc.
MI3
Non-Postal
High Self Plus One
Monthly
1967.75
Humana Health Plan, Inc.
MI4
Non-Postal
Standard Self
Monthly
396.98
Humana Health Plan, Inc.
MI5
Non-Postal
Standard Self & Family
Monthly
852.65
Humana Health Plan, Inc.
MI6
Non-Postal
Standard Self Plus One
Monthly
857.68
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))
N71
Non-Postal
HDHP Self
Monthly
173.21
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N72
Non-Postal
HDHP Self & Family
Monthly
398.39
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N73
Non-Postal
HDHP Self Plus One
Monthly
372.41
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ1
Non-Postal
High Self
Monthly
253.42
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ2
Non-Postal
High Self & Family
Monthly
723.9
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ3
Non-Postal
High Self Plus One
Monthly
549.06
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