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2023 Plan Information for Kentucky
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
H41
Non-Postal
CDHP Self
Monthly
302.2
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
646.78
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
737.95
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Value Self
Monthly
338.43
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Value Self & Family
Monthly
743.37
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Value Self Plus One
Monthly
813.13
Humana CoverageFirst and Humana Value Plan
6N1
Non-Postal
CDHP Self
Monthly
337.35
Humana CoverageFirst and Humana Value Plan
6N2
Non-Postal
CDHP Self & Family
Monthly
700.42
Humana CoverageFirst and Humana Value Plan
6N3
Non-Postal
CDHP Self Plus One
Monthly
720.68
Humana CoverageFirst and Humana Value Plan
6N4
Non-Postal
Value Self
Monthly
169.55
Humana CoverageFirst and Humana Value Plan
6N5
Non-Postal
Value Self & Family
Monthly
381.47
Humana CoverageFirst and Humana Value Plan
6N6
Non-Postal
Value Self Plus One
Monthly
364.52
Humana CoverageFirst and Humana Value Plan
DT1
Non-Postal
HDHP Self
Monthly
127.65
Humana CoverageFirst and Humana Value Plan
DT2
Non-Postal
HDHP Self & Family
Monthly
318.12
Humana CoverageFirst and Humana Value Plan
DT3
Non-Postal
HDHP Self Plus One
Monthly
280.02
Humana CoverageFirst and Humana Value Plan
FW1
Non-Postal
HDHP Self
Monthly
103.42
Humana CoverageFirst and Humana Value Plan
FW2
Non-Postal
HDHP Self & Family
Monthly
257.54
Humana CoverageFirst and Humana Value Plan
FW3
Non-Postal
HDHP Self Plus One
Monthly
226.71
Humana CoverageFirst and Humana Value Plan
FZ1
Non-Postal
HDHP Self
Monthly
103.42
Humana CoverageFirst and Humana Value Plan
FZ2
Non-Postal
HDHP Self & Family
Monthly
257.54
Humana CoverageFirst and Humana Value Plan
FZ3
Non-Postal
HDHP Self Plus One
Monthly
226.71
Humana CoverageFirst and Humana Value Plan
TC1
Non-Postal
CDHP Self
Monthly
243.53
Humana CoverageFirst and Humana Value Plan
TC2
Non-Postal
CDHP Self & Family
Monthly
489.28
Humana CoverageFirst and Humana Value Plan
TC3
Non-Postal
CDHP Self Plus One
Monthly
518.98
Humana CoverageFirst and Humana Value Plan
TC4
Non-Postal
Value Self
Monthly
156.52
Humana CoverageFirst and Humana Value Plan
TC5
Non-Postal
Value Self & Family
Monthly
352.19
Humana CoverageFirst and Humana Value Plan
TC6
Non-Postal
Value Self Plus One
Monthly
336.54
Humana CoverageFirst and Humana Value Plan
X31
Non-Postal
CDHP Self
Monthly
389.28
Humana CoverageFirst and Humana Value Plan
X32
Non-Postal
CDHP Self & Family
Monthly
817.27
Humana CoverageFirst and Humana Value Plan
X33
Non-Postal
CDHP Self Plus One
Monthly
832.37
Humana CoverageFirst and Humana Value Plan
X34
Non-Postal
Value Self
Monthly
183.13
Humana CoverageFirst and Humana Value Plan
X35
Non-Postal
Value Self & Family
Monthly
412.04
Humana CoverageFirst and Humana Value Plan
X36
Non-Postal
Value Self Plus One
Monthly
393.73
Humana Health Plan of Ohio, Inc.
A64
Non-Postal
Standard Self
Monthly
741.73
Humana Health Plan of Ohio, Inc.
A65
Non-Postal
Standard Self & Family
Monthly
1610.31
Humana Health Plan of Ohio, Inc.
A66
Non-Postal
Standard Self Plus One
Monthly
1590.16
Humana Health Plan of Ohio, Inc.
W61
Non-Postal
Basic Self
Monthly
195.52
Humana Health Plan of Ohio, Inc.
W62
Non-Postal
Basic Self & Family
Monthly
426.52
Humana Health Plan of Ohio, Inc.
W63
Non-Postal
Basic Self Plus One
Monthly
415.78
Humana Health Plan, Inc.
MH4
Non-Postal
Standard Self
Monthly
535.99
Humana Health Plan, Inc.
MH5
Non-Postal
Standard Self & Family
Monthly
1147.36
Humana Health Plan, Inc.
MH6
Non-Postal
Standard Self Plus One
Monthly
1147.75
Humana Health Plan, Inc.
MI4
Non-Postal
Standard Self
Monthly
477.9
Humana Health Plan, Inc.
MI5
Non-Postal
Standard Self & Family
Monthly
1016.67
Humana Health Plan, Inc.
MI6
Non-Postal
Standard Self Plus One
Monthly
1022.95
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N71
Non-Postal
HDHP Self
Monthly
195.11
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N72
Non-Postal
HDHP Self & Family
Monthly
435.76
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
N73
Non-Postal
HDHP Self Plus One
Monthly
414.94
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ1
Non-Postal
High Self
Monthly
412.73
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ2
Non-Postal
High Self & Family
Monthly
1113.89
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LJ3
Non-Postal
High Self Plus One
Monthly
882.74
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