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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 Postal Premium Rates for Pennsylvania

HMO Plans

2004 Total Biweekly Premium

2005 Total Biweekly Premium

2005 Biweekly Postal Premium Rates

Plan

Option

Enrollment Code

USPS Pays

Employee Pays

Change in employee payment

PA Aetna

High Self

P31

158.9

185.14

154.74

30.4

12.52

High Family

P32

383.43

446.74

352.08

94.66

38.35

PA Aetna

High Self

YE1

123.99

134.23

119.13

15.1

1.15

High Family

YE2

341.92

370.14

328.5

41.64

3.17

PA Aetna HealthFund (CDHP/HDHP)

CDHP Self

221

129.44

136.8

121.41

15.39

0.83

CDHP Family

222

297.73

314.65

279.25

35.4

1.91

HDHP Self

224

New Plan

153.73

136.44

17.29

N/A

HDHP Family

225

New Plan

353.59

313.81

39.78

N/A

PA Coventry Health Care of Delaware

High Self

2J1

New Plan

193.32

154.74

38.58

N/A

High Family

2J2

New Plan

488.13

352.08

136.05

N/A

HDHP Self

2J4

New Plan

159.4

141.47

17.93

N/A

HDHP Family

2J5

New Plan

391.87

347.78

44.09

N/A

PA HealthAmerica Pennsylvania

High Self

261

164.23

170.32

151.16

19.16

-1.75

High Family

262

418.79

434.34

352.08

82.26

-9.41

Standard Self

264

147.93

158.98

141.09

17.89

1.25

Standard Family

265

377.22

405.41

352.08

53.33

3.23

PA HealthAmerica Pennsylvania

High Self

4N1

179.14

238.06

154.74

83.32

47.5

High Family

4N2

444.26

547.54

352.08

195.46

78.32

Standard Self

4N4

161.5

211.05

154.74

56.31

38.13

Standard Family

4N5

400.52

485.42

352.08

133.34

59.94

PA HealthAmerica Pennsylvania - HDHP

HDHP Self

9N1

New Plan

183.76

154.74

29.02

N/A

HDHP Family

9N2

New Plan

414.45

352.08

62.37

N/A

PA HealthAmerica Pennsylvania

High Self

PN1

New Plan

233.6

154.74

78.86

N/A

High Family

PN2

New Plan

536.37

352.08

184.29

N/A

Standard Self

PN4

New Plan

209.4

154.74

54.66

N/A

Standard Family

PN5

New Plan

480.7

352.08

128.62

N/A

PA HealthAmerica Pennsylvania

High Self

SW1

177.2

202.73

154.74

47.99

14.11

High Family

SW2

429.17

466.28

352.08

114.2

12.15

Standard Self

SW4

159.17

186.46

154.74

31.72

13.81

Standard Family

SW5

385.51

428.86

352.08

76.78

18.39

PA HealthAmerica Pennsylvania - HDHP

HDHP Self

Y61

New Plan

151.89

134.8

17.09

N/A

HDHP Family

Y62

New Plan

373.42

331.41

42.01

N/A

PA HealthAmerica Pennsylvania - HDHP

HDHP Self

YN1

New Plan

190.76

154.74

36.02

N/A

HDHP Family

YN2

New Plan

431.16

352.08

79.08

N/A

PA HealthAmerica Pennsylvania - HDHP

HDHP Self

YW1

New Plan

171.59

152.29

19.3

N/A

HDHP Family

YW2

New Plan

387.1

343.55

43.55

N/A

PA Keystone Health Plan Central

High Self

S41

174.21

208.21

154.74

53.47

22.58

High Family

S42

418.17

496.79

352.08

144.71

53.66

PA Keystone Health Plan East

High Self

ED1

160.74

164.6

146.08

18.52

0.44

High Family

ED2

423.86

434.06

352.08

81.98

-14.76

PA UPMC Health Plan

High Self

8W1

156.11

170.97

151.74

19.23

1.67

High Family

8W2

398.21

436.07

352.08

83.99

12.9