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  • Rates
  • Changes for 2023
  • Summary of Benefits
A Health Maintenance Organization (High Option)

This plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See FEHB Facts for details. This Plan is accredited. See Section 1.

Serving: Arizona, California, Georgia, and Pennsylvania.

Enrollment in this plan is limited. You must live or work in our geographic service area to enroll. See Section 1 for requirements.

Enrollment codes for Phoenix & Tucson, AZ:
WQ1 Self Only
WQ3 Self Plus One
WQ2 Self and Family

Enrollment codes for Los Angeles & San Diego, CA:
2X1 Self Only
2X3 Self Plus One
2X2 Self and Family

Enrollment codes for Athens & Atlanta, GA:
2U1 Self Only
2U3 Self Plus One
2U2 Self and Family

Enrollment codes for Pittsburgh & Western PA:
YE1 Self Only
YE3 Self Plus One
YE2 Self and Family


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