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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 Guam

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

GU PacifiCare Asia Pacific

High Self

JK1

144.58

193.16

131.08

62.08

25.94

313.26

418.51

284.01

134.5

56.19

High Family

JK2

379.92

461.88

298.23

163.65

60.82

823.16

1000.74

646.17

354.57

131.77

Standard Self

JK4

113.98

136.85

102.64

34.21

5.72

246.96

296.51

222.38

74.13

12.39

Standard Family

JK5

301

361.38

271.04

90.34

15.09

652.17

782.99

587.24

195.75

32.71


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