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    2017 Plan Information for Louisiana 
    
        Choose a Location, Employee Type, & Payment Period  
        
                    Alabama 
                    Alaska 
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                    District of Columbia 
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                    Rhode Island 
                    South Carolina 
                    South Dakota 
                    Tennessee 
                    Texas 
                    Utah 
                    Vermont 
                    Virgin Islands 
                    Virginia 
                    Washington 
                    West Virginia 
                    Wisconsin 
                    Wyoming 
                    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 
                            138.7 
                         
                        
                            Aetna Direct  
                            225 
                            Non-Postal 
                            HDHP Self & Family 
                            Monthly 
                            305.95 
                         
                        
                            Aetna Direct  
                            226 
                            Non-Postal 
                            HDHP Self Plus One 
                            Monthly 
                            299.95 
                         
                        
                            Aetna Direct  
                            N61 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            120.05 
                         
                        
                            Aetna Direct  
                            N62 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            302.77 
                         
                        
                            Aetna Direct  
                            N63 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            263.29 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F51 
                            Non-Postal 
                            CDHP Self 
                            Monthly 
                            236.68 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F52 
                            Non-Postal 
                            CDHP Self & Family 
                            Monthly 
                            540.15 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F53 
                            Non-Postal 
                            CDHP Self Plus One 
                            Monthly 
                            587.71 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F54 
                            Non-Postal 
                            Value Self 
                            Monthly 
                            139.84 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F55 
                            Non-Postal 
                            Value Self & Family 
                            Monthly 
                            320.21 
                         
                        
                            Aetna HealthFund CDHP and Aetna Value Plan 
                            F56 
                            Non-Postal 
                            Value Self Plus One 
                            Monthly 
                            313.93 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            280.04 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            616.07 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            603.78 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE4 
                            Non-Postal 
                            Standard Self 
                            Monthly 
                            190.21 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE5 
                            Non-Postal 
                            Standard Self & Family 
                            Monthly 
                            413.99 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            AE6 
                            Non-Postal 
                            Standard Self Plus One 
                            Monthly 
                            410.71 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            186.74 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            406.17 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            403.24 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC4 
                            Non-Postal 
                            Standard Self 
                            Monthly 
                            142.96 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC5 
                            Non-Postal 
                            Standard Self & Family 
                            Monthly 
                            321.67 
                         
                        
                            Humana Health Benefit Plan of Louisiana, Inc. 
                            BC6 
                            Non-Postal 
                            Standard Self Plus One 
                            Monthly 
                            307.37 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            LS1 
                            Non-Postal 
                            HDHP Self 
                            Monthly 
                            115.28 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            LS2 
                            Non-Postal 
                            HDHP Self & Family 
                            Monthly 
                            288.2 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) 
                            LS3 
                            Non-Postal 
                            HDHP Self Plus One 
                            Monthly 
                            247.85 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            KK1 
                            Non-Postal 
                            High Self 
                            Monthly 
                            139.64 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            KK2 
                            Non-Postal 
                            High Self & Family 
                            Monthly 
                            349.1 
                         
                        
                            UnitedHealthcare Insurance Company, Inc. (Choice Open Access)  
                            KK3 
                            Non-Postal 
                            High Self Plus One 
                            Monthly 
                            300.22 
                         
                 
            
         
 
				 
			 
		 
		
		
			
				
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