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ATTACHMENT 1 – FEHB PROGRAM 

TABLE 1 

PLANS LEAVING THE FEHB PROGRAM 

Enrollees in the terminating FEHB plans who do not change their health plan by enrolling 

in another FEHB plan during Open Season will not have health benefits for 2016. 

State FEHB Plan Name 2015

Enrollment 

Codes

General Location

Florida Coventry Health Plan of 

Florida

5E1, 5E2, 

5E4, 5E5, 

J41, J42

South Florida

Indiana Physicians Health Plan 

of Northern Indiana

DQ1, DQ2, 

DQ4, DQ5

Northeast Indiana

Louisiana Coventry Health Care 

of Louisiana

BJ1, BJ2, 

BJ4, BJ5

New Orleans

Massachusetts Fallon Community 

Health Plan

JG1, JG2 Central and portions of Eastern 

Massachusetts

Ohio The Health Plan of the 

Upper Ohio Valley, Inc.

U41, U42 Northeast and Eastern Ohio

Virginia Piedmont Community 

Health Plan

2C1, 2C2 Lynchburg Area

West Virginia The Health Plan of the 

Upper Ohio Valley, Inc.

U41, U42 55 counties in West Virginia

TABLE 2 

FEHB PLANS REDUCING 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 2016. 

State FEHB Plan Name 2015 

Enrollment

Codes

Area Dropped

Nevada Aetna Open Access HF1, HF2 State of Nevada

TABLE 3 
2

FEHB PLANS REDUCING SERVICE AREAS 

WITHOUT TERMINATING ENROLLMENT CODES 

Enrollees in the areas being reduced who do not change FEHB plans during Open Season 

will only have emergency health services where they live and they will have to travel to their 

FEHB plan’s remaining service area to obtain medical care in order to receive full benefits 

from the FEHB plan in 2016. 

State FEHB Plan Name 2015 

Enrollment

Codes

Areas Reduced

Idaho Select Health SF1, SF2, SF4, 

SF5

Idaho County

TABLE 4 

FEHB PLANS TERMINATING OPTION AND ENROLLMENT CODES 

The payroll office must automatically move enrollees in the FEHB plan’s terminating 

option into their plan’s surviving option and enrollment code unless the enrollees select 

another FEHB plan during Open Season. 

State FEHB Plan Name Terminating 

Options (end of 

2015)

Terminating 

Enrollment 

Codes 

(end of 2015)

Deemed 2016 

Enrollment 

Codes 

Kansas Coventry 

Healthcare of 

Kansas

HDHP* 9H1, 9H2 HA4, HA5

Missouri Coventry 

Healthcare of 

Kansas

HDHP* 9H1, 9H2 HA4, HA5

*Enrollees who want to continue enrollment in 2016 in an 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 2015 

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 

2016 HDHP HSA Fiduciary. 
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TABLE 5 

FEHB PLAN CONTRACT AND ENROLLMENT CODE MERGER WITH 

TERMINATING ENROLLMENT CODES 

The payroll office must automatically move enrollees into their new FEHB plan’s 2016 

codes unless the enrollees select another FEHB plan during Open Season. 

State FEHB Plan Name Terminating 

Enrollment

Codes (end 

of 2015)

Merging into 2016 

FEHB Plan 

Merging into 

2016 Enrollment

Codes 

Iowa Coventry Health 

Care of Iowa*

SV1, SV2

SV4, SV5

SY4, SY5

Aetna Value Plan H44, H45

North Dakota Sanford Heart of 

America Health 

Plan**

RU1, RU2 Sanford Health Plan C91, C92

Pennsylvania HealthAmerica 

Pennsylvania***

261, 262

Y61, Y62

Aetna Open Access YE1, YE2

*Coventry Health Care of Iowa - all options, including the High, Standard, and HDHP options, 

will merge into the Aetna Value Plan (H4). Members will automatically transfer from codes SV 

& SY to code H4. 

**Sanford Health of America Health Plan (RU) will to merge with Sanford Health Plan. Sanford 

Health will become the surviving contract. Members from Code RU will automatically transfer 

to Sanford Health Plan code C9. 

***HealthAmerica Pennsylvania – Both the High and HDHP options, will merge with Aetna 

Open Access. Members will automatically transfer from codes 26 and Y6 to code YE. 

Enrollees merging from an HDHP option to another option as listed above, who want to 

continue enrollment in 2016 in an 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 2015 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 2016 HDHP HSA Fiduciary. 

If enrollees do not want to continue in an HDHP, they will be automatically merged to the 

plan codes listed above or they can change to another health plan option 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. 

 
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TABLE 6 

ENROLLMENT CODE MERGING INTO A DIFFERENT FEHB PLAN 

Enrollees who take no action during Open Season will remain in the same code, but will be 

under a different FEHB plan for 2016 and will be subject to the receiving plan’s benefits 

and premiums. 

State FEHB Plan Name 2015/2016 

Enrollment Codes 

Merging into 2016 FEHB 

Plan

Illinois Humana Benefit Plan of 

Illinois, Inc.*

9F, AB Humana Health Plan, Inc.

* Enrollment codes 9F and AB under the Humana Benefit Plan of Illinois, Inc. are merging into a 

different plan: the Humana Health Plan, Inc. The Humana Benefit Plan of Illinois will not 

participate after December 31, 2015. 

TABLE 7 

SERVICE AREA MOVEMENT TO ANOTHER EXISTING ENROLLMENT CODE 

Certain areas of King, Madera, Mariposa, and Tulare Counties will be moved from the 

Northern California Region to the Fresno County Region. Enrollees who do not change 

their enrollment code from 59 or KC to NZ during Open Season will remain enrolled in the 

Northern California 59 or KC enrollment code. 

State FEHB Plan 

Name

Service Area Moving From 

2015 Enrollment 

Codes

Moving To 

2016 Enrollment 

Codes

California Kaiser 

Foundation 

Health PlanNorthern 

California

King County: 93230, 93232

Madera County: 93601, 

93604, 93614, 93623, 93626, 

93636-39, 93643-45, 93653, 

93669

Mariposa County: 93601, 

93623, 93653

Tulare County: 93238, 93261, 

93618, 93666, 93673, codes 

591, 592, 594, and 595

591, 592, 594, 595

KC1, KC2

Northern 

California Region

NZ1, NZ2, NZ4, 

NZ5

Fresno County 

Region

Kaiser Foundation Health Plan-Northern California will move part of its Northern California 

Service area (parts of King, Madera, Mariposa, and Tulare counties) under codes 591, 592, 594, 

and 595 (High Option and Standard Option) and KC1 and KC2 (Basic Option) to the Fresno 

County Region under codes NZ1, NZ2, NZ4, and NZ5 (High Option & Standard Option). 

Current plan enrollees that work or live in the service area described above should make a 

positive enrollment election into enrollment codes NZ1, NZ2, NZ4, or NZ5 during Open Season. 

If enrollees in the FEHB Plan’s Northern California Service area as described above 

(enrollment codes 59 or KC) do not make a positive enrollment election, they will remain 

enrolled in their original High Option or Standard Option 59 enrollment code or Basic 

Option KC enrollment code. Please note that the 2016 premiums for the NZ codes for the 

Fresno County region service area will be lower than the premiums for the 59 and KC 
5

codes for the Northern California region. 

TABLE 8

NEW PLANS ENTERING THE FEHB PROGRAM 

State Plan Name Plan 

Option

3 Digit 

Plan 

Code

Location of Areas

Alabama UnitedHealthcare 

Insurance Company 

Choice Plan

High KK1, 

KK2,

KK3

All of Alabama

Alabama UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LS1, LS2, 

LS3

All of Alabama

Arizona UnitedHealthcare 

Insurance Company 

Choice Plan

High KT1, 

KT2, KT3

Phoenix and Tucson areas

Arizona UnitedHealthcare 

Insurance Company

Choice Plus HDHP

HDHP LU1, 

LU2, LU3

Phoenix and Tucson areas

Arkansas UnitedHealthcare 

Insurance Company 

Choice Plan

High KK1, 

KK2, 

KK3

All of Arkansas

Arkansas UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LS1, LS2, 

LS3

All of Arkansas

Colorado UnitedHealthcare 

Insurance Company 

Choice Plan

High KT1, 

KT2, KT3

All of Colorado

Colorado UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LU1, 

LU2, LU3

All of Colorado

District of 

Columbia

UnitedHealthcare 

Insurance Company 

Choice Plan

High LR1, LR2, 

LR3

All of the District of Columbia

Iowa UnitedHealthcare 

Insurance Company 

Choice Plan

High LJ1, LJ2, 

LJ3

Des Moines

Iowa UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP N71,N72, 

N73

Des Moines

Kentucky UnitedHealthcare 

Insurance Company 

Choice Plan

High LJ1, LJ2, 

LJ3

Western Kentucky

Kentucky UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP N71,N72, 

N73

Western Kentucky
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Louisiana UnitedHealthcare 

Insurance Company 

Choice Plan

High KK1, 

KK2, 

KK3

All of Louisiana

Louisiana UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LS1, LS2, 

LS3

All of Louisiana

Maryland UnitedHealthcare 

Insurance Company 

Choice Plan

High LR1, LR2, 

LR3

All of Maryland

Mississippi UnitedHealthcare 

Insurance Company 

Choice Plan

High KK1, 

KK2.

KK3

All of Mississippi

Mississippi UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LS1, LS2, 

LS3

All of Mississippi

Ohio Paramount Health 

Care

High N81, N82, 

N83

Northwestern Ohio

Tennessee UnitedHealthcare 

Insurance Company 

Choice Plan

High KK1, 

KK2, 

KK3

Knoxville

Tennessee UnitedHealthcare 

Insurance Company 

Choice Plus HDHP

HDHP LS1, LS2, 

LS3

Knoxville

Virginia UnitedHealthcare 

Insurance Company 

Choice Plan

High LR1, LR2, 

LR3

Northern Virginia

Virginia Optima Health Plan High PG1, PG2, 

PG3

Hampton Roads Region

TABLE 9 

FEHB PLANS ADDING NEW OPTIONS AND ENROLLMENT CODES 

State FEHB Plan Name New 

Option 

2016 Enrollment 

Codes

General Location 

California Health Net of California Basic P61, P62, P63 Southern California

Idaho Group Health Cooperative HDHP PT1, PT2, PT3 Northern Idaho

New Mexico Presbyterian Health Plan Standard PS4, PS5, PS6 All of New Mexico

Washington Group Health Cooperative

HDHP

PT1, PT2, PT3 Western and Central 

Washington, Spokane &

Pullman

Wisconsin Physicians Plus Insurance 

Corporation Standard

LW4, LW5, LW6 South Central Counties in WI
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TABLE 10 

SERVICE AREA EXPANSIONS WITHOUT NEW ENROLLMENT CODES 

State FEHB Plan 

Name

Plan Type 2016 

Enrollment 

Codes

Location of Areas

Colorado Humana Health 

Plan, Inc.

High

Standard

NT1,NT2,

NT3, 

NT4,NT5, 

NT6

County of Boulder

Florida Aetna 

HealthFund 

CDHP/Aetna 

Value Plan

CDHP

Value

F51, F52, F53

F54, F55, F56

Counties of DeSoto, Madison

Florida Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP 

CDHP

224, 225, 226

N61, N62, 

N63

Counties of DeSoto, Madison

Hawaii Kaiser 

Foundation 

Health Plan 

Hawaii

High

Standard

631,632,633

634,635,636

Hawaii Volcano National Park, Pahala, and 

Naaleu

Illinois Health Alliance

HMO

High

Standard

FX1, FX2, 

FX3, K84, 

K85, K86

Counties of Marshall, Warren, and Putnam 

Kansas Aetna 

HealthFund 

CDHP/Aetna 

Value Plan

CDHP

Value

G51, G52, 

G53, G54, 

G55, G56

Counties of Barber, Decatur, Edwards, Gove, 

Jackson, Kiowa, Lane, Mitchell, Nemaha, 

Norton, Rawlins, Rush, Sheridan, Sherman, 

Wabaunsee, Wallace

Kansas Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP

CDHP

224,225,226

N61,N62,N63

Counties of Barber, Decatur, Edwards, Gove, 

Jackson, Kiowa, Lane, Mitchell, Nemaha, 

Norton, Rawlins, Rush, Sheridan, Sherman, 

Wabaunsee, Wallace

Kentucky Aetna 

HealthFund 

CDHP/Aetna 

Value Plan

CDHP

Value

H41, H42, 

H43, H44, 

H45, H46

County of Montgomery

Kentucky Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP

CDHP

224,225, 226

N61,N62,N63

County of Montgomery

Maryland Aetna Open 

Access

High

Basic

JN1, JN2, 

JN3, JN4, 

JN5, JN6

Counties of Allegany, Caroline, Dorchester, 

Garrett, Somerset and Worcester
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Michigan Health Alliance 

Plan

High 

Standard

521, 522, 523, 

GY4, GY5, 

GY6

Counties of Sanilac and Shiawassee

Missouri Aetna 

HealthFund 

CDHP/Aetna 

Value Plan

CDHP

Value

G51, G52, 

G53, G54, 

G55, G56

County of Johnson

Missouri Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP

CDHP

224,225, 226

N61,N62,N63

County of Johnson

New York MVP Health 

Care

High

Standard

MX1, MX2, 

MX3, MX4, 

MX5, MX6

County of Westchester

Pennsylvania Aetna Open 

Access

High YE1, YE2, 

YE3

Counties of Cameron, Clearfield, Crawford, Elk, 

Forest, Mckean, Potter, Warren

South Dakota Aetna 

HealthFund 

CDHP/Aetna 

Value Plan

CDHP

Value

G51, G52, 

G53, G54, 

G55, G56

County of Butte

South Dakota Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP

CDHP

224,225, 226

N61,N62,N63

County of Butte

Tennessee Aetna 

HealtFund 

CDHP/Aetna 

Value Plan

CDHP

Value

F51, F52, F53

F54, F55, F56

Counties of Monroe, Polk, Rhea

Tennessee Aetna 

HealthFund 

HDHP/Aetna 

Direct Plan

HDHP

CDHP

224,225, 226

N61,N62,N63

Counties of Monroe, Polk, Rhea

Virginia Aetna Open 

Access

High

Basic

JN1, JN2, 

JN3, JN4, 

JN5, JN6

Counties of Greene, Madison, Orange, and 

Rappahannock

Wisconsin Group Health 

Cooperative of 

South Central 

Wisconsin

High WJ1, WJ2, 

WJ3

Counties of Adams, Juneau, Richland, Vernon

TABLE 11 

FEHB PLAN NAME CHANGE 
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State 2015 FEHB Plan Name 2016 Enrollment

Codes

2016 FEHB Plan Name 

Kansas Coventry Healthcare of 

Kansas

HA1, HA2, HA3, 

HA4, HA5, HA6

Aetna Open Access

Missouri Coventry Healthcare of 

Kansas

HA1, HA2, HA3, 

HA4, HA5, HA6

Aetna Open Access

New Mexico Lovelace Health Plan Q11, Q12, Q13 New Mexico BlueHMO 

Preferred

Utah Altius Health Plan, Inc. 9K1, 9K2, 9K3, 

9K4, 9K5, 9K6, 

DK4, DK5, DK6

Aetna Health of Utah, Inc. dba 

Altius Health Plans