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 Maryland

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	JN1	141.44	160.96	120.72	40.24	4.88	306.45	348.75	261.56	87.19	10.58
High Family	JN2	318.55	362.51	271.88	90.63	10.99	690.19	785.44	589.08	196.36	23.81
Standard Self	JN4	105.74	105.75	79.31	26.44	0.01	229.10	229.13	171.85	57.28	0.01
Standard Family	JN5	247.46	247.47	185.60	61.87	0.01	536.16	536.19	402.14	134.05	0.01
Aetna HealthFund (Consumer Driven Plan)
High Self	221	New Plan	129.44	97.08	32.36	N/A	New Code	280.45	210.34	70.11	N/A
High Family	222	New Plan	297.73	223.30	74.43	N/A	New Code	645.08	483.81	161.27	N/A
CareFirst BlueChoice
High Self	2G1	160.71	181.64	121.40	60.24	8.83	348.21	393.55	263.03	130.52	19.13
High Family	2G2	361.58	408.63	277.09	131.54	19.58	783.42	885.37	600.36	285.01	42.43
Kaiser Permanente
High Self	E31	123.23	145.98	109.49	36.49	5.68	267.00	316.29	237.22	79.07	12.32
High Family	E32	293.29	347.45	260.59	86.86	13.54	635.46	752.81	564.61	188.20	29.34
M.D. IPA
High Self	JP1	138.80	146.81	110.11	36.70	2.00	300.73	318.09	238.57	79.52	4.34
High Family	JP2	333.17	352.37	264.28	88.09	4.54	721.87	763.47	572.60	190.87	9.84

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

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