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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 Missouri

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

MO 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

MO 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

MO BlueCHOICE

High Self

9G1

153.68

177.5

131.08

46.42

8

332.97

384.58

284.01

100.57

17.33

High Family

9G2

332.73

384.3

288.23

96.07

12.89

720.92

832.65

624.49

208.16

27.93

MO Community Health Plan

High Self

IC1

New Plan

138.65

103.99

34.66

N/A

New Plan

300.41

225.31

75.1

N/A

High Family

IC2

New Plan

381.71

286.28

95.43

N/A

New Plan

827.04

620.28

206.76

N/A

MO 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

MO Group Health Plan

High Self

MM1

197.52

205.81

131.08

74.73

-1.39

427.96

445.92

284.01

161.91

-3.02

High Family

MM2

426.63

444.53

298.23

146.3

-3.24

924.37

963.15

646.17

316.98

-7.03

HDHP Self

MM4

New Plan

170.3

127.73

42.57

N/A

New Plan

368.98

276.74

92.24

N/A

HDHP Family

MM5

New Plan

364.62

273.47

91.15

N/A

New Plan

790.01

592.51

197.5

N/A

MO 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

MO 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

MO Mercy Health Plans/Premier Health Plans

High Self

7M1

193.54

216.77

131.08

85.69

13.55

419.34

469.67

284.01

185.66

29.35

High Family

7M2

418.06

468.23

298.23

170

29.03

905.8

1014.5

646.17

368.33

62.89

MO 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

249.40

83.13

N/A

New Plan

720.48

540.36

180.12

N/A


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