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2021 Plan Information for Texas
Choose a Location, Employee Type, & Payment Period
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Nationwide
Non-Postal
Certain Temporary Employees
Annuitant
U.S. Postal Service (Category 1)
Former Spouse Enrollee
Federal Deposit Insurance Corporation
Temporary Continuation of Coverage (TCC)
U.S. Postal Service (Category 2)
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
262.6
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
515.62
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
578.72
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
153.96
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
388.27
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
337.64
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
JS1
Non-Postal
CDHP Self
Monthly
486.51
Aetna HealthFund CDHP and Aetna Value Plan
JS2
Non-Postal
CDHP Self & Family
Monthly
1083.94
Aetna HealthFund CDHP and Aetna Value Plan
JS3
Non-Postal
CDHP Self Plus One
Monthly
1158.17
Aetna HealthFund CDHP and Aetna Value Plan
JS4
Non-Postal
Value Self
Monthly
571.16
Aetna HealthFund CDHP and Aetna Value Plan
JS5
Non-Postal
Value Self & Family
Monthly
1280.59
Aetna HealthFund CDHP and Aetna Value Plan
JS6
Non-Postal
Value Self Plus One
Monthly
1352.91
Baylor Scott and White Health Plan
A81
Non-Postal
Basic Self
Monthly
146.47
Baylor Scott and White Health Plan
A82
Non-Postal
Basic Self & Family
Monthly
343.63
Baylor Scott and White Health Plan
A83
Non-Postal
Basic Self Plus One
Monthly
324.65
Baylor Scott and White Health Plan
A84
Non-Postal
Standard Self
Monthly
337.81
Baylor Scott and White Health Plan
A85
Non-Postal
Standard Self & Family
Monthly
803.57
Baylor Scott and White Health Plan
A86
Non-Postal
Standard Self Plus One
Monthly
788.89
Baylor Scott and White Health Plan
P81
Non-Postal
Basic Self
Monthly
150.98
Baylor Scott and White Health Plan
P82
Non-Postal
Basic Self & Family
Monthly
354.24
Baylor Scott and White Health Plan
P83
Non-Postal
Basic Self Plus One
Monthly
334.67
Baylor Scott and White Health Plan
P84
Non-Postal
Standard Self
Monthly
443.26
Baylor Scott and White Health Plan
P85
Non-Postal
Standard Self & Family
Monthly
1051.22
Baylor Scott and White Health Plan
P86
Non-Postal
Standard Self Plus One
Monthly
1022.8
Humana CoverageFirst and Humana Value Plan
T31
Non-Postal
CDHP Self
Monthly
288.45
Humana CoverageFirst and Humana Value Plan
T32
Non-Postal
CDHP Self & Family
Monthly
608.46
Humana CoverageFirst and Humana Value Plan
T33
Non-Postal
CDHP Self Plus One
Monthly
624.35
Humana CoverageFirst and Humana Value Plan
T34
Non-Postal
Value Self
Monthly
141.28
Humana CoverageFirst and Humana Value Plan
T35
Non-Postal
Value Self & Family
Monthly
317.88
Humana CoverageFirst and Humana Value Plan
T36
Non-Postal
Value Self Plus One
Monthly
303.75
Humana CoverageFirst and Humana Value Plan
TP1
Non-Postal
CDHP Self
Monthly
248.72
Humana CoverageFirst and Humana Value Plan
TP2
Non-Postal
CDHP Self & Family
Monthly
519.07
Humana CoverageFirst and Humana Value Plan
TP3
Non-Postal
CDHP Self Plus One
Monthly
538.92
Humana CoverageFirst and Humana Value Plan
TP4
Non-Postal
Value Self
Monthly
113.12
Humana CoverageFirst and Humana Value Plan
TP5
Non-Postal
Value Self & Family
Monthly
254.51
Humana CoverageFirst and Humana Value Plan
TP6
Non-Postal
Value Self Plus One
Monthly
243.2
Humana CoverageFirst and Humana Value Plan
TU1
Non-Postal
CDHP Self
Monthly
206.31
Humana CoverageFirst and Humana Value Plan
TU2
Non-Postal
CDHP Self & Family
Monthly
423.71
Humana CoverageFirst and Humana Value Plan
TU3
Non-Postal
CDHP Self Plus One
Monthly
447.77
Humana CoverageFirst and Humana Value Plan
TU4
Non-Postal
Value Self
Monthly
150.15
Humana CoverageFirst and Humana Value Plan
TU5
Non-Postal
Value Self & Family
Monthly
337.85
Humana CoverageFirst and Humana Value Plan
TU6
Non-Postal
Value Self Plus One
Monthly
322.84
Humana CoverageFirst and Humana Value Plan
TV1
Non-Postal
CDHP Self
Monthly
385.97
Humana CoverageFirst and Humana Value Plan
TV2
Non-Postal
CDHP Self & Family
Monthly
827.95
Humana CoverageFirst and Humana Value Plan
TV3
Non-Postal
CDHP Self Plus One
Monthly
834.08
Humana CoverageFirst and Humana Value Plan
TV4
Non-Postal
Value Self
Monthly
195.85
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
425.32
Humana Health Plan of Texas, Inc.
EW1
Non-Postal
High Self
Monthly
744.41
Humana Health Plan of Texas, Inc.
EW2
Non-Postal
High Self & Family
Monthly
1634.38
Humana Health Plan of Texas, Inc.
EW3
Non-Postal
High Self Plus One
Monthly
1604.66
Humana Health Plan of Texas, Inc.
EW4
Non-Postal
Standard Self
Monthly
412.82
Humana Health Plan of Texas, Inc.
EW5
Non-Postal
Standard Self & Family
Monthly
888.29
Humana Health Plan of Texas, Inc.
EW6
Non-Postal
Standard Self Plus One
Monthly
891.72
Humana Health Plan of Texas, Inc.
Q21
Non-Postal
Basic Self
Monthly
262.95
Humana Health Plan of Texas, Inc.
Q22
Non-Postal
Basic Self & Family
Monthly
551.11
Humana Health Plan of Texas, Inc.
Q23
Non-Postal
Basic Self Plus One
Monthly
569.47
Humana Health Plan of Texas, Inc.
Q61
Non-Postal
Basic Self
Monthly
175.74
Humana Health Plan of Texas, Inc.
Q62
Non-Postal
Basic Self & Family
Monthly
393.29
Humana Health Plan of Texas, Inc.
Q63
Non-Postal
Basic Self Plus One
Monthly
382.07
Humana Health Plan of Texas, Inc.
QX1
Non-Postal
Basic Self
Monthly
293.96
Humana Health Plan of Texas, Inc.
QX2
Non-Postal
Basic Self & Family
Monthly
620.88
Humana Health Plan of Texas, Inc.
QX3
Non-Postal
Basic Self Plus One
Monthly
636.2
Humana Health Plan of Texas, Inc.
QY1
Non-Postal
Basic Self
Monthly
321.23
Humana Health Plan of Texas, Inc.
QY2
Non-Postal
Basic Self & Family
Monthly
682.26
Humana Health Plan of Texas, Inc.
QY3
Non-Postal
Basic Self Plus One
Monthly
694.88
Humana Health Plan of Texas, Inc.
UC1
Non-Postal
High Self
Monthly
648.53
Humana Health Plan of Texas, Inc.
UC2
Non-Postal
High Self & Family
Monthly
1418.71
Humana Health Plan of Texas, Inc.
UC3
Non-Postal
High Self Plus One
Monthly
1398.57
Humana Health Plan of Texas, Inc.
UC4
Non-Postal
Standard Self
Monthly
375.23
Humana Health Plan of Texas, Inc.
UC5
Non-Postal
Standard Self & Family
Monthly
803.75
Humana Health Plan of Texas, Inc.
UC6
Non-Postal
Standard Self Plus One
Monthly
810.92
Humana Health Plan of Texas, Inc.
UR1
Non-Postal
High Self
Monthly
1040.33
Humana Health Plan of Texas, Inc.
UR2
Non-Postal
High Self & Family
Monthly
2300.24
Humana Health Plan of Texas, Inc.
UR3
Non-Postal
High Self Plus One
Monthly
2240.9
Humana Health Plan of Texas, Inc.
UR4
Non-Postal
Standard Self
Monthly
546.13
Humana Health Plan of Texas, Inc.
UR5
Non-Postal
Standard Self & Family
Monthly
1188.24
Humana Health Plan of Texas, Inc.
UR6
Non-Postal
Standard Self Plus One
Monthly
1178.32
Humana Health Plan of Texas, Inc.
UU1
Non-Postal
High Self
Monthly
1098.57
Humana Health Plan of Texas, Inc.
UU2
Non-Postal
High Self & Family
Monthly
2431.22
Humana Health Plan of Texas, Inc.
UU3
Non-Postal
High Self Plus One
Monthly
2366.09
Humana Health Plan of Texas, Inc.
UU4
Non-Postal
Standard Self
Monthly
1084.77
Humana Health Plan of Texas, Inc.
UU5
Non-Postal
Standard Self & Family
Monthly
2400.19
Humana Health Plan of Texas, Inc.
UU6
Non-Postal
Standard Self Plus One
Monthly
2336.41
UnitedHealthcare Advantage Plan
Y51
Non-Postal
High Self
Monthly
102.93
UnitedHealthcare Advantage Plan
Y52
Non-Postal
High Self & Family
Monthly
272.77
UnitedHealthcare Advantage Plan
Y53
Non-Postal
High Self Plus One
Monthly
226.45
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
138.65
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
388.79
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
270.79
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Monthly
149.87
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Monthly
354.44
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Monthly
322.22
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Monthly
144.18
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Monthly
340.98
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Monthly
309.98
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service