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2024 Plan Information for Virginia
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
272.61
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
498.46
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
590.61
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
160.8
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
405.51
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
352.64
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
F51
Non-Postal
CDHP Self
Monthly
471.38
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
1015.69
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
1121.06
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
435.87
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
944.77
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
1028.06
Aetna Open Access
JN1
Non-Postal
High Self
Monthly
775.97
Aetna Open Access
JN2
Non-Postal
High Self & Family
Monthly
1666.6
Aetna Open Access
JN3
Non-Postal
High Self Plus One
Monthly
1765.51
Aetna Open Access
JN4
Non-Postal
Basic Self
Monthly
216.73
Aetna Open Access
JN5
Non-Postal
Basic Self & Family
Monthly
460.45
Aetna Open Access
JN6
Non-Postal
Basic Self Plus One
Monthly
422.82
Aetna Open Access
QQ4
Non-Postal
Saver Self
Monthly
155.57
Aetna Open Access
QQ5
Non-Postal
Saver Self & Family
Monthly
356.03
Aetna Open Access
QQ6
Non-Postal
Saver Self Plus One
Monthly
326.94
CareFirst BlueChoice
2G4
Non-Postal
Standard Self
Monthly
527.28
CareFirst BlueChoice
2G5
Non-Postal
Standard Self & Family
Monthly
1250.06
CareFirst BlueChoice
2G6
Non-Postal
Standard Self Plus One
Monthly
960.01
CareFirst BlueChoice
B61
Non-Postal
HDHP Self
Monthly
181.63
CareFirst BlueChoice
B62
Non-Postal
HDHP Self & Family
Monthly
431.54
CareFirst BlueChoice
B63
Non-Postal
HDHP Self Plus One
Monthly
363.25
CareFirst BlueChoice
B64
Non-Postal
Blue Value Plus Self
Monthly
193.76
CareFirst BlueChoice
B65
Non-Postal
Blue Value Plus Self & Family
Monthly
460.36
CareFirst BlueChoice
B66
Non-Postal
Blue Value Plus Self Plus One
Monthly
387.52
Kaiser Permanente - Mid-Atlantic States
E31
Non-Postal
High Self
Monthly
301.77
Kaiser Permanente - Mid-Atlantic States
E32
Non-Postal
High Self & Family
Monthly
646.64
Kaiser Permanente - Mid-Atlantic States
E33
Non-Postal
High Self Plus One
Monthly
775.95
Kaiser Permanente - Mid-Atlantic States
E34
Non-Postal
Standard Self
Monthly
176.88
Kaiser Permanente - Mid-Atlantic States
E35
Non-Postal
Standard Self & Family
Monthly
406.82
Kaiser Permanente - Mid-Atlantic States
E36
Non-Postal
Standard Self Plus One
Monthly
406.82
Kaiser Permanente - Mid-Atlantic States
T71
Non-Postal
Prosper Self
Monthly
106.25
Kaiser Permanente - Mid-Atlantic States
T72
Non-Postal
Prosper Self & Family
Monthly
298.95
Kaiser Permanente - Mid-Atlantic States
T73
Non-Postal
Prosper Self Plus One
Monthly
253.86
M.D. IPA
JP1
Non-Postal
High Self
Monthly
565.2
M.D. IPA
JP2
Non-Postal
High Self & Family
Monthly
1833.8
M.D. IPA
JP3
Non-Postal
High Self Plus One
Monthly
981.67
Sentara Health Plans
F21
Non-Postal
High Self
Monthly
177.35
Sentara Health Plans
F22
Non-Postal
High Self & Family
Monthly
405.88
Sentara Health Plans
F23
Non-Postal
High Self Plus One
Monthly
405.85
Sentara Health Plans
PG1
Non-Postal
High Self
Monthly
266.13
Sentara Health Plans
PG2
Non-Postal
High Self & Family
Monthly
664.04
Sentara Health Plans
PG3
Non-Postal
High Self Plus One
Monthly
793.2
Sentara Health Plans
PG4
Non-Postal
HDHP Self
Monthly
163.03
Sentara Health Plans
PG5
Non-Postal
HDHP Self & Family
Monthly
359.61
Sentara Health Plans
PG6
Non-Postal
HDHP Self Plus One
Monthly
352.56
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V41
Non-Postal
HDHP Self
Monthly
173.39
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V42
Non-Postal
HDHP Self & Family
Monthly
396.95
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V43
Non-Postal
HDHP Self Plus One
Monthly
372.8
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR1
Non-Postal
High Self
Monthly
419.44
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR2
Non-Postal
High Self & Family
Monthly
987.82
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR3
Non-Postal
High Self Plus One
Monthly
895.46
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
192.31
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
461.56
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
408.67
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
203.41
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
471.92
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
431.04
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
181.3
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
428.78
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
389.8
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service