U.S. Office of Personnel Management www.opm.gov - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People

Insurance Services Programs

Federal Employees Health Benefits Program

2004 Premiums

2004 FEHB Non-Postal Premium Rates for Arizona

HMO Plans		2003 Total Biweekly Premium	2004 Biweekly premium rates				2003 Total Monthly Premium	2004 Monthly premium rates
Plan - Option - Enrollment Code		2003 Total Biweekly Premium	Total Premium	Gov't Pays	Empl. Pays	Change in employee payment	2003 Total Monthly Premium	Total Premium	Gov't Pays	Empl. Pays	Change in employee payment
Aetna Health Inc.
High Self	WQ1	104.45	115.49	86.62	28.87	2.76	226.31	250.23	187.67	62.56	5.98
High Family	WQ2	286.89	317.23	237.92	79.31	7.59	621.60	687.33	515.50	171.83	16.43
Health Net of Arizona, Inc.
High Self	A71	127.59	141.63	106.22	35.41	3.51	276.45	306.87	230.15	76.72	7.61
High Family	A72	323.27	358.85	269.14	89.71	8.89	700.42	777.51	583.13	194.38	19.28
Humana CoverageFirst (Consumer Driven Plan)
High Self	DB1	New Plan	91.27	68.45	22.82	N/A	New Plan	197.75	148.31	49.44	N/A
High Family	DB2	New Plan	209.91	157.43	52.48	N/A	New Plan	454.81	341.11	113.70	N/A
PacifiCare Desert Region (AZ & NV)
High Self	A31	129.96	128.38	96.29	32.09	-0.40	281.58	278.16	208.62	69.54	-0.85
High Family	A32	356.94	319.68	239.76	79.92	-27.40	773.37	692.64	519.48	173.16	-59.37

This page can be found on the web at the following url: http://www.opm.gov/insure/archive/health/04rates/html/nonpostal/az.asp

U.S. Office of Personnel Management 1900 E Street, NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532