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Federal Employees Health Benefits Program

2004 Premiums

FEHB Home | Non-Postal Premiums

You are here: OPM Home > Insurance > FEHB > 2004 Premiums > Non-postal > California

2004 FEHB Non-Postal Premium Rates for California

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	2X1	107.98	108.27	81.20	27.07	0.08	233.96	234.59	175.94	58.65	0.16
High Family	2X2	256.16	263.99	197.99	66.00	1.96	555.01	571.98	428.99	142.99	4.24
Aetna HealthFund (Consumer Driven Plan)
High Self	221	New Plan	129.44	97.08	32.36	N/A	New Code	280.45	210.34	N/A	70.11
High Family	222	New Plan	297.73	223.30	74.43	N/A	New Code	645.08	483.81	161.27	N/A
Blue Cross- HMO
High Self	M51	133.38	154.52	115.89	38.63	5.29	288.99	334.79	251.09	83.70	11.45
High Family	M52	340.29	381.12	277.09	104.03	13.36	737.30	825.76	600.36	225.40	28.94
Blue Shield of CA Access+
High Self	SJ1	130.94	134.87	101.15	33.72	0.99	283.70	292.22	219.17	73.05	2.13
High Family	SJ2	324.80	334.55	250.91	83.64	2.44	703.73	724.86	543.65	181.21	5.28
Health Net of California
High Self	LB1	125.90	142.95	107.21	35.74	4.27	272.78	309.73	232.30	77.43	9.24
High Family	LB2	298.02	338.40	253.80	84.60	10.10	645.71	733.20	549.90	183.30	21.87
Kaiser Permanente
High Self	591	138.11	157.97	118.48	39.49	4.96	299.24	342.27	256.70	85.57	10.76
High Family	592	329.68	377.07	277.09	99.98	17.56	714.31	816.99	600.36	216.63	38.05
Kaiser Permanente
High Self	621	129.31	148.21	111.16	37.05	4.72	280.17	321.12	240.84	80.28	10.24
High Family	622	298.89	342.54	256.91	85.63	10.91	647.60	742.17	556.63	185.54	23.64
PacifiCare of California
High Self	CY1	105.60	119.95	89.96	29.99	3.59	228.80	259.89	194.92	64.97	7.77
High Family	CY2	273.30	278.29	208.72	69.57	1.25	592.15	602.96	452.22	150.74	2.70
UHP Healthcare
High Self	C41	105.40	107.67	80.75	26.92	0.57	228.37	233.29	174.97	58.32	1.23
High Family	C42	224.43	229.28	171.96	57.32	1.21	486.27	496.77	372.58	124.19	2.62
Universal Care
High Self	6Q1	104.06	110.14	82.61	27.53	1.52	225.46	238.64	178.98	59.66	3.30
High Family	6Q2	274.73	290.74	218.06	72.68	4.00	595.25	629.94	472.46	157.48	8.67

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