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2019 Plan Information for Utah
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
164.93
Aetna Direct
225
Non-Postal
HDHP Self & Family
Monthly
363.8
Aetna Direct
226
Non-Postal
HDHP Self Plus One
Monthly
360.1
Aetna Direct
N61
Non-Postal
CDHP Self
Monthly
139.33
Aetna Direct
N62
Non-Postal
CDHP Self & Family
Monthly
351.38
Aetna Direct
N63
Non-Postal
CDHP Self Plus One
Monthly
305.56
Aetna HealthFund CDHP and Aetna Value Plan
G51
Non-Postal
CDHP Self
Monthly
286.42
Aetna HealthFund CDHP and Aetna Value Plan
G52
Non-Postal
CDHP Self & Family
Monthly
652.69
Aetna HealthFund CDHP and Aetna Value Plan
G53
Non-Postal
CDHP Self Plus One
Monthly
706.59
Aetna HealthFund CDHP and Aetna Value Plan
G54
Non-Postal
Value Self
Monthly
171.86
Aetna HealthFund CDHP and Aetna Value Plan
G55
Non-Postal
Value Self & Family
Monthly
397.67
Aetna HealthFund CDHP and Aetna Value Plan
G56
Non-Postal
Value Self Plus One
Monthly
439.18
Altius Health Plans
9K1
Non-Postal
High Self
Monthly
436.52
Altius Health Plans
9K2
Non-Postal
High Self & Family
Monthly
930.07
Altius Health Plans
9K3
Non-Postal
High Self Plus One
Monthly
981.19
Altius Health Plans
9K4
Non-Postal
HDHP Self
Monthly
126.73
Altius Health Plans
9K5
Non-Postal
HDHP Self & Family
Monthly
264.85
Altius Health Plans
9K6
Non-Postal
HDHP Self Plus One
Monthly
259.66
Altius Health Plans
DK4
Non-Postal
Standard Self
Monthly
213.72
Altius Health Plans
DK5
Non-Postal
Standard Self & Family
Monthly
435.11
Altius Health Plans
DK6
Non-Postal
Standard Self Plus One
Monthly
491.11
SelectHealth, Inc.
SF1
Non-Postal
High Self
Monthly
545.74
SelectHealth, Inc.
SF2
Non-Postal
High Self & Family
Monthly
1242.35
SelectHealth, Inc.
SF3
Non-Postal
High Self Plus One
Monthly
1313.95
SelectHealth, Inc.
SF4
Non-Postal
Standard Self
Monthly
154.8
SelectHealth, Inc.
SF5
Non-Postal
Standard Self & Family
Monthly
352.81
SelectHealth, Inc.
SF6
Non-Postal
Standard Self Plus One
Monthly
352.81
SelectHealth, Inc.
WX1
Non-Postal
HDHP Self
Monthly
126.73
SelectHealth, Inc.
WX2
Non-Postal
HDHP Self & Family
Monthly
288.83
SelectHealth, Inc.
WX3
Non-Postal
HDHP Self Plus One
Monthly
288.83
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service
