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U.S. Office of Personnel Management - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People

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Federal Employees Health Benefits Program

2005 FEHB Non-Postal Premium Rates for Colorado

HMO Plans

2004 Total Biweekly Premium

2005 Biweekly premium rates

2004 Total Monthly Premium

2005 Monthly premium rates

Plan

Option

Enrollment Code

Total Premium

Gov't Pays

Empl. Pays

Change in employee payment

Total Premium

Gov't Pays

Empl. Pays

Change in employee payment

CO Aetna

High Self

9E1

New Plan

158.35

118.76

39.59

N/A

New Plan

343.09

257.32

85.77

N/A

High Family

9E2

New Plan

407.61

298.23

109.38

N/A

New Plan

883.16

646.17

236.99

N/A

CO Aetna HealthFund (CDHP/HDHP)

CDHP Self

221

129.44

136.8

102.6

34.2

1.84

280.45

296.4

222.3

74.1

3.99

CDHP Family

222

297.73

314.65

235.99

78.66

4.23

645.08

681.74

511.31

170.43

9.16

HDHP Self

224

New Plan

153.73

115.3

38.43

N/A

New Plan

333.08

249.81

83.27

N/A

HDHP Family

225

New Plan

353.59

265.19

88.4

N/A

New Plan

766.11

574.58

191.53

N/A

CO Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

7T1

New Plan

107.98

80.99

26.99

N/A

New Plan

233.96

175.47

58.49

N/A

CDHP Family

7T2

New Plan

248.38

186.29

62.09

N/A

New Plan

538.16

403.62

134.54

N/A

CO Kaiser Permanente

High Self

651

143.02

160.88

120.66

40.22

4.47

309.88

348.57

261.43

87.14

9.67

High Family

652

369

387.69

290.77

96.92

4.67

799.5

840

630

210

10.13

Standard Self

654

New Plan

122.13

91.6

30.53

N/A

New Plan

264.62

198.47

66.15

N/A

Standard Family

655

New Plan

294.32

220.74

73.58

N/A

New Plan

637.69

478.27

159.42

N/A

CO PacifiCare of Colorado

High Self

D61

155.99

173.5

130.13

43.37

4.37

337.98

375.92

281.94

93.98

9.49

High Family

D62

372.83

410.53

298.23

112.3

16.56

807.8

889.48

646.17

243.31

35.87


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