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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

2006 FEHB Non-Postal Premium Rates for New York

HMO Plans

2005 Total Biweekly Premium

2006 Biweekly premium rates

2005 Total Monthly Premium

2006 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

NY Aetna HealthFund

Consumer Driven Self

221

136.8

135.55

101.66

33.89

-0.31

296.4

293.69

220.27

73.42

-0.68

Consumer Driven Family

222

314.65

311.79

233.84

77.95

-0.71

681.74

675.55

506.66

168.89

-1.54

High Deductible Self

224

153.73

150.58

112.94

37.64

-0.79

333.08

326.26

244.7

81.56

-1.71

High Deductible Family

225

353.59

343.31

257.48

85.83

-2.57

766.11

743.84

557.88

185.96

-5.57

NY Aetna Open Access

High Self

JC1

177.65

193.06

139.18

53.88

7.31

384.91

418.3

301.56

116.74

15.84

High Family

JC2

437.3

475.22

316.08

159.14

20.07

947.48

1029.64

684.84

344.8

43.49

NY Blue Choice

High Self

MK1

130.07

131.93

98.95

32.98

0.46

281.82

285.85

214.39

71.46

1.01

High Family

MK2

325.87

330.26

247.7

82.56

1.09

706.05

715.56

536.67

178.89

2.38

NY CDPHP Universal Benefits, Inc.

High Self

SG1

155.33

188.28

139.18

49.1

10.27

336.55

407.94

301.56

106.38

22.24

High Family

SG2

391.44

444.34

316.08

128.26

30.4

848.12

962.74

684.84

277.9

65.87

Standard Self

SG4

New Plan

165.05

123.79

41.26

N/A

New Plan

357.61

268.21

89.4

N/A

Standard Family

SG5

New Plan

412.64

309.48

103.16

N/A

New Plan

894.05

670.54

223.51

N/A

NY GHI Health Plan

High Self

801

200.91

217.98

139.18

78.8

8.97

435.31

472.29

301.56

170.73

19.43

High Family

802

502.28

544.97

316.08

228.89

24.84

1088.27

1180.77

684.84

495.93

53.83

Standard Self

804

170.15

174.74

131.06

43.68

1.14

368.66

378.6

283.95

94.65

2.49

Standard Family

805

397.2

407.92

305.94

101.98

2.68

860.6

883.83

662.87

220.96

5.81

NY GHI HMO Select

High Self

6V1

183.75

210.1

139.18

70.92

18.25

398.13

455.22

301.56

153.66

39.54

High Family

6V2

467.78

532.86

316.08

216.78

47.23

1013.52

1154.53

684.84

469.69

102.34

Standard Self

6V4

157.7

178.51

133.88

44.63

5.21

341.68

386.77

290.08

96.69

11.27

Standard Family

6V5

401.46

451.02

316.08

134.94

31.71

869.83

977.21

684.84

292.37

68.71

NY GHI HMO Select

High Self

X41

169.75

185.78

139.18

46.6

4.16

367.79

402.52

301.56

100.96

9.01

High Family

X42

437.49

474

316.08

157.92

18.66

947.9

1027

684.84

342.16

40.43

Standard Self

X44

154.35

174

130.5

43.5

4.91

334.43

377

282.75

94.25

10.64

Standard Family

X45

390.3

442.87

316.08

126.79

29.22

845.65

959.55

684.84

274.71

63.3

NY HIP of Greater New York

High Self

511

159.41

176.11

132.08

44.03

4.18

345.39

381.57

286.18

95.39

9.04

High Family

512

446.35

493.13

316.08

177.05

28.93

967.09

1068.45

684.84

383.61

62.69

Standard Self

514

131.51

153.8

115.35

38.45

5.57

284.94

333.23

249.92

83.31

12.08

Standard Family

515

368.23

430.63

316.08

114.55

22.49

797.83

933.03

684.84

248.19

48.73

NY HMO Blue

High Self

AH1

173.97

252.78

139.18

113.6

70.11

376.94

547.69

301.56

246.13

151.9

High Family

AH2

442.45

645.41

316.08

329.33

185.11

958.64

1398.39

684.84

713.55

401.08

NY HMOBlue-CNY

High Self

EB1

172.49

195.74

139.18

56.56

13.44

373.73

424.1

301.56

122.54

29.11

High Family

EB2

441.23

477.76

316.08

161.68

18.68

956

1035.15

684.84

350.31

40.48

NY Independent Health Assoc

High Self

QA1

129.64

138.58

103.94

34.64

2.23

280.89

300.26

225.2

75.06

4.84

High Family

QA2

355.56

380.09

285.07

95.02

6.13

770.38

823.53

617.65

205.88

13.29

High Deductible Self

QA4

New Plan

145.19

108.89

36.3

N/A

New Plan

314.58

235.94

78.64

N/A

High Deductible Family

QA5

New Plan

346.4

259.8

86.6

N/A

New Plan

750.53

562.9

187.63

N/A

NY MVP Health Care

High Self

GA1

148.03

160.66

120.5

40.16

3.15

320.73

348.1

261.08

87.02

6.84

High Family

GA2

382.28

414.92

311.19

103.73

8.16

828.27

898.99

674.24

224.75

17.68

NY MVP Health Care

High Self

M91

161.06

176.35

132.26

44.09

3.83

348.96

382.09

286.57

95.52

8.28

High Family

M92

415.92

455.43

316.08

139.35

21.66

901.16

986.77

684.84

301.93

46.94

NY MVP Health Care

High Self

MX1

166.04

179.52

134.64

44.88

3.37

359.75

388.96

291.72

97.24

7.3

High Family

MX2

428.8

463.53

316.08

147.45

16.88

929.07

1004.32

684.84

319.48

36.58

NY Preferred Care

High Self

GV1

127.06

128.96

96.72

32.24

0.48

275.3

279.41

209.56

69.85

1.03

High Family

GV2

339.21

345.06

258.8

86.26

1.46

734.96

747.63

560.72

186.91

3.17

NY Univera Healthcare

High Self

KQ1

146.79

177.03

132.77

44.26

7.56

318.05

383.57

287.68

95.89

16.38

High Family

KQ2

388.88

468.73

316.08

152.65

55.43

842.57

1015.58

684.84

330.74

120.1

NY Univera Healthcare

High Self

Q81

117.88

140.68

105.51

35.17

5.7

255.41

304.81

228.61

76.2

12.35

High Family

Q82

334.24

398.85

299.14

99.71

16.15

724.19

864.18

648.14

216.04

34.99

NY Vytra Health Plans

High Self

J61

190.63

196.37

139.18

57.19

-2.36

413.03

425.47

301.56

123.91

-5.11

High Family

J62

500.08

511.53

316.08

195.45

-6.4

1083.51

1108.32

684.84

423.48

-13.86

Standard Self

J64

New Plan

177.65

133.24

44.41

N/A

New Plan

384.91

288.68

96.23

N/A

Standard Family

J65

New Plan

463.98

316.08

147.9

N/A

New Plan

1005.29

684.84

320.45

N/A


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