Insurance Services Programs
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2004 FEHB Non-Postal Fee-for-Service Premium Rates
APWU Health Plan
High Self
471
161.38
178.32
121.40
56.92
4.84
349.66
386.36
263.03
123.33
10.49
High Family
472
354.15
391.34
277.09
114.25
9.72
767.33
847.90
600.36
247.54
21.05
Consumer-Driven Self
474
145.60
155.79
116.84
38.95
2.55
315.47
337.55
253.16
84.39
5.52
Consumer-Driven Family
475
335.92
362.79
272.09
90.70
4.40
727.83
786.05
589.54
196.51
9.52
Blue Cross and Blue Shield Service Benefit Plan
Standard Self
104
154.96
170.30
121.40
48.90
3.24
335.75
368.98
263.03
105.95
7.02
Standard Family
105
354.84
389.97
277.09
112.88
7.66
768.82
844.94
600.36
244.58
16.60
Basic Self
111
139.98
151.98
113.99
37.99
3.00
303.29
329.29
246.97
82.32
6.50
Basic Family
112
329.10
355.98
266.99
88.99
6.72
713.05
771.29
578.47
192.82
14.56
GEHA Benefit Plan
High Self
311
176.47
197.64
121.40
76.24
9.07
382.35
428.22
263.03
165.19
19.66
High Family
312
384.06
430.14
277.09
153.05
18.61
832.13
931.97
600.36
331.61
40.32
Standard Self
314
110.00
121.00
90.75
30.25
2.75
238.33
262.17
196.63
65.54
5.96
Standard Family
315
250.00
275.00
206.25
68.75
6.25
541.67
595.83
446.87
148.96
13.54
Mail Handlers
High Self
451
173.59
216.99
121.40
95.59
31.30
376.11
470.15
263.03
207.12
67.83
High Family
452
366.16
457.70
277.09
180.61
64.07
793.35
991.68
600.36
391.32
138.81
Standard Self
454
112.35
128.64
96.48
32.16
4.07
243.43
278.72
209.04
69.68
8.82
Standard Family
455
243.89
279.25
209.44
69.81
8.84
528.43
605.04
453.78
151.26
19.15
NALC
High Self
321
157.74
173.08
121.40
51.68
3.24
341.77
375.01
263.03
111.98
7.03
High Family
322
337.07
369.87
277.09
92.78
5.33
730.32
801.39
600.36
201.03
11.55
PBP Health Plan
High Self
361
269.12
304.46
121.40
183.06
23.24
583.09
659.66
263.03
396.63
50.36
High Family
362
580.64
656.87
277.09
379.78
48.76
1258.05
1423.22
600.36
822.86
105.65
Standard Self
364
157.75
189.30
121.40
67.90
19.45
341.79
410.15
263.03
147.12
42.15
Standard Family
365
357.32
428.79
277.09
151.70
44.00
774.19
929.05
600.36
328.69
95.34
Association Benefit Plan
High Self
421
163.85
180.16
121.40
58.76
4.21
355.01
390.35
263.03
127.32
9.13
High Family
422
377.46
415.01
277.09
137.92
10.08
817.83
899.19
600.36
298.83
21.84
Foreign Service Benefit Plan
High Self
401
148.56
162.68
121.40
41.28
2.02
321.88
352.47
263.03
89.44
4.38
High Family
402
360.81
394.00
277.09
116.91
5.72
781.76
853.67
600.36
253.31
12.39
Panama Canal Area Benefit Plan
High Self
431
144.96
152.21
114.16
38.05
1.81
314.08
329.79
247.34
82.45
3.93
High Family
432
302.59
317.72
238.29
79.43
3.78
655.61
688.39
516.29
172.10
8.20
Rural Carrier Benefit Plan
High Self
381
179.98
199.94
121.40
78.54
7.86
389.96
433.20
263.03
170.17
17.03
High Family
382
366.60
406.82
277.09
129.73
12.75
794.30
881.44
600.36
281.08
27.62
SAMBA
High Self
441
182.96
192.11
121.40
70.71
-2.95
396.41
416.24
263.03
153.21
-6.38
High Family
442
430.88
452.42
277.09
175.33
-5.93
933.57
980.24
600.36
379.88
-12.85
Secret Service Employees Health Association
High Self
Y71
146.45
175.74
121.40
54.34
17.19
317.31
380.77
263.03
117.74
37.25
High Family
Y72
347.08
416.50
277.09
139.41
41.95
752.01
902.42
600.36
302.06
90.89
U.S. Office of Personnel Management 1900 E Street NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532