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ATTACHMENT 1 – 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 be enrolled in the Blue Cross and Blue 

Shield Service Benefit Plan FEP Blue Focus (the lowest-cost nationwide plan option 

for 2019 as determined by OPM). 

State Plan Name 2018

Enrollment 

Code

General Location

Arizona Health Net of 

Arizona, Inc.

A74, A76, A75 Cochise, Gila, Maricopa, Pima, 

Pinal, and Santa Cruz counties

California UnitedHealthcare 

of California

CY1, CY3, 

CY2, CY4, 

CY6, CY5 

Southern and Central California

Iowa UnitedHealthcare 

Plan of the River 

Valley, Inc.

YH1, YH3, 

YH2 

Eastern and Central Iowa

Illinois UnitedHealthcare 

Plan of the River 

Valley, Inc.

YH1, YH3, 

YH2 

West Central Illinois

Wisconsin Physicians Plus 

Insurance 

Corporation 

LW1, LW3, 

LW2, LW4, 

LW6, LW5 

South Central Wisconsin, including the 

following counties: Adams, Columbia, 

Crawford, Dane, Dodge, Grant, Green, 

Green Lake, Iowa, Jefferson, Juneau, 

Lafayette, Marquette, Portage, Richland, 

Rock, Sauk, Vernon, Walworth, Waukesha, 

Waushara and Wood Counties
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TABLE 2

PLANS REDUCING SERVICE AREAS 

WITHOUT TERMINATING ENROLLMENT CODES

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

Season will only have emergency services where they live and they 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 2019. 

 

State Plan Name 2018

Enrollment 

Code

Area Dropped

Alaska Aetna HDHP/Aetna 

Direct

224, 226, 225, 

N61, N63, N62 

Borough of Wade Hampton

Alaska Aetna CDHP/Aetna 

Value Plan

JS1, JS3, JS2, 

JS4, JS6, JS5 

Borough of Wade Hampton

Idaho Aetna HDHP/Aetna 

Direct

224, 226, 225, 

N61, N63, N62 

Butte County

Idaho Aetna CDHP/Aetna 

Value Plan

H41, H43, 

H42, H44, 

H46, H45

Butte County

Kentucky Aetna HDHP/Aetna 

Direct

224, 226, 225, 

N61, N63, N62 

Union County

Kentucky Aetna CDHP/Aetna 

Value Plan

H41, H43, 

H42, H44, 

H46, H45

Union County

Virginia Aetna Open Access JN1, JN3, JN2, 

JN4, JN6, JN5 

Surry and Sussex counties

Washington Kaiser Foundation 

Health Plan of the 

Northwest

571, 573, 572, 

574, 576, 575 

Lewis County
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TABLE 3 

PLANS TERMINATING OPTION AND ENROLLMENT CODES 

Enrollees in the plan’s terminating option will be automatically enrolled into the

plan option that is identified in the table below unless they enroll in another plan 

during Open Season. 

State Plan Name Terminating 

Options

(end of 2018)

Terminating 

Codes 

(end of 2018)

Option and Codes for 2019

District of 

Columbia 

CareFirst

BlueChoice 

High Option 2G1, 2G3, 2G2 Standard Option

2G4, 2G6, 2G5 

Idaho Kaiser Foundation 

Health Plan of 

Washington

HDHP PT1, PT3, PT2 Standard Option

544, 546, 545 

Maryland CareFirst

BlueChoice 

High Option 2G1, 2G3, 2G2 Standard Option

2G4, 2G6, 2G5 

New Jersey GHI Health Plan High Option 801,803,802 Standard Option

804,806,805 

New York MVP Health Care High Option GA1, GA3, 

GA2, MX1, 

MX3, MX2, 

MF1, MF3, 

MF2, M91, 

M93, M92, 

GV1, GV3, 

GV2

Standard Option

GA4, GA6, GA5, MX4, MX6, 

MX5, M94, M96, M95, MF4, 

MF6, MF5, GV4, GV6, GV5 

New York GHI Health Plan High Option 801,803,802 Standard Option

804,806,805 

Ohio Medical Mutual of 

Ohio

High Option 641, 643, 642 Standard Option

644, 646, 645 

Virginia CareFirst

BlueChoice 

High Option 2G1, 2G3, 2G2 Standard Option

2G4, 2G6, 2G5 

Washington Kaiser Foundation 

Health Plan of 

Washington 

HDHP PT1, PT3, PT2 Standard Option

544, 546, 545 
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TABLE 4 

PLANS ADDING NEW OPTIONS AND ENROLLMENT CODES 

State Plan Name New 

Option 

2019 Enrollment

Codes

General Location 

All States Blue Cross and Blue 

Shield Service Benefit 

Plan FEP Blue Focus

FEP 

Blue 

Focus

131,133,132 Nationwide

California Blue Shield of 

California 

Standard SI4, SI6, SI5 San Diego County

Florida AvMed HDHP WZ1,WZ3,WZ2 South Florida

Kentucky Humana Health Plan

of Ohio, Inc. 

Basic W61,W63, W62 Northern Kentucky

New York Health Insurance Plan 

(HIP/HMO)

Standard YL4, YL6, YL5 Greater New York City Area 

(including Long Island and 

surrounding counties)

Ohio Humana Health Plan 

of Ohio, Inc. 

Basic W61,W63, W62 Greater Cincinnati

Utah SelectHealth Plan HDHP WX1,WX3,WX2 State of Utah

Virginia Optima Health Plan HDHP PG4, PG6, PG5 Greater Hampton Roads Region
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TABLE 5 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES

State Plan Name Plan Option 2019

Enrollment 

Codes

Location of Areas

California Blue Shield of 

California 

High SI1, SI3, 

SI2 

Los Angeles, San Diego, and Kern

counties 

Illinois Union Health Service High 761, 763, 

762 

Lake County

Michigan Health Alliance Plan High, 

Standard

521, 523, 

522, GY4, 

GY6, GY5 

Hillsdale County

Minnesota Aetna HDHP/Aetna 

Direct

HDHP 224, 226, 

225, N61, 

N63, N62 

Cook, Marshall, Red Lake counties

Minnesota Aetna CDHP/Aetna 

Value Plan

CDHP H41, H43, 

H42, H44, 

H46, H45 

Cook, Marshall, Red Lake counties

Ohio Medical Mutual of 

Ohio

Standard, 

Basic

644, 646, 

645, UX1, 

UX3, UX2 

Ashtabula, Columbiana, Erie, 

Huron, Richland, and Ashland 

Oregon Kaiser Foundation 

Health Plan of 

Northwest

High, 

Standard

571, 573, 

572, 574, 

576, 575 

Lane, Benton counties; Rest of Linn 

County 

Pennsylvania UPMC High, 

Standard, 

HDHP

8W1, 8W3, 

8W2 

UW4, UW6, 

UW5

8W4, 8W6, 

8W5

Centre County

New York CDPHP Universal 

Benefits, Inc.

High

Standard

SG1, SG3, 

SG2, SG4, 

SG6, SG5

Franklin and Clinton Counties
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TABLE 6

SERVICE AREA EXPANSIONS ADDING

NEW ENROLLMENT CODES

State FEHB Plan

Name

Plan 

Option

2019 New

Enrollment Codes

Location of Areas

Florida Humana 

CoverageFirst 

Humana Value 

Plan

CDHP

Value

W91, W93, W92 Daytona – Flagler and Volusia counties

W94, W96,W95 

Florida Humana 

CoverageFirst 

Humana Value 

Plan

CDHP

Value

X21, X23, X22

X24,X26, X25 

Orlando – Lake, Seminole, Orange and 

Osceola counties

Indiana 

Humana 

CoverageFirst

Humana Value 

Plan

CDHP

Value

X31, X33, X32

X34, X36, X35 

Dearborn, Franklin, Ohio, Ripley and Union

counties 

Kentucky Humana 

CoverageFirst

Humana Value 

Plan

CDHP

Value

X31, X33, X32

X34,X36, X35 

Boone, Campbell, Kenton, Gallatin, Grant 

and Pendleton counties 

Ohio

Humana 

CoverageFirst

Humana Value 

Plan

CDHP

Value

X31, X33, X32

X34,X36, X35 

Greater Cincinnati –Adams, Brown, Butler, 

Clermont, Clinton, Gallia, Hamilton, 

Highland, Jackson, Lawrence, Pike, Scioto 

and Warren counties 

Ohio Medical Mutual 

of Ohio 

Basic

Standard

X61, X63, X62,

X64, X66, X65 

Fulton, Lucas, Ottawa, Defiance, Henry, 

Wood, Sandusky, Seneca, Putnam, and 

Allen

Ohio Medical Mutual 

of Ohio 

Basic

Standard

YF1, YF3, YF2,

YF4, YF6, YF5 

Champaign, Clark, Montgomery, Greene, 

Butler, Hamilton, Clermont, and Brown 

counties 
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TABLE 7 

NEW PLAN ENTERING THE FEHB PROGRAM

State FEHB Plan

Name

Plan 

Option

2019 New 

Enrollment Codes

Location of Areas

Colorado BlueAdvantage 

HMO on the 

Pathway HMO 

Network

High WW1,WW3,WW2 Adams, Arapahoe, Boulder, Broomfield, 

Denver, Douglas, Jefferson, El Paso 

(Colorado Springs Region only) and 

Larimer (Ft. Collins Region only) counties