FEHB PROGRAM 

TABLE 1 

PLANS LEAVING THE FEHB PROGRAM 

Enrollees in these terminating plans must make a positive election into another FEHB plan 

during Open Season or they will not have health benefits coverage for 2011. 

 

State Plan Name 3 Digit Plan Code 

Arizona, Arkansas, 

California, Colorado, 

District of Columbia, 

Florida, Georgia, 

Illinois, Iowa, Kansas, 

Louisiana, Maryland, 

Mississippi, Missouri, 

Nevada, New Mexico, 

North Carolina, Ohio, 

Oklahoma, Oregon, 

Rhode Island, 

Tennessee, Texas, 

Virginia, Washington, 

Wisconsin 

UnitedHealthcare Insurance 

Company, Inc. 

High Deductible Health 

Plan (HDHP)* and 

Consumer Driven Health 

Plan (CDHP) 

(*See Table 3 also for 

HDHP) 

E91*, E92* 

E94, E95 

(*See Table 3 also 

for E91 & E92) 

Louisiana Vantage Health Plans 

 

MV1, MV2 

MV4, MV5 

 Massachusetts BlueCHiP Coordinated 

Health Plan 

DA1, DA2 

Nevada PacifiCare of Nevada K91, K92 

New Jersey AmeriHealth HMO FK1, FK2 

FK4, FK5 

New York Community Blue BS1, BS2 

BX1, BX2 

BZ1, BZ2 

Rhode Island BlueCHiP Coordinated 

Health Plan 

DA1, DA2 

1
TABLE 2 

PLANS REDUCING THEIR SERVICE AREAS 

AND TERMINATING ENROLLMENT CODES 

Enrollees in these terminating enrollment codes must make a positive election into another 

FEHB plan during Open Season or they will not have health benefits coverage for 2011. 

State Plan Name 3 Plan Digit 

Code 

Area Dropped 

Arizona Humana CoverageFirst 

Consumer Driven Health 

Plan (CDHP) 

DB1, DB2 Phoenix/Tucson area 

Florida Humana CoverageFirst MQ1, MQ2 Jacksonville area 

CDHP YG1, YG2 Orlando area 

Louisiana Humana CoverageFirst 9L1, 9L2 Baton Rouge area 

CDHP 9J1, 9J2 New Orleans area 

Ohio Aetna Open Access 7D1, 7D2 Cleveland/Toledo area 

Pennsylvania HealthAmerica 

Pennsylvania 

PN4, PN5 

9N1*, 9N2* 

(*See Table 4 

for 9N1 & 

9N2)

Southeastern Pennsylvania area 

Tennessee Humana CoverageFirst L61, L62 Memphis area 

CDHP BT1, BT2 Nashville area 

Texas Humana CoverageFirst T81, T82 Dallas area 

CDHP T21, T22 Houston area 

Utah Humana CoverageFirst 

CDHP 

IA1, IA2 Salt Lake City area 

2
TABLE 3 

PLANS TERMINATING THEIR HIGH DEDUCTIBLE HEALTH PLANS (HDHPs) AND 

TERMINATING THEIR HDHP ENROLLMENT CODES 

Enrollees in these terminating enrollment codes must make a positive election into another 

FEHB plan during Open Season or they will not have health benefits coverage for 2011. 

Enrollees who want to continue enrollment in 2011 in a HDHP and receive or make 

additional contributions to the Health Savings Account (HSA), must change to another 

HDHP in the FEHB Program during Open Season. They need to contact their current 2010 

HDHP HSA Fiduciary and the Internal Revenue Service (IRS) for any guidance and 

questions about their HSA including tax considerations and penalties. If enrollees are 

interested in consolidating their HSA accounts, they also need to contact their upcoming 

2011 HDHP HSA Fiduciary. 

If enrollees do not want to continue in a HDHP, they must change to another FEHB plan 

during Open Season or they will not have health benefits coverage for 2011. However, the 

enrollees must contact the HDHP HSA Fiduciary and IRS for any guidance and questions 

about the HSA concerning tax considerations and penalties. 

State Plan Name 3 Digit Plan 

Code 

Arizona, Arkansas, California, 

Colorado, 

District of Columbia, 

Florida, Georgia, Illinois, Iowa, 

Kansas, Louisiana, Maryland, 

Mississippi, Missouri, 

Nevada, New Mexico, North 

Carolina, Ohio, Oklahoma, 

Oregon, Rhode Island, 

Tennessee, Texas, Virginia, 

Washington, Wisconsin 

UnitedHealthcare Insurance Company, Inc. 

High Deductible Health Plan 

(See Table 1 also) 

E91, E92 

(See Table 1 

also) 

Louisiana Coventry Health Care of Louisiana 

High Deductible Health Plan 

HB1, HB2 

3
TABLE 4 

HIGH DEDUCTIBLE HEALTH PLAN (HDHP) REDUCING ITS SERVICE AREA 

AND TERMINATING ITS ENROLLMENT CODES 

Enrollees in these terminating enrollment codes must make a positive election into another 

FEHB plan during Open Season or they will not have health benefits coverage for 2011. 

Enrollees who want to continue enrollment in 2011 in a HDHP and receive or make 

additional contributions to the Health Savings Account (HSA), must change to another 

HDHP in the FEHB Program during Open Season. They need to contact their current 2010 

HDHP HSA Fiduciary and the Internal Revenue Service (IRS) for any guidance and 

questions about their HSA including tax considerations and penalties. If enrollees are 

interested in consolidating their HSA accounts, they also need to contact their upcoming 

2011 HDHP HSA Fiduciary. 

If enrollees do not want to continue in a HDHP, they must change to another FEHB plan 

during Open Season or they will not have health benefits coverage for 2011. However, the 

enrollees must contact their HDHP HSA Fiduciary and IRS for any guidance and questions 

about the HSA concerning tax considerations and penalties. 

State Plan Name 3 Digit Plan Code Area Dropped 

Pennsylvania HealthAmerica 

Pennsylvania 

9N1, 9N2 

(See Table 2 also) 

Southeastern Pennsylvania area 

4
TABLE 5 

PLAN TERMINATING OPTION, OPTION’S SERVICE AREA AND ENROLLMENT 

CODES 

Enrollees in the plan’s terminating option and enrollment codes must make a positive 

election into another FEHB plan during Open Season or they will not have health benefits 

coverage for 2011. 

State Plan Name Terminating 

3 Digit Code 

(end of 

2010) 

Terminating 

Option 

(end of 2010)

Area Dropped 

Massachusetts Fallon 

Community 

Health Plan 

JV4, JV5 Standard 

Option 

(Select Care) 

Massachusetts service area for the 

Standard Option (Select Care) only 

Fallon Community Health Plan is terminating their Standard Option (code JV) including 

the service area for the Standard Option. Fallon Community Health Plan’s Basic Option 

(code JG) will remain; however, the Basic Option’s service area is smaller than the 

terminating Standard Option’s service area. 

 

5
TABLE 6 

PLANS REDUCING THEIR SERVICE AREAS 

WITHOUT TERMINATING ENROLLMENT CODES 

Enrollees in the service 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 2011. 

State Plan Name 3 Digit Plan 

Code 

Area Dropped 

Kansas Coventry 

of Kansas 

HA1, HA2, 

HA4, HA5, 

9H1*, 9H2* 

(*HDHP 

See below) 

Entire counties of: Butler, Chase, Chautauqa, 

Coffey, Cowley, Dickinson, Elk, Ellis, 

Ellsworth, Geary, Greenwood, Harper, Harvey, 

Kingman, Lincoln, Lyon, Marion, McPherson, 

Montgomery, Morris, Ottawa, Pratt, Reno, Riley, 

Russell, Saline, Sedgwick, Sumner, Wilson, 

Woodson 

Tennessee Bluegrass 

Family 

Health Plan 

KV1*, KV2* 

(*HDHP 

 See below)

The entire state of Tennessee 

*Enrollees in 9H1, 9H2 , KV1, or KV2 who change plans but want to continue enrollment in 

2011 in a High Deductible Health Plan (HDHP) and receive or make additional 

contributions to the Health Savings Account (HSA), must change to another HDHP in the 

FEHB Program during Open Season. They need to contact their current 2010 HDHP HSA 

Fiduciary and the Internal Revenue Service (IRS) for any guidance and questions about 

their HSA including tax considerations and penalties. If enrollees are interested in 

consolidating their HSA accounts, they also need to contact their upcoming 2011 HDHP 

HSA Fiduciary. 

*Enrollees in 9H1, 9H2, KV1, or KV2 who change plans but do not want to continue in a 

HDHP, must change to another FEHB plan during Open Season. However, the enrollees 

must contact the HDHP HSA Fiduciary and IRS for any guidance and questions about the 

HSA concerning tax considerations and penalties. 

6
TABLE 7 

ENROLLMENT CODE MERGERS 

The payroll office must automatically move enrollees into their plan’s surviving code unless 

the enrollees select another health plan during Open Season. 

State Plan Name Plan Codes (2010) 2011 Surviving 

Codes 

New York Univera Healthcare Q81, Q82, 

KQ1, KQ2 

Q81, Q82 

 

 TABLE 8 

PLANS DROPPING OPTIONS 

Enrollees in these plans will be automatically enrolled in their plans’ remaining option 

unless they make a positive enrollment change to another plan during Open Season. 

State Plan Name Dropping 

Options 

Dropping 

Codes 

Remaining Options 

and Codes for 2011 

Michigan Physicians Health Plan of 

Mid-Michigan 

High Option 9U1, 9U2 Standard Option 

9U4, 9U5 

Pennsylvania HealthAmerica 

Pennsylvania 

Standard 

Option 

264, 265 High Option 

261, 262 

Pennsylvania Geisinger Health Plan High Option GG1, GG2 Standard Option 

GG4, GG5 

7
TABLE 9 

PLAN NAME CHANGES 

State 2010 Plan Name (Old) 3 Digit Plan 

Codes 

 2011 Plan Name (New) 

Closed Nationwide 

Fee-for-Service (FFS) 

Plan Open Only to 

Specific Groups 

Association Benefit 

Plan 

421, 422 Compass Rose Health Plan 

Florida Vista Healthplan of 

South Florida 

5E1, 5E2, 

5E4, 5E5 

Coventry Health Plan of 

Florida 

TABLE 10 

CLOSED NATIONWIDE FEE-FOR-SERVICE (FFS) PLAN FOR SPECIFIC GROUPS 

NEWLY AVAILABLE TO AN AGENCY AND ALL ITS EMPLOYEES AND 

ANNUITANTS 

State 2010 Plan Name (Old) 

2011 Plan Name (New) 

3 Digit 

Plan 

Codes 

Agency 

Closed Nationwide 

FFS Plan Open Only 

to Specific Groups 

Association Benefit Plan 

(2010 Old Plan Name) 

 Compass Rose Health Plan 

(2011 New Plan Name) 

421, 422 Department of State: 

All Employees and 

Annuitants 

8
TABLE 11 

NEW PLANS ENTERING THE FEHB PROGRAM 

State Plan Name Plan Type 3 Digit Plan Code General Location 

Utah SelectHealth HMO SF1, SF2 Entire counties of: Beaver, 

Box Elder, Cache, Davis, 

Duchesne, Garfield, Iron, 

Juab, Millard, Morgan, 

Piute, Salt Lake, Sanpete, 

Sevier, Summit, Tooele, 

Uintah, Utah, Wasatch, 

Washington, Wayne, 

Weber 

Wisconsin MercyCare HMO HMO EY1, EY2 Entire counties of: Dane, 

Green, Jefferson, Rock, 

Walworth 

TABLE 12 

PLAN ADDING A NEW OPTION 

Enrollees who do not enroll in their plan’s new option will automatically remain enrolled in 

their current option. 

 

State Plan Name New Option New 3 Digit 

Codes 

Montana New West Health 

Services 

Standard Option NV4, NV5 

TABLE 13 

SERVICE AREA EXPANSIONS WITH NEW ENROLLMENT CODES 

State Plan Name New 3 Digit 

Plan Code 

General Location 

H61, H62 Entire counties of: Benzie, 

Michigan Blue Care Network Grand Traverse, Leelanaw 

J31, J32 Entire counties of: Kent, 

Muskegon, Newago, Oceana, 

Ottawa 

9
TABLE 14 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State Plan Name 3 Digit Plan 

Code 

General Location of New Area 

Florida Capital Health Plan EA1, EA2 The following counties by zip code: 

Calhoun: 32449, 32424, 32421, 32430 

Liberty: 32334, 32321, 32360 

Idaho Altius Health Plans 9K1, 9K2, 

9K4, 9K5, 

DK4, DK5 

Entire counties of Adams and Washington 

Iowa Health Alliance 

HMO 

FX1, FX2 Entire counties of: Butler, Cedar, Fayette, 

Grundy, Guthrie, Humboldt, Jones, Keokuk, 

Louisa, Madison, Muscatine, Poweshiek 

Massachusetts Fallon Community 

Health Plan 

(Basic Option/ 

Direct Care) 

JG1, JG2 The following cities and towns of: 

Cohasset, Duxbury, Hingham, Hull, Kingston 

Marshfield, Marshfield Hills, North 

Marshfield, North Scituate, Plympton, Scituate 

Michigan HealthPlus of 

Michigan 

X51, X52 Entire county of Wayne 

Montana New West Health 

Services 

NV1, NV2, 

NV4, NV5 

Entire cities of: Cut Bank, Ennis, Scobey, 

Sheridan 

Oklahoma Globalhealth Inc. IM1, IM2 Entire counties of: Caddo, Carter, Cherokee, 

Comanche, Custer, Garfield, Jackson, 

Kingfisher, Kiowa, Love, McIntosh, Murray, 

Muskogee, Noble, Nowata, Okfuskee Pawnee, 

Payne, Sequoyah, Stephens, Washington 

Pennsylvania UPMC 8W1, 8W2 

8W4, 8W5 

UW4, UW5 

Entire county of Huntingdon 

Virginia Optima Health Plan 9R1, 9R2 

9R4, 9R5 

Entire cities of: Bedford City, Buena Vista 

City, Danville City, Harrisonburg City, 

Lexington City, Lynchburg City, Martinsville 

City, Radford City, Roanoke City, Salem City, 

Staunton City, Waynesboro City; 

Entire counties of: Alleghany, Amherst, 

Appomattox, Augusta, Bath, Bedford, 

Botetourt, Campbell, Covington, Craig, Floyd, 

Franklin, Giles, Halifax, Henry, Highland, 

Montgomery, Patrick, Pittsylvania, Pulaski, 

Roanoke, Rockbridge 

10