Plan State Opted out of standards relating to benefits for mothers and newborns Opted out of parity in the application of certain limits to mental health benefits Opted out of requiring coverage for reconstructive surgery following mastectomies Opted out of coverage for dependent students on medically necessary leaves of absence
Auburn University Alabama ‐‐‐ X ‐‐‐ ‐‐‐
Board of Trustees for The University of Alabama (The University of Alabama ‐ Self Funded Health Plan)  

Alabama

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Board of Trustees for The University of Alabama (The University of Alabama ‐ System

Office)

 

Alabama

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Baldwin County Commission Alabama ‐‐‐ X ‐‐‐ ‐‐‐
City of Athens Alabama ‐‐‐ X ‐‐‐ ‐‐‐
City of Mobile Alabama X X X X
City of Orange Beach Alabama ‐‐‐ X X X
City of Opelika Alabama ‐‐‐ X ‐‐‐ ‐‐‐
Local Government Health Insurance Board Alabama ‐‐‐ X ‐‐‐ ‐‐‐
Public Education Employees’ Health Insurance Fund (14000) Alabama ‐‐‐ X ‐‐‐ ‐‐‐
Public Education Employees’ Health Insurance Fund (61000) Alabama ‐‐‐ X ‐‐‐ ‐‐‐
Public Education Employees’ Health Insurance Fund (81000) Alabama ‐‐‐ X ‐‐‐ ‐‐‐
State Employees’ Insurance Board Alabama ‐‐‐ X ‐‐‐ ‐‐‐
University of South Alabama Alabama X X X X
Alaska Care Employee Health Plan Alaska ‐‐‐ X ‐‐‐ ‐‐‐
Public Employees Local 71 Trust ‐ covering: the State of Alaska, Anchorage School District, Municipality of Anchorage, and the Haines Borough  

Alaska

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Pima County Community College District Group Health Plan Arizona ‐‐‐ X ‐‐‐ ‐‐‐
BluePreferred Saver Plan (Tempe School District No.3) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
BluePreferred Low Plan (Tempe School District No.3) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
BluePreferred High Plan (Tempe School District No.3) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Central Arizona Water Conservation District Arizona ‐‐‐ X ‐‐‐ ‐‐‐
City of Chandler Arizona ‐‐‐ X ‐‐‐ ‐‐‐
City of Sierra Vista Arizona ‐‐‐ X ‐‐‐ ‐‐‐
City of Tucson (Cigna Network Plan) NEW Arizona ‐‐‐ X ‐‐‐ ‐‐‐
City of Tucson (Cigna High Deductible Health Plan (HDHP) with H S A) NEW Arizona ‐‐‐ X ‐‐‐ ‐‐‐
City of Tucson (Cigna High Deductible Health Plan (HDHP) with H R A) NEW Arizona ‐‐‐ X ‐‐‐ ‐‐‐
County of Maricopa Arizona ‐‐‐ X ‐‐‐ ‐‐‐
County of Mohave Arizona ‐‐‐ X ‐‐‐ ‐‐‐
County of Pima Arizona X X X X
County of Yuma Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Gila River Indian Community (GRICI) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Northern Arizona Public Employees Benefit Trust Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Mesa Unified School District #4 (NEW) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Mesa Unified School District #4 ‐ HDDP 1500 Plan (NEW) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Mesa Unified School District #4 ‐ HDDP 2500 Plan (NEW) Arizona ‐‐‐ X ‐‐‐ ‐‐‐
Washington Elementary School District Employee Benefit Trust Arizona ‐‐‐ X ‐‐‐ ‐‐‐
County of Orange ‐ Sharewell Choice Health Plan California ‐‐‐ X ‐‐‐ ‐‐‐
County of Orange ‐ Sharewell Retiree Health Plan California ‐‐‐ X ‐‐‐ ‐‐‐
County of Orange ‐ Wellwise Choice Health Plan California ‐‐‐ X ‐‐‐ ‐‐‐
County of Orange ‐ Wellwise Retiree Health Plan California ‐‐‐ X ‐‐‐ ‐‐‐
Fresno Unified School District ‐ covering: Fresno Teachers Association, California School

Employees Association, Chapter 125, California School Employees Association, Chapter 143, SEIU Local 535, Building and Construction Trades Council of Fresno, Madera, Kings

 

 

California

 

 

‐‐‐

 

 

X

 

 

‐‐‐

 

 

‐‐‐

Gold Coast Joint Benefits Trust California ‐‐‐ X ‐‐‐ ‐‐‐
Los Angeles Firemen’s Relief Association California ‐‐‐ X ‐‐‐ ‐‐‐
Redding Rancheria California ‐‐‐ X ‐‐‐ ‐‐‐
Tri‐County Schools Insurance Group California ‐‐‐ X ‐‐‐ ‐‐‐
Poudre School District Colorado ‐‐‐ X ‐‐‐ ‐‐‐
Town of Avon Colorado ‐‐‐ X ‐‐‐ ‐‐‐
Calhoun County School Board Florida ‐‐‐ X ‐‐‐ ‐‐‐
School Board of Alachua County Health Plan Florida ‐‐‐ X ‐‐‐ ‐‐‐
County of St. Johns Board of County Commissioners Florida ‐‐‐ X ‐‐‐ ‐‐‐
Florida Firefighters Insurance Trust Fund Florida ‐‐‐ X ‐‐‐ ‐‐‐
Lee Health Plan (LMHFJ05) Florida X X X X
Manatee County Government Board of County Commissioners Florida ‐‐‐ X ‐‐‐ ‐‐‐
Miami Beach Fraternal Order of Police Florida ‐‐‐ X ‐‐‐ ‐‐‐
School Board of Orange County ‐ covering: OESPA CBLT ‐ Orange Education Support Professionals Association and CTA CBLT ‐ Orange County Classroom Teachers

Association

 

 

Florida

 

 

‐‐‐

 

 

X

 

 

‐‐‐

 

 

‐‐‐

St. Johns County School District Florida ‐‐‐ X ‐‐‐ ‐‐‐
City of Chicago (Medical PPO Option for Police) Illinois ‐‐‐ X ‐‐‐ ‐‐‐
City of Chicago (Group Health Plan: Medical PPO Plan) Illinois ‐‐‐ X ‐‐‐ ‐‐‐
City of Loves Park Illinois X X ‐‐‐ ‐‐‐
 

County of Henry ‐ covering: Fraternal Order of Police, American Federation of State, County and Municipal Employees, and Laborers International Union of North America

 

 

Illinois

 

 

X

 

 

X

 

 

X

 

 

X

County of Tazewell ‐ covering: Tazewell County Medical Health Insurance Plan and Central States Medical Insurance Plan  

Illinois

 

X

 

X

 

X

 

X

Community Consolidated School District #15 Illinois ‐‐‐ X ‐‐‐ ‐‐‐
Tazewell County Medical Health Insurance Plan Illinois ‐‐‐ X ‐‐‐ ‐‐‐
Concord Community Schools Indiana ‐‐‐ X ‐‐‐ ‐‐‐
Kosciusko County Indiana ‐‐‐ X ‐‐‐ ‐‐‐
Saint Joseph County Indiana ‐‐‐ X ‐‐‐ ‐‐‐
Wa‐Nee Community Schools Indiana ‐‐‐ X ‐‐‐ ‐‐‐
Wawasee Community Schools Indiana ‐‐‐ X ‐‐‐ ‐‐‐
Black Hawk County Iowa ‐‐‐ X ‐‐‐ ‐‐‐
Metro Interagency Insurance Program (MIIP) Iowa ‐‐‐ X ‐‐‐ ‐‐‐
City of Wichita (City of Wichita Premium Plan) Kansas ‐‐‐ X ‐‐‐ ‐‐‐
City of Wichita (City of Wichita Select Plan) Kansas ‐‐‐ X ‐‐‐ ‐‐‐
Calcasieu Parish Police Jury Louisiana ‐‐‐ X ‐‐‐ ‐‐‐
LaFayette City‐Parish Consolidated Government Louisiana X X X X
North Oaks Health System Employee Health Benefit Plan ‐ PPO Medical and

Prescription Drug Plan

 

Louisiana

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

North Oaks Health System Employee Health Benefit Plan ‐ PCA Medical and Prescription

Drug Plan

 

Louisiana

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

St. Martin Parish School Board Louisiana ‐‐‐ X ‐‐‐ ‐‐‐
State of Michigan (State Health Plan PPO ‐ Retiree) Michigan ‐‐‐ X ‐‐‐ ‐‐‐
State of Michigan (State Health Plan PPO) Michigan ‐‐‐ X ‐‐‐ ‐‐‐
State of Michigan (State Health Plan MA ‐ Retiree) Michigan ‐‐‐ X ‐‐‐ ‐‐‐
State of Michigan (State HDHP with HSA) Michigan ‐‐‐ X ‐‐‐ ‐‐‐
Department of Finance and Administration State and School Employees’ Life and Health

Insurance Plan

 

Mississippi

 

X

 

X

 

X

 

‐‐‐

Carthage R‐9 School District Missouri ‐‐‐ X ‐‐‐ ‐‐‐
City Utilities of Springfield, Missouri Missouri ‐‐‐ X ‐‐‐ ‐‐‐
Webb City R‐VII School District Missouri ‐‐‐ X ‐‐‐ ‐‐‐
County of Holt Nebraska ‐‐‐ X ‐‐‐ ‐‐‐
Clark County Nevada ‐ covering: Clark County Self‐Funded Group Medical and Dental Benefit Plan  

Nevada

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Las Vegas Firefighters Health & Welfare Trust (CBA) Nevada ‐‐‐ X ‐‐‐ ‐‐‐
Township of West Caldwell New Jersey ‐‐‐ X ‐‐‐ ‐‐‐
New Mexico Public Schools Insurance Authority (NMPSIA) New Mexico ‐‐‐ X ‐‐‐ ‐‐‐
Tri‐County Schools Insurance Group New Mexico ‐‐‐ X ‐‐‐ ‐‐‐
Regents of the University of New Mexico for its Public Operation Known as UNM New Mexico ‐‐‐ X ‐‐‐ ‐‐‐
Carmel Central School District (Carmel Schools Health Benefit Plan) New York ‐‐‐ X ‐‐‐ X
 

Cayuga‐Onondaga Area School Employees’ Healthcare Plan (Modified Traditional Plan)

 

New York

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Cayuga‐Onondaga Area School Employees’ Healthcare Plan (Traditional Plan) New York ‐‐‐ X ‐‐‐ ‐‐‐
County of Westchester ‐ covering: CSEA, NYSNA, COBA, SOA, PBA, SPBA, Teamster, and

UFPO

 

New York

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

County of Suffolk ‐ covering: Police Benevolent Association, Superior Officers’

Association, Suffolk County Association of Municipal Employees, Suffolk Detectives’ Association, Correction Officers’ Association, Deputy Sheriffs’ Benevolent Association, Detective Investigators’ PBA, Guild of Administrative Officers, Faculty Association ‐ Suffolk County Community College, Suffolk County Probation Officers

 

 

 

 

New York

 

 

 

 

‐‐‐

 

 

 

 

X

 

 

 

 

‐‐‐

 

 

 

 

‐‐‐

Horseheads Central School District New York ‐‐‐ X ‐‐‐ ‐‐‐
Niagara County ‐ covering: Premium, Core, Value, and First Choice New York ‐‐‐ X ‐‐‐ ‐‐‐
Orange‐Ulster School Districts Health Plan New York ‐‐‐ X ‐‐‐ ‐‐‐
Steuben Area Schools Employees Benefit Plan New York ‐‐‐ X ‐‐‐ ‐‐‐
Suffolk School Employees Health Plan New York ‐‐‐ X ‐‐‐ ‐‐‐
County of Craven North Carolina X ‐‐‐ X ‐‐‐
County of Mecklenburg (BlueShield Options HSA Plan) North Carolina ‐‐‐ X ‐‐‐ ‐‐‐
County of Mecklenburg (BlueCross BlueShield Blue Options PPO) North Carolina ‐‐‐ X ‐‐‐ ‐‐‐
System Employee Health Benefit Plan) Oklahoma ‐‐‐ X ‐‐‐ ‐‐‐
Emerald People’s Utility District Oregon ‐‐‐ X ‐‐‐ ‐‐‐
Cocalico School District (Cocalico School District Preferred Provider Organization ‐ Aetna Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
County of Lebanon ‐ covering: Social Services, Court Appointed Professionals, Court

Related Non‐Professionals, Prison, EMA, Detectives, and Non‐Union

 

Pennsylvania

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

County of Schuylkill Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
Donegal School District Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
East Lampeter Township ‐ covering: East Lampeter Township Police Officers Association

and East Lampeter Township Non‐Uniformed Employees

 

Pennsylvania

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Northern York County Regional Police Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
Pennsylvania Municipal Health Insurance Purchasing Cooperative Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
York Area Regional Police Department Pennsylvania ‐‐‐ X ‐‐‐ ‐‐‐
Clarksville Montgomery County School System (Group Retiree Medical Plan, Employees

Insurance Trust Group Med Plan, and Group Standard Med Plan, and Group PPO)

 

Tennessee

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

County of Dallas (PEBC Dental Plan) Texas X X X X
County of Dallas (PEBC High Deductible Medical Plan HDP) Texas X X X X
County of Dallas (PEBC PPO Medical Plan) Texas X X X X
County of Denton (PEBC Dental Plan) Texas X X X X
County of Denton (PEBC High Deductible Medical Plan HDP) Texas X X X X
County of Denton (PEBC PPO Medical Plan) Texas X X X X
County of Parker (PEBC Dental Plan) Texas X X X X
County of Parker (PEBC High Deductible Medical Plan HDP) Texas X X X X
County of Parker (PEBC PPO Medical Plan) Texas X X X X
County of Tarrant (PEBC Dental Plan) Texas X X X X
County of Tarrant (PEBC High Deductible Medical Plan HDP) Texas X X X X
County of Tarrant (PEBC PPO Medical Plan) Texas X X X X
County of Harrison Texas X X ‐‐‐ ‐‐‐
County of Montgomery Texas X X X ‐‐‐
County of Potter Texas ‐‐‐ X ‐‐‐ ‐‐‐
County of Williamson (Williamson County) Texas X X X X
Ector County Independent School District Texas X X X ‐‐‐
Fort Bend County Texas X X X ‐‐‐
Guadalupe Regional Medical Center Texas ‐‐‐ X ‐‐‐ ‐‐‐
ISD of Eagle Pass Texas ‐‐‐ X ‐‐‐ ‐‐‐
ISD of Plano Texas X X ‐‐‐ ‐‐‐
Leander ISD Medical Plan Texas ‐‐‐ X ‐‐‐ ‐‐‐
Lubbock County Hospital District d/b/a UMC Health Plan Texas ‐‐‐ X ‐‐‐ ‐‐‐
North Texas Tollway Authority (PEBC Dental Plan) Texas X X X X
North Texas Tollway Authority (PEBC High Deductible Medical Plan HDP) Texas X X X X
North Texas Tollway Authority (PEBC PPO Medical Plan) Texas X X X X
Southeast Texas Government Employees Benefits Pool Texas X X ‐‐‐ ‐‐‐
Teachers Retirement System of Texas Texas ‐‐‐ X ‐‐‐ ‐‐‐
Texas Association of Counties Health and Employee Benefits Pool Texas ‐‐‐ X ‐‐‐ ‐‐‐
The University of Texas System ‐ UT SELECT Texas X X X X
The University of Texas System ‐ UT CONNECT Texas X X X X
TML MultiState Intergovernmental Employee Benefits Pool Texas X X X X
Uvalde County Hospital Authority Texas ‐‐‐ X ‐‐‐ ‐‐‐
 

Canyons School District (Canyons School District Qualified High Deductible Health Plan)

 

Utah

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Canyons School District (Canyons School District Traditional Health Plan) Utah ‐‐‐ X ‐‐‐ ‐‐‐
County of Washington Utah ‐‐‐ X ‐‐‐ ‐‐‐
Layton City Corporation Utah ‐‐‐ X ‐‐‐ ‐‐‐
Millard School District Utah ‐‐‐ X ‐‐‐ ‐‐‐
Salt Lake Community College Utah ‐‐‐ X ‐‐‐ ‐‐‐
University of Utah Early Retirement Incentive Program Health Care Plan Utah X X X X
University of Utah Employee Health Care Plan Utah X X X X
University of Utah Hospitals and Clinics Utah X X X X
Utah State University Utah ‐‐‐ X ‐‐‐ ‐‐‐
Utah Valley University Utah ‐‐‐ X ‐‐‐ ‐‐‐
A1000 The Rector and Board of Visitors of the University of Virginia – UVA Health

Plan

Virginia ‐‐‐ X ‐‐‐ ‐‐‐
A1000 The Rector and Board of Visitors of the University of Virginia – UVA J Visa Health Plan  

Virginia

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

Alaska State Employees Association American Federation of State County and Mun

(ASEA/AFSCME Local 52 Health Trust

 

Washington

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

City of Bellevue ‐ covering: City of Bellevue Health Plans General Affordable Plan,

General Core Plan, and LEOFF 1 Plan

 

Washington

 

‐‐‐

 

X

 

‐‐‐

 

‐‐‐

City of Renton Washington ‐‐‐ X ‐‐‐ ‐‐‐
CWPU Unified Insurance Program Trust 100000030 CDHP Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
CWPU Unified Insurance Program Trust 100000030 PPO Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, High Deductible Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, PPO 100 Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, PPO 300 Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, PPO 750 Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, PPO Plus Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, Retiree Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
Washington Fire Commissioners Association, Traditional Plan Washington ‐‐‐ X ‐‐‐ ‐‐‐
West Virginia Public Employees Insurance Agency (PEIA) West Virginia ‐‐‐ X ‐‐‐ ‐‐‐
County of Portage “NEW” Wisconsin ‐‐‐ X ‐‐‐ X
Milwaukee Public Schools (Employee Wellness Program) Wisconsin X X X X
Milwaukee Public Schools (Health and Productivity Management Program) Wisconsin X X X X
Milwaukee Public Schools (United Healthcare EPO Health Plan) Wisconsin X X X X
Milwaukee Public Schools (United Healthcare High Deductible Health Plan ‐ HDHP) Wisconsin X X X X
Milwaukee Public Schools (United Healthcare PPO Health Plan) Wisconsin X X X X