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Federal Employees Health Benefits Program

2004 Premiums

FEHB Home | Non-Postal Premiums

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2004 FEHB Non-Postal Premium Rates for Wisconsin

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
Dean Health Plan
High Self	WD1	127.18	135.34	101.51	33.83	2.04	275.56	293.24	219.93	73.31	4.42
High Family	WD2	343.36	365.40	274.05	91.35	-2.39	743.95	791.70	593.78	197.92	-5.19
Group Health Cooperative
High Self	WJ1	130.29	132.42	99.32	33.10	0.53	282.30	286.91	215.18	71.73	1.16
High Family	WJ2	349.42	357.96	268.47	89.49	-10.31	757.08	775.58	581.69	193.89	-22.35
HealthPartners Classic
High Self	531	163.13	193.43	121.40	72.03	18.20	353.45	419.10	263.03	156.07	39.44
High Family	532	391.51	464.22	277.09	187.13	45.24	848.27	1005.81	600.36	405.45	98.02
Standard Self	534	New Code	163.96	121.40	42.56	N/A	New Code	355.25	263.03	92.22	N/A
Standard Family	535	New Code	393.48	277.09	116.39	N/A	New Code	852.54	600.36	252.18	N/A
HealthPartners Primary Clinic Plan
High Self	HQ1	203.05	239.89	121.40	118.49	24.74	439.94	519.76	263.03	256.73	53.61
High Family	HQ2	487.31	575.72	277.09	298.63	60.94	1055.84	1247.39	600.36	647.03	132.03
Humana CoverageFirst (Consumer Driven Plan)
High Self	FB1	New Plan	105.68	79.26	26.42	N/A	New Plan	228.97	171.73	57.24	N/A
High Family	FB2	New Plan	243.06	182.30	60.76	N/A	New Plan	526.63	394.97	131.66	N/A

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