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Healthcare Plan Information

Temporary Continuation of Coverage Premium Rates and Former Spouse Premiums

FFS (Fee-for-Service/Nationwide Plans)

Plan - Option Enrollment Code 2019 TCC Premium 2020 Temporary Continuation of Coverage Monthly Premiums 2019 Former Spouse Premium 2020 Former Spouse Monthly Premiums
Total Premium Gov't Pays Empl. Pays Change in empl. payment Total Premium Gov't Pays Empl. Pays Change in empl. payment
Nationwide APWU Health Plan
CDHP Self 474 609.63 609.63 0 609.63 0 597.68 597.68 0 597.68 0
CDHP Self & Family 475 1445.43 1445.43 0 1445.43 0 1417.09 1417.09 0 1417.09 0
CDHP Self Plus One 476 1324.98 1324.98 0 1324.98 0 1299 1299 0 1299 0
High Self 471 740.74 740.74 0 740.74 0 726.22 726.22 0 726.22 0
High Self & Family 472 1777.77 1777.77 0 1777.77 0 1742.91 1742.91 0 1742.91 0
High Self Plus One 473 1555.53 1555.53 0 1555.53 0 1525.03 1525.03 0 1525.03 0
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option
Basic Self 111 651.73 671.35 0 671.35 19.62 638.95 658.19 0 658.19 19.24
Basic Self & Family 112 1552.65 1630.3 0 1630.3 77.65 1522.21 1598.33 0 1598.33 76.12
Basic Self Plus One 113 1464.87 1508.84 0 1508.84 43.97 1436.15 1479.25 0 1479.25 43.1
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus
FEP Blue Focus Self 131 469.8 469.8 0 469.8 0 460.59 460.59 0 460.59 0
FEP Blue Focus Self & Family 132 1110.96 1110.96 0 1110.96 0 1089.18 1089.18 0 1089.18 0
FEP Blue Focus Self Plus One 133 1010.01 1010.01 0 1010.01 0 990.21 990.21 0 990.21 0
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option
Standard Self 104 756.73 779.42 0 779.42 22.69 741.89 764.14 0 764.14 22.25
Standard Self & Family 105 1753.71 1841.4 0 1841.4 87.69 1719.32 1805.29 0 1805.29 85.97
Standard Self Plus One 106 1654.87 1704.51 0 1704.51 49.64 1622.42 1671.09 0 1671.09 48.67
Nationwide Compass Rose Health Plan
High Self 421 710.21 745.72 0 745.72 35.51 696.28 731.1 0 731.1 34.82
High Self & Family 422 1704.51 1789.74 0 1789.74 85.23 1671.09 1754.65 0 1754.65 83.56
High Self Plus One 423 1562.47 1640.6 0 1640.6 78.13 1531.83 1608.43 0 1608.43 76.6
Nationwide Foreign Service Benefit Plan
High Self 401 592.68 609.85 0 609.85 17.17 581.06 597.89 0 597.89 16.83
High Self & Family 402 1466.25 1508.76 0 1508.76 42.51 1437.5 1479.18 0 1479.18 41.68
High Self Plus One 403 1451.66 1493.76 0 1493.76 42.1 1423.2 1464.47 0 1464.47 41.27
Nationwide GEHA Benefit Plan
High Self 311 742.9 754.04 0 754.04 11.14 728.33 739.25 0 739.25 10.92
High Self & Family 312 1852.58 1880.4 0 1880.4 27.82 1816.25 1843.53 0 1843.53 27.28
High Self Plus One 313 1634.37 1658.9 0 1658.9 24.53 1602.32 1626.37 0 1626.37 24.05
Standard Self 314 519.64 535.21 0 535.21 15.57 509.45 524.72 0 524.72 15.27
Standard Self & Family 315 1309.33 1374.8 0 1374.8 65.47 1283.66 1347.84 0 1347.84 64.18
Standard Self Plus One 316 1117.25 1150.77 0 1150.77 33.52 1095.34 1128.21 0 1128.21 32.87
Nationwide GEHA HDHP
HDHP Self 341 518.96 524.13 0 524.13 5.17 508.78 513.85 0 513.85 5.07
HDHP Self & Family 342 1287.75 1326.36 0 1326.36 38.61 1262.5 1300.35 0 1300.35 37.85
HDHP Self Plus One 343 1115.74 1126.91 0 1126.91 11.17 1093.86 1104.81 0 1104.81 10.95
Nationwide GEHA Indemnity Benefit Plan
Elevate Plus Self 251 New Plan 642.43 0 642.43 New Plan New Plan 629.83 0 629.83 New Plan
Elevate Plus Self & Family 252 New Plan 1593.21 0 1593.21 New Plan New Plan 1561.97 0 1561.97 New Plan
Elevate Plus Self Plus One 253 New Plan 1490.4 0 1490.4 New Plan New Plan 1461.18 0 1461.18 New Plan
Elevate Self 254 New Plan 418.33 0 418.33 New Plan New Plan 410.13 0 410.13 New Plan
Elevate Self & Family 255 New Plan 1171.37 0 1171.37 New Plan New Plan 1148.4 0 1148.4 New Plan
Elevate Self Plus One 256 New Plan 962.19 0 962.19 New Plan New Plan 943.32 0 943.32 New Plan
Nationwide MHBP Consumer Option
HDHP Self 481 573.27 584.75 0 584.75 11.48 562.03 573.28 0 573.28 11.25
HDHP Self & Family 482 1332.06 1358.71 0 1358.71 26.65 1305.94 1332.07 0 1332.07 26.13
HDHP Self Plus One 483 1268.66 1294.02 0 1294.02 25.36 1243.78 1268.65 0 1268.65 24.87
Nationwide MHBP Standard Option
Standard Self 454 588.17 582.27 0 582.27 -5.9 576.64 570.85 0 570.85 -5.79
Standard Self & Family 455 1366.84 1353.18 0 1353.18 -13.66 1340.04 1326.65 0 1326.65 -13.39
Standard Self Plus One 456 1353.83 1340.3 0 1340.3 -13.53 1327.28 1314.02 0 1314.02 -13.26
Nationwide MHBP Value Plan
Value Self 414 486.71 462.38 0 462.38 -24.33 477.17 453.31 0 453.31 -23.86
Value Self & Family 415 1176.25 1117.44 0 1117.44 -58.81 1153.19 1095.53 0 1095.53 -57.66
Value Self Plus One 416 1153.22 1095.56 0 1095.56 -57.66 1130.61 1074.08 0 1074.08 -56.53
Nationwide NALC Health Benefit Plan
CDHP Self 324 483 483 0 483 0 473.53 473.53 0 473.53 0
CDHP Self & Family 325 1089.02 1110.81 0 1110.81 21.79 1067.67 1089.03 0 1089.03 21.36
CDHP Self Plus One 326 1055.04 1065.57 0 1065.57 10.53 1034.35 1044.68 0 1044.68 10.33
High Self 321 695.73 721.81 0 721.81 26.08 682.09 707.66 0 707.66 25.57
High Self & Family 322 1562.31 1624.82 0 1624.82 62.51 1531.68 1592.96 0 1592.96 61.28
High Self Plus One 323 1531.47 1596.58 0 1596.58 65.11 1501.44 1565.27 0 1565.27 63.83
Nationwide NALC Health Benefit Plan
Value Self KM1 396.41 396.41 0 396.41 0 388.64 388.64 0 388.64 0
Value Self & Family KM2 894.16 912.04 0 912.04 17.88 876.63 894.16 0 894.16 17.53
Value Self Plus One KM3 865.84 874.5 0 874.5 8.66 848.86 857.35 0 857.35 8.49
Nationwide Panama Canal Area Benefit Plan
High Self 431 613.5 641.1 0 641.1 27.6 601.47 628.53 0 628.53 27.06
High Self & Family 432 1280.63 1338.24 0 1338.24 57.61 1255.52 1312 0 1312 56.48
High Self Plus One 433 1224.47 1279.57 0 1279.57 55.1 1200.46 1254.48 0 1254.48 54.02
Nationwide Rural Carrier Benefit Plan
High Self 381 699.4 791.18 0 791.18 91.78 685.69 775.67 0 775.67 89.98
High Self & Family 382 1381.43 1622.14 0 1622.14 240.71 1354.34 1590.33 0 1590.33 235.99
High Self Plus One 383 1354.36 1566.89 0 1566.89 212.53 1327.8 1536.17 0 1536.17 208.37
Nationwide SAMBA Health Benefit Plan
High Self 441 930.94 919.79 0 919.79 -11.15 912.69 901.75 0 901.75 -10.94
High Self & Family 442 2234.25 2207.43 0 2207.43 -26.82 2190.44 2164.15 0 2164.15 -26.29
High Self Plus One 443 2048.05 2023.5 0 2023.5 -24.55 2007.89 1983.82 0 1983.82 -24.07
Standard Self 444 700.64 694.12 0 694.12 -6.52 686.9 680.51 0 680.51 -6.39
Standard Self & Family 445 1611.53 1583.6 0 1583.6 -27.93 1579.93 1552.55 0 1552.55 -27.38
Standard Self Plus One 446 1541.45 1493.96 0 1493.96 -47.49 1511.23 1464.67 0 1464.67 -46.56
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