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2018 Plan Information for Virginia
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
F51
Non-Postal
CDHP Self
Monthly
309.25
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Monthly
707.57
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Monthly
755.63
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Monthly
145.75
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Monthly
333.75
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Monthly
327.2
Aetna Open Access
JN1
Non-Postal
High Self
Monthly
606.38
Aetna Open Access
JN2
Non-Postal
High Self & Family
Monthly
1349.86
Aetna Open Access
JN3
Non-Postal
High Self Plus One
Monthly
1391.55
Aetna Open Access
JN4
Non-Postal
Basic Self
Monthly
166.14
Aetna Open Access
JN5
Non-Postal
Basic Self & Family
Monthly
386.86
Aetna Open Access
JN6
Non-Postal
Basic Self Plus One
Monthly
348.25
CareFirst BlueChoice
2G1
Non-Postal
High Self
Monthly
358.37
CareFirst BlueChoice
2G2
Non-Postal
High Self & Family
Monthly
901.51
CareFirst BlueChoice
2G3
Non-Postal
High Self Plus One
Monthly
646.3
CareFirst BlueChoice
2G4
Non-Postal
Standard Self
Monthly
196.91
CareFirst BlueChoice
2G5
Non-Postal
Standard Self & Family
Monthly
517.96
CareFirst BlueChoice
2G6
Non-Postal
Standard Self Plus One
Monthly
346.81
CareFirst BlueChoice
B61
Non-Postal
HDHP Self
Monthly
152.43
CareFirst BlueChoice
B62
Non-Postal
HDHP Self & Family
Monthly
362.17
CareFirst BlueChoice
B63
Non-Postal
HDHP Self Plus One
Monthly
304.86
Kaiser Permanente - Mid-Atlantic States
E31
Non-Postal
High Self
Monthly
165.09
Kaiser Permanente - Mid-Atlantic States
E32
Non-Postal
High Self & Family
Monthly
388.74
Kaiser Permanente - Mid-Atlantic States
E33
Non-Postal
High Self Plus One
Monthly
455
Kaiser Permanente - Mid-Atlantic States
E34
Non-Postal
Standard Self
Monthly
126.24
Kaiser Permanente - Mid-Atlantic States
E35
Non-Postal
Standard Self & Family
Monthly
290.37
Kaiser Permanente - Mid-Atlantic States
E36
Non-Postal
Standard Self Plus One
Monthly
290.37
Kaiser Permanente - Mid-Atlantic States
T71
Non-Postal
Basic Self
Monthly
115.01
Kaiser Permanente - Mid-Atlantic States
T72
Non-Postal
Basic Self & Family
Monthly
276.12
Kaiser Permanente - Mid-Atlantic States
T73
Non-Postal
Basic Self Plus One
Monthly
251.55
M.D. IPA
JP1
Non-Postal
High Self
Monthly
221.06
M.D. IPA
JP2
Non-Postal
High Self & Family
Monthly
882.57
M.D. IPA
JP3
Non-Postal
High Self Plus One
Monthly
350.45
Sentara Health Plans
PG1
Non-Postal
High Self
Monthly
162.82
Sentara Health Plans
PG2
Non-Postal
High Self & Family
Monthly
443.71
Sentara Health Plans
PG3
Non-Postal
High Self Plus One
Monthly
509.86
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V41
Non-Postal
HDHP Self
Monthly
141.74
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V42
Non-Postal
HDHP Self & Family
Monthly
354.37
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA))
V43
Non-Postal
HDHP Self Plus One
Monthly
304.75
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR1
Non-Postal
High Self
Monthly
152
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR2
Non-Postal
High Self & Family
Monthly
389.91
UnitedHealthcare Insurance Company, Inc. (Choice Open Access)
LR3
Non-Postal
High Self Plus One
Monthly
326.8
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L91
Non-Postal
Value Self
Monthly
115.83
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L92
Non-Postal
Value Self & Family
Monthly
324.79
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
L93
Non-Postal
Value Self Plus One
Monthly
226.22
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service
