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2016 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
130.08
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
286.94
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
281.31
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
118.33
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
298.42
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
259.5
Aetna HealthFund CDHP and Aetna Value Plan
JS1
Non-Postal
CDHP Self
Monthly
412.06
Aetna HealthFund CDHP and Aetna Value Plan
JS2
Non-Postal
CDHP Self & Family
Monthly
934.7
Aetna HealthFund CDHP and Aetna Value Plan
JS3
Non-Postal
CDHP Self Plus One
Monthly
974.5
Aetna HealthFund CDHP and Aetna Value Plan
JS4
Non-Postal
Basic Self
Monthly
190.54
Aetna HealthFund CDHP and Aetna Value Plan
JS5
Non-Postal
Basic Self & Family
Monthly
431.94
Aetna HealthFund CDHP and Aetna Value Plan
JS6
Non-Postal
Basic Self Plus One
Monthly
476.71
Aetna Whole Health
ES1
Non-Postal
Basic Self
Monthly
138.06
Aetna Whole Health
ES2
Non-Postal
Basic Self & Family
Monthly
403.67
Aetna Whole Health
ES3
Non-Postal
Basic Self Plus One
Monthly
448.76
Baylor Scott and White Health Plan
A84
Non-Postal
Standard Self
Monthly
147.34
Baylor Scott and White Health Plan
A85
Non-Postal
Standard Self & Family
Monthly
345.68
Baylor Scott and White Health Plan
A86
Non-Postal
Standard Self Plus One
Monthly
308.95
Firstcare
CK1
Non-Postal
High Self
Monthly
139.26
Firstcare
CK2
Non-Postal
High Self & Family
Monthly
320.29
Firstcare
CK3
Non-Postal
High Self Plus One
Monthly
264.6
Humana CoverageFirst and Humana Value Plan
TP1
Non-Postal
CDHP Self
Monthly
178.69
Humana CoverageFirst and Humana Value Plan
TP2
Non-Postal
CDHP Self & Family
Monthly
383.8
Humana CoverageFirst and Humana Value Plan
TP3
Non-Postal
CDHP Self Plus One
Monthly
379.23
Humana CoverageFirst and Humana Value Plan
TP4
Non-Postal
Value Self
Monthly
116.61
Humana CoverageFirst and Humana Value Plan
TP5
Non-Postal
Value Self & Family
Monthly
262.37
Humana CoverageFirst and Humana Value Plan
TP6
Non-Postal
Value Self Plus One
Monthly
250.7
Humana CoverageFirst and Humana Value Plan
TU1
Non-Postal
CDHP Self
Monthly
166.23
Humana CoverageFirst and Humana Value Plan
TU2
Non-Postal
CDHP Self & Family
Monthly
355.74
Humana CoverageFirst and Humana Value Plan
TU3
Non-Postal
CDHP Self Plus One
Monthly
352.45
Humana CoverageFirst and Humana Value Plan
TU4
Non-Postal
Value Self
Monthly
116.61
Humana CoverageFirst and Humana Value Plan
TU5
Non-Postal
Value Self & Family
Monthly
262.37
Humana CoverageFirst and Humana Value Plan
TU6
Non-Postal
Value Self Plus One
Monthly
250.7
Humana CoverageFirst and Humana Value Plan
TV1
Non-Postal
CDHP Self
Monthly
188.42
Humana CoverageFirst and Humana Value Plan
TV2
Non-Postal
CDHP Self & Family
Monthly
405.68
Humana CoverageFirst and Humana Value Plan
TV3
Non-Postal
CDHP Self Plus One
Monthly
400.14
Humana CoverageFirst and Humana Value Plan
TV4
Non-Postal
Value Self
Monthly
116.61
Humana CoverageFirst and Humana Value Plan
TV5
Non-Postal
Value Self & Family
Monthly
262.37
Humana CoverageFirst and Humana Value Plan
TV6
Non-Postal
Value Self Plus One
Monthly
250.7
Humana Health Plan of Texas, Inc.
EW1
Non-Postal
High Self
Monthly
187.05
Humana Health Plan of Texas, Inc.
EW2
Non-Postal
High Self & Family
Monthly
402.56
Humana Health Plan of Texas, Inc.
EW3
Non-Postal
High Self Plus One
Monthly
397.19
Humana Health Plan of Texas, Inc.
EW4
Non-Postal
Standard Self
Monthly
148.07
Humana Health Plan of Texas, Inc.
EW5
Non-Postal
Standard Self & Family
Monthly
333.17
Humana Health Plan of Texas, Inc.
EW6
Non-Postal
Standard Self Plus One
Monthly
318.36
Humana Health Plan of Texas, Inc.
UC1
Non-Postal
High Self
Monthly
219.14
Humana Health Plan of Texas, Inc.
UC2
Non-Postal
High Self & Family
Monthly
474.8
Humana Health Plan of Texas, Inc.
UC3
Non-Postal
High Self Plus One
Monthly
466.18
Humana Health Plan of Texas, Inc.
UC4
Non-Postal
Standard Self
Monthly
181.72
Humana Health Plan of Texas, Inc.
UC5
Non-Postal
Standard Self & Family
Monthly
390.63
Humana Health Plan of Texas, Inc.
UC6
Non-Postal
Standard Self Plus One
Monthly
385.77
Humana Health Plan of Texas, Inc.
UR1
Non-Postal
High Self
Monthly
845.44
Humana Health Plan of Texas, Inc.
UR2
Non-Postal
High Self & Family
Monthly
1883.98
Humana Health Plan of Texas, Inc.
UR3
Non-Postal
High Self Plus One
Monthly
1812.74
Humana Health Plan of Texas, Inc.
UR4
Non-Postal
Standard Self
Monthly
217.69
Humana Health Plan of Texas, Inc.
UR5
Non-Postal
Standard Self & Family
Monthly
471.55
Humana Health Plan of Texas, Inc.
UR6
Non-Postal
Standard Self Plus One
Monthly
463.08
Humana Health Plan of Texas, Inc.
UU1
Non-Postal
High Self
Monthly
626.49
Humana Health Plan of Texas, Inc.
UU2
Non-Postal
High Self & Family
Monthly
1391.34
Humana Health Plan of Texas, Inc.
UU3
Non-Postal
High Self Plus One
Monthly
1341.99
Humana Health Plan of Texas, Inc.
UU4
Non-Postal
Standard Self
Monthly
297.25
Humana Health Plan of Texas, Inc.
UU5
Non-Postal
Standard Self & Family
Monthly
650.63
Humana Health Plan of Texas, Inc.
UU6
Non-Postal
Standard Self Plus One
Monthly
634.2
UnitedHealthcare Benefits of Texas, Inc.
GF1
Non-Postal
High Self
Monthly
396.29
UnitedHealthcare Benefits of Texas, Inc.
GF2
Non-Postal
High Self & Family
Monthly
1349.05
UnitedHealthcare Benefits of Texas, Inc.
GF3
Non-Postal
High Self Plus One
Monthly
677.93
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
115.22
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
323.08
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
225.02
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service