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Healthcare Plan Information

Tribal Premium Rates for the Federal Employees Health Benefits Program

FFS (Fee-for-Service/Nationwide Plans)

Plan - Option Enrollment Code 2022 Total Monthly Premium 2023 Monthly Premium Rates - Total Premium 2023 Monthly Premium Rates - Tribal Employer Pays 2023 Monthly Premium Rates - Employee Pays 2023 Monthly Premium Rates - Change in Employee Payment
Nationwide APWU Health Plan - CDHP Self 474 603.66 639.86 479.90 159.96 9.05
Nationwide APWU Health Plan - CDHP Self & Family 475 1431.26 1517.12 1137.84 379.28 21.47
Nationwide APWU Health Plan - CDHP Self Plus One 476 1311.98 1390.70 1043.03 347.67 19.68
Nationwide APWU Health Plan - High Self 471 761.04 824.89 562.73 262.16 31.65
Nationwide APWU Health Plan - High Self & Family 472 1826.41 1979.64 1324.74 654.90 72.44
Nationwide APWU Health Plan - High Self Plus One 473 1598.11 1732.19 1214.46 517.73 56.32
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self 111 694.94 750.51 562.73 187.78 14.05
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self & Family 112 1703.91 1840.22 1324.74 515.48 55.52
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self Plus One 113 1561.65 1686.58 1214.46 472.12 47.17
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self 131 460.59 469.86 352.40 117.46 2.31
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self & Family 132 1089.18 1111.02 833.27 277.75 5.46
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self Plus One 133 990.21 1010.06 757.55 252.51 4.96
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self 104 806.72 871.26 562.73 308.53 32.34
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self & Family 105 1924.52 2078.51 1324.74 753.77 73.20
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self Plus One 106 1764.19 1905.30 1214.46 690.84 63.35
Nationwide GEHA Benefit Plan - High Self 311 757.73 791.83 562.73 229.10 1.90
Nationwide GEHA Benefit Plan - High Self & Family 312 1898.82 1984.26 1324.74 659.52 4.65
Nationwide GEHA Benefit Plan - High Self Plus One 313 1667.01 1742.02 1214.46 527.56 -2.75
Nationwide GEHA Benefit Plan - Standard Self 314 543.10 596.05 447.04 149.01 13.24
Nationwide GEHA Benefit Plan - Standard Self & Family 315 1428.70 1568.00 1176.00 392.00 34.83
Nationwide GEHA Benefit Plan - Standard Self Plus One 316 1167.70 1281.56 961.17 320.39 28.47
Nationwide GEHA HDHP - HDHP Self 341 547.80 601.21 450.91 150.30 13.35
Nationwide GEHA HDHP - HDHP Self & Family 342 1447.31 1588.43 1191.32 397.11 35.28
Nationwide GEHA HDHP - HDHP Self Plus One 343 1177.78 1292.61 969.46 323.15 28.71
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self 251 685.77 743.38 557.54 185.84 14.40
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self & Family 252 1652.15 1779.38 1324.74 454.64 41.60
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self Plus One 253 1532.14 1621.01 1214.46 406.55 11.11
Nationwide GEHA Indemnity Benefit Plan - Elevate Self 254 422.44 439.34 329.51 109.83 4.22
Nationwide GEHA Indemnity Benefit Plan - Elevate Self & Family 255 1182.85 1253.83 940.37 313.46 17.75
Nationwide GEHA Indemnity Benefit Plan - Elevate Self Plus One 256 971.62 1029.90 772.43 257.47 14.57
Nationwide MHBP Consumer Option - HDHP Self 481 662.11 682.00 511.50 170.50 4.97
Nationwide MHBP Consumer Option - HDHP Self & Family 482 1538.53 1584.68 1188.51 396.17 11.54
Nationwide MHBP Consumer Option - HDHP Self Plus One 483 1465.27 1509.24 1131.93 377.31 10.99
Nationwide MHBP Standard Option - Standard Self 454 678.25 698.60 523.95 174.65 5.09
Nationwide MHBP Standard Option - Standard Self & Family 455 1576.21 1623.51 1217.63 405.88 11.83
Nationwide MHBP Standard Option - Standard Self Plus One 456 1561.19 1608.06 1206.05 402.01 -22.48
Nationwide MHBP Value Plan - Value Self 414 485.05 504.44 378.33 126.11 4.85
Nationwide MHBP Value Plan - Value Self & Family 415 1172.21 1219.10 914.33 304.77 11.72
Nationwide MHBP Value Plan - Value Self Plus One 416 1149.27 1195.24 896.43 298.81 11.49
Nationwide NALC Health Benefit Plan - CDHP Self 324 473.53 482.97 362.23 120.74 2.36
Nationwide NALC Health Benefit Plan - CDHP Self & Family 325 1110.92 1144.24 858.18 286.06 8.33
Nationwide NALC Health Benefit Plan - CDHP Self Plus One 326 1044.68 1065.59 799.19 266.40 5.23
Nationwide NALC Health Benefit Plan - High Self 321 743.47 785.85 562.73 223.12 10.18
Nationwide NALC Health Benefit Plan - High Self & Family 322 1681.66 1782.56 1324.74 457.82 20.11
Nationwide NALC Health Benefit Plan - High Self Plus One 323 1644.46 1738.21 1214.46 523.75 15.99
Nationwide NALC Health Benefit Plan - Value Self KM1 388.64 396.41 297.31 99.10 1.94
Nationwide NALC Health Benefit Plan - Value Self & Family KM2 912.15 939.51 704.63 234.88 6.84
Nationwide NALC Health Benefit Plan - Value Self Plus One KM3 857.35 874.49 655.87 218.62 4.28
Nationwide SAMBA Health Benefit Plan - High Self 441 874.68 900.92 562.73 338.19 -5.96
Nationwide SAMBA Health Benefit Plan - High Self & Family 442 2099.22 2162.20 1324.74 837.46 -17.81
Nationwide SAMBA Health Benefit Plan - High Self Plus One 443 1924.30 1982.02 1214.46 767.56 -20.04
Nationwide SAMBA Health Benefit Plan - Standard Self 444 707.94 729.17 546.88 182.29 4.88
Nationwide SAMBA Health Benefit Plan - Standard Self & Family 445 1615.12 1663.57 1247.68 415.89 12.11
Nationwide SAMBA Health Benefit Plan - Standard Self Plus One 446 1523.71 1569.40 1177.05 392.35 5.34
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