U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

Insurance Services Programs

Federal Employees Health Benefits Program

2004 Premiums

2004 FEHB Non-Postal Premium Rates for Missouri

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
BlueCHOICE
High Self	9G1	139.61	153.68	115.26	38.42	3.52	302.49	332.97	249.73	83.24	7.62
High Family	9G2	302.26	332.73	249.55	83.18	7.62	654.90	720.92	540.69	180.23	16.51
Coventry Health Care of Kansas - Kansas City
High Self	HA1	113.98	132.36	99.27	33.09	4.60	246.96	286.78	215.09	71.69	9.95
High Family	HA2	294.08	341.54	256.16	85.38	11.86	637.17	740.00	555.00	185.00	25.71
Group Health Plan
High Self	MM1	166.14	197.52	121.40	76.12	19.28	359.97	427.96	263.03	164.93	41.78
High Family	MM2	358.86	426.63	277.09	149.54	40.30	777.53	924.37	600.36	324.01	87.32
Humana CoverageFirst (Consumer Driven Plan)
High Self	PH1	New Plan	76.86	57.65	19.21	N/A	New Plan	166.53	124.90	41.63	N/A
High Family	PH2	New Plan	176.77	132.58	44.19	N/A	New Plan	383.00	287.25	95.75	N/A
Humana Health Plan, Inc.
High Self	MS1	140.81	170.71	121.40	49.31	14.11	305.09	369.87	263.03	106.84	30.57
High Family	MS2	337.82	392.64	277.09	115.55	27.35	731.94	850.72	600.36	250.36	59.26
Standard Self	MS4	81.88	122.89	92.17	30.72	10.25	177.41	266.26	199.70	66.56	22.21
Standard Family	MS5	196.42	282.64	211.98	70.66	21.56	425.58	612.39	459.29	153.10	46.71
Mercy Health Plans/Premier Health Plans
High Self	7M1	174.24	193.54	121.40	72.14	7.20	377.52	419.34	263.03	156.31	15.61
High Family	7M2	405.29	418.06	277.09	140.97	-14.70	878.13	905.80	600.36	305.44	-31.85

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