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| FEHB Home | Non-Postal Premiums |
2004 FEHB Non-Postal Premium Rates for Ohio
| HMO Plans | 2003 Total Biweekly Premium | 2004 Biweekly premium rates | 2003 Total Monthly Premium | 2004 Monthly premium rates | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Plan - Option - Enrollment Code | Total Premium | Gov't Pays | Empl. Pays | Change in employee payment | Total Premium | Gov't Pays | Empl. Pays | Change in employee payment | |||
| Aetna Health Inc. | |||||||||||
| High Self | 7D1 | 139.73 | 141.10 | 105.83 | 35.27 | 0.34 | 302.75 | 305.72 | 229.29 | 76.43 | 0.74 |
| High Family | 7D2 | 336.55 | 339.83 | 254.87 | 84.96 | -1.97 | 729.19 | 736.30 | 552.23 | 184.07 | -4.28 |
| Aetna Health Inc. | |||||||||||
| High Self | RD1 | 139.97 | 151.00 | 113.25 | 37.75 | 2.76 | 303.27 | 327.17 | 245.38 | 81.79 | 5.97 |
| High Family | RD2 | 343.99 | 371.08 | 277.09 | 93.99 | -0.38 | 745.31 | 804.01 | 600.36 | 203.65 | -0.82 |
| AultCare HMO | |||||||||||
| High Self | 3A1 | 150.42 | 145.88 | 109.41 | 36.47 | -4.65 | 325.91 | 316.07 | 237.05 | 79.02 | -10.07 |
| High Family | 3A2 | 380.95 | 358.16 | 268.62 | 89.54 | -41.79 | 825.39 | 776.01 | 582.01 | 194.00 | -90.55 |
| Blue HMO | |||||||||||
| High Self | R51 | 149.10 | 173.71 | 121.40 | 52.31 | 12.51 | 323.05 | 376.37 | 263.03 | 113.34 | 27.11 |
| High Family | R52 | 370.33 | 431.43 | 277.09 | 154.34 | 33.63 | 802.38 | 934.77 | 600.36 | 334.41 | 72.87 |
| HMO Health Ohio | |||||||||||
| High Self | L41 | 133.69 | 151.14 | 113.36 | 37.78 | 4.36 | 289.66 | 327.47 | 245.60 | 81.87 | 9.46 |
| High Family | L42 | 341.96 | 386.65 | 277.09 | 109.56 | 17.22 | 740.91 | 837.74 | 600.36 | 237.38 | 37.31 |
| HOMETOWN HEALTH PLAN | |||||||||||
| High Self | MZ1 | New Plan | 129.67 | 97.25 | 32.42 | N/A | New Plan | 280.95 | 210.71 | 70.24 | N/A |
| High Family | MZ2 | New Plan | 324.19 | 243.14 | 81.05 | N/A | New Plan | 702.41 | 526.81 | 175.60 | N/A |
| Humana CoverageFirst (Consumer Driven Plan) | |||||||||||
| High Self | L81 | New Plan | 96.08 | 72.06 | 24.02 | N/A | New Plan | 208.17 | 156.13 | 52.04 | N/A |
| High Family | L82 | New Plan | 220.97 | 165.73 | 55.24 | N/A | New Plan | 478.77 | 359.08 | 119.69 | N/A |
| Kaiser Permanente | |||||||||||
| High Self | 641 | 137.00 | 151.78 | 113.84 | 37.94 | 3.69 | 296.83 | 328.86 | 246.65 | 82.21 | 8.00 |
| High Family | 642 | 336.18 | 372.47 | 277.09 | 95.38 | 8.82 | 728.39 | 807.02 | 600.36 | 206.66 | 19.11 |
| Paramount Health Care | |||||||||||
| High Self | U21 | 140.20 | 154.56 | 115.92 | 38.64 | 3.59 | 303.77 | 334.88 | 251.16 | 83.72 | 7.78 |
| High Family | U22 | 371.19 | 409.23 | 277.09 | 132.14 | 10.57 | 804.25 | 886.67 | 600.36 | 286.31 | 22.90 |
| SummaCare Health Plan | |||||||||||
| High Self | 5W1 | 132.62 | 145.43 | 109.07 | 36.36 | 3.21 | 287.34 | 315.10 | 236.33 | 78.77 | 6.94 |
| High Family | 5W2 | 364.66 | 399.92 | 277.09 | 122.83 | 7.79 | 790.10 | 866.49 | 600.36 | 266.13 | 16.87 |
| SuperMed HMO | |||||||||||
| High Self | 5M1 | 154.60 | 168.06 | 121.40 | 46.66 | 1.36 | 334.97 | 364.13 | 263.03 | 101.10 | 2.95 |
| High Family | 5M2 | 395.45 | 429.89 | 277.09 | 152.80 | 6.97 | 856.81 | 931.43 | 600.36 | 331.07 | 15.10 |
| The Health Plan of the Upper Ohio Valley | |||||||||||
| High Self | U41 | 149.39 | 154.45 | 115.84 | 38.61 | -1.48 | 323.68 | 334.64 | 250.98 | 83.66 | -3.20 |
| High Family | U42 | 410.83 | 355.20 | 266.40 | 88.80 | -72.41 | 890.13 | 769.60 | 577.20 | 192.40 | -156.89 |
| United Healthcare of Ohio, Inc. | |||||||||||
| High Self | 3U1 | 177.82 | 197.49 | 121.40 | 76.09 | 7.57 | 385.28 | 427.90 | 263.03 | 164.87 | 16.41 |
| High Family | 3U2 | 409.00 | 454.23 | 277.09 | 177.14 | 17.76 | 886.17 | 984.17 | 600.36 | 383.81 | 38.48 |
This page can be found on the web at the following url: http://www.opm.gov/insure/archive/health/04rates/html/nonpostal/oh.asp