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Non-Postal Premium Rates for the Federal Employees Health Benefits Program
FFS (Fee-for-Service/Nationwide Plans)
Nationwide APWU Health Plan - CDHP Self
474
275.85
278.61
208.96
69.65
0.69
597.68
603.66
452.75
150.91
1.49
Nationwide APWU Health Plan - CDHP Self & Family
475
654.04
660.58
495.44
165.14
1.63
1417.09
1431.26
1073.45
357.81
3.54
Nationwide APWU Health Plan - CDHP Self Plus One
476
599.54
605.53
454.15
151.38
1.50
1299.00
1311.98
983.99
327.99
3.24
Nationwide APWU Health Plan - High Self
471
335.18
345.24
241.58
103.66
4.25
726.22
748.02
523.42
224.60
9.22
Nationwide APWU Health Plan - High Self & Family
472
804.42
828.55
562.25
266.30
8.35
1742.91
1795.19
1218.21
576.98
18.09
Nationwide APWU Health Plan - High Self Plus One
473
703.86
724.97
517.46
207.51
7.77
1525.03
1570.77
1121.16
449.61
16.84
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self
111
303.78
314.42
235.82
78.60
2.66
658.19
681.24
510.93
170.31
5.76
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self & Family
112
737.69
763.52
562.25
201.27
10.05
1598.33
1654.29
1218.21
436.08
21.77
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self Plus One
113
682.73
706.63
517.46
189.17
10.56
1479.25
1531.03
1121.16
409.87
22.88
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self
131
212.58
212.58
159.44
53.14
0.00
460.59
460.59
345.44
115.15
0.00
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self & Family
132
502.70
502.70
377.03
125.67
0.00
1089.18
1089.18
816.89
272.29
0.00
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self Plus One
133
457.02
457.02
342.77
114.25
0.00
990.21
990.21
742.66
247.55
0.00
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self
104
352.68
365.03
241.58
123.45
6.54
764.14
790.90
523.42
267.48
14.18
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self & Family
105
833.21
862.37
562.25
300.12
13.38
1805.29
1868.47
1218.21
650.26
28.99
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self Plus One
106
771.27
798.27
517.46
280.81
13.66
1671.09
1729.59
1121.16
608.43
29.60
Nationwide Compass Rose Health Plan - High Self
421
337.43
347.55
241.58
105.97
4.31
731.10
753.03
523.42
229.61
9.35
Nationwide Compass Rose Health Plan - High Self & Family
422
809.84
834.13
562.25
271.88
8.51
1754.65
1807.28
1218.21
589.07
18.44
Nationwide Compass Rose Health Plan - High Self Plus One
423
742.35
764.62
517.46
247.16
8.93
1608.43
1656.68
1121.16
535.52
19.35
Nationwide Foreign Service Benefit Plan - High Self
401
275.95
287.02
215.27
71.75
2.76
597.89
621.88
466.41
155.47
6.00
Nationwide Foreign Service Benefit Plan - High Self & Family
402
682.70
710.02
532.52
177.50
6.83
1479.18
1538.38
1153.79
384.59
14.80
Nationwide Foreign Service Benefit Plan - High Self Plus One
403
675.91
696.19
517.46
178.73
6.94
1464.47
1508.41
1121.16
387.25
15.04
Nationwide GEHA Benefit Plan - High Self
311
341.19
349.72
241.58
108.14
2.72
739.25
757.73
523.42
234.31
5.90
Nationwide GEHA Benefit Plan - High Self & Family
312
850.86
876.38
562.25
314.13
9.74
1843.53
1898.82
1218.21
680.61
21.10
Nationwide GEHA Benefit Plan - High Self Plus One
313
750.63
769.39
517.46
251.93
5.42
1626.37
1667.01
1121.16
545.85
11.74
Nationwide GEHA Benefit Plan - Standard Self
314
242.18
250.66
188.00
62.66
2.12
524.72
543.10
407.33
135.77
4.59
Nationwide GEHA Benefit Plan - Standard Self & Family
315
622.08
659.40
494.55
164.85
9.33
1347.84
1428.70
1071.53
357.17
20.21
Nationwide GEHA Benefit Plan - Standard Self Plus One
316
520.71
538.94
404.21
134.73
4.55
1128.21
1167.70
875.78
291.92
9.87
Nationwide GEHA HDHP - HDHP Self
341
237.16
245.47
184.10
61.37
2.08
513.85
531.85
398.89
132.96
4.50
Nationwide GEHA HDHP - HDHP Self & Family
342
600.16
636.18
477.14
159.04
9.00
1300.35
1378.39
1033.79
344.60
19.51
Nationwide GEHA HDHP - HDHP Self Plus One
343
509.91
527.76
395.82
131.94
4.46
1104.81
1143.48
857.61
285.87
9.67
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self
251
290.69
301.44
226.08
75.36
2.69
629.83
653.12
489.84
163.28
5.82
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self & Family
252
720.91
747.57
560.68
186.89
6.66
1561.97
1619.74
1214.81
404.93
14.44
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self Plus One
253
674.39
693.27
517.46
175.81
5.54
1461.18
1502.09
1121.16
380.93
12.01
Nationwide GEHA Indemnity Benefit Plan - Elevate Self
254
189.29
189.29
141.97
47.32
0.00
410.13
410.13
307.60
102.53
0.00
Nationwide GEHA Indemnity Benefit Plan - Elevate Self & Family
255
530.03
530.03
397.52
132.51
0.00
1148.40
1148.40
861.30
287.10
0.00
Nationwide GEHA Indemnity Benefit Plan - Elevate Self Plus One
256
435.38
435.38
326.54
108.84
0.00
943.32
943.32
707.49
235.83
0.00
Nationwide MHBP Consumer Option - HDHP Self
481
264.59
291.04
218.28
72.76
6.61
573.28
630.59
472.94
157.65
14.33
Nationwide MHBP Consumer Option - HDHP Self & Family
482
614.80
676.28
507.21
169.07
15.37
1332.07
1465.27
1098.95
366.32
33.30
Nationwide MHBP Consumer Option - HDHP Self Plus One
483
585.53
644.08
483.06
161.02
14.64
1268.65
1395.51
1046.63
348.88
31.72
Nationwide MHBP Standard Option - Standard Self
454
263.47
287.19
215.39
71.80
5.93
570.85
622.25
466.69
155.56
12.85
Nationwide MHBP Standard Option - Standard Self & Family
455
612.30
667.41
500.56
166.85
13.78
1326.65
1446.06
1084.55
361.51
29.85
Nationwide MHBP Standard Option - Standard Self Plus One
456
606.47
661.06
495.80
165.26
13.64
1314.02
1432.30
1074.23
358.07
29.57
Nationwide MHBP Value Plan - Value Self
414
209.22
213.41
160.06
53.35
1.05
453.31
462.39
346.79
115.60
2.27
Nationwide MHBP Value Plan - Value Self & Family
415
505.63
515.75
386.81
128.94
2.53
1095.53
1117.46
838.10
279.36
5.48
Nationwide MHBP Value Plan - Value Self Plus One
416
495.73
505.65
379.24
126.41
2.48
1074.08
1095.58
821.69
273.89
5.37
Nationwide NALC Health Benefit Plan - CDHP Self
324
218.55
218.55
163.91
54.64
0.00
473.53
473.53
355.15
118.38
0.00
Nationwide NALC Health Benefit Plan - CDHP Self & Family
325
502.63
507.66
380.75
126.91
1.25
1089.03
1099.93
824.95
274.98
2.72
Nationwide NALC Health Benefit Plan - CDHP Self Plus One
326
482.16
482.16
361.62
120.54
0.00
1044.68
1044.68
783.51
261.17
0.00
Nationwide NALC Health Benefit Plan - High Self
321
326.61
336.41
241.58
94.83
3.99
707.66
728.89
523.42
205.47
8.65
Nationwide NALC Health Benefit Plan - High Self & Family
322
735.21
760.94
562.25
198.69
9.95
1592.96
1648.70
1218.21
430.49
21.55
Nationwide NALC Health Benefit Plan - High Self Plus One
323
722.43
744.10
517.46
226.64
8.33
1565.27
1612.22
1121.16
491.06
18.05
Nationwide NALC Health Benefit Plan - Value Self
KM1
179.37
179.37
134.53
44.84
0.00
388.64
388.64
291.48
97.16
0.00
Nationwide NALC Health Benefit Plan - Value Self & Family
KM2
412.69
416.82
312.62
104.20
1.03
894.16
903.11
677.33
225.78
2.24
Nationwide NALC Health Benefit Plan - Value Self Plus One
KM3
395.70
395.70
296.78
98.92
0.00
857.35
857.35
643.01
214.34
0.00
Nationwide Panama Canal Area Benefit Plan - High Self
431
290.09
304.60
228.45
76.15
3.63
628.53
659.97
494.98
164.99
7.86
Nationwide Panama Canal Area Benefit Plan - High Self & Family
432
605.54
635.81
476.86
158.95
7.57
1312.00
1377.59
1033.19
344.40
16.40
Nationwide Panama Canal Area Benefit Plan - High Self Plus One
433
578.99
607.94
455.96
151.98
7.23
1254.48
1317.20
987.90
329.30
15.68
Nationwide Rural Carrier Benefit Plan - High Self
381
358.00
368.30
241.58
126.72
4.49
775.67
797.98
523.42
274.56
9.73
Nationwide Rural Carrier Benefit Plan - High Self & Family
382
734.00
781.71
562.25
219.46
31.93
1590.33
1693.71
1218.21
475.50
69.19
Nationwide Rural Carrier Benefit Plan - High Self Plus One
383
709.00
744.21
517.46
226.75
21.87
1536.17
1612.46
1121.16
491.30
47.39
Nationwide SAMBA Health Benefit Plan - High Self
441
416.19
403.70
241.58
162.12
-18.30
901.75
874.68
523.42
351.26
-39.65
Nationwide SAMBA Health Benefit Plan - High Self & Family
442
998.84
968.87
562.25
406.62
-45.75
2164.15
2099.22
1218.21
881.01
-99.12
Nationwide SAMBA Health Benefit Plan - High Self Plus One
443
915.61
888.14
517.46
370.68
-40.81
1983.82
1924.30
1121.16
803.14
-88.42
Nationwide SAMBA Health Benefit Plan - Standard Self
444
314.08
323.50
241.58
81.92
3.40
680.51
700.92
523.42
177.50
7.37
Nationwide SAMBA Health Benefit Plan - Standard Self & Family
445
716.56
738.06
553.55
184.51
5.37
1552.55
1599.13
1199.35
399.78
11.64
Nationwide SAMBA Health Benefit Plan - Standard Self Plus One
446
676.00
696.28
517.46
178.82
6.94
1464.67
1508.61
1121.16
387.45
15.04
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service