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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 Fee-for-Service Premium Rates

Fee-for-Service Plans (FFS)

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

APWU Health Plan

High Self

471

178.32

190.8

131.08

59.72

2.8

386.36

413.4

284.01

129.39

6.06

High Family

472

391.34

418.74

298.23

120.51

6.26

847.9

907.27

646.17

261.1

13.56

Consumer Driven Self

474

155.79

163.58

122.69

40.89

1.94

337.55

354.42

265.82

88.6

4.21

Consumer Driven Family

475

362.79

380.93

285.7

95.23

4.53

786.05

825.35

619.01

206.34

9.83

Blue Cross and Blue Shield Service Benefit Plan

Standard Self

104

170.3

181.79

131.08

50.71

1.81

368.98

393.88

284.01

109.87

3.92

Standard Family

105

389.97

416.29

298.23

118.06

5.18

844.94

901.96

646.17

255.79

11.21

Basic Self

111

151.98

151.98

113.99

37.99

0

329.29

329.29

246.97

82.32

0

Basic Family

112

355.98

355.98

266.99

88.99

0

771.29

771.29

578.47

192.82

0

GEHA Benefit Plan

High Self

311

197.64

220.37

131.08

89.29

13.05

428.22

477.47

284.01

193.46

28.27

High Family

312

430.14

479.61

298.23

181.38

28.33

931.97

1039.16

646.17

392.99

61.38

Standard Self

314

121

133.11

99.83

33.28

3.03

262.17

288.41

216.31

72.1

6.56

Standard Family

315

275

302.49

226.87

75.62

6.87

595.83

655.4

491.55

163.85

14.89

GEHA High Deductible Health Plan

HDHP Self

341

New Plan

175.76

131.08

44.68

N/A

New Plan

380.81

284.01

96.8

N/A

HDHP Family

342

New Plan

401.44

298.23

103.21

N/A

New Plan

869.79

646.17

223.62

N/A

Mail Handlers Benefit Plan

High Self

451

216.99

282.09

131.08

151.01

55.42

470.15

611.2

284.01

327.19

120.07

High Family

452

457.7

595.02

298.23

296.79

116.18

991.68

1289.21

646.17

643.04

251.72

Standard Self

454

128.64

176.24

131.08

45.16

13

278.72

381.85

284.01

97.84

28.16

Standard Family

455

279.25

382.57

286.93

95.64

25.83

605.04

828.9

621.68

207.22

55.96

Mail Handlers Benefit Plan Consumer Option

HDHP Self

481

New Plan

169.02

126.77

42.25

N/A

New Plan

366.21

274.66

91.55

N/A

HDHP Family

482

New Plan

383.02

287.27

95.75

N/A

New Plan

829.88

622.41

207.47

N/A

NALC

High Self

321

173.08

189.39

131.08

58.31

6.63

375.01

410.35

284.01

126.34

14.36

High Family

322

369.87

404.73

298.23

106.5

13.72

801.39

876.92

646.17

230.75

29.72

PBP Health Plan

High Self

361

304.46

304.46

131.08

173.38

-9.68

659.66

659.66

284.01

375.65

-20.98

High Family

362

656.87

656.87

298.23

358.64

-21.14

1423.22

1423.22

646.17

777.05

-45.81

Standard Self

364

189.3

204.44

131.08

73.36

5.46

410.15

442.95

284.01

158.94

11.82

Standard Family

365

428.79

463.09

298.23

164.86

13.16

929.05

1003.36

646.17

357.19

28.5

Association Benefit Plan

High Self

421

180.16

191.51

131.08

60.43

1.67

390.35

414.94

284.01

130.93

3.61

High Family

422

415.01

441.16

298.23

142.93

5.01

899.19

955.85

646.17

309.68

10.85

Foreign Service Benefit Plan

High Self

401

162.68

175.69

131.08

44.61

3.33

352.47

380.66

284.01

96.65

7.21

High Family

402

394

419.62

298.23

121.39

4.48

853.67

909.18

646.17

263.01

9.7

Panama Canal Area Benefit Plan

High Self

431

152.21

159.83

119.87

39.96

1.91

329.79

346.3

259.73

86.57

4.12

High Family

432

317.72

333.61

250.21

83.4

3.97

688.39

722.82

542.12

180.7

8.6

Rural Carrier Benefit Plan

High Self

381

199.94

208.58

131.08

77.5

-1.04

433.2

451.92

284.01

167.91

-2.26

High Family

382

406.82

424.39

298.23

126.16

-3.57

881.44

919.51

646.17

273.34

-7.74

SAMBA

High Self

441

192.11

206.51

131.08

75.43

4.72

416.24

447.44

284.01

163.43

10.22

High Family

442

452.42

486.36

298.23

188.13

12.8

980.24

1053.78

646.17

407.61

27.73

Standard Self

444

New Plan

166.95

125.21

41.74

N/A

New Plan

361.73

271.3

90.43

N/A

Standard Family

445

New Plan

395.68

296.76

98.92

N/A

New Plan

857.31

642.98

214.33

N/A


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