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2023 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
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
JS1
Non-Postal
CDHP Self
Monthly
603.67
Aetna HealthFund CDHP and Aetna Value Plan
JS2
Non-Postal
CDHP Self & Family
Monthly
1334.15
Aetna HealthFund CDHP and Aetna Value Plan
JS3
Non-Postal
CDHP Self Plus One
Monthly
1418.08
Aetna HealthFund CDHP and Aetna Value Plan
JS4
Non-Postal
Value Self
Monthly
544.24
Aetna HealthFund CDHP and Aetna Value Plan
JS5
Non-Postal
Value Self & Family
Monthly
1202.31
Aetna HealthFund CDHP and Aetna Value Plan
JS6
Non-Postal
Value Self Plus One
Monthly
1287.61
Baylor Scott and White Health Plan
A81
Non-Postal
Basic Self
Monthly
147.77
Baylor Scott and White Health Plan
A82
Non-Postal
Basic Self & Family
Monthly
346.68
Baylor Scott and White Health Plan
A83
Non-Postal
Basic Self Plus One
Monthly
327.52
Baylor Scott and White Health Plan
A84
Non-Postal
Standard Self
Monthly
357.15
Baylor Scott and White Health Plan
A85
Non-Postal
Standard Self & Family
Monthly
834.65
Baylor Scott and White Health Plan
A86
Non-Postal
Standard Self Plus One
Monthly
825.57
Baylor Scott and White Health Plan
P81
Non-Postal
Basic Self
Monthly
152.32
Baylor Scott and White Health Plan
P82
Non-Postal
Basic Self & Family
Monthly
357.37
Baylor Scott and White Health Plan
P83
Non-Postal
Basic Self Plus One
Monthly
337.63
Baylor Scott and White Health Plan
P84
Non-Postal
Standard Self
Monthly
383.04
Baylor Scott and White Health Plan
P85
Non-Postal
Standard Self & Family
Monthly
895.51
Baylor Scott and White Health Plan
P86
Non-Postal
Standard Self Plus One
Monthly
883.05
Humana CoverageFirst and Humana Value Plan
AN1
Non-Postal
HDHP Self
Monthly
118.1
Humana CoverageFirst and Humana Value Plan
AN2
Non-Postal
HDHP Self & Family
Monthly
294.23
Humana CoverageFirst and Humana Value Plan
AN3
Non-Postal
HDHP Self Plus One
Monthly
259
Humana CoverageFirst and Humana Value Plan
CG1
Non-Postal
HDHP Self
Monthly
131.98
Humana CoverageFirst and Humana Value Plan
CG2
Non-Postal
HDHP Self & Family
Monthly
328.94
Humana CoverageFirst and Humana Value Plan
CG3
Non-Postal
HDHP Self Plus One
Monthly
289.55
Humana CoverageFirst and Humana Value Plan
DX1
Non-Postal
HDHP Self
Monthly
104.18
Humana CoverageFirst and Humana Value Plan
DX2
Non-Postal
HDHP Self & Family
Monthly
259.43
Humana CoverageFirst and Humana Value Plan
DX3
Non-Postal
HDHP Self Plus One
Monthly
228.39
Humana CoverageFirst and Humana Value Plan
FD1
Non-Postal
HDHP Self
Monthly
102.43
Humana CoverageFirst and Humana Value Plan
FD2
Non-Postal
HDHP Self & Family
Monthly
255.06
Humana CoverageFirst and Humana Value Plan
FD3
Non-Postal
HDHP Self Plus One
Monthly
224.53
Humana CoverageFirst and Humana Value Plan
T31
Non-Postal
CDHP Self
Monthly
401.68
Humana CoverageFirst and Humana Value Plan
T32
Non-Postal
CDHP Self & Family
Monthly
845.11
Humana CoverageFirst and Humana Value Plan
T33
Non-Postal
CDHP Self Plus One
Monthly
859
Humana CoverageFirst and Humana Value Plan
T34
Non-Postal
Value Self
Monthly
164.66
Humana CoverageFirst and Humana Value Plan
T35
Non-Postal
Value Self & Family
Monthly
395.18
Humana CoverageFirst and Humana Value Plan
T36
Non-Postal
Value Self Plus One
Monthly
354.03
Humana CoverageFirst and Humana Value Plan
TP1
Non-Postal
CDHP Self
Monthly
303.7
Humana CoverageFirst and Humana Value Plan
TP2
Non-Postal
CDHP Self & Family
Monthly
624.72
Humana CoverageFirst and Humana Value Plan
TP3
Non-Postal
CDHP Self Plus One
Monthly
648.4
Humana CoverageFirst and Humana Value Plan
TP4
Non-Postal
Value Self
Monthly
133.64
Humana CoverageFirst and Humana Value Plan
TP5
Non-Postal
Value Self & Family
Monthly
320.74
Humana CoverageFirst and Humana Value Plan
TP6
Non-Postal
Value Self Plus One
Monthly
287.33
Humana CoverageFirst and Humana Value Plan
TU1
Non-Postal
CDHP Self
Monthly
308.12
Humana CoverageFirst and Humana Value Plan
TU2
Non-Postal
CDHP Self & Family
Monthly
634.69
Humana CoverageFirst and Humana Value Plan
TU3
Non-Postal
CDHP Self Plus One
Monthly
657.91
Humana CoverageFirst and Humana Value Plan
TU4
Non-Postal
Value Self
Monthly
156.15
Humana CoverageFirst and Humana Value Plan
TU5
Non-Postal
Value Self & Family
Monthly
351.34
Humana CoverageFirst and Humana Value Plan
TU6
Non-Postal
Value Self Plus One
Monthly
335.73
Humana CoverageFirst and Humana Value Plan
TV1
Non-Postal
CDHP Self
Monthly
371.95
Humana CoverageFirst and Humana Value Plan
TV2
Non-Postal
CDHP Self & Family
Monthly
778.31
Humana CoverageFirst and Humana Value Plan
TV3
Non-Postal
CDHP Self Plus One
Monthly
795.12
Humana CoverageFirst and Humana Value Plan
TV4
Non-Postal
Value Self
Monthly
179.82
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
386.62
Humana Health Plan of Texas, Inc.
EW4
Non-Postal
Standard Self
Monthly
442.21
Humana Health Plan of Texas, Inc.
EW5
Non-Postal
Standard Self & Family
Monthly
936.35
Humana Health Plan of Texas, Inc.
EW6
Non-Postal
Standard Self Plus One
Monthly
946.12
Humana Health Plan of Texas, Inc.
Q21
Non-Postal
Basic Self
Monthly
368.66
Humana Health Plan of Texas, Inc.
Q22
Non-Postal
Basic Self & Family
Monthly
770.88
Humana Health Plan of Texas, Inc.
Q23
Non-Postal
Basic Self Plus One
Monthly
787.97
Humana Health Plan of Texas, Inc.
Q61
Non-Postal
Basic Self
Monthly
229.32
Humana Health Plan of Texas, Inc.
Q62
Non-Postal
Basic Self & Family
Monthly
457.39
Humana Health Plan of Texas, Inc.
Q63
Non-Postal
Basic Self Plus One
Monthly
488.45
Humana Health Plan of Texas, Inc.
QX1
Non-Postal
Basic Self
Monthly
399.68
Humana Health Plan of Texas, Inc.
QX2
Non-Postal
Basic Self & Family
Monthly
840.69
Humana Health Plan of Texas, Inc.
QX3
Non-Postal
Basic Self Plus One
Monthly
854.73
Humana Health Plan of Texas, Inc.
QY1
Non-Postal
Basic Self
Monthly
452.66
Humana Health Plan of Texas, Inc.
QY2
Non-Postal
Basic Self & Family
Monthly
959.88
Humana Health Plan of Texas, Inc.
QY3
Non-Postal
Basic Self Plus One
Monthly
968.63
Humana Health Plan of Texas, Inc.
UC4
Non-Postal
Standard Self
Monthly
430.3
Humana Health Plan of Texas, Inc.
UC5
Non-Postal
Standard Self & Family
Monthly
909.55
Humana Health Plan of Texas, Inc.
UC6
Non-Postal
Standard Self Plus One
Monthly
920.51
Humana Health Plan of Texas, Inc.
UR4
Non-Postal
Standard Self
Monthly
590.02
Humana Health Plan of Texas, Inc.
UR5
Non-Postal
Standard Self & Family
Monthly
1268.96
Humana Health Plan of Texas, Inc.
UR6
Non-Postal
Standard Self Plus One
Monthly
1263.95
Humana Health Plan of Texas, Inc.
UU4
Non-Postal
Standard Self
Monthly
1125.84
Humana Health Plan of Texas, Inc.
UU5
Non-Postal
Standard Self & Family
Monthly
2474.53
Humana Health Plan of Texas, Inc.
UU6
Non-Postal
Standard Self Plus One
Monthly
2415.96
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
174.25
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
418.2
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
370.29
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
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