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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 Kansas

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

KS Aetna

High Self

KS1

New Plan

144.33

108.25

36.08

N/A

New Plan

312.72

234.54

78.18

N/A

High Family

KS2

New Plan

370.81

278.11

92.7

N/A

New Plan

803.42

602.57

200.85

N/A

KS 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

KS Coventry Health Care of KS-Wichita/Salinas (HDHP)

HDHP Self

7G1

New Plan

121.04

90.78

30.26

N/A

New Plan

262.25

196.69

65.56

N/A

HDHP Family

7G2

New Plan

298.91

224.18

74.73

N/A

New Plan

647.64

485.73

161.91

N/A

KS Coventry Health Care of Kansas-Wichita/Salinas

High Self

7W1

New Plan

157.04

117.78

39.26

N/A

New Plan

340.25

255.19

85.06

N/A

High Family

7W2

New Plan

400.45

298.23

102.22

N/A

New Plan

867.64

646.17

221.47

N/A

Standard Self

7W4

New Plan

148.7

111.53

37.17

N/A

New Plan

322.18

241.64

80.54

N/A

Standard Family

7W5

New Plan

379.17

284.38

94.79

N/A

New Plan

821.54

616.16

205.38

N/A

KS Coventry Health Care of KS-Kansas City (HDHP)

HDHP Self

9H1

New Plan

128.89

96.67

32.22

N/A

New Plan

279.26

209.45

69.81

N/A

HDHP Family

9H2

New Plan

332.53

249.4

83.13

N/A

New Plan

720.48

540.36

180.12

N/A

KS Coventry Health Care of Kansas-Kansas City

High Self

HA1

132.36

148.84

111.63

37.21

4.12

286.78

322.49

241.87

80.62

8.93

High Family

HA2

341.54

384.11

288.08

96.03

10.65

740

832.24

624.18

208.06

23.06

Standard Self

HA4

New Plan

140.97

105.73

35.24

N/A

New Plan

305.44

229.08

76.36

N/A

Standard Family

HA5

New Plan

363.79

272.84

90.95

N/A

New Plan

788.21

591.16

197.05

N/A

KS Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

PH1

76.86

78.54

58.91

19.63

0.42

166.53

170.17

127.63

42.54

0.91

CDHP Family

PH2

176.77

180.64

135.48

45.16

0.97

383

391.39

293.54

97.85

2.1

KS Humana Health Plan, Inc.

High Self

MS1

170.71

192.85

131.08

61.77

12.46

369.87

417.84

284.01

133.83

26.99

High Family

MS2

392.64

443.55

298.23

145.32

29.77

850.72

961.03

646.17

314.86

64.5

Standard Self

MS4

122.89

127.14

95.36

31.78

1.06

266.26

275.47

206.6

68.87

2.31

Standard Family

MS5

282.64

292.44

219.33

73.11

2.45

612.39

633.62

475.22

158.4

5.3

KS Preferred Plus of Kansas

High Self

VA1

212.27

219.52

131.08

88.44

-2.43

459.92

475.63

284.01

191.62

-5.27

High Family

VA2

564.64

583.94

298.23

285.71

-1.84

1223.39

1265.2

646.17

619.03

-4


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