1 

ATTACHMENT 1 – FEHB Significant Plan Changes 

Table 1 

Plans Leaving the FEHB Programs 

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

FEHB plan during Open Season or they will be enrolled in GEHA’s Indemnity 

Benefit Plan Elevate (the lowest-cost nationwide plan option for 2021 as determined

by OPM). 

State FEHB 

Carrier 

Plan Name 2020 Enrollment 

Code(s) 

Location 

(List All Counties and/or ZIP 

codes that are affected)

Illinois MercyCare 

Health Plans 

MercyCare 

Health Plans 

EY1, EY3, EY2 

EY4, EY6, EY5 

Boone and Winnebago 

counties 

Wisconsin MercyCare 

Health Plans 

MercyCare 

Health Plans 

EY1, EY3, EY2 

EY4, EY6, EY5 

Green, Jefferson, Rock, and 

Walworth counties

Table 2 

Plans Reducing Services 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 be enrolled in GEHA’s 

Indemnity Benefit Plan Elevate (the lowest-cost nationwide plan option for 2021 as 

determined by OPM) 

State FEHB Carrier Plan Name 2020 

Enrollment 

Code 

Area Dropped 

(List All Counties and/or ZIP 

codes that are affected) 

Tennessee Aetna Health, 

Inc. 

Aetna Open Access UB1, UB3, UB2 Crockett, Dyer, Fayette, Haywood, 

Lauderdale, Shelby, and Tipton 

counties 
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 FEHB Carrier Plan Name Terminating 

Options 

(end of 2020) 

Terminating 

Codes 

(end of 2020) 

Option and Codes for 

2021

California Blue Shield of 

California 

Blue Shield of 

California 

Standard SI4, SI6, SI5 High - SI1, SI3, SI2 

California Health Net of 

California 

Health Net of 

California 

Standard LP4, LP6, LP5 Basic - P61, P63, P62 

New Jersey GHI GHI HDHP* 811, 813, 812 Standard - 804, 806, 805 

New York Capital District 

Physicians’ 

Health Plan, Inc 

CDPHP Universal 

Benefits, Inc. 

High SG1, SG3, SG2 Standard - SG4, SG6, SG5 

New York GHI GHI HDHP* 811, 813, 812 Standard - 804, 806, 805 

Pennsylvania UPMC Health 

Plan 

UPMC Health 

Plan 

High 8W1, 8W3, 8W2 Standard - UW4, UW6, UW5 

Pennsylvania UPMC Health 

Plan 

UPMC Health 

Plan 

High YS1, YS3, YS2 Standard - YT4, YT6, YT5 

*Enrollees who want to continue enrollment in 2021 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 2020 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 2021 HDHP HSA Fiduciary. 
3 

Table 4 

Plans Adding New Options and Enrollment Codes 

State FEHB 

Carrier 

Plan Name New 

Option 

2021 Enrollment 

Codes 

Location 

(List All Counties and/or 

ZIP codes that are affected)

Idaho Kaiser 

Foundation 

Health Plan of 

Washington 

Kaiser Permanente 

- 

 Washington Core**

Basic* PT4, PT6, PT5 Kootenai and Latah counties 

Oregon Kaiser 

Foundation 

Health Plan of 

the Northwest 

Kaiser Permanente 

 - Northwest**

Basic* AM1, AM3, AM2 Clackamas, Columbia, Lane, 

Marion, Multnomah, Polk, 

Washington and Yamhill 

counties 

Benton County ZIP codes: 

97330, 97331, 97333, 97339, 

97370, 97456 

Hood River County ZIP codes: 

97014, 97031, 97041, 97044 

Linn County ZIP codes: 97321, 

97322, 97335, 97355, 97358, 

97360, 97374, 97389, 97446

Pennsylvania Geisinger 

Health Plan

Geisinger Health 

Plan

Basic AJ1, AJ3, AJ2 Adams, Berks, Blair, Bradford, 

Cambria, Cameron, Carbon, 

Centre, Clearfield, Clinton, 

Columbia, Cumberland, 

Dauphin, Fulton, Huntingdon, 

Jefferson, Juniata, Lackawanna, 

Lancaster, Lebanon, Lehigh, 

Luzerne, Lycoming, Mifflin, 

Monroe, Montour, 

Northampton, Northumberland, 

Perry, Pike, Potter, Schuylkill, 

Snyder, Somerset, Sullivan, 

Susquehanna, Tioga, Union, 

Wayne, Wyoming, and York 

counties 

Bedford County ZIP codes: 

15521, 15554, 16614, 16633, 

16650, 16655, 16659, 16664, 

16667, 16670, 16672, 16678, 

16679, 16695 

Elk County ZIP codes: 15821, 

15822, 15823, 15827, 15831, 

15841, 15846, 15860, 15868
4 

State FEHB 

Carrier 

Plan Name New 

Option 

2021 Enrollment 

Codes 

Location 

(List All Counties and/or 

ZIP codes that are affected)

Washington Kaiser 

Foundation 

Health Plan of

Washington 

Kaiser Permanente 

- 

Washington Core**

Basic* PT4, PT6, PT5 Benton, Columbia, Franklin, 

Island, King, Kitsap, Kittitas, 

Lewis, Mason, Pierce, Skagit, 

Snohomish, Spokane, Thurston, 

Walla Walla, Whatcom, 

Whitman, and Yakima counties 

Grays Harbor County ZIP 

codes: 98541, 98559, 98557, 

98568 

Jefferson County ZIP codes: 

98320, 98325, 98334, 

98339, 98358, 98365, 98368, 

98376

Washington Kaiser 

Foundation 

Health Plan of 

the Northwest 

Kaiser Permanente 

 - Northwest**

Basic* AM1, AM3, AM2 Clark and Cowlitz counties 

Wahkiakum County ZIP codes: 

98612, 98647 

Skamania County ZIP codes: 

98605, 98610, 98639, 98648, 

98651, 98671 

Wisconsin Dean Health 

Plan, Inc. 

Dean Health Plan, 

Inc. 

Basic AG1, AG3, AG2 Dane, Dodge, Fond du Lac, 

Green, Rock, and Sauk counties

Wisconsin Group Health 

Cooperative of 

South Central 

Wisconsin 

Group Health 

Cooperative of 

South Central 

Wisconsin 

Standard WJ4, WJ6, WJ5 Adams, Columbia, Dane, 

Dodge, Green, Iowa, Jefferson, 

Juneau, Lafayette, Richland, 

Rock, Sauk, and Vernon 

counties

*Branded as Prosper in the Plan brochure 

**Plan name changed in 2021 
5 

Table 5 

Service Area Expansions Without New Enrollment Codes 

State FEHB Carrier Plan Name Plan Option 2021 Enrollment 

Codes 

Location of Areas 

(List All Counties 

and/or ZIP codes that 

are affected)

Georgia Anthem BCBS Blue Open Access 

POS 

High QM1, QM3, QM2 Banks, Bibb, 

Chattahoochee, 

Columbia, Crawford, 

Harris, Houston, Jackson, 

McDuffie, Monroe, 

Muscogee, Peach, 

Richmond, Talbot, 

Taliaferro, Troup, Upson, 

and Wilkes counties

Iowa HealthPartners HealthPartners High 

Standard 

V31, V33, V32 

V34, V36, V35 

Adair, Adams, 

Appanoose, Audubon, 

Benton, Boone, Butler, 

Calhoun, Carroll, Cass, 

Cedar, Clarke, Clinton, 

Crawford, Dallas, Davis, 

Decatur, Des Moines, 

Dubuque, Franklin, 

Fremont, Greene, Grundy, 

Guthrie, Hamilton, 

Hardin, Harrison, Henry, 

Humboldt, Ida, Iowa, 

Jackson, Jasper, Jefferson, 

Johnson, Jones, Keokuk, 

Lee, Linn, Louisa, Lucas, 

Madison, Mahaska, 

Marion, Marshall, Mills, 

Monona, Monroe, 

Montgomery, Muscatine, 

Page, Polk, 

Pottawattamie, 

Poweshiek, Ringgold, 

Sac, Scott, Shelby, Story, 

Tama, Taylor, Union, Van 

Buren, Wapello, Warren, 

Washington, Wayne, 

Webster, and Wright 

counties

Ohio Medical Mutual Medical Mutual of 

Ohio 

Standard 

Basic 

X64, X66, X65 

X61, X63, X62 

Auglaize, Mercer, and 

Williams counties 
6 

State FEHB Carrier Plan Name Plan Option 2021 Enrollment 

Codes 

Location of Areas 

(List All Counties 

and/or ZIP codes that 

are affected)

Oregon Kaiser 

Foundation 

Health Plan of the 

Northwest 

Kaiser Permanente 

- Northwest**

High 

Standard

571, 573, 572 

574, 576, 575 

Lane County 

97412, 97413, 97430, 

97434, 97439, 97453, 

97463, 97480, 97488, 

97490, 97492, 97493 

Wisconsin HealthPartners HealthPartners High 

 Standard 

V31, V33, V32, 

V34, V36, V35 

Brown, Calumet, 

Florence, Forest, Green 

Lake, Kewaunee, 

Langlade, Lincoln, 

Manitowoc, Marinette, 

Marquette, Menominee, 

Oconto, Outagamie, 

Shawano, Waupaca, 

Waushara, and 

Winnebago counties

**Plan name changed in 2021 

Table 6 

New Plan Entering the FEHB Program 

State FEHB Carrier Plan Name Plan Option 2021 New 

Enrollment Codes 

Location of Areas 

(List All Counties 

and/or ZIP codes 

that are affected)

Alpha-numerical 

order

All Contiguous 

States and 

Washington, DC 

EXCEPT: Alaska, 

Hawaii, and the US 

Territories 

UnitedHealthcare 

Insurance Company, 

Inc. 

UnitedHealthcare 

Advantage Plan 

High Y51, Y53, Y52 All Contiguous 

States and 

Washington, DC 

EXCEPT: Alaska, 

Hawaii, and the US 

Territories 
7

Table 7

Plans Changing Name

State FEHB Carrier Old Plan Name New Plan Name Plan Codes

Alabama UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary

AS1, AS3, AS2

Alabama UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary

Y81, Y83, Y82

Arizona UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary

VD1, VD3, VD2

Arizona UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary

WF1, WF3, WF2

Arkansas UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary

AS1, AS3, AS2

Arkansas UnitedHealthcare 

Insurance 

Company, Inc.

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary

Y81, Y83, Y82

California Kaiser 

Foundation 

Health Plan, Inc. 

Northern 

California 

Region: Fresno 

Kaiser Foundation 

Health Plan, Inc. 

Northern California 

Region: Fresno

Kaiser Permanente 

- Fresno California

NZ1, NZ3, NZ2 

NZ4, NZ6, NZ5

California Kaiser

Foundation 

Health Plan, Inc. 

Northern 

California Region

Kaiser Foundation 

Health Plan, Inc. 

Northern California 

Region

Kaiser Permanente 

-

Northern California

591, 593, 592 

594, 596, 595 

KC1, KC3, KC2

California Kaiser 

Foundation 

Health Plan, Inc. 

Southern 

California Region

Kaiser Foundation 

Health Plan, Inc. 

Southern California 

Region

Kaiser Permanente 

-

Southern California

621, 623, 622 

624, 626, 625
8 

State FEHB Carrier Old Plan Name New Plan Name Plan Codes 

Colorado Kaiser 

Foundation 

Health Plan of 

Colorado 

Kaiser Foundation 

Health Plan of 

Colorado 

Kaiser Permanente 

- Colorado 

651, 653, 652 

654,656, 655 

N41, N43, N42 

District of 

Columbia 

Kaiser 

Foundation 

Health Plan of 

the Mid-Atlantic 

States, Inc. 

Kaiser Foundation 

Health Plan of the 

Mid-Atlantic States, 

Inc. 

Kaiser Permanente 

- 

Mid-Atlantic States 

E31, E33, E32 

E34, E36, E35 

T71, T73, T72 

District of 

Columbia 

UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

District of 

Columbia 

UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Florida UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Florida UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Georgia Kaiser 

Foundation 

Health Plan of 

Georgia, Inc. 

Kaiser Foundation 

Health Plan of 

Georgia, Inc. 

Kaiser Permanente 

- Georgia 

F81, F83, F82 

F84, F86, F85 

LA1, LA3, LA2 

Georgia UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Georgia UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Hawaii Kaiser 

Foundation 

Health Plan, Inc. 

Hawaii Region 

Kaiser Foundation 

Health Plan, Inc. 

Hawaii Region 

Kaiser Permanente 

- Hawaii 

631, 633, 632, 

634, 636, 635 
9 

State FEHB Carrier Old Plan Name New Plan Name Plan Codes 

Idaho Kaiser 

Foundation 

Health Plan of 

Washington 

Kaiser Foundation 

Health Plan of 

Washington 

Kaiser Permanente 

- Washington Core 

541, 543, 542 

544,546, 545 

Illinois UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Illinois UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Iowa UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Iowa UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Kentucky UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Kentucky UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Louisiana UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Louisiana UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Maryland Kaiser 

Foundation 

Health Plan of 

the Mid-Atlantic 

States, Inc. 

Kaiser Foundation 

Health Plan of the 

Mid-Atlantic States, 

Inc. 

Kaiser Permanente 

- 

Mid-Atlantic States 

E31, E33, E32 

E34, E36, E35 

T71, T73, T72 
10 

State FEHB Carrier Old Plan Name New Plan Name Plan Codes 

Maryland UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Maryland UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Mississippi UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Mississippi UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Missouri UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Missouri UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Nevada UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

VD1, VD3, VD2 

Nevada UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

WF1, WF3, WF2 

North Carolina UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

North Carolina UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 
11 

State FEHB Carrier Old Plan Name New Plan Name Plan Codes 

Oregon Kaiser 

Foundation 

Health Plan of 

the Northwest 

Kaiser Foundation 

Health Plan of the 

Northwest 

Kaiser Permanente 

- Northwest 

571, 573, 572 

574, 576, 575 

Oregon UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

VD1, VD3, VD2 

Oregon UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

WF1, WF3, WF2 

Pennsylvania UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Pennsylvania UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Tennessee UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Tennessee UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Texas UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Texas UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Virginia Kaiser 

Foundation 

Health Plan of 

the Mid-Atlantic 

States, Inc. 

Kaiser Foundation 

Health Plan of the 

Mid-Atlantic States, 

Inc. 

Kaiser Permanente 

- 

Mid-Atlantic States 

E31, E33, E32 

E34, E36, E35 

T71, T73, T72 
12 

State FEHB Carrier Old Plan Name New Plan Name Plan Codes 

Virginia UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

AS1, AS3, AS2 

Virginia UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

Y81, Y83, Y82 

Washington Kaiser 

Foundation 

Health Plan of 

the Northwest 

Kaiser Foundation 

Health Plan of the 

Northwest 

Kaiser Permanente 

- Northwest 

571, 573, 572 

574,576, 575 

Washington Kaiser 

Foundation 

Health Plan of 

Washington 

Kaiser Foundation 

Health Plan of 

Washington 

Kaiser Permanente 

- 

Washington Core 

541, 543, 542 

544,546, 545 

Washington UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Primary 

Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Primary 

VD1, VD3, VD2 

Washington UnitedHealthcare 

Insurance 

Company, Inc. 

UnitedHealthcare 

Insurance Company, 

Inc. Choice Plus 

Primary Advantage 

UnitedHealthcare 

Insurance 

Company, Inc. 

Choice Plus 

Primary 

WF1, WF3, WF2