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2021 Plan Information for Missouri
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
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
Aetna Open Access
HA1
Non-Postal
High Self
Monthly
633.1
Aetna Open Access
HA2
Non-Postal
High Self & Family
Monthly
1513.7
Aetna Open Access
HA3
Non-Postal
High Self Plus One
Monthly
1583.73
Aetna Open Access
HA4
Non-Postal
Standard Self
Monthly
377.94
Aetna Open Access
HA5
Non-Postal
Standard Self & Family
Monthly
909.33
Aetna Open Access
HA6
Non-Postal
Standard Self Plus One
Monthly
985.32
Blue Preferred
9G1
Non-Postal
High Self
Monthly
350.81
Blue Preferred
9G2
Non-Postal
High Self & Family
Monthly
766.31
Blue Preferred
9G3
Non-Postal
High Self Plus One
Monthly
740.96
Blue Preferred
9G4
Non-Postal
Standard Self
Monthly
158.41
Blue Preferred
9G5
Non-Postal
Standard Self & Family
Monthly
540.02
Blue Preferred
9G6
Non-Postal
Standard Self Plus One
Monthly
453.42
Humana CoverageFirst and Humana Value Plan
PH1
Non-Postal
CDHP Self
Monthly
234.61
Humana CoverageFirst and Humana Value Plan
PH2
Non-Postal
CDHP Self & Family
Monthly
487.37
Humana CoverageFirst and Humana Value Plan
PH3
Non-Postal
CDHP Self Plus One
Monthly
508.61
Humana CoverageFirst and Humana Value Plan
PH4
Non-Postal
Value Self
Monthly
131.9
Humana CoverageFirst and Humana Value Plan
PH5
Non-Postal
Value Self & Family
Monthly
296.78
Humana CoverageFirst and Humana Value Plan
PH6
Non-Postal
Value Self Plus One
Monthly
283.59
Humana Health Plan, Inc.
MS1
Non-Postal
High Self
Monthly
1273.42
Humana Health Plan, Inc.
MS2
Non-Postal
High Self & Family
Monthly
2824.68
Humana Health Plan, Inc.
MS3
Non-Postal
High Self Plus One
Monthly
2742.01
Humana Health Plan, Inc.
MS4
Non-Postal
Standard Self
Monthly
677.17
Humana Health Plan, Inc.
MS5
Non-Postal
Standard Self & Family
Monthly
1483.13
Humana Health Plan, Inc.
MS6
Non-Postal
Standard Self Plus One
Monthly
1460.16
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 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