2017 Plan Information for District of Columbia
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Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 138.7 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 305.95 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 299.95 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 120.05 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 302.77 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 263.29 |
| Aetna HealthFund CDHP and Aetna Value Plan | F51 | Non-Postal | CDHP Self | Monthly | 236.68 |
| Aetna HealthFund CDHP and Aetna Value Plan | F52 | Non-Postal | CDHP Self & Family | Monthly | 540.15 |
| Aetna HealthFund CDHP and Aetna Value Plan | F53 | Non-Postal | CDHP Self Plus One | Monthly | 587.71 |
| Aetna HealthFund CDHP and Aetna Value Plan | F54 | Non-Postal | Value Self | Monthly | 139.84 |
| Aetna HealthFund CDHP and Aetna Value Plan | F55 | Non-Postal | Value Self & Family | Monthly | 320.21 |
| Aetna HealthFund CDHP and Aetna Value Plan | F56 | Non-Postal | Value Self Plus One | Monthly | 313.93 |
| Aetna Open Access | JN1 | Non-Postal | High Self | Monthly | 536.05 |
| Aetna Open Access | JN2 | Non-Postal | High Self & Family | Monthly | 1190.28 |
| Aetna Open Access | JN3 | Non-Postal | High Self Plus One | Monthly | 1231.42 |
| Aetna Open Access | JN4 | Non-Postal | Basic Self | Monthly | 159.34 |
| Aetna Open Access | JN5 | Non-Postal | Basic Self & Family | Monthly | 359.96 |
| Aetna Open Access | JN6 | Non-Postal | Basic Self Plus One | Monthly | 343.5 |
| CareFirst BlueChoice | 2G1 | Non-Postal | High Self | Monthly | 297.05 |
| CareFirst BlueChoice | 2G2 | Non-Postal | High Self & Family | Monthly | 752.29 |
| CareFirst BlueChoice | 2G3 | Non-Postal | High Self Plus One | Monthly | 523.79 |
| CareFirst BlueChoice | 2G4 | Non-Postal | Standard Self | Monthly | 180.31 |
| CareFirst BlueChoice | 2G5 | Non-Postal | Standard Self & Family | Monthly | 474.92 |
| CareFirst BlueChoice | 2G6 | Non-Postal | Standard Self Plus One | Monthly | 330.3 |
| CareFirst BlueChoice | B61 | Non-Postal | HDHP Self | Monthly | 152.43 |
| CareFirst BlueChoice | B62 | Non-Postal | HDHP Self & Family | Monthly | 362.17 |
| CareFirst BlueChoice | B63 | Non-Postal | HDHP Self Plus One | Monthly | 304.86 |
| Kaiser Permanente - Mid-Atlantic States | E31 | Non-Postal | High Self | Monthly | 161.41 |
| Kaiser Permanente - Mid-Atlantic States | E32 | Non-Postal | High Self & Family | Monthly | 406.99 |
| Kaiser Permanente - Mid-Atlantic States | E33 | Non-Postal | High Self Plus One | Monthly | 419.4 |
| Kaiser Permanente - Mid-Atlantic States | E34 | Non-Postal | Standard Self | Monthly | 121.01 |
| Kaiser Permanente - Mid-Atlantic States | E35 | Non-Postal | Standard Self & Family | Monthly | 283.16 |
| Kaiser Permanente - Mid-Atlantic States | E36 | Non-Postal | Standard Self Plus One | Monthly | 273.47 |
| M.D. IPA | JP1 | Non-Postal | High Self | Monthly | 210.44 |
| M.D. IPA | JP2 | Non-Postal | High Self & Family | Monthly | 842.17 |
| M.D. IPA | JP3 | Non-Postal | High Self Plus One | Monthly | 337.25 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 151.52 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 420.62 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 310.63 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L91 | Non-Postal | Value Self | Monthly | 108.27 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L92 | Non-Postal | Value Self & Family | Monthly | 303.59 |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced) | L93 | Non-Postal | Value Self Plus One | Monthly | 211.44 |