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2023 Plan Information for Missouri
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
HA1
Non-Postal
High Self
Monthly
634.18
Aetna Open Access
HA2
Non-Postal
High Self & Family
Monthly
1502.57
Aetna Open Access
HA3
Non-Postal
High Self Plus One
Monthly
1584.87
Aetna Open Access
HA4
Non-Postal
Standard Self
Monthly
332.28
Aetna Open Access
HA5
Non-Postal
Standard Self & Family
Monthly
787.8
Aetna Open Access
HA6
Non-Postal
Standard Self Plus One
Monthly
877.18
Humana CoverageFirst and Humana Value Plan
BK1
Non-Postal
HDHP Self
Monthly
103.8
Humana CoverageFirst and Humana Value Plan
BK2
Non-Postal
HDHP Self & Family
Monthly
258.51
Humana CoverageFirst and Humana Value Plan
BK3
Non-Postal
HDHP Self Plus One
Monthly
227.57
Humana CoverageFirst and Humana Value Plan
PH1
Non-Postal
CDHP Self
Monthly
187.55
Humana CoverageFirst and Humana Value Plan
PH2
Non-Postal
CDHP Self & Family
Monthly
421.99
Humana CoverageFirst and Humana Value Plan
PH3
Non-Postal
CDHP Self Plus One
Monthly
403.24
Humana CoverageFirst and Humana Value Plan
PH4
Non-Postal
Value Self
Monthly
146.89
Humana CoverageFirst and Humana Value Plan
PH5
Non-Postal
Value Self & Family
Monthly
330.52
Humana CoverageFirst and Humana Value Plan
PH6
Non-Postal
Value Self Plus One
Monthly
315.84
Humana Health Plan, Inc.
MS4
Non-Postal
Standard Self
Monthly
800.02
Humana Health Plan, Inc.
MS5
Non-Postal
Standard Self & Family
Monthly
1741.46
Humana Health Plan, Inc.
MS6
Non-Postal
Standard Self Plus One
Monthly
1715.5
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