Department of
Defense--Federal Employees Health Benefits Program Demonstration Project |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fee-for-Service
Plans (FFS) |
2001
Total Monthly DoD-FEHB Premium |
2002 DoD-FEHB Monthly Premium |
|
|
Plan - Option - Enrollment Code |
Total
Premium |
DoD Pays |
DoD-FEHB
Enrollee Pays |
Change
in enrollee payment |
|
|
|
|
|
|
|
|
Alliance
Health Plan |
|
|
|
|
High Self |
1R1 |
397.50 |
445.19 |
212.03 |
233.16 |
23.27 |
|
|
High Family |
1R2 |
842.79 |
943.93 |
484.06 |
459.87 |
41.36 |
|
APWU
Health Plan |
|
|
|
|
High Self |
471 |
495.76 |
644.48 |
212.03 |
432.45 |
124.30 |
|
|
High Family |
472 |
1087.93 |
1414.31 |
484.06 |
930.25 |
266.60 |
|
Blue
Cross and Blue Shield Service Benefit Plan |
|
|
|
Standard Self |
104 |
261.84 |
286.07 |
212.03 |
74.04 |
-0.19 |
|
|
Standard Family |
105 |
599.58 |
655.05 |
484.06 |
170.99 |
-4.31 |
|
|
Basic Self |
111 |
New code |
260.30 |
195.23 |
65.07 |
N/A |
|
|
Basic Family |
112 |
New code |
615.75 |
461.81 |
153.94 |
N/A |
|
GEHA
Benefit Plan |
|
|
|
|
High Self |
311 |
296.86 |
341.38 |
212.03 |
129.35 |
20.10 |
|
|
High Family |
312 |
646.06 |
742.97 |
484.06 |
258.91 |
37.13 |
|
|
Standard Self |
314 |
238.33 |
238.33 |
178.75 |
59.58 |
0.00 |
|
|
Standard Family |
315 |
541.67 |
541.67 |
406.25 |
135.42 |
0.00 |
|
Mail
Handlers |
|
|
|
|
High Self |
451 |
290.77 |
332.93 |
212.03 |
120.90 |
17.74 |
|
|
High Family |
452 |
671.00 |
768.30 |
484.06 |
284.24 |
37.52 |
|
|
Standard Self |
454 |
263.14 |
307.91 |
212.03 |
95.88 |
20.35 |
|
|
Standard Family |
455 |
607.25 |
710.47 |
484.06 |
226.41 |
43.44 |
|
NALC |
|
|
|
|
|
High Self |
321 |
323.18 |
311.42 |
212.03 |
99.39 |
-36.18 |
|
|
High Family |
322 |
690.56 |
665.45 |
484.06 |
181.39 |
-84.89 |
|
PBP
Health Plan |
|
|
|
|
High Self |
361 |
594.38 |
594.38 |
212.03 |
382.35 |
-24.42 |
|
|
High Family |
362 |
1282.49 |
1282.49 |
484.06 |
798.43 |
-59.78 |
|
|
Standard Self |
364 |
406.94 |
419.16 |
212.03 |
207.13 |
-12.20 |
|
|
Standard Family |
365 |
880.30 |
906.73 |
484.06 |
422.67 |
-33.35 |
|
Department
of Defense--Federal Employees Health Benefits Program Demonstration Project |
|
|
|
HMO Plans |
2001
Total Monthly DoD-FEHB Premium |
2002 DoD-FEHB Monthly Premium |
|
|
Location - Plan -
Option - Enrollment Code |
Total
Premium |
DoD Pays |
DoD-FEHB
Enrollee Pays |
Change
in enrollee payment |
|
|
|
|
|
|
|
|
CA Aetna U. S. Healthcare, Inc. |
|
|
|
High Self |
2X1 |
286.78 |
278.83 |
209.12 |
69.71 |
-29.46 |
|
|
High Family |
2X2 |
566.80 |
557.64 |
418.23 |
139.41 |
-3.11 |
|
CA Blue Cross- HMO |
|
|
|
|
High Self |
M51 |
232.57 |
260.24 |
195.18 |
65.06 |
6.92 |
|
|
High Family |
M52 |
593.06 |
663.63 |
484.06 |
179.57 |
10.79 |
|
CA Blue Shield of CA Access+ |
|
|
|
High Self |
SJ1 |
297.29 |
297.29 |
212.03 |
85.26 |
-24.42 |
|
|
High Family |
SJ2 |
636.05 |
636.05 |
477.04 |
159.01 |
-52.76 |
|
CA CIGNA HealthCare of California |
|
|
|
High Self |
9T1 |
326.73 |
339.80 |
212.03 |
127.77 |
-11.35 |
|
|
High Family |
9T2 |
653.47 |
679.60 |
484.06 |
195.54 |
-33.65 |
|
CA Health Net |
|
|
|
|
High Self |
LB1 |
328.88 |
302.75 |
212.03 |
90.72 |
-50.55 |
|
|
High Family |
LB2 |
625.08 |
687.01 |
484.06 |
202.95 |
2.15 |
|
CA Kaiser Permanente |
|
|
|
High Self |
621 |
273.72 |
242.36 |
181.77 |
60.59 |
-25.52 |
|
|
High Family |
622 |
545.33 |
484.73 |
363.55 |
121.18 |
-15.15 |
|
CA PacifiCare Health Plans |
|
|
|
High Self |
CY1 |
281.67 |
281.67 |
211.25 |
70.42 |
-23.64 |
|
|
High Family |
CY2 |
658.47 |
658.47 |
484.06 |
174.41 |
-59.78 |
|
FL Av-Med Health Plan |
|
|
|
|
High Self |
EM1 |
337.91 |
340.93 |
212.03 |
128.9 |
-21.40 |
|
|
High Family |
EM2 |
787.35 |
794.37 |
484.06 |
310.31 |
-52.76 |
|
IN Aetna U. S. Healthcare, Inc. |
|
|
|
High Self |
7L1 |
359.06 |
372.75 |
212.03 |
160.72 |
-10.73 |
|
|
High Family |
7L2 |
718.16 |
745.49 |
484.06 |
261.43 |
-32.45 |
|
IN Humana Health Plan |
|
|
|
High Self |
D21 |
271.90 |
319.45 |
212.03 |
107.42 |
23.13 |
|
|
High Family |
D22 |
653.94 |
769.45 |
484.06 |
285.39 |
55.73 |
|
IA Coventry Health Care of Iowa |
|
|
|
High Self |
SV1 |
323.51 |
176.93 |
132.70 |
44.23 |
-91.67 |
|
|
High Family |
SV2 |
647.03 |
707.66 |
484.06 |
223.60 |
0.85 |
|
KS Coventry HC Kansas Cty formerly Kaiser |
|
|
|
High Self |
HA1 |
265.24 |
144.76 |
108.57 |
36.19 |
-41.44 |
|
|
High Family |
HA2 |
684.34 |
579.02 |
434.27 |
144.75 |
-115.31 |
|
KS Humana Kansas City, Inc. |
|
|
|
High Self |
MS1 |
279.65 |
280.56 |
210.42 |
70.14 |
-21.90 |
|
|
High Family |
MS2 |
649.13 |
649.29 |
484.06 |
165.23 |
-59.62 |
|
|
Standard Self |
MS4 |
218.75 |
232.29 |
174.22 |
58.07 |
3.38 |
|
|
Standard Family |
MS5 |
502.95 |
533.48 |
400.11 |
133.37 |
7.63 |
|
Department
of Defense--Federal Employees Health Benefits Program Demonstration Project |
|
|
|
HMO Plans |
2001
Total Monthly DoD-FEHB Premium |
2002 DoD-FEHB Monthly Premium |
|
|
Location - Plan -
Option - Enrollment Code |
Total
Premium |
DoD Pays |
DoD-FEHB
Enrollee Pays |
Change
in enrollee payment |
|
|
|
|
|
|
|
|
KY Aetna U. S. Healthcare, Inc. |
|
|
|
High Self |
7L1 |
359.06 |
372.75 |
212.03 |
160.72 |
-10.73 |
|
|
High Family |
7L2 |
718.16 |
745.49 |
484.06 |
261.43 |
-32.45 |
|
KY Humana Health Plan |
|
|
|
High Self |
D21 |
271.90 |
319.45 |
212.03 |
107.42 |
23.13 |
|
|
High Family |
D22 |
653.94 |
769.45 |
484.06 |
285.39 |
55.73 |
|
LA Coventry Healthcare Louisiana former
Maxicare LA |
|
|
|
High Self |
BJ1 |
New area |
175.18 |
131.39 |
43.79 |
N/A |
|
|
High Family |
BJ2 |
New area |
700.72 |
484.06 |
216.66 |
N/A |
|
LA Coventry Healthcare Louisiana former
Maxicare LA |
|
|
|
High Self |
JA1 |
221.85 |
203.60 |
152.70 |
50.90 |
-4.56 |
|
|
High Family |
JA2 |
465.90 |
814.41 |
484.06 |
330.35 |
213.88 |
|
MD MD-IPA |
|
|
|
|
High Self |
JP1 |
269.62 |
301.62 |
212.03 |
89.59 |
7.58 |
|
|
High Family |
JP2 |
539.24 |
603.24 |
452.43 |
150.81 |
16.00 |
|
MN HealthPartners Classic |
|
|
|
High Self |
531 |
280.13 |
295.97 |
212.03 |
83.94 |
-8.58 |
|
|
High Family |
532 |
560.28 |
591.96 |
443.97 |
147.99 |
7.92 |
|
|
Standard Self |
534 |
249.69 |
264.42 |
198.32 |
66.10 |
3.68 |
|
|
Standard Family |
535 |
499.35 |
528.86 |
396.65 |
132.21 |
7.37 |
|
MN HealthPartners Health Plan |
|
|
|
High Self |
HQ1 |
301.86 |
332.89 |
212.03 |
120.86 |
6.61 |
|
|
High Family |
HQ2 |
603.72 |
665.77 |
484.06 |
181.71 |
2.27 |
|
MO BlueCHOICE |
|
|
|
|
High Self |
9G1 |
313.73 |
327.86 |
212.03 |
115.83 |
-10.29 |
|
|
High Family |
9G2 |
624.52 |
652.60 |
484.06 |
168.54 |
-31.70 |
|
MO Coventry HC Kansas Cty formerly Kaiser |
|
|
|
High Self |
HA1 |
265.24 |
144.76 |
108.57 |
36.19 |
-41.44 |
|
|
High Family |
HA2 |
684.34 |
579.02 |
434.27 |
144.75 |
-115.31 |
|
MO Group Health Plan |
|
|
|
|
High Self |
MM1 |
327.19 |
327.19 |
212.03 |
115.16 |
-24.42 |
|
|
High Family |
MM2 |
693.12 |
693.12 |
484.06 |
209.06 |
-58.78 |
|
MO Humana Kansas City, Inc. |
|
|
|
High Self |
MS1 |
279.65 |
280.56 |
210.42 |
70.14 |
-21.90 |
|
|
High Family |
MS2 |
649.13 |
649.29 |
484.06 |
165.23 |
-59.62 |
|
|
Standard Self |
MS4 |
218.75 |
232.29 |
174.22 |
58.07 |
3.38 |
|
|
Standard Family |
MS5 |
502.95 |
533.48 |
400.11 |
133.37 |
7.63 |
|
MO Mercy Health Plans/Premier |
|
|
|
High Self |
7M1 |
292.93 |
378.97 |
212.03 |
166.94 |
61.62 |
|
|
High Family |
7M2 |
585.87 |
757.92 |
484.06 |
273.86 |
112.27 |
|
NC PARTNERS NHP of NC |
|
|
|
High Self |
EQ1 |
360.53 |
353.17 |
212.03 |
141.14 |
-31.78 |
|
|
High Family |
EQ2 |
721.07 |
706.33 |
484.06 |
222.27 |
-74.52 |
|
Department
of Defense--Federal Employees Health Benefits Program Demonstration Project |
|
|
|
HMO Plans |
2001
Total Monthly DoD-FEHB Premium |
2002 DoD-FEHB Monthly Premium |
|
|
Location - Plan -
Option - Enrollment Code |
Total
Premium |
DoD Pays |
DoD-FEHB
Enrollee Pays |
Change
in enrollee payment |
|
|
|
|
PR Triple-S |
|
|
|
|
High Self |
891 |
228.41 |
216.99 |
162.74 |
54.25 |
-2.85 |
|
|
High Family |
892 |
540.76 |
513.72 |
385.29 |
128.43 |
-6.76 |
|
TX HMO Blue Texas |
|
|
|
|
High Self |
YX1 |
310.16 |
354.49 |
212.03 |
142.46 |
19.91 |
|
|
High Family |
YX2 |
620.32 |
709.02 |
484.06 |
224.96 |
28.92 |
|
TX PacifiCare Health Plans |
|
|
|
High Self |
GF1 |
281.67 |
281.67 |
211.25 |
70.42 |
-23.64 |
|
|
High Family |
GF2 |
654.85 |
654.85 |
484.06 |
170.79 |
-59.78 |
|
TX Texas Health Choice, L. C. |
|
|
|
High Self |
UK1 |
281.78 |
316.12 |
212.03 |
104.09 |
9.92 |
|
|
High Family |
UK2 |
563.53 |
632.23 |
474.17 |
158.06 |
17.18 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|