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2022 Plan Information for Arizona
Choose a Location, Employee Type, & Payment Period
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Nationwide
Federal & U.S. Postal Service Employee
Certain Temporary Employees
Annuitant
Former Spouse Enrollee
Federal Deposit Insurance Corporation
Temporary Continuation of Coverage (TCC)
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
293.78
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
574.3
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
645.93
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
157.07
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
396.12
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
344.47
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
604.57
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
1345.26
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
1426.9
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
303.85
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
667.12
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
736.93
Aetna Open Access
WQ1
Non-Postal
High Self
Monthly
908.14
Aetna Open Access
WQ2
Non-Postal
High Self & Family
Monthly
2249.11
Aetna Open Access
WQ3
Non-Postal
High Self Plus One
Monthly
2321.73
Humana CoverageFirst and Humana Value Plan
BV1
Non-Postal
HDHP Self
Monthly
113.29
Humana CoverageFirst and Humana Value Plan
BV2
Non-Postal
HDHP Self & Family
Monthly
282.25
Humana CoverageFirst and Humana Value Plan
BV3
Non-Postal
HDHP Self Plus One
Monthly
248.46
Humana CoverageFirst and Humana Value Plan
BY1
Non-Postal
HDHP Self
Monthly
99.44
Humana CoverageFirst and Humana Value Plan
BY2
Non-Postal
HDHP Self & Family
Monthly
247.63
Humana CoverageFirst and Humana Value Plan
BY3
Non-Postal
HDHP Self Plus One
Monthly
217.99
Humana CoverageFirst and Humana Value Plan
R61
Non-Postal
CDHP Self
Monthly
342.62
Humana CoverageFirst and Humana Value Plan
R62
Non-Postal
CDHP Self & Family
Monthly
720.61
Humana CoverageFirst and Humana Value Plan
R63
Non-Postal
CDHP Self Plus One
Monthly
740.54
Humana CoverageFirst and Humana Value Plan
R64
Non-Postal
Value Self
Monthly
166.36
Humana CoverageFirst and Humana Value Plan
R65
Non-Postal
Value Self & Family
Monthly
374.31
Humana CoverageFirst and Humana Value Plan
R66
Non-Postal
Value Self Plus One
Monthly
357.68
Humana CoverageFirst and Humana Value Plan
R91
Non-Postal
CDHP Self
Monthly
233.18
Humana CoverageFirst and Humana Value Plan
R92
Non-Postal
CDHP Self & Family
Monthly
474.33
Humana CoverageFirst and Humana Value Plan
R93
Non-Postal
CDHP Self Plus One
Monthly
505.2
Humana CoverageFirst and Humana Value Plan
R94
Non-Postal
Value Self
Monthly
146.3
Humana CoverageFirst and Humana Value Plan
R95
Non-Postal
Value Self & Family
Monthly
329.18
Humana CoverageFirst and Humana Value Plan
R96
Non-Postal
Value Self Plus One
Monthly
314.56
Humana Health Plan, Inc.
BF4
Non-Postal
Standard Self
Monthly
716.06
Humana Health Plan, Inc.
BF5
Non-Postal
Standard Self & Family
Monthly
1560.91
Humana Health Plan, Inc.
BF6
Non-Postal
Standard Self Plus One
Monthly
1543.51
Humana Health Plan, Inc.
C74
Non-Postal
Standard Self
Monthly
385.67
Humana Health Plan, Inc.
C75
Non-Postal
Standard Self & Family
Monthly
817.5
Humana Health Plan, Inc.
C76
Non-Postal
Standard Self Plus One
Monthly
833.13
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU1
Non-Postal
HDHP Self
Monthly
168.02
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU2
Non-Postal
HDHP Self & Family
Monthly
386.46
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU3
Non-Postal
HDHP Self Plus One
Monthly
361.26
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT1
Non-Postal
High Self
Monthly
334.34
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT2
Non-Postal
High Self & Family
Monthly
918.21
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT3
Non-Postal
High Self Plus One
Monthly
722.76
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF1
Non-Postal
High Self
Monthly
167.11
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF2
Non-Postal
High Self & Family
Monthly
395.23
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF3
Non-Postal
High Self Plus One
Monthly
359.29
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD1
Non-Postal
High Self
Monthly
164.41
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD2
Non-Postal
High Self & Family
Monthly
388.85
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD3
Non-Postal
High Self Plus One
Monthly
353.49
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service