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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 Louisiana

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

LA Coventry Healthcare Louisiana

High Self

BJ1

122.31

155.12

116.34

38.78

8.2

265.01

336.09

252.07

84.02

17.77

High Family

BJ2

284.08

360.26

270.2

90.06

19.04

615.51

780.56

585.42

195.14

41.26

HDHP Self

BJ4

New Plan

123.19

92.39

30.8

N/A

New Plan

266.91

200.18

66.73

N/A

HDHP Family

BJ5

New Plan

286.11

214.58

71.53

N/A

New Plan

619.91

464.93

154.98

N/A

LA Coventry Healthcare Louisiana

High Self

JA1

170.49

162.59

121.94

40.65

-8.44

369.4

352.28

264.21

88.07

-18.3

High Family

JA2

395.95

377.62

283.22

94.4

-24.46

857.89

818.18

613.64

204.54

-52.99

HDHP Self

JA4

New Plan

130.53

97.9

32.63

N/A

New Plan

282.82

212.12

70.7

N/A

HDHP Family

JA5

New Plan

303.17

227.38

75.79

N/A

New Plan

656.87

492.65

164.22

N/A

LA Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

9J1

New Plan

93.28

69.96

23.32

N/A

New Plan

202.11

151.58

50.53

N/A

CDHP Family

9J2

New Plan

214.5

160.88

53.62

N/A

New Plan

464.75

348.56

116.19

N/A

LA Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

9L1

New Plan

112.91

84.68

28.23

N/A

New Plan

244.64

183.48

61.16

N/A

CDHP Family

9L2

New Plan

259.67

194.75

64.92

N/A

New Plan

562.62

421.97

140.65

N/A

LA Humana CoverageFirst (Consumer Driven Plan)

CDHP Self

9S1

New Plan

127.63

95.72

31.91

31.91

New Plan

276.53

207.4

69.13

N/A

CDHP Family

9S2

New Plan

293.54

220.16

73.38

73.38

New Plan

636

477

159

N/A

LA Vantage Health Plan

High Self

MV1

178.03

187.55

131.08

56.47

-0.16

385.73

406.36

284.01

122.35

-0.35

High Family

MV2

462.87

431.38

298.23

133.15

-52.63

1002.89

934.66

646.17

288.49

-114.04


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