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    2018 Plan Information for Kentucky 
    
        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 
                            151.86 
                         
                        
                            Aetna Direct  
                            225 
                            Non-Postal 
                            HDHP Self & Family 
                            Monthly 
                            334.98 
                         
                        
                            Aetna Direct  
                            226 
                            Non-Postal 
                            HDHP Self Plus One 
                            Monthly 
                            328.41 
                         
                        
                            Aetna Direct  
                            N61 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            131.92 
                         
                        
                            Aetna Direct  
                            N62 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            332.67 
                         
                        
                            Aetna Direct  
                            N63 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            289.29 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H41 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            326.13 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H42 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            745.55 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H43 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            793.24 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H44 
                            Non-Postal 
                            Value Self 
                            Monthly 
                            143.93 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H45 
                            Non-Postal 
                            Value Self & Family 
                            Monthly 
                            330.34 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            H46 
                            Non-Postal 
                            Value Self Plus One 
                            Monthly 
                            323.86 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            6N1 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            146.27 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            6N2 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            329.09 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            6N3 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            314.47 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            TC1 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            150.58 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            TC2 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            338.81 
                         
                        
                            Humana CoverageFirst and Humana Value Plan 
                            TC3 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            323.75 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A61 
                            Non-Postal 
                            High Self 
                            Monthly 
                            547.69 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A62 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            1219.81 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A63 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            1181.64 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A64 
                            Non-Postal 
                            Standard Self 
                            Monthly 
                            339.17 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A65 
                            Non-Postal 
                            Standard Self & Family 
                            Monthly 
                            750.64 
                         
                        
                            Humana Health Plan of Ohio, Inc. 
                            A66 
                            Non-Postal 
                            Standard Self Plus One 
                            Monthly 
                            733.31 
                         
                        
                            Humana Health Plan, Inc. 
                            MH1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            304.91 
                         
                        
                            Humana Health Plan, Inc. 
                            MH2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            673.55 
                         
                        
                            Humana Health Plan, Inc. 
                            MH3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            659.62 
                         
                        
                            Humana Health Plan, Inc. 
                            MH4 
                            Non-Postal 
                            Standard Self 
                            Monthly 
                            176.34 
                         
                        
                            Humana Health Plan, Inc. 
                            MH5 
                            Non-Postal 
                            Standard Self & Family 
                            Monthly 
                            384.26 
                         
                        
                            Humana Health Plan, Inc. 
                            MH6 
                            Non-Postal 
                            Standard Self Plus One 
                            Monthly 
                            383.22 
                         
                        
                            Humana Health Plan, Inc. 
                            MI1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            503.6 
                         
                        
                            Humana Health Plan, Inc. 
                            MI2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            1120.56 
                         
                        
                            Humana Health Plan, Inc. 
                            MI3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            1086.8 
                         
                        
                            Humana Health Plan, Inc. 
                            MI4 
                            Non-Postal 
                            Standard Self 
                            Monthly 
                            266.87 
                         
                        
                            Humana Health Plan, Inc. 
                            MI5 
                            Non-Postal 
                            Standard Self & Family 
                            Monthly 
                            587.99 
                         
                        
                            Humana Health Plan, Inc. 
                            MI6 
                            Non-Postal 
                            Standard Self Plus One 
                            Monthly 
                            577.88 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            N71 
                            Non-Postal 
                            HDHP Self 
                            Monthly 
                            125.45 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            N72 
                            Non-Postal 
                            HDHP Self & Family 
                            Monthly 
                            313.62 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            N73 
                            Non-Postal 
                            HDHP Self Plus One 
                            Monthly 
                            269.72 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            LJ1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            152.67 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            LJ2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            396.67 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            LJ3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            328.25 
                         
                 
            
         
 
				 
			 
		 
		
		
			
				
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