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2022 Plan Information for Colorado
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
BlueAdvantage HMO
WW1
Non-Postal
High Self
Monthly
169.43
BlueAdvantage HMO
WW2
Non-Postal
High Self & Family
Monthly
446.55
BlueAdvantage HMO
WW3
Non-Postal
High Self Plus One
Monthly
418.08
BlueAdvantage HMO
WW4
Non-Postal
HDHP Self
Monthly
159.94
BlueAdvantage HMO
WW5
Non-Postal
HDHP Self & Family
Monthly
389.44
BlueAdvantage HMO
WW6
Non-Postal
HDHP Self Plus One
Monthly
363.85
Humana Health Plan, Inc.
NR1
Non-Postal
High Self
Monthly
440.27
Humana Health Plan, Inc.
NR2
Non-Postal
High Self & Family
Monthly
940.33
Humana Health Plan, Inc.
NR3
Non-Postal
High Self Plus One
Monthly
950.52
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
344.76
Humana Health Plan, Inc.
NT2
Non-Postal
High Self & Family
Monthly
725.49
Humana Health Plan, Inc.
NT3
Non-Postal
High Self Plus One
Monthly
745.18
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
151.47
Humana Health Plan, Inc.
R22
Non-Postal
Basic Self & Family
Monthly
340.8
Humana Health Plan, Inc.
R23
Non-Postal
Basic Self Plus One
Monthly
325.65
Humana Health Plan, Inc.
RZ1
Non-Postal
Basic Self
Monthly
129.73
Humana Health Plan, Inc.
RZ2
Non-Postal
Basic Self & Family
Monthly
291.89
Humana Health Plan, Inc.
RZ3
Non-Postal
Basic Self Plus One
Monthly
278.93
Kaiser Permanente - Colorado
651
Non-Postal
High Self
Monthly
242.36
Kaiser Permanente - Colorado
652
Non-Postal
High Self & Family
Monthly
502.8
Kaiser Permanente - Colorado
653
Non-Postal
High Self Plus One
Monthly
610.05
Kaiser Permanente - Colorado
654
Non-Postal
Standard Self
Monthly
164.79
Kaiser Permanente - Colorado
655
Non-Postal
Standard Self & Family
Monthly
372.43
Kaiser Permanente - Colorado
656
Non-Postal
Standard Self Plus One
Monthly
372.43
Kaiser Permanente - Colorado
N41
Non-Postal
Prosper Self
Monthly
97.54
Kaiser Permanente - Colorado
N42
Non-Postal
Prosper Self & Family
Monthly
239.94
Kaiser Permanente - Colorado
N43
Non-Postal
Prosper Self Plus One
Monthly
220.43
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
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service