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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 > Washington

2004 FEHB Non-Postal Premium Rates for Washington


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 8J1 125.93 118.93 89.20 29.73 -1.75 272.85 257.68 193.26 64.42 -3.79
High Family 8J2 320.23 302.42 226.82 75.60 -4.46 693.83 655.24 491.43 163.81 -9.65
Aetna HealthFund (Consumer Driven Plan)
High Self 221 New Plan 129.44 97.08 32.36 N/A New Code 280.45 210.34 70.11 N/A
High Family 222 New Plan 297.73 223.30 74.43 N/A New Code 645.08 483.81 161.27 N/A
Group Health Cooperative
High Self 541 153.49 169.52 121.40 48.12 3.93 332.56 367.29 263.03 104.26 8.52
High Family 542 346.52 382.68 277.09 105.59 8.69 750.79 829.14 600.36 228.78 18.83
Standard Self 544 New Code 141.91 106.43 35.48 N/A New Code 307.47 230.60 76.87 7N/A
Standard Family 545 New Code 320.37 240.28 80.09 N/A New Code 694.14 520.61 173.53 N/A
Group Health Cooperative
High Self VR1 144.97 159.23 119.42 39.81 3.57 314.10 345.00 258.75 86.25 7.73
High Family VR2 372.32 388.22 277.09 111.13 -11.57 806.69 841.14 600.36 240.78 -25.07
Standard Self VR4 New Code 137.99 103.49 34.50 N/A New Code 298.98 224.24 74.74 N/A
Standard Family VR5 New Code 317.38 238.04 79.34 N/A New Code 687.66 515.75 171.91 N/A
Kaiser Permanente
High Self 571 153.30 170.62 121.40 49.22 5.22 332.15 369.68 263.03 106.65 11.32
High Family 572 351.81 391.57 277.09 114.48 12.29 762.26 848.40 600.36 248.04 26.62
Standard Self 574 137.06 149.67 112.25 37.42 3.16 296.96 324.29 243.22 81.07 6.83
Standard Family 575 314.57 343.49 257.62 85.87 7.23 681.57 744.23 558.17 186.06 15.67
KPS Health Plans
High Self VT1 222.64 178.87 121.40 57.47 -55.87 482.39 387.55 263.03 124.52 -121.05
High Family VT2 476.23 390.84 277.09 113.75 -112.86 1031.83 846.82 600.36 246.46 -244.53
Standard Self L11 New Code 143.99 107.99 36.00 N/A New Code 311.98 233.99 77.99 N/A
Standard Family L12 New Code 314.63 235.97 78.66 N/A New Code 681.70 511.28 170.42 N/A
PacifiCare of Oregon
High Self 7Z1 162.08 167.15 121.40 45.75 -7.03 351.17 362.16 263.03 99.13 -15.22
High Family 7Z2 359.10 376.10 277.09 99.01 -10.47 778.05 814.88 600.36 214.52 -22.69
 
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Page modified 09/24/2003