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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 Washington

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

WA Aetna

High Self

8J1

118.93

139.14

104.36

34.78

5.05

257.68

301.47

226.1

75.37

10.95

High Family

8J2

302.42

353.83

265.37

88.46

12.86

655.24

766.63

574.97

191.66

27.85

WA 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

WA Group Health Cooperative

High Self

541

169.52

178.62

131.08

47.54

-0.58

367.29

387.01

284.01

103

-1.26

High Family

542

382.68

403.24

298.23

105.01

-0.58

829.14

873.69

646.17

227.52

-1.26

Standard Self

544

141.91

141.45

106.09

35.36

-0.12

307.47

306.48

229.86

76.62

-0.25

Standard Family

545

320.37

319.34

239.51

79.83

-0.26

694.14

691.9

518.93

172.97

-0.56

WA Group Health Cooperative

High Self

VR1

159.23

173.91

130.43

43.48

3.67

345

376.81

282.61

94.2

7.95

High Family

VR2

388.22

424.02

298.23

125.79

14.66

841.14

918.71

646.17

272.54

31.76

Standard Self

VR4

137.99

147.12

110.34

36.78

2.28

298.98

318.76

239.07

79.69

4.95

Standard Family

VR5

317.38

338.36

253.77

84.59

5.25

687.66

733.11

549.83

183.28

11.37

WA Kaiser Permanente

High Self

571

170.62

172.99

129.74

43.25

-5.97

369.68

374.81

281.11

93.7

-12.95

High Family

572

391.57

394.77

296.08

98.69

-15.79

848.4

855.34

641.51

213.83

-34.21

Standard Self

574

149.67

158.89

119.17

39.72

2.3

324.29

344.26

258.2

86.06

4.99

Standard Family

575

343.49

362.58

271.94

90.64

4.77

744.23

785.59

589.19

196.4

10.34

WA KPS Health Plans

High Self

VT1

178.87

187.92

131.08

56.84

-0.63

387.55

407.16

284.01

123.15

-1.37

High Family

VT2

390.84

410.62

298.23

112.39

-1.36

846.82

889.68

646.17

243.51

-2.95

Standard Self

L11

143.99

153.89

115.42

38.47

2.47

311.98

333.43

250.07

83.36

5.37

Standard Family

L12

314.63

332.16

249.12

83.04

4.38

681.7

719.68

539.76

179.92

9.5

WA PacifiCare Northwest Region (Oregon/Washington)

High Self

7Z1

167.15

186.09

131.08

55.01

9.26

362.16

403.2

284.01

119.19

20.06

High Family

7Z2

376.1

416.41

298.23

118.18

19.17

814.88

902.22

646.17

256.05

41.53

WA PacifiCare Northwest Region (Oregon/Washington)

High Self

SA1

New Plan

128.27

96.2

32.07

N/A

New Plan

277.92

208.44

69.48

N/A

High Family

SA2

New Plan

299.84

224.88

74.96

N/A

New Plan

649.65

487.24

162.41

N/A


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