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Federal Employees Health Benefits Program

2004 Premiums

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2004 FEHB Postal Premium Rates for Florida

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
Av-Med Health Plan
High Self	ML1	125.51	146.82	130.30	16.52	2.40
High Family	ML2	345.12	403.68	327.12	76.56	26.14
Capital Health Plan
High Self	EA1	142.02	148.52	131.81	16.71	0.73
High Family	EA2	377.53	393.61	327.12	66.49	-16.34
Humana CoverageFirst (Consumer Driven Plan)
High Self	MJ1	New Plan	100.88	89.53	11.35	N/A
High Family	MJ2	New Plan	232.01	205.91	26.10	N/A
Humana CoverageFirst (Consumer Driven Plan)
High Self	MQ1	New Plan	105.68	93.79	11.89	N/A
High Family	MQ2	New Plan	243.06	215.72	27.34	N/A
Humana CoverageFirst (Consumer Driven Plan)
High Self	QP1	New Plan	96.08	85.27	10.81	N/A
High Family	QP2	New Plan	220.97	196.11	24.86	N/A
Humana Medical Plan
High Self	EE1	118.86	150.59	133.65	16.94	3.57
High Family	EE2	297.15	346.38	307.41	38.97	5.54
JMH Health Plan
High Self	J81	96.91	132.66	117.74	14.92	4.02
High Family	J82	238.39	328.29	291.36	36.93	10.11
Total Health Choice
High Self	4A1	116.80	116.79	103.65	13.14	0.00
High Family	4A2	291.01	291.00	258.26	32.74	0.00
Vista Healthplan
High Self	3N1	137.77	162.29	143.32	18.97	3.47
High Family	3N2	384.39	446.18	327.12	119.06	29.37
Vista Healthplan
High Self	RK1	129.42	158.65	140.80	17.85	3.29
High Family	RK2	345.56	423.61	327.12	96.49	45.63
Vista Healthplan
High Self	UL1	New Code	126.45	112.22	14.23	N/A
High Family	UL2	New Code	337.63	299.65	37.98	N/A
Vista Healthplan
High Self	Y91	New Code	119.15	105.75	13.40	N/A
High Family	Y92	New Code	318.16	282.37	35.79	N/A
Vista Healthplan of South Florida
High Self	5E	91.06	112.51	99.85	12.66	2.42
High Family	5E	250.43	309.41	274.60	34.81	6.64

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