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 

1 
 

 

 

 

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 

2 
 

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, 2G5, 2G6 

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, 2G5, 2G6 

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, 2G5, 2G6 

Washington Kaiser Foundation 

Health Plan of 

Washington 

HDHP PT1, PT3, PT2 Standard Option 

544, 546, 545 

3 
 

 

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 

4 
 

 

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 

5 
 

 

 

 

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 

CDHP W91, W93, W92 Daytona – Flagler and Volusia counties 

Humana Value 

Plan 

Value 

W94, W96,W95 

Florida Humana 

CoverageFirst 

CDHP X21, X23, X22 Orlando – Lake, Seminole, Orange and 

Osceola counties 

Humana Value 

Plan 

Value X24,X26, X25 

Indiana 

Humana 

CoverageFirst 

CDHP X31, X33, X32 Dearborn, Franklin, Ohio, Ripley and Union 

counties 

Humana Value 

Plan Value 

X34, X36, X35 

Kentucky Humana 

CoverageFirst 

CDHP X31, X33, X32 Boone, Campbell, Kenton, Gallatin, Grant 

and Pendleton counties 

Humana Value 

Plan 

Value X34,X36, X35 

Ohio 

Humana 

CoverageFirst 

CDHP X31, X33, X32 Greater Cincinnati –Adams, Brown, Butler, 

Clermont, Clinton, Gallia, Hamilton, 

Highland, Jackson, Lawrence, Pike, Scioto 

Humana Value and Warren counties 

Plan 

Value X34,X36, X35 

Ohio Medical Mutual 

of Ohio 

Basic X61, X63, X62, Fulton, Lucas, Ottawa, Defiance, Henry, 

Wood, Sandusky, Seneca, Putnam, and 

Standard X64, X66, X65 Allen 

6 
 

Ohio Medical Mutual 

of Ohio 

Basic YF1, YF3, YF2, Champaign, Clark, Montgomery, Greene, 

Butler, Hamilton, Clermont, and Brown 

Standard YF4, YF6, YF5 counties 

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 

7