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2023 Plan Information for Georgia
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
F51
Non-Postal
CDHP Self
Monthly
415.48
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
905.69
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
993.87
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
445.55
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
984.15
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
1049.12
Aetna Open Access
2U1
Non-Postal
High Self
Monthly
1219.92
Aetna Open Access
2U2
Non-Postal
High Self & Family
Monthly
2781.53
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Monthly
2851.16
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Monthly
685.44
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Monthly
1483.61
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Monthly
1469.07
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Monthly
312.89
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Monthly
645.3
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Monthly
668.03
Humana CoverageFirst and Humana Value Plan
AR1
Non-Postal
HDHP Self
Monthly
122.94
Humana CoverageFirst and Humana Value Plan
AR2
Non-Postal
HDHP Self & Family
Monthly
306.35
Humana CoverageFirst and Humana Value Plan
AR3
Non-Postal
HDHP Self Plus One
Monthly
269.67
Humana CoverageFirst and Humana Value Plan
AZ1
Non-Postal
HDHP Self
Monthly
121.64
Humana CoverageFirst and Humana Value Plan
AZ2
Non-Postal
HDHP Self & Family
Monthly
303.09
Humana CoverageFirst and Humana Value Plan
AZ3
Non-Postal
HDHP Self Plus One
Monthly
266.8
Humana CoverageFirst and Humana Value Plan
B21
Non-Postal
HDHP Self
Monthly
125.4
Humana CoverageFirst and Humana Value Plan
B22
Non-Postal
HDHP Self & Family
Monthly
312.51
Humana CoverageFirst and Humana Value Plan
B23
Non-Postal
HDHP Self Plus One
Monthly
275.08
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Monthly
276.55
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Monthly
563.66
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Monthly
590.01
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Monthly
223.49
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Monthly
444.26
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Monthly
475.95
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Monthly
272.65
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Monthly
554.87
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Monthly
581.6
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Monthly
176.99
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Monthly
398.22
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Monthly
380.52
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Monthly
814.12
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Monthly
1773.16
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Monthly
1745.77
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Monthly
932.49
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Monthly
2039.55
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Monthly
2000.4
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Monthly
423.58
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Monthly
894.36
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Monthly
906.04
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Monthly
480.98
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Monthly
1023.6
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Monthly
1029.47
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Monthly
233.69
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Monthly
467.25
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Monthly
497.88
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Monthly
329.61
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Monthly
683.05
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Monthly
704.1
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Monthly
244.92
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Monthly
500.53
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Monthly
610.81
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Monthly
158.02
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Monthly
357.13
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Monthly
357.13
Kaiser Permanente - Georgia
LA1
Non-Postal
Prosper Self
Monthly
108.62
Kaiser Permanente - Georgia
LA2
Non-Postal
Prosper Self & Family
Monthly
282.02
Kaiser Permanente - Georgia
LA3
Non-Postal
Prosper Self Plus One
Monthly
245.49
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Monthly
442.71
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Monthly
1691.56
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Monthly
947.22
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
177.95
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
420.84
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
382.58
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
168.85
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
399.34
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
363.03
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service