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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 > Wisconsin

2004 FEHB Non-Postal Premium Rates for Wisconsin


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
Dean Health Plan
High Self WD1 127.18 135.34 101.51 33.83 2.04 275.56 293.24 219.93 73.31 4.42
High Family WD2 343.36 365.40 274.05 91.35 -2.39 743.95 791.70 593.78 197.92 -5.19
Group Health Cooperative
High Self WJ1 130.29 132.42 99.32 33.10 0.53 282.30 286.91 215.18 71.73 1.16
High Family WJ2 349.42 357.96 268.47 89.49 -10.31 757.08 775.58 581.69 193.89 -22.35
HealthPartners Classic
High Self 531 163.13 193.43 121.40 72.03 18.20 353.45 419.10 263.03 156.07 39.44
High Family 532 391.51 464.22 277.09 187.13 45.24 848.27 1005.81 600.36 405.45 98.02
Standard Self 534 New Code 163.96 121.40 42.56 N/A New Code 355.25 263.03 92.22 N/A
Standard Family 535 New Code 393.48 277.09 116.39 N/A New Code 852.54 600.36 252.18 N/A
HealthPartners Primary Clinic Plan
High Self HQ1 203.05 239.89 121.40 118.49 24.74 439.94 519.76 263.03 256.73 53.61
High Family HQ2 487.31 575.72 277.09 298.63 60.94 1055.84 1247.39 600.36 647.03 132.03
Humana CoverageFirst (Consumer Driven Plan)
High Self FB1 New Plan 105.68 79.26 26.42 N/A New Plan 228.97 171.73 57.24 N/A
High Family FB2 New Plan 243.06 182.30 60.76 N/A New Plan 526.63 394.97 131.66 N/A
 
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Page modified 09/24/2003