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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 Kentucky

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

KY Aetna

High Self

RD1

151

162.03

121.52

40.51

2.76

327.17

351.07

263.3

87.77

5.98

High Family

RD2

371.08

393.74

295.31

98.43

4.44

804.01

853.1

639.83

213.27

9.62

KY 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

KY Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

6N1

New Plan

122.71

92.03

30.68

N/A

New Plan

265.87

199.4

66.47

N/A

CDHP Family

6N2

New Plan

282.26

211.7

70.56

N/A

New Plan

611.56

458.67

152.89

N/A

KY Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

BM1

115.28

117.81

88.36

29.45

0.63

249.77

255.26

191.45

63.81

1.37

CDHP Family

BM2

265.16

270.96

203.22

67.74

1.45

574.51

587.08

440.31

146.77

3.14

KY Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

L81

96.08

98.18

73.64

24.54

0.52

208.17

212.72

159.54

53.18

1.14

CDHP Family

L82

220.97

225.8

169.35

56.45

1.21

478.77

489.23

366.92

122.31

2.62

KY Humana Health Plan

High Self

D21

178.07

198.88

131.08

67.8

11.13

385.82

430.91

284.01

146.9

24.11

High Family

D22

409.53

457.42

298.23

159.19

26.75

887.32

991.08

646.17

344.91

57.95

KY United Healthcare of Ohio, Inc.

High Self

3U1

197.49

251.27

131.08

120.19

44.1

427.9

544.42

284.01

260.41

95.54

High Family

3U2

454.23

554.9

298.23

256.67

79.53

984.17

1202.28

646.17

556.11

172.3

Standard Self

3U4

New Plan

202.19

131.08

71.11

N/A

New Plan

438.08

284.01

154.07

N/A

Standard Family

3U5

New Plan

440.78

298.23

142.55

N/A

New Plan

955.02

646.17

308.85

N/A


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