Attachment 

BAL 05-405 October 13, 2005 

2005 Federal Employees Health Benefits (FEHB) Program Open Season: 

Significant Plan Changes
TABLE 1 

PLANS DROPPING OUT OF THE FEHB PROGRAM FOR 2006 

Enrollees in these terminating plans who do not change health plans during Open Season will not 

have health benefits for 2006: 

 

State Plan Name Codes 

California UHP Healthcare C41, C42 

Kentucky Humana Health Plan – Louisville D21, D22 

Nevada NevadaCare IF1, IF2 

Wisconsin PHP Insurance Plan – Prevea ID1, ID2 

TABLE 2 

PLANS DROPPING AN OPTION 

Enrollees in United Healthcare of Ohio’s Standard Option (Codes 3U4, 3U5) who do not change 

health plans during Open Season will automatically be enrolled in the Plan’s High Option Plan 

(Codes 3U1, 3U2), if they do not choose to make a positive enrollment in another plan during Open 

Season. 

State Plan Name Codes 

Ohio United Healthcare of Ohio – Standard Option 3U4, 3U5 

TABLE 3 

PLANS REDUCING THEIR SERVICE AREAS 

WITHOUT TERMINATING AN ENROLLMENT CODE 

Enrollees in the area being dropped who do not change health plans during Open Season will have 

to travel to their plan’s remaining service area to obtain medical care in order to receive full 

benefits from the plan in 2006. 

State Plan Name Codes Area Dropped 

California Universal Care 6Q1, 

6Q2 

San Diego County 

Georgia Aetna Open Access 2U1, 

2U2 

Dawson, Haralson, Heard, Lamar, 

Madison and Pike Counties 

Illinois Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Alexander and Montgomery Counties 

2
Minnesota Avera Health Plan AV1, 

AV2 

Cottonwood, Jackson, Lincoln, Murray, 

Nobles, Pipestone and Rock counties 

Minnesota Health Partners 

Classic 

531, 

532 

The following zip codes in Minnesota: 

56248, 56271, 56309 and 56311 

Texas Aetna Open Access P11, 

P12 

Williamson County, except for 

Georgetown, Round Rock and Taylor 

Virginia Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

City of Winchester 

TABLE 4 

NEW PLANS ENTERING THE PROGRAM FOR 2006 

State Plan Name Codes General Location 

Colorado United HealthCare – 

Colorado 

CH1, 

CH2 

Colorado 

Indiana M*Plan Indiana IN1, 

IN2 

Indiana 

Kansas United HealthCare – 

Midwest – Kansas City 

GX1, 

GX2 

Kansas City area 

Missouri United HealthCare –

Midwest – St. Louis 

B91, 

B92 

St. Louis area 

TABLE 5 

EXISTING PLANS OFFERING A HIGH DEDUCTIBLE HEALTH PLAN (HDHP) WITHOUT 

NEW ENROLLMENT CODES

State Plan Name Codes 

California Universal Care of California 6Q4, 6Q5 

New York Independent Health Association QA4, 

QA5 

Utah Altius Health Plan 9K4, 9K5 

Washington KPS Health Plan L14, L15 

TABLE 6 

EXISTING AND/OR NEW PLANS OFFERING HDHP WITH NEW ENROLLMENT CODES 

State Plan Name Codes 

Delaware Coventry Health Care HDHP LK1, LK2 

3
Georgia Kaiser of Georgia GW1, GW2 

Illinois Unicare HMO 721, 722 

Indiana Unicare HMO 721, 722 

Louisiana Coventry Health Care of Louisiana HDHP HB1, HB2 

Louisiana Coventry Health Care of Louisiana HDHP L31, L32 

Louisiana Coventry Health Care of Louisiana HDHP LT1, LT2 

Maryland Coventry Health Care HDHP GZ1, GZ2 

Massachusetts Fallon CHP DV1, DV2 

New Jersey Coventry Health Care HDHP LK1, LK2 

4
TABLE 7 

SERVICE AREA EXPANSIONS WITH NEW ENROLLMENT CODES 

State Plan Name New 

Codes 

General Location 

Colorado Humana 

CoverageFirst 

FC1, 

FC2 

Entire County of: El Paso 

Florida Humana 

CoverageFirst 

DL1, 

DL2 

City of: Daytona; Entire Counties of Flagler 

and Volusia 

Florida Humana 

CoverageFirst 

BP1, 

BP2 

Cities of: Pensacola/Ft. Walton; Entire 

Counties of: Escambia, Okaloosa, Santa Rosa 

and Walton 

Georgia Humana 

CoverageFirst 

AD1, 

AD2 

Cities of: Atlanta and Macon; Entire Counties 

of: Barrow, Barton, Cherokee, Clayton, Cobb, 

Coweta, Dekalb, Douglas, Fayette, Forsyth, 

Gulton, Gwinett, Hall, Newton, Paulding, 

Rockdale, Spalding, and Walton 

Georgia Humana 

CoverageFirst 

LM1, 

LM2 

Entire Counties of: Macon , Bibb, Houston, 

Jones, and Twiggs 

Indiana Humana 

CoverageFirst 

HZ1, 

HZ2 

City of Indianapolis; Entire Counties of: 

Boone, Hamilton, Hancock, Hendricks, 

Johnson, Madison, Marion, Morgan, and 

Shelby 

Louisiana Coventry 

HealthCare of 

Louisiana 

HS1,HS2 Entire Parrishes of: Bossier, Caddo, DeSoto 

Red River and Webster 

Louisiana Coventry Health 

Care of Louisiana 

L31, L32 Entire Parrishes of: Bossier, Caddo, DeSoto 

Red River and Webster 

Michigan Humana 

CoverageFirst 

BW1, 

BW2 

Entire Counties of: Macomb, Oakland, St. 

Clair and Wayne 

Michigan Humana 

CoverageFirst 

GT1, 

GT2 

Entire Counties of Allegan, Kent Muskegon 

and Ottawa 

Michigan Humana 

CoverageFirst 

FT1, 

FT2 

Entire counties of: Alcona, Alger, Alpena, 

Antrim, Arenac, Baraga, Barry, Bay, Benzie, 

Berrien, Branch, Calhoun, Cass, Cheboygan, 

Chippewa, Clinton, Delta, Dickinson, Eaton, 

Emmet, Genesee, Gogebic, Grand traverse, 

Gratiot, Hillsdale, Houghton, Huron, Ingham, 

Ionia, Iosco, Iron, Jackson, Kalamazoo, 

Kalkaska, Keweenaw, Lake, Lapeer, Leelanau, 

Lenawee, Livingston, Luce, Mackinac, 

Manistee, Marquette, Mason, Mecosta, 

Menominee, Missaukee, Monroe, Montcalm, 

Montmorency, Newaygo, Oceana, Ogemaw, 

5
Ontonagon, Osceola, Oscoda, Otsego, Presque 

Isle, and Roscommon 

Ohio United Healthcare 

of OH 

AK1, 

AK2 

City of: Cleveland 

Ohio United Healthcare 

of OH 

CA1, 

CA2 

City of: Columbus 

Tennessee Humana 

CoverageFirst 

BT1, 

BT2 

City of Nashville; Entire Counties of: Bedford, 

Cannon, Cheatham, Coffee, Davidson, 

DeKalb, Dickson, Franklin, Giles, Lewis, 

Macon, Montgomery, Moore, Robertson, 

Rutherford, Smith, Sumner, Trousdale, 

Williamson and Wilson 

TABLE 8 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Codes General Location of New Area 

Alabama Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties of: Choctaw and 

Sumter 

Arizona Humana CoverageFirst DB1, 

DB2 

City of Phoenix; Entire County of: 

Pinal 

Arkansas Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the Little Rock 

Area: Arkansas, Benton, Boone, 

Carroll, Cleburne, Columbia, 

Conway, Craighead, Crawford, 

Faulkner, Franklin, Garland, 

Grant, Hot Spring, Independence, 

Jackson, Jefferson, Johnson, 

Lawrence, Logan, Lonoke, Madison, 

Monroe, Ouachita, Perry, Poinsett, 

Pope, Prairie, Pulaski, Saline, Scott, 

Sebastian, Sharp, Stone, 

Washington, White, Woodruff, and 

Yell 

California Aetna HMO 2X1, 

2X2 

Town in the County of Riverside: 

Moreno Valley 

Colorado Aetna Open Access 9E1, 

9E2 

County in the Denver Area: Weld 

Colorado Humana CoverageFirst 7T1, 

7T2 

Entire Counties of: Boulder and 

Larimer 

Connecticut Aetna Open Access JC1, 

JC2 

Entire State of Connecticut 

6
Florida Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties of: Brevard, Indian 

River, Martin, Okeechobee, Palm 

Beach and St. Lucie. Entire 

Counties in the Florida Panhandle 

Area: Escambia, Holmes, Okaloosa, 

Santa Rosa, and Walton. Entire 

Counties in the Gainesville Area: 

Alachua, Bradford, Columbia, 

Gilchrist, Levy, Putnam, Suwannee 

and Union 

Georgia Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in Northwestern 

GA: Catoosa, Dade and Walker. 

Entire Counties in the Augusta Area: 

Burke, Columbia, Glascock, 

Jefferson, Lincoln, McDuffie, 

Richmond, Taliaferro, Warren and 

Wilkes. Entire Counties in the 

Savannah Area: Appling, Bryan, 

Bulloch, Candler, Chatham, 

Effingham, Evans, Liberty, Long 

and Tattnall 

Hawaii Kaiser of Hawaii 631, 

632, 

634, 

635 

Entire Island of: Kauai 

Idaho Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire County of: Kootenai 

Illinois Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in Eastern IL: Clark 

and Edgar; Entire Counties in 

Northern IL: Boone, Champaign, 

Fulton, Knox, LaSalle, Lee, 

Marshall, Ogle, Peoria, Tazewell, 

Vermillion, Winnebago, and 

Woodford 

TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Codes General Location of New Area 

Illinois Group Health Plan, Inc. MM1, 

MM2, 

MM4, 

MM5 

Counties in Illinois: Cass, Greene, 

Jackson, Jefferson, Macon, Marion, 

Moultrie, Perry, Randolph, Schuyler, 

Scott Shelby, Union, and 

Washington 

7
Illinois PersonalCare of Illinois GE1, 

GE2 

Following Counties in Illinois: Bond, 

Calhoun, Effington, LaSalle, Lee, 

Madison, Marshall, Montgomery, 

Monroe, Ogle, St. Clair, Stark, 

Stephenson, Washington, Whiteside, 

Winnebago and Woodford 

Indiana Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 225

Entire Counties in the Evansville 

Area: Gibson, Knox, Pike, Posey, 

Vanderburgh, and Warrick; Entire 

Counties in the Fort Wayne Area: 

Adams, Allen, Blackford, Cass, 

DeKalb, Huntington, Jay, Kosciusko, 

Lagrange, Miami, Noble, Steuben, 

Wabash, Wells and Whitley; Entire 

Counties in the Indianapolis Area: 

Benton, Boone, Brown, Carroll, 

Clay, Clinton, Decatur, Delaware, 

Fountain, Grant, Greene, Hamilton, 

Hancock, Hendricks, Henry, 

Howard, Johnson, Lawrence, 

Madison, Marion, Monroe, 

Montgomery, Morgan, Owen, Parke, 

Putnam, Randolph, Rush, Shelby, 

Sullivan, Tippecanoe, Tipton, 

Vermillion, Vigo, Warren and White; 

Entire Counties in Southeastern 

Indiana: Clark, Floyd, Harrison, 

Jefferson, Scott and Washington 

Indiana Physicians Health of Northern 

IN 

DQ1, 

DQ2 

Entire County of: St. Joseph 

Iowa Coventry Health Care of Iowa SV1, 

SV2, 

SV4, 

SV5 

Entire Counties of: Appanoose, 

Calhoun, Cedar, Davis, Decatur, 

Grundy, Iowa, Jones, Keokuk, 

Plymouth, Pocahontas, Sac, Scott 

and Webster 

Iowa HealthPartners Open Access 

Deductible 

534, 535 Portions of Iowa (Allamakee, Clay, 

Dickinson, Emmet, Howard, Lyon, 

Mitchell, O’Brien, Osceola, Palo 

Alto, Plymouth, Sioux, Winnebago, 

Winneshiek and Worth) 

Kansas Aetna HealthFund 

(CDHP/HDHP) 

221,222, 

224, 225

Entire County in Southeastern KS: 

Cherokee 

8
TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Codes General Location of New Area 

Kentucky Aetna 

HealthFund 

(CDHP/HDH

P) 

221, 

222, 

224, 225

Entire Counties of Western KY: Henderson and 

Union; Entire Counties of Eastern KY: Bell, 

Breathitt, Elliott, Floyd, Harlan, Johnson, Knott, 

Letcher, Magoffin, Morgan, Perry and Pike; Entire 

Counties in the Lexington Area: Anderson, 

Bourbon, Clark, Estill, Fayette, Franklin, Harrison, 

Jessamine, Madison, Owen, Robertson, Scott, and 

Woodford. Entire Counties in the Louisville Area: 

Breckinridge, Bullitt, Carroll, Hardin, Henry, 

Jefferson, Larue, Marion, Meade, Nelson, Oldham, 

Shelby, Spencer, Trimble and Washington 

Louisiana Aetna 

HealthFund 

(CDHP/HDH

P) 

221, 

222, 

224, 225

Entire Parishes in the Baton Rouge/Lafayette Areas: 

Acadia, Allen, Ascension, Assumption, Beauregard, 

Calcasieu, Cameron, East Baton Rouge, East 

Feliciana, Evangeline, Iberia, Iberville, Jefferson 

Davis, Lafayette, Livingston, Pointe Coupee, St. 

Helena, St. James, St. Landry, St. Martin, St. Mary, 

Tangipahoa, Vermilion, West Baton Rouge and 

West Feliciana. Entire Parishes in the New Orleans 

Area: Jefferson, Lafourche, Orleans, Plaquemines, 

St. Bernard, St. Charles, St. Tammany, St. John the 

Baptist, Terrebonne, and Washington. Entire 

Parishes in the Shreveport Area: Bienville, Bossier, 

Caddo, Claiborne, De Soto, Jackson, Lincoln, 

Natchitoches, Ouachita, Red River, Sabine, Union, 

Webster, and Winn. Entire Counties in Northeast 

LA: East Carroll, and Madison.

Louisiana Vantage 

Health Plan, 

Inc. 

MV1, 

MV2 

Parishes in the Alexandria Area: Beauregard, 

Catahoula, Concordia and Vernon 

Maine Aetna 

HealthFund 

(CDHP/HDH

P) 

221,222, 

224,225 

Entire State of Maine 

Michigan 

Aetna 

HealthFund 

(CDHP/HDH

P) 

221,222, 

224,225 

Entire Counties in Central/Western MI: Allegan, 

Barry, Bay, Calhoun, Clare, Clinton, Eaton, 

Gladwin, Gratiot, Hillsdale, Huron, Ingham, Ionia, 

Isabella, Jackson, Kalamazoo, Kent, Lake, Lenawee, 

Manistee, Midland, Montcalm, Muskegon, 

Newaygo, Oceana, Ottawa, Saginaw, St. Joseph, 

Tuscola, and Van Buren 
TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Code General Location of New Area 

Minnesota HealthPartners Classic 531, 

532 

New Zip Codes in Minnesota have 

been added: 54759, 55467, 55735 and 

56571 

Minnesota HealthPartners Open Access 

Deductible 

534, 

535 

Portions of Minnesota (Aitkin, Becker, 

Beltrami, Big Stone, Blue Earth, 

Brown, Cass, Chippewa, Clay, 

Clearwater, Cottonwood, Crow Wing, 

Dodge, Douglas, Faribault, Freeborn, 

Grant, Hubbard, Itasca, Jackson, 

Kanabec, Kandiyohi, Kittson, Lac Qui 

Parle, Lyon, Mahnomen, Marshall, 

Martin, Mower, Murray, Nicollet, 

Nobles, Norman, Otter Tail, 

Pennington, Pine, Pipestone, Polk, 

Pope, Red Lake, Redwood, Renville, 

Rock, Roseau, Sibley, Stevens, Swift, 

Todd, Traverse, Waseca, Watonwan, 

Wilkin, and Yellow Medicine) 

Mississippi Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the Gulfport Area: 

George, Hancock, Harrison, Jackson, 

and Stone. Entire Counties in the 

Jackson/Vicksburg Areas: Adams, 

Amite, Attala, Carroll, Claiborne, 

Clarke, Copiah, Covington, Forrest, 

Hinds, Holmes, Jefferson Davis, 

Jones, Lamar, Lauderdale, Lawrence, 

Leflore, Madison, Marion, Newton, 

Noxubee, Perry, Pike, Rankin, Scott, 

Simpson, Sunflower, Tallahatchie, 

Walthall, and Warren. 

Missouri Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the 

Columbia/Jefferson City Areas: Adair, 

Audrain, Boone, Callaway, Camden, 

Chariton, Cole, Cooper, Gasconade, 

Howard, Linn, Macon, Maries, Miller, 

Moniteau, Monroe, Montgomery, 

Morgan, Osage, Pettis, Phelps, 

Pulaski, Putnam, Randolph, Saline, 

Scotland, and Sullivan. Entire 

Counties in the Joplin Area: Barton, 

Jasper, McDonald, and Newton. 

Entire Counties in the Springfield 

Area: Christian, Dade, Dallas, Greene, 

Lawrence, Polk, and Webster 

10
Missouri Group Health Plan MM1, 

MM2, 

MM4, 

MM5 

Following Counties in Missouri: 

Boone, Cole, Montgomery, St. Francis 

and Washington 

Montana New West Health Services NV1, 

NV2 

City of Bozeman 

TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Codes General Location of New Area 

Nebraska Avera Health Plans AV1, 

AV2 

Following Counties in Nebraska 

have been added: Boyd, Cedar, Holt 

and Knox 

Nebraska Coventry HealthCare of 

Nebraska 

IE1, 

IE2 

Entire counties of Nebraska: Arthur, 

Blaine, Buffalo, Chase, Clay, Colfax, 

Custer, Dawson, Dundy, Franklin, 

Frontier, Furnas, Gage, Garden, 

Garfield, Gosper, Grant, Greely, 

Hamilton, Hayes, Hitchcock, Holt, 

Hooker, Kearney, Keith, Lincoln, 

Logan, Loup, McPherson, Nance, 

Nuckolls, Perkins, Phelps, Platte, 

Red Willow, Rock, Seward, 

Sherman, Thayer, Thomas, Valley, 

Wheeler and York 

New Jersey GHI Health Plan – Standard 

Option 

804, 

805 

Portions of Northern New Jersey 

North 

Carolina 

Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the WinstonSalem (Triad) Area: Davidson, 

Davie, Forsyth, Guilford, Randolph, 

Rockingham, Stokes, Surry and 

Yadkin 

 North 

Dakota 

HealthPartners Open Access 

Deductible 

534, 

535 

Portions of North Dakota (Barnes, 

Cass, Grand Forks, LaMoure, 

Pembina, Ransom, Richland, 

Sargent, Steele, Stutsman and Traill) 

Ohio United Healthcare of Ohio 3U1, 

3U2 

Cities of: Cleveland and Columbus 

Oklahoma GlobalHealth IM1, 

IM2 

Following Counties in Oklahoma: 

Canadian, Cleveland, Creek, 

Lincoln, Logan, Mayes, Oklahoma, 

Osage, Pottowatomie, Rogers, Tulsa 

and Wagoner 

11
Pennsylvania Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in Central PA: 

Adams, Cumberland, Dauphin, 

Franklin, Fulton, Lancaster, 

Lebanon, Perry, Schuylkill, and 

York. Entire Counties in The Lehigh 

Valley Area: Lehigh, and 

Northampton. Entire Counties in 

Northeastern PA: Bradford, Carbon, 

Clinton, Columbia, Lackawanna, 

Luzerne, Lycoming, 

Northumberland, Pike, Snyder, 

Sullivan, Susquehanna, Wayne, and 

Wyoming 

Pennsylvania HealthAmerica 261, 

262, 

264, 

265 

Bedford County 

12
TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Code

s 

General Location of New Area 

South 

Caroli

na 

Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties of: Aiken, Barnwell and 

Edgefield 

South 

Dakot

a 

HealthPartners Open Access 

Deductible 

534, 

535 

Portions of South Dakota (Bon Homme, 

Brookings, Brule, Charles Mix, Clay, 

Codington, Day, Deuel, Douglas, Grant, 

Gregory, Hamlin, Hutchinson, Kingsbury, 

Lake Lincoln, McCook, Minnehaha, 

Moody, Roberts, Tripp, Turner, Union and 

Yankton). 

Tenne

ssee 

Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the Chattanooga Area: 

Bradley, Hamilton, Marion, Meigs and 

Sequatchie. Entire Counties in the Jackson 

Area: Chester, Crockett, Decatur, Gibson, 

Hardeman, Haywood, Henderson, and 

Madison. Entire Counties in the Knoxville 

Area: Anderson, Blount, Cocke, Grainger, 

Hamblen, Jefferson, Knox, Loudon, 

Morgan, Roane, Sevier and Union. Entire 

Counties in the Tri-Cities Area: Carter, 

Greene, Hancock, Hawkins, Johnson, 

Sullivan, Unicoi and Washington 

Texas Aetna HealthFund 

(CDHP/HDHP 

221, 

222, 

224, 

225 

Entire Counties in the Abilene Area: Jones 

and Taylor. Entire Counties in the 

Brownwood Area: Bosque, Brown, 

Coleman, Comanche, Hamilton and Mills. 

Entire Counties in the Bryan/College 

Station Areas: Brazos, Burleson, Madison, 

Milam, Robertson and Washington. Entire 

Counties in the Victoria Area: Calhoun, 

Jackson and Victoria. Entire Counties in 

the Corpus Christi Area: Aransas, Bee, 

Duval, Jim Wells, Kleberg, Live Oak, 

Nueces and San Patricio. Entire County in 

the El Paso Area: El Paso. Entire Counties 

in the Hill Country Area: Blanco, Edwards, 

Gillespie, Kerr, Kimble, Llano, Mason, Real 

and San Saba. Entire Counties in the 

Karnes City Area: Goliad, Gonzales, 

Karnes, Lavaca and Refugio. Entire 

Counties in the Laredo Area: Brooks, 

Dimmit, Frio Jim Hogg, Kenedy, Kinney, 

13
La Salle Maverick, McMullen, Uvalde, 

Webb, Zapata and Zavala. Entire Counties 

in the Rio Grande Valley Area: Cameron, 

Hidalgo, Starr and Willacy. Entire Counties 

in Western Texas: Brewster, Crockett, 

Culberson, Hudspeth, Jeff Davis, Loving, 

Pecos, Presidio, Reeves, Sutton, Terrell, Val 

Verde, Ward and Winkler 

TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Code

s 

General Location of New Area 

Texas Aetna Open Access P11, 

P12 

County in the Austin/San Antonio Area: 

Caldwell 

Virginia Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties and Cities in the Hampton 

Roads/Norfolk Area: 

Chesapeake City, Essex, Franklin City, 

Gloucester, Hampton City, Isle of Wight, 

James City, King and Queen, Lancaster, 

Mathews, Middlesex, Newport News City, 

Norfolk City, Northumberland, Poquoson 

City, Portsmouth City, Southampton, 

Suffolk City, Surry, Sussex, Virginia Beach 

City, Williamsburg City, and York. Entire 

counties and Cities in the Roanoke Area: 

Alleghany, Bedford, Bland, Botetourt, 

Buchanan, Carroll, Covington City, Craig, 

Dickenson, Floyd, Franklin, Galax City, 

Giles, Grayson, Henry, Lee, Martinsville 

City, Montgomery, Norton City, Patrick, 

Pulaski, Radford, Roanoke, Roanoke City, 

Russell, Salem, Smyth, Tazewell, Wise, and 

Wythe. Entire Counties and City in 

Southwestern VA: Bristol City, Scott, and 

Washington 

Virginia Optima Health Plan 9R1, 

9R2 

Richmond Area: the city of Petersburg as 

well as the counties of Amelia, Brunswick, 

Caroline, Chesterfield, Cumberland, 

Dinwiddie, Essex, Fluvanna, Goochland, 

Greensville, Hanover, Henrico, King and 

Queen, Lancaster, Louisa, Lunenberg, 

Mecklenburg, Middlesex, Northumberland, 

Nottoway, Powhatan, Prince Edward, 

Prince George, Richmond, Sussex and 

Westmoreland. 

14
Washing

ton 

Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties in the Eastern WA 

(Spokane) Area: Adams, Asotin, Benton, 

Chelan, Columbia, Douglas, Ferry, 

Franklin, Garfield, Grant, Kittitas, Lincoln, 

Okanogan, Pend Oreille, Spokane, Stevens, 

Walla Walla, Whitman and Yakima 

Washing

ton 

Aetna Open Access 8J1, 

8J2 

Counties in the Seattle and Puget Sound 

Areas: Clallam, Lewis, Skagit, Thurston and 

Walla Walla 

TABLE 8 (Continued) 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name Code

s 

General Location of New Area 

West 

Virgini

a 

Aetna HealthFund 

(CDHP/HDHP) 

221, 

222, 

224, 

225 

Entire Counties of: Barbour, Berkeley, 

Boone, Braxton, Brooke, Cabell, Calhoun, 

Clay, Doddridge, Fayette, Gilmer, 

Greenbrier, Hancock, Harrison, Jackson, 

Jefferson, Kanawha, Lewis, Lincoln, Logan, 

Marion, Marshall, Mason, McDowell, 

Mercer, Mingo, Monongalia, Monroe, 

Nicholas, Ohio, Pleasants, Preston, Putnam, 

Raleigh, Ritchie, Roane, Summers, Tyler, 

Upshur, Wayne, Wetzel, Wirt, Wood, and 

Wyoming 

Wiscon

sin 

HealthPartners Open Access 

Deductible 

534, 

535 

Entire Counties of: Barron, Burnett, 

Chippewa, Crawford, Douglas, Eau Claire, 

Jackson, Monroe, Trempeleau , Vernon and 

Washburn 

TABLE 9 

PLAN NAME CHANGES 

State Plan Name (Old) Code(s) Plan Name (New) 

Nationwide Aetna 2U1, 2U2, 

2X1, 2X2, 

6J1, 6J2, 7D1, 

Aetna Open Access 

15
7D2, 8G1, 

8G2, 8J1, 8J2, 

9E1, 9E2, 

IK1, IK2, JC1, 

JC2, JR1, JR2, 

KS1, KS2, 

ND1, ND2, 

P11, P12, P31, 

P32, PU1, 

PU2, RD1, 

RD2, SL1, 

SL2, UB1, 

UB2, WQ1, 

WQ2, Y11, 

Y12, YE1, 

YE2 

Massachusetts Blue Chip 

Coordinated Health 

Partners 

DA1, DA2 Blue Cross and Blue 

Shield of Rhode Island 

Rhode Island Blue Chip 

Coordinated Health 

Partners 

DA1, DA2 Blue Cross and Blue 

Shield of Rhode Island 

16
TABLE 10 

PLANS ADDING A NEW STANDARD OPTION 

Enrollees who do not choose the Standard Option will automatically be enrolled in the High 

Option. 

State Plan Name Code(s

) 

Connecticut ConnectiCare TE4, 

TE5 

Delaware Coventry Health Care 2J4, 

2J5 

Illinois Unicare HMO 174, 

175 

Indiana Unicare HMO 174, 

175 

Louisiana Coventry Health Care of Louisiana BJ4, 

BJ5, 

JA4, 

JA5, 

HS4, 

HS5 

Maryland Coventry Health Care IG4, 

IG5 

Michigan BlueCare Network of Michigan K54, 

K55, 

KR4, 

KR5, 

LN4, 

LN5, 

LX4, 

LX5 

New Jersey Coventry Health Care 2J4, 

2J5 

New York CDPHP SG4, 

SG5 

New York Vytra Health Plan J64, 

J65 

Ohio Kaiser Foundation Health Plan of Ohio 644, 

645 

Pennsylvania Keystone Health Plan Central – Harrisburg S44, 

S45 

17
 

TABLE 11 

PLANS SPLITTING A SERVICE AREA 

In 2006, enrollment codes P31, P32 will cover Southern New Jersey (Counties of: Atlantic, Burlington, 

Camden, Cape May, Cumberland, Gloucester, Mercer and Salem) and Southeast Pennsylvania only. 

Enrollment Code JR1, JR2 will cover the Northern New Jersey Area to include: Bergen, Essex, Hudson, 

Hunterdon, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, Sussex, Union and Warren. If you 

live and/or work in the Northern New Jersey Area and want to remain in this plan, you must change to the 

new enrollment code JR1, JR2 or select another health plan during Open Season. 

State Plan 

Name 

General Location Codes 

(2005) 

Codes 

(2006) 

New 

Jerse

y 

Aetna 

Open 

Access 

Entire Counties in the Northern New Jersey 

Area: Bergen, Essex, Hudson, Hunterdon, 

Middlesex, Monmouth, Morris, Ocean, 

Passaic, Somerset, Sussex, Union and 

Warren 

P31, 

P32 

JR1, 

JR2 

 

TABLE 12 

SERVICE AREA MOVEMENT 

Kaiser Foundation Health Plan of California – Plan Codes 621, 622, 624 and 625, which serves the 

Southern California Area will move two Zip Codes in Tulare County: 93238 and 93261 to its Northern 

California Plan – Plan Codes 591, 592, 594 and 595. 

Southern California members enrolled in Plan Codes 621, 622, 624 and 625 who live in Zip Codes 93238 

or 93261must make a positive Open Season change to enroll in the Kaiser Northern California - Plan 

Codes 591, 592, 594 and 595 or elect another health plan during the open season. Southern California 

members will not be transferred automatically to the Northern California Plan – Code 591, 592, 

594 and 595. 

State Plan Name Codes 

(2005) 

Codes 

(2006) 

General Location 

California Kaiser 

Foundation 

Health Plan of 

California 

621, 622, 

624, 625 

591, 592, 

594, 595, 

Tulare County Zip Codes: 

93238 and 93261 

18