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2022 Plan Information for Texas
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
JS1
Non-Postal
CDHP Self
Monthly
506.81
Aetna HealthFund CDHP and Aetna Value Plan
JS2
Non-Postal
CDHP Self & Family
Monthly
1120.71
Aetna HealthFund CDHP and Aetna Value Plan
JS3
Non-Postal
CDHP Self Plus One
Monthly
1204.54
Aetna HealthFund CDHP and Aetna Value Plan
JS4
Non-Postal
Value Self
Monthly
563.98
Aetna HealthFund CDHP and Aetna Value Plan
JS5
Non-Postal
Value Self & Family
Monthly
1254.69
Aetna HealthFund CDHP and Aetna Value Plan
JS6
Non-Postal
Value Self Plus One
Monthly
1337.24
Baylor Scott and White Health Plan
A81
Non-Postal
Basic Self
Monthly
138.43
Baylor Scott and White Health Plan
A82
Non-Postal
Basic Self & Family
Monthly
324.72
Baylor Scott and White Health Plan
A83
Non-Postal
Basic Self Plus One
Monthly
306.78
Baylor Scott and White Health Plan
A84
Non-Postal
Standard Self
Monthly
482.15
Baylor Scott and White Health Plan
A85
Non-Postal
Standard Self & Family
Monthly
1133.49
Baylor Scott and White Health Plan
A86
Non-Postal
Standard Self Plus One
Monthly
1109.33
Baylor Scott and White Health Plan
P81
Non-Postal
Basic Self
Monthly
142.68
Baylor Scott and White Health Plan
P82
Non-Postal
Basic Self & Family
Monthly
334.75
Baylor Scott and White Health Plan
P83
Non-Postal
Basic Self Plus One
Monthly
316.25
Baylor Scott and White Health Plan
P84
Non-Postal
Standard Self
Monthly
510.64
Baylor Scott and White Health Plan
P85
Non-Postal
Standard Self & Family
Monthly
1200.51
Baylor Scott and White Health Plan
P86
Non-Postal
Standard Self Plus One
Monthly
1172.6
Humana CoverageFirst and Humana Value Plan
AN1
Non-Postal
HDHP Self
Monthly
114.65
Humana CoverageFirst and Humana Value Plan
AN2
Non-Postal
HDHP Self & Family
Monthly
285.66
Humana CoverageFirst and Humana Value Plan
AN3
Non-Postal
HDHP Self Plus One
Monthly
251.46
Humana CoverageFirst and Humana Value Plan
CG1
Non-Postal
HDHP Self
Monthly
128.14
Humana CoverageFirst and Humana Value Plan
CG2
Non-Postal
HDHP Self & Family
Monthly
319.36
Humana CoverageFirst and Humana Value Plan
CG3
Non-Postal
HDHP Self Plus One
Monthly
281.11
Humana CoverageFirst and Humana Value Plan
DX1
Non-Postal
HDHP Self
Monthly
101.14
Humana CoverageFirst and Humana Value Plan
DX2
Non-Postal
HDHP Self & Family
Monthly
251.87
Humana CoverageFirst and Humana Value Plan
DX3
Non-Postal
HDHP Self Plus One
Monthly
221.73
Humana CoverageFirst and Humana Value Plan
FD1
Non-Postal
HDHP Self
Monthly
99.44
Humana CoverageFirst and Humana Value Plan
FD2
Non-Postal
HDHP Self & Family
Monthly
247.63
Humana CoverageFirst and Humana Value Plan
FD3
Non-Postal
HDHP Self Plus One
Monthly
217.99
Humana CoverageFirst and Humana Value Plan
T31
Non-Postal
CDHP Self
Monthly
342.23
Humana CoverageFirst and Humana Value Plan
T32
Non-Postal
CDHP Self & Family
Monthly
719.72
Humana CoverageFirst and Humana Value Plan
T33
Non-Postal
CDHP Self Plus One
Monthly
739.72
Humana CoverageFirst and Humana Value Plan
T34
Non-Postal
Value Self
Monthly
148.34
Humana CoverageFirst and Humana Value Plan
T35
Non-Postal
Value Self & Family
Monthly
356.02
Humana CoverageFirst and Humana Value Plan
T36
Non-Postal
Value Self Plus One
Monthly
318.94
Humana CoverageFirst and Humana Value Plan
TP1
Non-Postal
CDHP Self
Monthly
241.61
Humana CoverageFirst and Humana Value Plan
TP2
Non-Postal
CDHP Self & Family
Monthly
493.33
Humana CoverageFirst and Humana Value Plan
TP3
Non-Postal
CDHP Self Plus One
Monthly
523.4
Humana CoverageFirst and Humana Value Plan
TP4
Non-Postal
Value Self
Monthly
121.6
Humana CoverageFirst and Humana Value Plan
TP5
Non-Postal
Value Self & Family
Monthly
291.84
Humana CoverageFirst and Humana Value Plan
TP6
Non-Postal
Value Self Plus One
Monthly
261.44
Humana CoverageFirst and Humana Value Plan
TU1
Non-Postal
CDHP Self
Monthly
242.99
Humana CoverageFirst and Humana Value Plan
TU2
Non-Postal
CDHP Self & Family
Monthly
496.51
Humana CoverageFirst and Humana Value Plan
TU3
Non-Postal
CDHP Self Plus One
Monthly
526.41
Humana CoverageFirst and Humana Value Plan
TU4
Non-Postal
Value Self
Monthly
153.91
Humana CoverageFirst and Humana Value Plan
TU5
Non-Postal
Value Self & Family
Monthly
346.3
Humana CoverageFirst and Humana Value Plan
TU6
Non-Postal
Value Self Plus One
Monthly
330.92
Humana CoverageFirst and Humana Value Plan
TV1
Non-Postal
CDHP Self
Monthly
378.86
Humana CoverageFirst and Humana Value Plan
TV2
Non-Postal
CDHP Self & Family
Monthly
802.23
Humana CoverageFirst and Humana Value Plan
TV3
Non-Postal
CDHP Self Plus One
Monthly
818.54
Humana CoverageFirst and Humana Value Plan
TV4
Non-Postal
Value Self
Monthly
188.74
Humana CoverageFirst and Humana Value Plan
TV5
Non-Postal
Value Self & Family
Monthly
404.6
Humana CoverageFirst and Humana Value Plan
TV6
Non-Postal
Value Self Plus One
Monthly
409.78
Humana Health Plan of Texas, Inc.
EW4
Non-Postal
Standard Self
Monthly
419.75
Humana Health Plan of Texas, Inc.
EW5
Non-Postal
Standard Self & Family
Monthly
894.12
Humana Health Plan of Texas, Inc.
EW6
Non-Postal
Standard Self Plus One
Monthly
906.36
Humana Health Plan of Texas, Inc.
Q21
Non-Postal
Basic Self
Monthly
295.17
Humana Health Plan of Texas, Inc.
Q22
Non-Postal
Basic Self & Family
Monthly
613.86
Humana Health Plan of Texas, Inc.
Q23
Non-Postal
Basic Self Plus One
Monthly
638.47
Humana Health Plan of Texas, Inc.
Q61
Non-Postal
Basic Self
Monthly
186.12
Humana Health Plan of Texas, Inc.
Q62
Non-Postal
Basic Self & Family
Monthly
403.12
Humana Health Plan of Texas, Inc.
Q63
Non-Postal
Basic Self Plus One
Monthly
404.13
Humana Health Plan of Texas, Inc.
QX1
Non-Postal
Basic Self
Monthly
339.17
Humana Health Plan of Texas, Inc.
QX2
Non-Postal
Basic Self & Family
Monthly
712.85
Humana Health Plan of Texas, Inc.
QX3
Non-Postal
Basic Self Plus One
Monthly
733.13
Humana Health Plan of Texas, Inc.
QY1
Non-Postal
Basic Self
Monthly
314.12
Humana Health Plan of Texas, Inc.
QY2
Non-Postal
Basic Self & Family
Monthly
656.54
Humana Health Plan of Texas, Inc.
QY3
Non-Postal
Basic Self Plus One
Monthly
679.36
Humana Health Plan of Texas, Inc.
UC4
Non-Postal
Standard Self
Monthly
368.12
Humana Health Plan of Texas, Inc.
UC5
Non-Postal
Standard Self & Family
Monthly
778.01
Humana Health Plan of Texas, Inc.
UC6
Non-Postal
Standard Self Plus One
Monthly
795.38
Humana Health Plan of Texas, Inc.
UR4
Non-Postal
Standard Self
Monthly
539.02
Humana Health Plan of Texas, Inc.
UR5
Non-Postal
Standard Self & Family
Monthly
1162.52
Humana Health Plan of Texas, Inc.
UR6
Non-Postal
Standard Self Plus One
Monthly
1162.81
Humana Health Plan of Texas, Inc.
UU4
Non-Postal
Standard Self
Monthly
1077.66
Humana Health Plan of Texas, Inc.
UU5
Non-Postal
Standard Self & Family
Monthly
2374.41
Humana Health Plan of Texas, Inc.
UU6
Non-Postal
Standard Self Plus One
Monthly
2320.85
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
165.94
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
396.6
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
331.88
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
162.73
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
384.86
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
349.87
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
145.31
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
343.67
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
312.43
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
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