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2023 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
269.92
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
511.92
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
586.26
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
160.35
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
404.39
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
351.67
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
589.68
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
1303.9
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
1388.18
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
311.33
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
677.2
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
748.24
Aetna Open Access
WQ1
Non-Postal
High Self
Monthly
883.09
Aetna Open Access
WQ2
Non-Postal
High Self & Family
Monthly
2185.65
Aetna Open Access
WQ3
Non-Postal
High Self Plus One
Monthly
2261.18
Humana CoverageFirst and Humana Value Plan
BV1
Non-Postal
HDHP Self
Monthly
116.69
Humana CoverageFirst and Humana Value Plan
BV2
Non-Postal
HDHP Self & Family
Monthly
290.72
Humana CoverageFirst and Humana Value Plan
BV3
Non-Postal
HDHP Self Plus One
Monthly
255.91
Humana CoverageFirst and Humana Value Plan
BY1
Non-Postal
HDHP Self
Monthly
102.43
Humana CoverageFirst and Humana Value Plan
BY2
Non-Postal
HDHP Self & Family
Monthly
255.06
Humana CoverageFirst and Humana Value Plan
BY3
Non-Postal
HDHP Self Plus One
Monthly
224.53
Humana CoverageFirst and Humana Value Plan
R61
Non-Postal
CDHP Self
Monthly
331.65
Humana CoverageFirst and Humana Value Plan
R62
Non-Postal
CDHP Self & Family
Monthly
687.57
Humana CoverageFirst and Humana Value Plan
R63
Non-Postal
CDHP Self Plus One
Monthly
708.41
Humana CoverageFirst and Humana Value Plan
R64
Non-Postal
Value Self
Monthly
171.22
Humana CoverageFirst and Humana Value Plan
R65
Non-Postal
Value Self & Family
Monthly
385.22
Humana CoverageFirst and Humana Value Plan
R66
Non-Postal
Value Self Plus One
Monthly
368.12
Humana CoverageFirst and Humana Value Plan
R91
Non-Postal
CDHP Self
Monthly
239.15
Humana CoverageFirst and Humana Value Plan
R92
Non-Postal
CDHP Self & Family
Monthly
479.47
Humana CoverageFirst and Humana Value Plan
R93
Non-Postal
CDHP Self Plus One
Monthly
509.51
Humana CoverageFirst and Humana Value Plan
R94
Non-Postal
Value Self
Monthly
152.15
Humana CoverageFirst and Humana Value Plan
R95
Non-Postal
Value Self & Family
Monthly
342.35
Humana CoverageFirst and Humana Value Plan
R96
Non-Postal
Value Self Plus One
Monthly
327.14
Humana Health Plan, Inc.
BF4
Non-Postal
Standard Self
Monthly
721.26
Humana Health Plan, Inc.
BF5
Non-Postal
Standard Self & Family
Monthly
1564.25
Humana Health Plan, Inc.
BF6
Non-Postal
Standard Self Plus One
Monthly
1546.18
Humana Health Plan, Inc.
C74
Non-Postal
Standard Self
Monthly
433.85
Humana Health Plan, Inc.
C75
Non-Postal
Standard Self & Family
Monthly
917.54
Humana Health Plan, Inc.
C76
Non-Postal
Standard Self Plus One
Monthly
928.14
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU1
Non-Postal
HDHP Self
Monthly
177.16
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU2
Non-Postal
HDHP Self & Family
Monthly
407.44
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
LU3
Non-Postal
HDHP Self Plus One
Monthly
380.88
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT1
Non-Postal
High Self
Monthly
400.72
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT2
Non-Postal
High Self & Family
Monthly
1083.88
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
KT3
Non-Postal
High Self Plus One
Monthly
856.94
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF1
Non-Postal
High Self
Monthly
177.43
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF2
Non-Postal
High Self & Family
Monthly
419.62
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
WF3
Non-Postal
High Self Plus One
Monthly
381.47
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD1
Non-Postal
High Self
Monthly
158.58
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD2
Non-Postal
High Self & Family
Monthly
375.04
UnitedHealthcare Insurance Company, Inc. Choice Primary
VD3
Non-Postal
High Self Plus One
Monthly
340.95
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service