Civil Service Federal Employees Federal Employees Federal Employees

Retirement Group Life Health Benefits Retirement

System Insurance Program System

United States

Office of Personnel Management

Retirement and Insurance Service

Benefits Administration Letter

Number: 97-403 Date: October 7, 1997 

Subject: 1997 Federal Employees Health Benefits (FEHB) Program Open Season:

Significant Plan Changes 

PURPOSE

This letter transmits lists of significant events affecting certain health plans during the

upcoming FEHB open season. Please note that some of these events will require action on the

part of agencies and enrollees.

TERMINATIONS

Attachment 1: Plans Dropping Out of FEHB for 1998

Attachment 2: Plans Reducing Their Service Areas by Terminating an Enrollment Code

1. What must employees do? Employees in these terminating plans/codes must

choose a new health plan during open season. Employees who do not choose a new

health plan will be considered to have cancelled their coverage and will not have health

benefits for 1998.

2. New Coverage. Coverage under an enrollee's new health plan will be effective the

first day of the first pay period beginning on or after January 1, 1998; for most

employees this will be January 4. Enrollees will remain covered and receive benefits

under the old plan until coverage under the new plan becomes effective.

3. Plan Notification. The plans in Attachments 1 and 2 are supposed to notify their

enrollees of the need to select a new health plan for 1998. However, some plans'

enrollment and address lists may not be up to date.

4. What must agencies do? Agencies must notify employees in these terminating

plans and enrollment codes of the need to select a new health plan to avoid losing

coverage. This is especially important since many employees will not receive a copy
Benefits Administration Letter 97-403 2

of the FEHB Guide and will therefore be unable to check the comparison chart to see if

their plan will still be participating in 1998.

We strongly recommend that you notify your employees by distributing copies of these

lists to each employee, along with your agency's notice to employees about open

season.

We also recommend that, before the end of open season, you follow up with employees

in these plans who have not made a new election and remind them to select a new

health plan.

5. Belated Changes. Despite these precautions, there are likely to be some

employees who do not get the word to change plans during open season. We

encourage you to be liberal in using your authority to accept belated open season

changes from employees enrolled in a terminating health plan/enrollment code.

SERVICE AREA REDUCTIONS

Attachment 3: Plans Significantly Reducing Their Service Area Without 

Terminating an Enrollment Code

Enrollees in the service areas being terminated should consider choosing a new plan for

1998. Enrollees who do not choose a new plan during open season will have to travel

to the plan's remaining service area to obtain medical care in order to receive full

benefits from the plan.

Attachment 4: Partial Service Area Transfers

Attachment 5: Plans Splitting a Service Area

Enrollees in plans covered by Attachments 4 and 5 should consider changing their code

(or plan) during open season. Otherwise they will have to travel to the area served by

their enrollment code to obtain medical care to receive full benefits from the plan. 

Agency Action Required. You may wish to distribute a copy of this list to each 

employee, along with your agency's notice to employees about open season. If you don't

distribute the list, remind employees to check their new health plan brochures carefully to see

if there have been any changes to their plans' service areas that will affect them.

OTHER SERVICE AREA CHANGES

Attachment 6: Service Area Consolidations

These plans are consolidating service areas; i.e., changing from two or more

enrollment areas to one. The service areas will remain the same, but they will be

included under one enrollment code. Enrollees in the "departing" enrollment codes

will be transferred automatically to the remaining enrollment code.
Benefits Administration Letter 97-403 3

ADDITIONS AND EXPANSIONS

Attachment 7: New Plans Entering the Program for 1998

Attachment 8: Service Area Expansions With a New Enrollment Code

Attachment 9: Significant Service Area Expansions Without New Enrollment Codes

Agency Action Required. Be sure to include these new plans and expanded service

areas when you count the number of eligible employees and place your orders for

brochures.

MISCELLANEOUS CHANGES

Attachment 10: Plan Mergers

1. These plans are merging with another plan at the end of 1997. Enrollees in the

"old" plans will be transferred automatically to the "new" plan and need take no action. 

Any enrollees in the old plans who do not wish to be transferred to the new plan must

choose a different plan during open season.

2. Please note that, in addition to merging, the Aetna and US Healthcare plans are

changing their name to Aetna US Healthcare.

Attachment 11: Plan Name Changes.

Attachment 12: Enrollment Code Changes

These plans have changed their enrollment codes. Enrollees in these plans will be

transferred automatically to the new enrollment codes. 

Attachment 13: Plans Adding a Point of Service Product

These existing plans are adding a point of service product for 1998.

Attachment 14: Plans Dropping a Point of Service Product

These plans are dropping a point of service product for 1998. Individuals who

enrolled in these plans primarily to have access to POS may want to consider changing

to new plans during open season.

 Abby L. Block, Chief

 Insurance Policy 

 and Information Division

Attachments
Benefits Administration Letter 97-403 4

 ATTACHMENT 1

PLANS DROPPING OUT OF FEHB FOR 1998

Employees in these plans who do not change health plans during open season will not

have health benefits for 1998.

Plan Name Code General Location

HMOBlue 6C Tennessee

Atrium Health Plan CV Western/Northwestern Wisconsin

QualMed Plans for Health MT Southern Colorado

Principal Louisiana RP New Orleans/River Region areas

Advantage Health Plan 1A, 2A Louisiana

Principal HC Carolinas 1P Charlotte, NC area; York County, SC

Principal HC Indiana XE Indianapolis/Ft. Wayne/

S.Bend/Evansville areas

CIGNA HC of Pennsylvania XU Bucks/Chester/Delaware,

Montgomery/Phila.

Principal HC of Delaware WS Delaware

Principal HC of Florida 2Z Jacksonville/Miami/Tampa/Orlando

C2 Pensacola, FL; Mobile/Southern

Alabama

PCA Health Plans of AL WV, Alabama

XS, XY

United HealthCare of AL NY, Alabama

NJ,

NL

MetraHealth of Louisiana X7 New Orleans area

MetraHealth of Georgia WE Atlanta area

PACC HMO 2P Oregon and Washington

CIGNA HC of North Carolina XP, U1 Raleigh and Charlotte areas

Queen's Island Care F9 Hawaii/Kauai/Maui/Oahu

Healthsource CMHC J1 Massachusetts

Healthsource North Texas 6H Fort Worth area

US Healthcare 1U Northern/Southeastern Virginia
Benefits Administration Letter 97-403 5

Plan Name Code General Location

Prudential HealthCare HMO 9C Colorado

HMO Arizona BlueSelect 5T, 5V Arizona

Healthsource Maine MY Maine

Healthsource Kentucky 8H Kentucky
Benefits Administration Letter 97-403 6

ATTACHMENT 2

PLANS REDUCING THEIR SERVICE AREA

BY TERMINATING AN ENROLLMENT CODE

Enrollees in these enrollment codes who do not change health plans during open season

will not have health benefits for 1998.

Plan Name Code Area Dropped

United HC of Florida 1X Pensacola area

United HealthCare of Louisiana S6 New Orleans area

(formerly Community Health

Network of Louisiana)

HMO Health Ohio MD Northwest/Southwest regions

Principal HC of Kansas City N3 Missouri counties of Cass, Clay, Clinton,

Dekalb, Henry, Jackson, Johnson,

Lafayette, Platte, and Ray; Kansas

counties of Douglas, Franklin, Jackson,

Jefferson, Johnson, Leavenworth, Miami,

Shawnee, and Wyandotte
Benefits Administration Letter 97-403 7

ATTACHMENT 3

PLANS SIGNIFICANTLY REDUCING THEIR SERVICE AREA

WITHOUT TERMINATING AN ENROLLMENT CODE

Enrollees in the areas being dropped who do not change health plans during open season

will have to travel to the plan's remaining service area to obtain medical care in order to

receive full benefits from the plan for 1998.

Plan Name Code Area Dropped

United HealthCare of TN QR Nashville area

FHP New Mexico P2 San Juan County

PacifiCare of Oregon SS Douglas, Josephine, and Lincoln counties

Care Choices KZ Michigan counties of Clinton, Eaton, Ingham,

Monroe, and Shiawassee

PacifiCare of Texas GF Austin, Brazoria, Brazos, Chambers,

(Formerly FHP of Texas, code Colorado, Grimes, Hardin, Jasper, Jefferson,

4F) Liberty, Matagorda, Newton, Orange, Polk,

San Jacinto, Tyler, Walker, Waller,

Washington, and Wharton counties

United HealthCare of MS QV Southern-most MS counties of Pearl River,

Stone, George, Hancock, Harrison, and

Jackson

PacifiCare of Washington WB Adams, Lincoln, and Grant counties

Carelink 4C West Virginia counties of Barbour,

Doddridge, Harrison, Lewis, McDowell,

Mercer, Monongalia, Pocahontas, Preston,

Taylor, Upshur, and Webster

United HealthCare Choice VB Missouri counties of Barry, Christian,

Greene, Howell, Lawrence, McDonald,

Taney, and Webster

United HealthCare Select H8 Missouri counties of Barry, Cass, Christian,

Clay, Dade, Dallas, Greene, Jackson, Jasper,

Johnson, Lafayette, Lawrence, McDonald,

Newton, Platte, Stone, and Webster 

Unity Health Plans W4 The Wisconsin counties of Monroe and

Outagamie

BCI HMO 3B The Illinois county of Vermilion 
Benefits Administration Letter 97-403 8

ATTACHMENT 4

PARTIAL SERVICE AREA TRANSFERS

FROM ONE EXISTING ENROLLMENT CODE

TO ANOTHER EXISTING ENROLLMENT CODE

Enrollees in these areas who do not change codes during open season will have to travel

to the area served by their enrollment code to obtain medical care in order to receive full

benefits from the plan.

Plan Name Code Part Being Transferred New Code

Foundation Health, A Florida 5C Palm Beach County 5E

Health Plan

Foundation Health, A Florida 5C Martin, St. Lucie, Charlotte, 5D

Health Plan and Lee counties
Benefits Administration Letter 97-403 9

ATTACHMENT 5

PLANS SPLITTING A SERVICE AREA

Enrollees in these plans under the 1997 enrollment codes shown below should check their

plan brochures to determine which 1998 code they should be under. Enrollees in these

1997 enrollment codes who should change, but do not, will have to travel to the area

served by their enrollment code to obtain medical care in order to receive full benefits

from the plan.

Plan Name 1997 Code 1998 Code

Humana Medical Plan - P5 (Orlando/Jacksonville) P5 (Orlando)

Florida 7F (Jacksonville)
Benefits Administration Letter 97-403 10

ATTACHMENT 6

 SERVICE AREA CONSOLIDATIONS--

TRANSFERRING TWO OR MORE ENROLLMENT CODES INTO ONE

Enrollees in the enrollment code(s) being dropped will be transferred automatically to the

remaining enrollment code unless they choose a different health plan during open season.

Plan Name Code(s) Being Dropped Remaining Code

HMO Blue ZK, ZL GM

Heritage National HP 3T 4T

Heritage National HP 3I, 3K, 3L, 3X 3J (except that enrollees

in code 3X will be

transferred to code 4T,

above, unless they

change plans)

WellCare of New York ZV X4

United HealthCare of Louisiana S8 RY

(formerly Community Health

Network of Louisiana)

SecureCare of Iowa 3S 3Q

HMO-CNY CE, 4E EB

Healthkeepers (formerly HMO V7, 4V X8

Virginia)

Keystone Blue ZT, ZU EF

Keystone Health Plan Central ST, Z3 S4

HealthAmerica Pennsylvania 1N 26

PacifiCare of Oklahoma N1 2N

Aetna US Healthcare ZY (Baltimore, MD area) V8

(formerly Aetna HP Mid-Atlantic)

Partners HMO ZM RN
Benefits Administration Letter 97-403 11

ATTACHMENT 7

NEW PLANS ENTERING THE PROGRAM FOR 1998

State Plan Name Code General Location

PR United HealthCare of Puerto 7U All of Puerto Rico

Rico

TN American Medical Security 4U Knoxville, Nashville, and Memphis

Health Plan areas

TX Certus HealthCare 3Y Aransas, Bee, Cameron, Hidalgo, Jim

Wells, Kleberg, Nueces, and San

Patricio counties.

LA Vantage Health Plan 7V Caldwell, East Carroll, Franklin,

Jackson, Lincoln, Madison,

Morehouse, Ouachita, Richland,

Tensas, Union, West Carroll, and

Winn parishes

TX WellChoice 3Z San Antonio area

OK CommunityCare HMO 7C South central Oklahoma

NC QualChoice-North Carolina 7Q Northwestern NC

FL Beacon Health Plans 4K Palm Beach, Dade, Broward,

Seminole, Orange, and Osceola

counties

WI North Central Health Protection 8R Central/Northcentral WI

Plan

WI Green Bay Health Protection 4L Northeast WI

Plan

IL OSF Health Plans 9F Boone, Bureau, DeKalb, Fulton,

Henderson, Henry, Kane, Knox,

LaSalle, Livingston, McDonough,

McHenry, McLean, Mercer, Ogle,

Peoria, Stark, Stephenson, Tazewell,

Warren, Winnebago, and Woodford

counties

OH HealthAssurance HMO 5X Belmont, Jefferson, Mahoning, and

Trumbull counties
Benefits Administration Letter 97-403 12

State Plan Name Code General Location

WV HealthAssurance HMO 6L Barbour, Brooke, Doddridge,

Hancock, Harrison, Lewis, Marion,

Marshall, Monongalia, Ohio,

Preston, Taylor, Upshur, and Wetzel

counties

ME NYLCare Health Plans - ME 9M All of Maine

AL VIVA Health Plan 4B Birmingham area

AR QCA Health Plan 8Q Little Rock area

TN Aetna US Healthcare 6J Nashville/middle TN areas

TX Aetna US Healthcare 5B Houston/San Antonio areas

FL Aetna US Healthcare 8A Tampa Bay/Jacksonville/Orlando

areas

NJ Physicians Health Services of 7B All of New Jersey

NJ

MS Integrity Hlth Plan of MS 4G Central/Northern Mississippi

OH SummaCare 5W Northern Ohio

WV Super Blue HMO 8T The cities of Charleston,

Parkersburg, Morgantown, Beckley,

Clarksburg, Wheeling, Lewiston,

Freemont, and Bluefield

OK Foundation Health 6G Most of Oklahoma

WA First Choice Health Plan 5G Seattle area

SD Mutual of Omaha of South 8S Greater Sioux Falls area

Dakota

TX Exclusive Healthcare 6E Dallas/Ft. Worth

NV Exclusive Healthcare 7E Las Vegas/Reno

KS Exclusive Healthcare 8K Kansas City area

MO Exclusive Healthcare 8K Kansas City area

MO Mercy Health Plans/Premier 7M East, Central, Southwest MO

IL Mercy Health Plans/Premier 7M Southwest IL
Benefits Administration Letter 97-403 13

ATTACHMENT 8

SERVICE AREA EXPANSIONS

WITH A NEW ENROLLMENT CODE

State Plan Name New General Location

Code

TX FIRSTCARE 6U Bell, Bosque, Brazos, Burleson,

Burnet, Coryell, Falls, Freestone,

Grimes, Hamilton, Hill, Houston,

Lampasas, Lee, Leon, Limestone,

Llano, Madison, McLennan, Milam,

Mills, Navarro, Robertson, San Saba,

Somervell, Walker, and Washington

counties

IA Health Alliance HMO 7X Central Iowa

SC Maxicare North Carolina TA Counties in the Greenville-Spartanburg

and Columbia areas

WI Compcare 6X Northwest/Northcentral WI
Benefits Administration Letter 97-403 14

ATTACHMENT 9

SIGNIFICANT SERVICE AREA EXPANSIONS

WITHOUT NEW ENROLLMENT CODES

State Plan Name Code General Location

OH Prudential HealthCare HMO - S3 Brown, Clarke, Clinton, Greene,

Cincinnati Miami, and Montgomery counties

IN Prudential HealthCare HMO - S3 Dearborne County

Cincinnati

GA Prudential HealthCare HMO - EZ Floyd and Hall counties

Atlanta

IN Prudential Healthcare HMO - 2I Allen, LaPorte, Morgan, and St.

Indiana Joseph counties

TN Prudential HealthCare HMO - UB Crockett and Dyer counties

Memphis

MS Prudential HealthCare HMO - UB Marshall County

Memphis

TN Prudential Healthcare HMO - UA Smith and Trousdale counties

Nashville

OH Prudential HealthCare HMO - Q9 Portage and Stark counties

Northern Ohio

KS United HC of the Midwest 4M Topeka area

OH United HC of Ohio 3U All of Ohio

KY United HC of Ohio VC Northern Kentucky

AL PrimeHealth of Alabama AA Autauga, Bibb, Blount, Bullock,

Chilton, Clarke, Colbert, Coosa,

Cullman, Dallas, Elmore, Escambia,

Franklin, Jackson, Jefferson,

Lauderdale, Lawrence, Limestone,

Lowndes, Macon, Madison, Marion,

Marshall, Montgomery, Morgan,

Shelby, St. Clair, Talladega,

Tallapoosa, Tuscaloosa, Walker,

Winston, and Washington counties

MS PrimeHealth of Alabama AA George, Hancock, Harrison, Jackson,

Pearl River, and Stone counties

OR Regence HMO Oregon 7A Gilliam, Morrow, and Sherman

(formerly HMO Oregon) counties
Benefits Administration Letter 97-403 15

State Plan Name Code General Location

WI Group Health Cooperative of WJ All of Jefferson County; Dodge

South Central WI County zip codes 53579, 53094, and

53036; Walworth County zip code

53190; and Rock County zip codes

53190 and 53563

MO United HealthCare Choice VB Chariton, Knox, Lewis, Linn,

Monroe, Pettis, Saline, Schuyler,

Scotland, Shelby, and Sullivan counties

MO United HealthCare Select H8 Cape Girardeau; Mississippi, Scott,

Texas, and Wright counties

IL United HealthCare Select H8 Williamson County

CA Omni Healthcare HN Humbolt, Del Norte, Sonoma, San

Francisco, San Mateo, Santa Clara,

and Merced counties

OR PacifiCare of Oregon SS Columbia County

NY WellCare of New York X4 Westchester County

PA Oxford Health Plans (PA) 3W Berks County

NY Oxford Health Plans (NY) GC Dutchess County

MA Matthew Thornton Health Plan NX Remaining cities and towns in Essex,

Middlesex, and Suffolk counties; and

the communities of Brookline,

Dedham, Dover, Hull, Milford,

Milton, Needham, Norwood, Quincy,

and Wellesley

VT MVP Health Plan VW Addison, Franklin, Grand Isle,

Lamoille, and Washington counties

AZ Health Plan of Nevada NM Mohave County

WV Health Plan of the Upper Ohio U4 Doddridge, Lewis, Gilmer, and

Valley Upshur counties

SC Kaiser of North Carolina QT Rock Hill area

MS United HealthCare of MS QV Six counties in southwest MS

AR Prudential HC HMO-Arkansas VY Benton, Carroll, Crawford, Logan,

Madison, Sebastian, and Washington

counties

KS Prudential HC HMO-Kansas 1K Shawnee County

City
Benefits Administration Letter 97-403 16

State Plan Name Code General Location

OK Prudential HC HMO - Tulsa RS Additional zip codes in Mayes,

Pawnee, Wagoner, Okmulgee, Rogers,

and Osage counties

OK Healthcare Oklahoma 6U Oklahoma City, Tulsa, and Lawton

areas

FL Healthplan Southeast 3E Cities of Pensacola, Tallahassee,

Panama City, Gainesville/Ocala, and

Jacksonville

FL PCA Health Plans of Florida PJ Columbia, DeSoto, Putnam, and Union

counties

TX NYLCare HP of SouthWest V2 Bowie, Cass, Harrison, and Marion

counties

WA NYLCare HP of NorthWest 8N Clallam, Cowlitz, Grays Harbor,

Kitsap, Lewis, Mason, Okanogan,

Pend Orielle, Spokane, Stevens, and

Thurston counties

NC, WellPath Select 2E The North Carolina counties of Burke,

SC Davidson, Davie, Forsyth, Guilford,

Iredell, Lee, Rowan, Stanly, Stokes,

Surry, and Yadkin; the South Carolina

counties of Chester, Greenville,

Lancaster, Spartanburg, and York

UT IHC SelectMed 6S Cache County

IN Aetna US Healthcare XC Indianapolis area

(formerly Aetna HP-Midwest)

OH, Aetna US Healthcare RD Ohio: 32 new counties

KY (formerly Aetna HP-Ohio) Kentucky: 11 new counties

VA CIGNA HealthCare of the XF Frederick and Warren counties

Mid-Atlantic

IN Physicians HP of Northern DQ Kosciusko and Wabash counties

Indiana

TX HMO Blue 4Z Dallas/Ft. Worth Metroplex;

Cent./South/Southeast/NortheastAnder

son County; Cherokee and Smith

counties

TX HMO Blue 4Y Bastrop and El Paso counties

KY Bluegrass Family Health 2B Adair, Green, Morgan, Pulaski, and

Taylor counties
Benefits Administration Letter 97-403 17

State Plan Name Code General Location

NC Partners HP of North Carolina EQ Ashe, Caldwell, Franklin, Granville,

Polk, Stanly, and Vance counties

OH PacifiCare of Ohio R8 Brown County

MO BlueChoice 9G St. Louis; Central and Southwest

counties
Benefits Administration Letter 97-403 18

ATTACHMENT 10

PLAN MERGERS

Enrollees in these plans will be transferred automatically to the surviving plan unless

they choose a different plan during open season.

Merging Plans Codes Surviving Plans Codes

PacifiCare of Texas GF,VN,T6 PacifiCare of Texas GF

FHP Texas 4F 

PacifiCare of California CQ PacifiCare of California CY

FHP Health Care CY

Community Health Plan PW,SM,8M Community Health Plan PW,QB,8

CHP/Hudson Valley Region QB (Note: Mass. enrollees in M

code SM will be moved

to code K1 of Community

Health Plan/Kaiser

Permanente. See below)

Kaiser Massachusetts K1 Community Health Plan/ K1, QH

Kaiser New York QH Kaiser Permanente

Community Health Plan SM (Note: Vermont enrollees

in code K1 will be moved

to Community Health

Plan code 8M. See

above) 

United HealthCare HMO FJ United HealthCare Select FP

United HealthCare Select FP

Humana Group Health Plan 50 Kaiser Mid Atlantic E3

Kaiser Mid Atlantic E3

Humana HealthChicago GQ Humana Health Plan 75

Humana Health Plan 75

Maxicare South Carolina TA Maxicare North Carolina TA, Q5

Maxicare North Carolina Q5

Kaiser Southern Calif. 62 Kaiser California 62, 59

Kaiser Northern Calif. 59

Partners Health Plan of TD, QS HealthPartners Health TD, QS,

Arizona Plan 2S

Samaritan Health Plan 2S

Healthsource Savannah 2H Healthsource Georgia 7H

Healthsource Georgia 7H
Benefits Administration Letter 97-403 19

Merging Plans Codes Surviving Plans Codes

Aetna HP - GA F3 Aetna US Healthcare 2U

US Healthcare (GA) 2U

Aetna HP - NJ XK (NJ) Aetna US Healthcare P3 (NJ)

Aetna HP Mid-Atlantic ZY (Balt) ZY and US will be V8

US Healthcare (NJ) Z1 (Richmond) Z1 

US Healthcare (Del) P3 (NJ) (Richmd)

ZR (Del) (Note: Enrollees in codes NK (Del)

V8(MD/DC/N moved to code V8.) (MD/DC/

VA) NVA)

NK (Del)

US (DC&MD) 

Aetna HP - PA CT, KJ, 4J Aetna US Healthcare KL, SU

US Healthcare (PA) - High SU, KL (Note: Enrollees in codes

Option CT and 4J will be moved

to code KL. Enrollees in

code KJ will be moved to

code SU.)
Benefits Administration Letter 97-403 20

ATTACHMENT 11

PLAN NAME CHANGES

NOTE: Aetna and US Healthcare plans are merging and being renamed as Aetna US

Healthcare for 1998. See the attachment on Plan Mergers for more details.

State Old Plan Name Code New Plan Name

NY MetraHealth of New York 3M United HealthCare of New York

TX MetraHealth of Texas U3 United HealthCare of Texas

KS, MetraHealth of Kansas City 4M United HealthCare of Midwest

MO

PA Prudential HealthCare HMO - VV Prudential HealthCare HMO -

Philadelphia Pennsylvania

OR HMO Oregon 7A Regence HMO Oregon

AL, PrimeHealth AA PrimeHealth of Alabama

MS

PA Geisinger Health Plan N9 Penn State Geisinger Health Plan

OH FHP of Ohio R8 PacifiCare of Ohio

UT FHP-UTAH KU PacifiCare of Utah

CO FHP Colorado D6 PacifiCare of Colorado

KY HealthWise of Kentucky DU United HealthCare of Kentucky

MD Chesapeake Health Plan BL United Healthcare of the MidAtlantic

ND, Northern Plains Hlth Plan 2R Altru Health Plan

MN

GA PCA Health Plns of Georgia WU HPC Health Plns of Georgia

AZ Partners Health Plan-AZ TD, HealthPartners Health Plans

 (merging with) QS, 2S

Samaritan Health Plan

NC PHP - North Carolina XM United Health Care of NC

CO Frontier Community HP 6F Aetna US Healthcare

VA HMO Virginia X8 Healthkeepers

LA Community Health Network of S6, S8, United HealthCare of Louisiana

Louisiana RY

TN Heritage National Healthplan of 4T Heritage National Healthplan

Tennessee
Benefits Administration Letter 97-403 21

State Old Plan Name Code New Plan Name

MN HealthPartners Select 53 HealthPartners Classic

ATTACHMENT 12

ENROLLMENT CODE CHANGES

Enrollees in these plans will be transferred automatically to the new code unless they

choose a different plan during open season.

Plan Name Old Code New Code

HMSA's Community Health Program F6 9Q

Heritage National HP 3X 4T

BlueChoice M4 9G
Benefits Administration Letter 97-403 22

ATTACHMENT 13

PLANS ADDING A POINT OF SERVICE PRODUCT

Plan Name Code Location

HMO Blue GM Southwestern Idaho

United HealthCare of Georgia UQ Atlanta/Northwestern Georgia

Community Blue J7 Western New York

Community Blue 6Z Northeastern New York

Blue Cross and Blue Shield Service 10 Kansas, Louisiana, New York

Benefit Plan - Std

Panama Canal Area Benefit Plan 43 Panama
Benefits Administration Letter 97-403 23

ATTACHMENT 14

PLANS DROPPING A POINT OF SERVICE PRODUCT

Individuals who enrolled in these plans primarily to have access to the point of service

products they offered in the past may want to consider changing plans.

Plan Name Code Location

HML - Guam 28 Guam

Aetna US Healthcare H1 Connecticut

(formerly US Healthcare) NK Delaware

NE Massachusetts

UJ New Hampshire

P3 (std opt) New Jersey

SU (std opt) Philadelphia, PA

KL (std opt) Pittsburgh/Harrisburg/ 

5U Rhode Island

Northeastern PA

Healthsource of Georgia 7H Georgia