Click here to skip navigation
OPM.gov Home  |  Subject Index  |  Important Links  |  Contact Us  |  Help

U.S. Office of Personnel Management www.opm.gov - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People
Advanced Search

Insurance Services Programs

Federal Employees Health Benefits Program 2004 Premiums   
  FEHB Home  |    Postal Premiums
You are here: OPM Home > Insurance > FEHB > 2004 Premiums > Postal Premiums > Pennsylvania

2004 FEHB Postal Premium Rates for Pennsylvania


HMO Plans 2003 Total Biweekly Premium 2004 Total Biweekly Premium 2004 Biweekly Postal
Premium Rates
Plan - Option - Enrollment Code USPS Pays Postal Empl. Pays Change in employee payment
Aetna Health Inc.
High Self P31 148.51 158.90 141.02 17.88 -1.60
High Family P32 358.34 383.43 327.12 56.31 -7.33
Aetna Health Inc.
High Self YE1 New Code 123.99 110.04 13.95 N/A
High Family YE2 New Code 341.92 303.45 38.47 N/A
Aetna HealthFund (Consumer Driven Plan)
High Self 221 New Plan 129.44 114.88 14.56 N/A
High Family 222 New Plan 297.73 264.24 33.49 N/A
HealthAmerica Pennsylvania
High Self 261 137.03 164.23 143.32 20.91 5.49
High Family 262 356.28 418.79 327.12 91.67 30.09
Standard Self 264 New Code 147.93 131.29 16.64 N/A
Standard Family 265 New Code 377.22 327.12 50.10 N/A
HealthAmerica Pennsylvania
High Self 4N1 New Code 179.14 143.32 35.82 N/A
High Family 4N2 New Code 444.26 327.12 117.14 N/A
Standard Self 4N4 New Code 161.50 143.32 18.18 N/A
Standard Family 4N5 New Code 400.52 327.12 73.40 N/A
HealthAmerica Pennsylvania
High Self SW1 141.82 177.20 143.32 33.88 17.93
High Family SW2 368.75 429.17 327.12 102.05 28.00
Standard Self SW4 New Code 159.17 141.26 17.91 N/A
Standard Family SW5 New Code 385.51 327.12 58.39 N/A
HealthAmerica Pennsylvania
High Self VJ1 New Code 149.54 132.72 16.82 N/A
High Family VJ2 New Code 381.34 327.12 54.22 N/A
Standard Self VJ4 New Code 136.88 121.48 15.40 N/A
Standard Family VJ5 New Code 349.07 309.80 39.27 N/A
Keystone Health Plan Central
High Self S41 156.21 174.21 143.32 30.89 3.71
High Family S42 378.36 418.17 327.12 91.05 7.39
Keystone Health Plan East
High Self ED1 146.63 160.74 142.66 18.08 0.48
High Family ED2 386.69 423.86 327.12 96.74 4.75
UPMC Health Plan
High Self 8W1 138.90 156.11 138.55 17.56 1.93
High Family 8W2 354.29 398.21 327.12 71.09 11.50

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

 
PDF Help U.S. Office of Personnel Management 1900 E Street, NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532

Page updated 9/25/03