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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 Virginia

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

VA 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

VA Aetna Open Access

High Self

JN1

160.96

176

131.08

44.92

4.68

348.75

381.33

284.01

97.32

10.13

High Family

JN2

362.51

394.23

295.67

98.56

7.93

785.44

854.17

640.63

213.54

17.18

Basic Self

JN4

105.75

115.88

86.91

28.97

2.53

229.13

251.07

188.3

62.77

5.49

Basic Family

JN5

247.47

271.17

203.38

67.79

5.92

536.19

587.54

440.66

146.88

12.83

VA CareFirst BlueChoice

High Self

2G1

181.64

181.64

131.08

50.56

-9.68

393.55

393.55

284.01

109.54

-20.98

High Family

2G2

408.63

408.63

298.23

110.4

-21.14

885.37

885.37

646.17

239.2

-45.81

VA Kaiser Permanente

High Self

E31

145.98

159.22

119.42

39.8

3.31

316.29

344.98

258.74

86.24

7.17

High Family

E32

347.45

378.96

284.22

94.74

7.88

752.81

821.08

615.81

205.27

17.07

Standard Self

E34

New Plan

128.15

96.11

32.04

N/A

New Plan

277.66

208.25

69.41

N/A

Standard Family

E35

New Plan

305

228.75

76.25

N/A

New Plan

660.83

495.62

165.21

N/A

VA M.D. IPA

High Self

JP1

146.81

161.1

120.83

40.27

3.57

318.09

349.05

261.79

87.26

7.74

High Family

JP2

352.37

386.69

290.02

96.67

8.58

763.47

837.83

628.37

209.46

18.59

VA Optima Health Plan

High Self

9R1

166.75

179.6

131.08

48.52

3.17

361.29

389.13

284.01

105.12

6.86

High Family

9R2

394.58

424.95

298.23

126.72

9.23

854.92

920.73

646.17

274.56

20

VA Piedmont Community Healthcare

High Self

2C1

162.15

163.77

122.83

40.94

0.19

351.33

354.84

266.13

88.71

0.41

High Family

2C2

371.3

375.01

281.26

93.75

-0.46

804.48

812.52

609.39

203.13

-0.99


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