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Federal Employees Health Benefits Program 2004 Premiums   
  FEHB Home  |    Non-Postal Premiums
You are here: OPM Home > Insurance > FEHB > 2004 Premiums > Non-postal > Ohio

2004 FEHB Non-Postal Premium Rates for Ohio


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
Aetna Health Inc.
High Self 7D1 139.73 141.10 105.83 35.27 0.34 302.75 305.72 229.29 76.43 0.74
High Family 7D2 336.55 339.83 254.87 84.96 -1.97 729.19 736.30 552.23 184.07 -4.28
Aetna Health Inc.
High Self RD1 139.97 151.00 113.25 37.75 2.76 303.27 327.17 245.38 81.79 5.97
High Family RD2 343.99 371.08 277.09 93.99 -0.38 745.31 804.01 600.36 203.65 -0.82
AultCare HMO
High Self 3A1 150.42 145.88 109.41 36.47 -4.65 325.91 316.07 237.05 79.02 -10.07
High Family 3A2 380.95 358.16 268.62 89.54 -41.79 825.39 776.01 582.01 194.00 -90.55
Blue HMO
High Self R51 149.10 173.71 121.40 52.31 12.51 323.05 376.37 263.03 113.34 27.11
High Family R52 370.33 431.43 277.09 154.34 33.63 802.38 934.77 600.36 334.41 72.87
HMO Health Ohio
High Self L41 133.69 151.14 113.36 37.78 4.36 289.66 327.47 245.60 81.87 9.46
High Family L42 341.96 386.65 277.09 109.56 17.22 740.91 837.74 600.36 237.38 37.31
HOMETOWN HEALTH PLAN
High Self MZ1 New Plan 129.67 97.25 32.42 N/A New Plan 280.95 210.71 70.24 N/A
High Family MZ2 New Plan 324.19 243.14 81.05 N/A New Plan 702.41 526.81 175.60 N/A
Humana CoverageFirst (Consumer Driven Plan)
High Self L81 New Plan 96.08 72.06 24.02 N/A New Plan 208.17 156.13 52.04 N/A
High Family L82 New Plan 220.97 165.73 55.24 N/A New Plan 478.77 359.08 119.69 N/A
Kaiser Permanente
High Self 641 137.00 151.78 113.84 37.94 3.69 296.83 328.86 246.65 82.21 8.00
High Family 642 336.18 372.47 277.09 95.38 8.82 728.39 807.02 600.36 206.66 19.11
Paramount Health Care
High Self U21 140.20 154.56 115.92 38.64 3.59 303.77 334.88 251.16 83.72 7.78
High Family U22 371.19 409.23 277.09 132.14 10.57 804.25 886.67 600.36 286.31 22.90
SummaCare Health Plan
High Self 5W1 132.62 145.43 109.07 36.36 3.21 287.34 315.10 236.33 78.77 6.94
High Family 5W2 364.66 399.92 277.09 122.83 7.79 790.10 866.49 600.36 266.13 16.87
SuperMed HMO
High Self 5M1 154.60 168.06 121.40 46.66 1.36 334.97 364.13 263.03 101.10 2.95
High Family 5M2 395.45 429.89 277.09 152.80 6.97 856.81 931.43 600.36 331.07 15.10
The Health Plan of the Upper Ohio Valley
High Self U41 149.39 154.45 115.84 38.61 -1.48 323.68 334.64 250.98 83.66 -3.20
High Family U42 410.83 355.20 266.40 88.80 -72.41 890.13 769.60 577.20 192.40 -156.89
United Healthcare of Ohio, Inc.
High Self 3U1 177.82 197.49 121.40 76.09 7.57 385.28 427.90 263.03 164.87 16.41
High Family 3U2 409.00 454.23 277.09 177.14 17.76 886.17 984.17 600.36 383.81 38.48
 
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Page updated 09/24/03