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2022 Plan Information for Georgia
Choose a Location, Employee Type, & Payment Period
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Nationwide
Federal & U.S. Postal Service Employee
Certain Temporary Employees
Annuitant
Former Spouse Enrollee
Federal Deposit Insurance Corporation
Temporary Continuation of Coverage (TCC)
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
Biweekly
135.59
Aetna Direct
225
Non-Postal
HDHP Self & Family
Biweekly
265.06
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Biweekly
298.12
Aetna Direct
N61
Non-Postal
CDHP Self
Biweekly
72.49
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Biweekly
182.82
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Biweekly
158.98
Aetna Direct
Z24
Non-Postal
Advantage Self
Biweekly
57.69
Aetna Direct
Z25
Non-Postal
Advantage Self & Family
Biweekly
152.88
Aetna Direct
Z26
Non-Postal
Advantage Self Plus One
Biweekly
126.92
Aetna HealthFund CDHP and Aetna Value Plan
F51
Non-Postal
CDHP Self
Biweekly
156.98
Aetna HealthFund CDHP and Aetna Value Plan
F52
Non-Postal
CDHP Self & Family
Biweekly
342.07
Aetna HealthFund CDHP and Aetna Value Plan
F53
Non-Postal
CDHP Self Plus One
Biweekly
382.5
Aetna HealthFund CDHP and Aetna Value Plan
F54
Non-Postal
Value Self
Biweekly
168.46
Aetna HealthFund CDHP and Aetna Value Plan
F55
Non-Postal
Value Self & Family
Biweekly
372.32
Aetna HealthFund CDHP and Aetna Value Plan
F56
Non-Postal
Value Self Plus One
Biweekly
403.27
Aetna Open Access
2U1
Non-Postal
High Self
Biweekly
553.43
Aetna Open Access
2U2
Non-Postal
High Self & Family
Biweekly
1264.7
Aetna Open Access
2U3
Non-Postal
High Self Plus One
Biweekly
1295.99
Blue Open Access POS
QM1
Non-Postal
High Self
Biweekly
80.97
Blue Open Access POS
QM2
Non-Postal
High Self & Family
Biweekly
276.69
Blue Open Access POS
QM3
Non-Postal
High Self Plus One
Biweekly
207.13
Humana CoverageFirst and Humana Value Plan
AD1
Non-Postal
CDHP Self
Biweekly
293.53
Humana CoverageFirst and Humana Value Plan
AD2
Non-Postal
CDHP Self & Family
Biweekly
637.23
Humana CoverageFirst and Humana Value Plan
AD3
Non-Postal
CDHP Self Plus One
Biweekly
632.9
Humana CoverageFirst and Humana Value Plan
AD4
Non-Postal
Value Self
Biweekly
136.39
Humana CoverageFirst and Humana Value Plan
AD5
Non-Postal
Value Self & Family
Biweekly
283.64
Humana CoverageFirst and Humana Value Plan
AD6
Non-Postal
Value Self Plus One
Biweekly
295.03
Humana CoverageFirst and Humana Value Plan
AR1
Non-Postal
HDHP Self
Biweekly
55.09
Humana CoverageFirst and Humana Value Plan
AR2
Non-Postal
HDHP Self & Family
Biweekly
137.27
Humana CoverageFirst and Humana Value Plan
AR3
Non-Postal
HDHP Self Plus One
Biweekly
120.84
Humana CoverageFirst and Humana Value Plan
AZ1
Non-Postal
HDHP Self
Biweekly
54.51
Humana CoverageFirst and Humana Value Plan
AZ2
Non-Postal
HDHP Self & Family
Biweekly
135.81
Humana CoverageFirst and Humana Value Plan
AZ3
Non-Postal
HDHP Self Plus One
Biweekly
119.55
Humana CoverageFirst and Humana Value Plan
B21
Non-Postal
HDHP Self
Biweekly
56.19
Humana CoverageFirst and Humana Value Plan
B22
Non-Postal
HDHP Self & Family
Biweekly
140.03
Humana CoverageFirst and Humana Value Plan
B23
Non-Postal
HDHP Self Plus One
Biweekly
123.26
Humana CoverageFirst and Humana Value Plan
LM1
Non-Postal
CDHP Self
Biweekly
117.22
Humana CoverageFirst and Humana Value Plan
LM2
Non-Postal
CDHP Self & Family
Biweekly
240.55
Humana CoverageFirst and Humana Value Plan
LM3
Non-Postal
CDHP Self Plus One
Biweekly
253.84
Humana CoverageFirst and Humana Value Plan
LM4
Non-Postal
Value Self
Biweekly
97.66
Humana CoverageFirst and Humana Value Plan
LM5
Non-Postal
Value Self & Family
Biweekly
196.55
Humana CoverageFirst and Humana Value Plan
LM6
Non-Postal
Value Self Plus One
Biweekly
211.8
Humana CoverageFirst and Humana Value Plan
S91
Non-Postal
CDHP Self
Biweekly
136.88
Humana CoverageFirst and Humana Value Plan
S92
Non-Postal
CDHP Self & Family
Biweekly
284.79
Humana CoverageFirst and Humana Value Plan
S93
Non-Postal
CDHP Self Plus One
Biweekly
296.12
Humana CoverageFirst and Humana Value Plan
S94
Non-Postal
Value Self
Biweekly
75.99
Humana CoverageFirst and Humana Value Plan
S95
Non-Postal
Value Self & Family
Biweekly
170.97
Humana CoverageFirst and Humana Value Plan
S96
Non-Postal
Value Self Plus One
Biweekly
163.37
Humana Employers Health Plan of Georgia, Inc.
CB4
Non-Postal
Standard Self
Biweekly
332.84
Humana Employers Health Plan of Georgia, Inc.
CB5
Non-Postal
Standard Self & Family
Biweekly
725.7
Humana Employers Health Plan of Georgia, Inc.
CB6
Non-Postal
Standard Self Plus One
Biweekly
717.43
Humana Employers Health Plan of Georgia, Inc.
DG4
Non-Postal
Standard Self
Biweekly
415.53
Humana Employers Health Plan of Georgia, Inc.
DG5
Non-Postal
Standard Self & Family
Biweekly
911.76
Humana Employers Health Plan of Georgia, Inc.
DG6
Non-Postal
Standard Self Plus One
Biweekly
895.25
Humana Employers Health Plan of Georgia, Inc.
DN4
Non-Postal
Standard Self
Biweekly
158.6
Humana Employers Health Plan of Georgia, Inc.
DN5
Non-Postal
Standard Self & Family
Biweekly
333.61
Humana Employers Health Plan of Georgia, Inc.
DN6
Non-Postal
Standard Self Plus One
Biweekly
342.78
Humana Employers Health Plan of Georgia, Inc.
Q71
Non-Postal
Basic Self
Biweekly
157.65
Humana Employers Health Plan of Georgia, Inc.
Q72
Non-Postal
Basic Self & Family
Biweekly
331.53
Humana Employers Health Plan of Georgia, Inc.
Q73
Non-Postal
Basic Self Plus One
Biweekly
340.77
Humana Employers Health Plan of Georgia, Inc.
RJ1
Non-Postal
Basic Self
Biweekly
81.15
Humana Employers Health Plan of Georgia, Inc.
RJ2
Non-Postal
Basic Self & Family
Biweekly
182.6
Humana Employers Health Plan of Georgia, Inc.
RJ3
Non-Postal
Basic Self Plus One
Biweekly
174.48
Humana Employers Health Plan of Georgia, Inc.
RM1
Non-Postal
Basic Self
Biweekly
120.62
Humana Employers Health Plan of Georgia, Inc.
RM2
Non-Postal
Basic Self & Family
Biweekly
248.2
Humana Employers Health Plan of Georgia, Inc.
RM3
Non-Postal
Basic Self Plus One
Biweekly
261.15
Kaiser Permanente - Georgia
F81
Non-Postal
High Self
Biweekly
110.39
Kaiser Permanente - Georgia
F82
Non-Postal
High Self & Family
Biweekly
228.75
Kaiser Permanente - Georgia
F83
Non-Postal
High Self Plus One
Biweekly
278.25
Kaiser Permanente - Georgia
F84
Non-Postal
Standard Self
Biweekly
69.31
Kaiser Permanente - Georgia
F85
Non-Postal
Standard Self & Family
Biweekly
156.64
Kaiser Permanente - Georgia
F86
Non-Postal
Standard Self Plus One
Biweekly
156.64
Kaiser Permanente - Georgia
LA1
Non-Postal
Prosper Self
Biweekly
46
Kaiser Permanente - Georgia
LA2
Non-Postal
Prosper Self & Family
Biweekly
119.42
Kaiser Permanente - Georgia
LA3
Non-Postal
Prosper Self Plus One
Biweekly
103.95
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV1
Non-Postal
Value Self
Biweekly
169.55
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV2
Non-Postal
Value Self & Family
Biweekly
669.09
UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced)
LV3
Non-Postal
Value Self Plus One
Biweekly
366.35
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS1
Non-Postal
High Self
Biweekly
75.1
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS2
Non-Postal
High Self & Family
Biweekly
177.63
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary
AS3
Non-Postal
High Self Plus One
Biweekly
161.48
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y81
Non-Postal
High Self
Biweekly
67.07
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y82
Non-Postal
High Self & Family
Biweekly
158.62
UnitedHealthcare Insurance Company, Inc. Choice Primary
Y83
Non-Postal
High Self Plus One
Biweekly
144.2
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service