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 Postal Premium Rates for Wisconsin

HMO Plans		2003 Total Biweekly Premium	2004 Total Biweekly Premium	2004 Biweekly Postal Premium Rates
Plan - Option - Enrollment Code		2003 Total Biweekly Premium	2004 Total Biweekly Premium	USPS Pays	Postal Empl. Pays	Change in employee payment
Dean Health Plan
High Self	WD1	127.18	135.34	120.11	15.23	0.92
High Family	WD2	343.36	365.40	324.29	41.11	-7.55
Group Health Cooperative
High Self	WJ1	130.29	132.42	117.52	14.90	0.24
High Family	WJ2	349.42	357.96	317.69	40.27	-14.45
HealthPartners Classic
High Self	531	163.13	193.43	143.32	50.11	16.01
High Family	532	391.51	464.22	327.12	137.10	40.29
Standard Self	534	New Code	163.96	143.32	20.64	N/A
Standard Family	535	New Code	393.48	327.12	66.36	N/A
HealthPartners Primary Clinic Plan
High Self	HQ1	203.05	239.89	143.32	96.57	22.55
High Family	HQ2	487.31	575.72	327.12	248.60	55.99
Humana CoverageFirst (Consumer Driven Plan)
High Self	FB1	New Plan	105.68	93.79	11.89	N/A
High Family	FB2	New Plan	243.06	215.72	27.34	N/A

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

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