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Healthcare

2021 Plan Information for District of Columbia

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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 F51 Non-Postal CDHP Self Monthly 328.32
Aetna HealthFund CDHP and Aetna Value Plan F52 Non-Postal CDHP Self & Family Monthly 723.82
Aetna HealthFund CDHP and Aetna Value Plan F53 Non-Postal CDHP Self Plus One Monthly 801.65
Aetna HealthFund CDHP and Aetna Value Plan F54 Non-Postal Value Self Monthly 298.4
Aetna HealthFund CDHP and Aetna Value Plan F55 Non-Postal Value Self & Family Monthly 663.67
Aetna HealthFund CDHP and Aetna Value Plan F56 Non-Postal Value Self Plus One Monthly 723.8
Aetna Open Access JN1 Non-Postal High Self Monthly 653.15
Aetna Open Access JN2 Non-Postal High Self & Family Monthly 1426.84
Aetna Open Access JN3 Non-Postal High Self Plus One Monthly 1497.69
Aetna Open Access JN4 Non-Postal Basic Self Monthly 191
Aetna Open Access JN5 Non-Postal Basic Self & Family Monthly 416.71
Aetna Open Access JN6 Non-Postal Basic Self Plus One Monthly 380.17
Aetna Open Access QQ4 Non-Postal Saver Self Monthly 148.8
Aetna Open Access QQ5 Non-Postal Saver Self & Family Monthly 340.53
Aetna Open Access QQ6 Non-Postal Saver Self Plus One Monthly 312.7
CareFirst BlueChoice 2G4 Non-Postal Standard Self Monthly 364.39
CareFirst BlueChoice 2G5 Non-Postal Standard Self & Family Monthly 891.21
CareFirst BlueChoice 2G6 Non-Postal Standard Self Plus One Monthly 654.45
CareFirst BlueChoice B61 Non-Postal HDHP Self Monthly 142.52
CareFirst BlueChoice B62 Non-Postal HDHP Self & Family Monthly 338.63
CareFirst BlueChoice B63 Non-Postal HDHP Self Plus One Monthly 285.04
CareFirst BlueChoice B64 Non-Postal Blue Value Plus Self Monthly 200.25
CareFirst BlueChoice B65 Non-Postal Blue Value Plus Self & Family Monthly 501.17
CareFirst BlueChoice B66 Non-Postal Blue Value Plus Self Plus One Monthly 361.82
Kaiser Permanente - Mid-Atlantic States E31 Non-Postal High Self Monthly 222.82
Kaiser Permanente - Mid-Atlantic States E32 Non-Postal High Self & Family Monthly 498.14
Kaiser Permanente - Mid-Atlantic States E33 Non-Postal High Self Plus One Monthly 595.19
Kaiser Permanente - Mid-Atlantic States E34 Non-Postal Standard Self Monthly 149.57
Kaiser Permanente - Mid-Atlantic States E35 Non-Postal Standard Self & Family Monthly 344.01
Kaiser Permanente - Mid-Atlantic States E36 Non-Postal Standard Self Plus One Monthly 344.01
Kaiser Permanente - Mid-Atlantic States T71 Non-Postal Basic Self Monthly 106.93
Kaiser Permanente - Mid-Atlantic States T72 Non-Postal Basic Self & Family Monthly 274.88
Kaiser Permanente - Mid-Atlantic States T73 Non-Postal Basic Self Plus One Monthly 237.96
M.D. IPA JP1 Non-Postal High Self Monthly 427.47
M.D. IPA JP2 Non-Postal High Self & Family Monthly 1448.07
M.D. IPA JP3 Non-Postal High Self Plus One Monthly 735.93
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. (A HDHP with a Health Savings Account (HSA)) V41 Non-Postal HDHP Self Monthly 129.98
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) V42 Non-Postal HDHP Self & Family Monthly 298.95
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) V43 Non-Postal HDHP Self Plus One Monthly 279.45
UnitedHealthcare Insurance Company, Inc. (Choice Open Access) LR1 Non-Postal High Self Monthly 246.98
UnitedHealthcare Insurance Company, Inc. (Choice Open Access) LR2 Non-Postal High Self & Family Monthly 607.62
UnitedHealthcare Insurance Company, Inc. (Choice Open Access) LR3 Non-Postal High Self Plus One Monthly 535.17
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
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