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
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| FEHB Home | Non-Postal Premiums |
2004 FEHB Non-Postal Premium Rates for South Dakota
| 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 | |||
| Avera Health Plans | |||||||||||
| High Self | AV1 | 118.18 | 144.77 | 108.58 | 36.19 | 6.65 | 256.06 | 313.67 | 235.25 | 78.42 | 14.41 |
| High Family | AV2 | 275.98 | 338.08 | 253.56 | 84.52 | 15.53 | 597.96 | 732.51 | 549.38 | 183.13 | 33.64 |
| Sioux Valley Health Plan | |||||||||||
| High Self | AU1 | 167.09 | 213.66 | 121.40 | 92.26 | 34.47 | 362.03 | 462.93 | 263.03 | 199.90 | 74.69 |
| High Family | AU2 | 382.64 | 491.25 | 277.09 | 214.16 | 81.14 | 829.05 | 1064.38 | 600.36 | 464.02 | 175.81 |
| Standard Self | AU4 | New Code | 181.32 | 121.40 | 59.92 | N/A | New Code | 392.86 | 263.03 | 129.83 | N/A |
| Standard Family | AU5 | New Code | 416.83 | 277.09 | 139.74 | N/A | New Code | 903.13 | 600.36 | 302.77 | N/A |
This page can be found on the web at the following url: http://www.opm.gov/insure/archive/health/04rates/html/nonpostal/sd.asp
U.S. Office of Personnel Management 1900 E Street, NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532