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Healthcare

Temporary Continuation of Coverage (TCC) Premium Rates and Former Spouse Premiums

FFS (Fee-for-Service/Nationwide Plans)

Plan - Option Enrollment Code 2024 TCC Premium 2025 TCC Monthly Premiums - Total Premium 2025 TCC Monthly Premiums - Government Pays 2025 TCC Monthly Premiums - Employee Pays 2025 TCC Monthly Premiums - Change in Employee Payment 2024 Former Spouse Premium 2025 Former Spouse Monthly Premiums - Total Premium 2025 Former Spouse Monthly Premiums - Government Pays 2025 Former Spouse Monthly Premiums - Employee Pays 2025 Former Spouse Monthly Premiums - Change in Employee Payment
Nationwide APWU Health Plan - CDHP Self 474 678.76 760.22 0.00 760.22 81.46 665.45 745.31 0.00 745.31 79.86
Nationwide APWU Health Plan - CDHP Self & Family 475 1609.37 1802.50 0.00 1802.50 193.13 1577.81 1767.16 0.00 1767.16 189.35
Nationwide APWU Health Plan - CDHP Self Plus One 476 1475.25 1652.29 0.00 1652.29 177.04 1446.32 1619.89 0.00 1619.89 173.57
Nationwide APWU Health Plan - High Self 471 875.05 901.30 0.00 901.30 26.25 857.89 883.63 0.00 883.63 25.74
Nationwide APWU Health Plan - High Self & Family 472 2100.01 2162.99 0.00 2162.99 62.98 2058.83 2120.58 0.00 2120.58 61.75
Nationwide APWU Health Plan - High Self Plus One 473 1837.51 1892.62 0.00 1892.62 55.11 1801.48 1855.51 0.00 1855.51 54.03
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Basic - Basic Self 111 811.45 908.84 0.00 908.84 97.39 795.54 891.02 0.00 891.02 95.48
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Basic - Basic Self & Family 112 2008.40 2249.43 0.00 2249.43 241.03 1969.02 2205.32 0.00 2205.32 236.30
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Basic - Basic Self Plus One 113 1823.54 2042.35 0.00 2042.35 218.81 1787.78 2002.30 0.00 2002.30 214.52
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self 131 488.90 523.11 0.00 523.11 34.21 479.31 512.85 0.00 512.85 33.54
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self & Family 132 1155.97 1236.93 0.00 1236.93 80.96 1133.30 1212.68 0.00 1212.68 79.38
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self Plus One 133 1050.95 1124.58 0.00 1124.58 73.63 1030.34 1102.53 0.00 1102.53 72.19
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Standard - Standard Self 104 933.11 1045.09 0.00 1045.09 111.98 914.81 1024.60 0.00 1024.60 109.79
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Standard - Standard Self & Family 105 2247.26 2516.92 0.00 2516.92 269.66 2203.20 2467.57 0.00 2467.57 264.37
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Standard - Standard Self Plus One 106 2040.58 2285.45 0.00 2285.45 244.87 2000.57 2240.64 0.00 2240.64 240.07
Nationwide Compass Rose Health Plan - High Self 421 830.85 933.86 0.00 933.86 103.01 814.56 915.55 0.00 915.55 100.99
Nationwide Compass Rose Health Plan - High Self & Family 422 1994.06 2241.34 0.00 2241.34 247.28 1954.96 2197.39 0.00 2197.39 242.43
Nationwide Compass Rose Health Plan - High Self Plus One 423 1827.87 2054.52 0.00 2054.52 226.65 1792.03 2014.24 0.00 2014.24 222.21
Nationwide Compass Rose Health Plan - Standard Self 424 467.32 514.07 0.00 514.07 46.75 458.16 503.99 0.00 503.99 45.83
Nationwide Compass Rose Health Plan - Standard Self & Family 425 1121.62 1233.78 0.00 1233.78 112.16 1099.63 1209.59 0.00 1209.59 109.96
Nationwide Compass Rose Health Plan - Standard Self Plus One 426 1028.16 1130.97 0.00 1130.97 102.81 1008.00 1108.79 0.00 1108.79 100.79
Nationwide Foreign Service Benefit Plan - High Self 401 730.36 825.30 0.00 825.30 94.94 716.04 809.12 0.00 809.12 93.08
Nationwide Foreign Service Benefit Plan - High Self & Family 402 1806.75 2041.62 0.00 2041.62 234.87 1771.32 2001.59 0.00 2001.59 230.27
Nationwide Foreign Service Benefit Plan - High Self Plus One 403 1763.14 1992.36 0.00 1992.36 229.22 1728.57 1953.29 0.00 1953.29 224.72
Nationwide GEHA Benefit Plan - High Self 311 839.98 961.77 0.00 961.77 121.79 823.51 942.91 0.00 942.91 119.40
Nationwide GEHA Benefit Plan - High Self & Family 312 2104.89 2410.12 0.00 2410.12 305.23 2063.62 2362.86 0.00 2362.86 299.24
Nationwide GEHA Benefit Plan - High Self Plus One 313 1847.93 2115.90 0.00 2115.90 267.97 1811.70 2074.41 0.00 2074.41 262.71
Nationwide GEHA Benefit Plan - Standard Self 314 620.13 710.05 0.00 710.05 89.92 607.97 696.13 0.00 696.13 88.16
Nationwide GEHA Benefit Plan - Standard Self & Family 315 1647.33 1894.44 0.00 1894.44 247.11 1615.03 1857.29 0.00 1857.29 242.26
Nationwide GEHA Benefit Plan - Standard Self Plus One 316 1333.31 1526.66 0.00 1526.66 193.35 1307.17 1496.73 0.00 1496.73 189.56
Nationwide GEHA HDHP - HDHP Self 341 631.65 674.27 0.00 674.27 42.62 619.26 661.05 0.00 661.05 41.79
Nationwide GEHA HDHP - HDHP Self & Family 342 1668.79 1781.44 0.00 1781.44 112.65 1636.07 1746.51 0.00 1746.51 110.44
Nationwide GEHA HDHP - HDHP Self Plus One 343 1358.00 1449.68 0.00 1449.68 91.68 1331.37 1421.25 0.00 1421.25 89.88
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self 251 826.50 975.87 0.00 975.87 149.37 810.29 956.74 0.00 956.74 146.45
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self & Family 252 1987.37 2346.56 0.00 2346.56 359.19 1948.40 2300.55 0.00 2300.55 352.15
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self Plus One 253 1810.50 2137.72 0.00 2137.72 327.22 1775.00 2095.80 0.00 2095.80 320.80
Nationwide GEHA Indemnity Benefit Plan - Elevate Self 254 461.56 511.19 0.00 511.19 49.63 452.51 501.17 0.00 501.17 48.66
Nationwide GEHA Indemnity Benefit Plan - Elevate Self & Family 255 1355.61 1501.37 0.00 1501.37 145.76 1329.03 1471.93 0.00 1471.93 142.90
Nationwide GEHA Indemnity Benefit Plan - Elevate Self Plus One 256 1113.55 1233.25 0.00 1233.25 119.70 1091.72 1209.07 0.00 1209.07 117.35
Nationwide MHBP Consumer Option - HDHP Self 481 695.64 744.32 0.00 744.32 48.68 682.00 729.73 0.00 729.73 47.73
Nationwide MHBP Consumer Option - HDHP Self & Family 482 1616.37 1729.52 0.00 1729.52 113.15 1584.68 1695.61 0.00 1695.61 110.93
Nationwide MHBP Consumer Option - HDHP Self Plus One 483 1539.42 1647.20 0.00 1647.20 107.78 1509.24 1614.90 0.00 1614.90 105.66
Nationwide MHBP Standard Option - Standard Self 454 712.57 741.08 0.00 741.08 28.51 698.60 726.55 0.00 726.55 27.95
Nationwide MHBP Standard Option - Standard Self & Family 455 1655.98 1722.21 0.00 1722.21 66.23 1623.51 1688.44 0.00 1688.44 64.93
Nationwide MHBP Standard Option - Standard Self Plus One 456 1640.22 1705.84 0.00 1705.84 65.62 1608.06 1672.39 0.00 1672.39 64.33
Nationwide MHBP Value Plan - Value Self 414 514.53 535.11 0.00 535.11 20.58 504.44 524.62 0.00 524.62 20.18
Nationwide MHBP Value Plan - Value Self & Family 415 1243.48 1293.23 0.00 1293.23 49.75 1219.10 1267.87 0.00 1267.87 48.77
Nationwide MHBP Value Plan - Value Self Plus One 416 1219.14 1267.92 0.00 1267.92 48.78 1195.24 1243.06 0.00 1243.06 47.82
Nationwide NALC Health Benefit Plan - CDHP Self 324 488.48 527.55 0.00 527.55 39.07 478.90 517.21 0.00 517.21 38.31
Nationwide NALC Health Benefit Plan - CDHP Self & Family 325 1186.22 1292.98 0.00 1292.98 106.76 1162.96 1267.63 0.00 1267.63 104.67
Nationwide NALC Health Benefit Plan - CDHP Self Plus One 326 1095.85 1194.48 0.00 1194.48 98.63 1074.36 1171.06 0.00 1171.06 96.70
Nationwide NALC Health Benefit Plan - High Self 321 841.65 959.49 0.00 959.49 117.84 825.15 940.68 0.00 940.68 115.53
Nationwide NALC Health Benefit Plan - High Self & Family 322 1918.21 2205.95 0.00 2205.95 287.74 1880.60 2162.70 0.00 2162.70 282.10
Nationwide NALC Health Benefit Plan - High Self Plus One 323 1861.61 2140.85 0.00 2140.85 279.24 1825.11 2098.87 0.00 2098.87 273.76
Nationwide Panama Canal Area Benefit Plan - High Self 431 855.69 941.27 0.00 941.27 85.58 838.91 922.81 0.00 922.81 83.90
Nationwide Panama Canal Area Benefit Plan - High Self & Family 432 1802.87 1983.15 0.00 1983.15 180.28 1767.52 1944.26 0.00 1944.26 176.74
Nationwide Panama Canal Area Benefit Plan - High Self Plus One 433 1723.82 1896.20 0.00 1896.20 172.38 1690.02 1859.02 0.00 1859.02 169.00
Nationwide SAMBA Health Benefit Plan - High Self 441 882.17 1014.50 0.00 1014.50 132.33 864.87 994.61 0.00 994.61 129.74
Nationwide SAMBA Health Benefit Plan - High Self & Family 442 2117.24 2434.82 0.00 2434.82 317.58 2075.73 2387.08 0.00 2387.08 311.35
Nationwide SAMBA Health Benefit Plan - High Self Plus One 443 1940.83 2231.92 0.00 2231.92 291.09 1902.77 2188.16 0.00 2188.16 285.39
Nationwide SAMBA Health Benefit Plan - Standard Self 444 754.91 845.48 0.00 845.48 90.57 740.11 828.90 0.00 828.90 88.79
Nationwide SAMBA Health Benefit Plan - Standard Self & Family 445 1722.28 1928.95 0.00 1928.95 206.67 1688.51 1891.13 0.00 1891.13 202.62
Nationwide SAMBA Health Benefit Plan - Standard Self Plus One 446 1624.82 1819.78 0.00 1819.78 194.96 1592.96 1784.10 0.00 1784.10 191.14
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