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Healthcare Plan Information

2022 Plan Information for Indiana

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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 293.78
Aetna Direct 225 Non-Postal HDHP Self & Family Monthly 574.3
Aetna Direct 226 Non-Postal HDHP Self Plus One Monthly 645.93
Aetna Direct N61 Non-Postal CDHP Self Monthly 157.07
Aetna Direct N62 Non-Postal CDHP Self & Family Monthly 396.12
Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly 344.47
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 506.81
Aetna HealthFund CDHP and Aetna Value Plan JS2 Non-Postal CDHP Self & Family Monthly 1120.71
Aetna HealthFund CDHP and Aetna Value Plan JS3 Non-Postal CDHP Self Plus One Monthly 1204.54
Aetna HealthFund CDHP and Aetna Value Plan JS4 Non-Postal Value Self Monthly 563.98
Aetna HealthFund CDHP and Aetna Value Plan JS5 Non-Postal Value Self & Family Monthly 1254.69
Aetna HealthFund CDHP and Aetna Value Plan JS6 Non-Postal Value Self Plus One Monthly 1337.24
Health Alliance HMO K84 Non-Postal Standard Self Monthly 176.02
Health Alliance HMO K85 Non-Postal Standard Self & Family Monthly 407.97
Health Alliance HMO K86 Non-Postal Standard Self Plus One Monthly 376.36
Humana CoverageFirst and Humana Value Plan BB1 Non-Postal HDHP Self Monthly 111.32
Humana CoverageFirst and Humana Value Plan BB2 Non-Postal HDHP Self & Family Monthly 277.33
Humana CoverageFirst and Humana Value Plan BB3 Non-Postal HDHP Self Plus One Monthly 244.13
Humana CoverageFirst and Humana Value Plan DT1 Non-Postal HDHP Self Monthly 123.93
Humana CoverageFirst and Humana Value Plan DT2 Non-Postal HDHP Self & Family Monthly 308.85
Humana CoverageFirst and Humana Value Plan DT3 Non-Postal HDHP Self Plus One Monthly 271.87
Humana CoverageFirst and Humana Value Plan MW1 Non-Postal CDHP Self Monthly 526.22
Humana CoverageFirst and Humana Value Plan MW2 Non-Postal CDHP Self & Family Monthly 1133.86
Humana CoverageFirst and Humana Value Plan MW3 Non-Postal CDHP Self Plus One Monthly 1135.38
Humana CoverageFirst and Humana Value Plan MW4 Non-Postal Value Self Monthly 269.17
Humana CoverageFirst and Humana Value Plan MW5 Non-Postal Value Self & Family Monthly 555.32
Humana CoverageFirst and Humana Value Plan MW6 Non-Postal Value Self Plus One Monthly 582.62
Humana CoverageFirst and Humana Value Plan TC1 Non-Postal CDHP Self Monthly 226.53
Humana CoverageFirst and Humana Value Plan TC2 Non-Postal CDHP Self & Family Monthly 459.38
Humana CoverageFirst and Humana Value Plan TC3 Non-Postal CDHP Self Plus One Monthly 490.94
Humana CoverageFirst and Humana Value Plan TC4 Non-Postal Value Self Monthly 144.93
Humana CoverageFirst and Humana Value Plan TC5 Non-Postal Value Self & Family Monthly 326.1
Humana CoverageFirst and Humana Value Plan TC6 Non-Postal Value Self Plus One Monthly 311.61
Humana CoverageFirst and Humana Value Plan X31 Non-Postal CDHP Self Monthly 371.84
Humana CoverageFirst and Humana Value Plan X32 Non-Postal CDHP Self & Family Monthly 786.39
Humana CoverageFirst and Humana Value Plan X33 Non-Postal CDHP Self Plus One Monthly 803.42
Humana CoverageFirst and Humana Value Plan X34 Non-Postal Value Self Monthly 173.58
Humana CoverageFirst and Humana Value Plan X35 Non-Postal Value Self & Family Monthly 390.56
Humana CoverageFirst and Humana Value Plan X36 Non-Postal Value Self Plus One Monthly 373.2
Humana Health Plan of Ohio, Inc. A64 Non-Postal Standard Self Monthly 712.55
Humana Health Plan of Ohio, Inc. A65 Non-Postal Standard Self & Family Monthly 1553
Humana Health Plan of Ohio, Inc. A66 Non-Postal Standard Self Plus One Monthly 1535.93
Humana Health Plan, Inc. 751 Non-Postal High Self Monthly 872.71
Humana Health Plan, Inc. 752 Non-Postal High Self & Family Monthly 1913.34
Humana Health Plan, Inc. 753 Non-Postal High Self Plus One Monthly 1880.28
Humana Health Plan, Inc. 754 Non-Postal Standard Self Monthly 525.27
Humana Health Plan, Inc. 755 Non-Postal Standard Self & Family Monthly 1131.61
Humana Health Plan, Inc. 756 Non-Postal Standard Self Plus One Monthly 1133.3
Humana Health Plan, Inc. MH4 Non-Postal Standard Self Monthly 462.37
Humana Health Plan, Inc. MH5 Non-Postal Standard Self & Family Monthly 990.01
Humana Health Plan, Inc. MH6 Non-Postal Standard Self Plus One Monthly 997.97
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