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2021 Plan Information for Illinois
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
H41
Non-Postal
CDHP Self
Monthly
303.42
Aetna HealthFund CDHP and Aetna Value Plan
H42
Non-Postal
CDHP Self & Family
Monthly
666.53
Aetna HealthFund CDHP and Aetna Value Plan
H43
Non-Postal
CDHP Self Plus One
Monthly
745.27
Aetna HealthFund CDHP and Aetna Value Plan
H44
Non-Postal
Value Self
Monthly
294.06
Aetna HealthFund CDHP and Aetna Value Plan
H45
Non-Postal
Value Self & Family
Monthly
657.95
Aetna HealthFund CDHP and Aetna Value Plan
H46
Non-Postal
Value Self Plus One
Monthly
718.23
Blue Preferred
9G1
Non-Postal
High Self
Monthly
350.81
Blue Preferred
9G2
Non-Postal
High Self & Family
Monthly
766.31
Blue Preferred
9G3
Non-Postal
High Self Plus One
Monthly
740.96
Blue Preferred
9G4
Non-Postal
Standard Self
Monthly
158.41
Blue Preferred
9G5
Non-Postal
Standard Self & Family
Monthly
540.02
Blue Preferred
9G6
Non-Postal
Standard Self Plus One
Monthly
453.42
Health Alliance HMO/POS
K84
Non-Postal
Standard Self
Monthly
170.89
Health Alliance HMO/POS
K85
Non-Postal
Standard Self & Family
Monthly
396.09
Health Alliance HMO/POS
K86
Non-Postal
Standard Self Plus One
Monthly
365.4
Humana CoverageFirst and Humana Value Plan
GB1
Non-Postal
CDHP Self
Monthly
704.32
Humana CoverageFirst and Humana Value Plan
GB2
Non-Postal
CDHP Self & Family
Monthly
1544.18
Humana CoverageFirst and Humana Value Plan
GB3
Non-Postal
CDHP Self Plus One
Monthly
1518.49
Humana CoverageFirst and Humana Value Plan
GB4
Non-Postal
Value Self
Monthly
265.05
Humana CoverageFirst and Humana Value Plan
GB5
Non-Postal
Value Self & Family
Monthly
555.79
Humana CoverageFirst and Humana Value Plan
GB6
Non-Postal
Value Self Plus One
Monthly
574
Humana CoverageFirst and Humana Value Plan
MW1
Non-Postal
CDHP Self
Monthly
502.54
Humana CoverageFirst and Humana Value Plan
MW2
Non-Postal
CDHP Self & Family
Monthly
1090.27
Humana CoverageFirst and Humana Value Plan
MW3
Non-Postal
CDHP Self Plus One
Monthly
1084.7
Humana CoverageFirst and Humana Value Plan
MW4
Non-Postal
Value Self
Monthly
284.34
Humana CoverageFirst and Humana Value Plan
MW5
Non-Postal
Value Self & Family
Monthly
599.19
Humana CoverageFirst and Humana Value Plan
MW6
Non-Postal
Value Self Plus One
Monthly
615.51
Humana Health Plan, Inc.
751
Non-Postal
High Self
Monthly
845.59
Humana Health Plan, Inc.
752
Non-Postal
High Self & Family
Monthly
1862.12
Humana Health Plan, Inc.
753
Non-Postal
High Self Plus One
Monthly
1822.26
Humana Health Plan, Inc.
754
Non-Postal
Standard Self
Monthly
521.93
Humana Health Plan, Inc.
755
Non-Postal
Standard Self & Family
Monthly
1133.82
Humana Health Plan, Inc.
756
Non-Postal
Standard Self Plus One
Monthly
1126.37
Humana Health Plan, Inc.
9F1
Non-Postal
High Self
Monthly
1492.43
Humana Health Plan, Inc.
9F2
Non-Postal
High Self & Family
Monthly
3317.43
Humana Health Plan, Inc.
9F3
Non-Postal
High Self Plus One
Monthly
3212.87
Humana Health Plan, Inc.
AB1
Non-Postal
Basic Self
Monthly
263.49
Humana Health Plan, Inc.
AB2
Non-Postal
Basic Self & Family
Monthly
552.39
Humana Health Plan, Inc.
AB3
Non-Postal
Basic Self Plus One
Monthly
570.75
Humana Health Plan, Inc.
AB4
Non-Postal
Standard Self
Monthly
718.28
Humana Health Plan, Inc.
AB5
Non-Postal
Standard Self & Family
Monthly
1575.69
Humana Health Plan, Inc.
AB6
Non-Postal
Standard Self Plus One
Monthly
1548.56
Humana Health Plan, Inc.
RW1
Non-Postal
Basic Self
Monthly
295.62
Humana Health Plan, Inc.
RW2
Non-Postal
Basic Self & Family
Monthly
624.65
Humana Health Plan, Inc.
RW3
Non-Postal
Basic Self Plus One
Monthly
639.8
Union Health Service
761
Non-Postal
High Self
Monthly
258.64
Union Health Service
762
Non-Postal
High Self & Family
Monthly
744.7
Union Health Service
763
Non-Postal
High Self Plus One
Monthly
611.18
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