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Premium Rates for the Federal Employees Health Benefits Program
FFS (Fee-for-Service/Nationwide Plans)
Nationwide APWU Health Plan - CDHP Self
474
278.61
278.61
208.96
69.65
0.00
603.66
603.66
452.75
150.91
0.00
Nationwide APWU Health Plan - CDHP Self & Family
475
660.58
660.58
495.44
165.14
0.00
1431.26
1431.26
1073.45
357.81
0.00
Nationwide APWU Health Plan - CDHP Self Plus One
476
605.53
605.53
454.15
151.38
0.00
1311.98
1311.98
983.99
327.99
0.00
Nationwide APWU Health Plan - High Self
471
345.24
351.25
244.86
106.39
2.73
748.02
761.04
530.53
230.51
5.91
Nationwide APWU Health Plan - High Self & Family
472
828.55
842.96
574.13
268.83
2.53
1795.19
1826.41
1243.95
582.46
5.48
Nationwide APWU Health Plan - High Self Plus One
473
724.97
737.59
524.63
212.96
5.45
1570.77
1598.11
1136.70
461.41
11.80
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self
111
314.42
320.74
240.56
80.18
1.58
681.24
694.94
521.21
173.73
3.42
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self & Family
112
763.52
786.42
574.13
212.29
11.02
1654.29
1703.91
1243.95
459.96
23.88
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self Plus One
113
706.63
720.76
524.63
196.13
6.96
1531.03
1561.65
1136.70
424.95
15.08
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
365.03
372.33
244.86
127.47
4.02
790.90
806.72
530.53
276.19
8.71
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self & Family
105
862.37
888.24
574.13
314.11
13.99
1868.47
1924.52
1243.95
680.57
30.31
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self Plus One
106
798.27
814.24
524.63
289.61
8.80
1729.59
1764.19
1136.70
627.49
19.06
Nationwide Compass Rose Health Plan - High Self
421
347.55
351.02
244.86
106.16
0.19
753.03
760.54
530.53
230.01
0.40
Nationwide Compass Rose Health Plan - High Self & Family
422
834.13
842.47
574.13
268.34
-3.54
1807.28
1825.35
1243.95
581.40
-7.67
Nationwide Compass Rose Health Plan - High Self Plus One
423
764.62
772.26
524.63
247.63
0.47
1656.68
1673.23
1136.70
536.53
1.01
Nationwide Foreign Service Benefit Plan - High Self
401
287.02
292.76
219.57
73.19
1.44
621.88
634.31
475.73
158.58
3.11
Nationwide Foreign Service Benefit Plan - High Self & Family
402
710.02
724.22
543.17
181.05
3.55
1538.38
1569.14
1176.86
392.28
7.69
Nationwide Foreign Service Benefit Plan - High Self Plus One
403
696.19
710.11
524.63
185.48
6.75
1508.41
1538.57
1136.70
401.87
14.62
Nationwide GEHA Benefit Plan - High Self
311
349.72
349.72
244.86
104.86
-3.28
757.73
757.73
530.53
227.20
-7.11
Nationwide GEHA Benefit Plan - High Self & Family
312
876.38
876.38
574.13
302.25
-11.88
1898.82
1898.82
1243.95
654.87
-25.74
Nationwide GEHA Benefit Plan - High Self Plus One
313
769.39
769.39
524.63
244.76
-7.17
1667.01
1667.01
1136.70
530.31
-15.54
Nationwide GEHA Benefit Plan - Standard Self
314
250.66
250.66
188.00
62.66
0.00
543.10
543.10
407.33
135.77
0.00
Nationwide GEHA Benefit Plan - Standard Self & Family
315
659.40
659.40
494.55
164.85
0.00
1428.70
1428.70
1071.53
357.17
0.00
Nationwide GEHA Benefit Plan - Standard Self Plus One
316
538.94
538.94
404.21
134.73
0.00
1167.70
1167.70
875.78
291.92
0.00
Nationwide GEHA HDHP - HDHP Self
341
245.47
252.83
189.62
63.21
1.84
531.85
547.80
410.85
136.95
3.99
Nationwide GEHA HDHP - HDHP Self & Family
342
636.18
667.99
500.99
167.00
7.96
1378.39
1447.31
1085.48
361.83
17.23
Nationwide GEHA HDHP - HDHP Self Plus One
343
527.76
543.59
407.69
135.90
3.96
1143.48
1177.78
883.34
294.44
8.57
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self
251
301.44
316.51
237.38
79.13
3.77
653.12
685.77
514.33
171.44
8.16
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self & Family
252
747.57
762.53
571.90
190.63
3.74
1619.74
1652.15
1239.11
413.04
8.11
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self Plus One
253
693.27
707.14
524.63
182.51
6.70
1502.09
1532.14
1136.70
395.44
14.51
Nationwide GEHA Indemnity Benefit Plan - Elevate Self
254
189.29
194.97
146.23
48.74
1.42
410.13
422.44
316.83
105.61
3.08
Nationwide GEHA Indemnity Benefit Plan - Elevate Self & Family
255
530.03
545.93
409.45
136.48
3.97
1148.40
1182.85
887.14
295.71
8.61
Nationwide GEHA Indemnity Benefit Plan - Elevate Self Plus One
256
435.38
448.44
336.33
112.11
3.27
943.32
971.62
728.72
242.90
7.07
Nationwide MHBP Consumer Option - HDHP Self
481
291.04
305.59
229.19
76.40
3.64
630.59
662.11
496.58
165.53
7.88
Nationwide MHBP Consumer Option - HDHP Self & Family
482
676.28
710.09
532.57
177.52
8.45
1465.27
1538.53
1153.90
384.63
18.31
Nationwide MHBP Consumer Option - HDHP Self Plus One
483
644.08
676.28
507.21
169.07
8.05
1395.51
1465.27
1098.95
366.32
17.44
Nationwide MHBP Standard Option - Standard Self
454
287.19
313.04
234.78
78.26
6.46
622.25
678.25
508.69
169.56
14.00
Nationwide MHBP Standard Option - Standard Self & Family
455
667.41
727.48
545.61
181.87
15.02
1446.06
1576.21
1182.16
394.05
32.54
Nationwide MHBP Standard Option - Standard Self Plus One
456
661.06
720.55
524.63
195.92
30.66
1432.30
1561.19
1136.70
424.49
66.42
Nationwide MHBP Value Plan - Value Self
414
213.41
223.87
167.90
55.97
2.62
462.39
485.05
363.79
121.26
5.66
Nationwide MHBP Value Plan - Value Self & Family
415
515.75
541.02
405.77
135.25
6.31
1117.46
1172.21
879.16
293.05
13.69
Nationwide MHBP Value Plan - Value Self Plus One
416
505.65
530.43
397.82
132.61
6.20
1095.58
1149.27
861.95
287.32
13.43
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
507.66
512.73
384.55
128.18
1.27
1099.93
1110.92
833.19
277.73
2.75
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
336.41
343.14
244.86
98.28
3.45
728.89
743.47
530.53
212.94
7.47
Nationwide NALC Health Benefit Plan - High Self & Family
322
760.94
776.15
574.13
202.02
3.33
1648.70
1681.66
1243.95
437.71
7.22
Nationwide NALC Health Benefit Plan - High Self Plus One
323
744.10
758.98
524.63
234.35
7.71
1612.22
1644.46
1136.70
507.76
16.70
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
416.82
420.99
315.74
105.25
1.05
903.11
912.15
684.11
228.04
2.26
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
304.60
325.92
244.44
81.48
5.33
659.97
706.16
529.62
176.54
11.55
Nationwide Panama Canal Area Benefit Plan - High Self & Family
432
635.81
686.68
515.01
171.67
12.72
1377.59
1487.81
1115.86
371.95
27.55
Nationwide Panama Canal Area Benefit Plan - High Self Plus One
433
607.94
656.57
492.43
164.14
12.16
1317.20
1422.57
1066.93
355.64
26.34
Nationwide Rural Carrier Benefit Plan - High Self
381
368.30
375.67
244.86
130.81
4.09
797.98
813.95
530.53
283.42
8.86
Nationwide Rural Carrier Benefit Plan - High Self & Family
382
781.71
811.02
574.13
236.89
17.43
1693.71
1757.21
1243.95
513.26
37.76
Nationwide Rural Carrier Benefit Plan - High Self Plus One
383
744.21
772.12
524.63
247.49
20.74
1612.46
1672.93
1136.70
536.23
44.93
Nationwide SAMBA Health Benefit Plan - High Self
441
403.70
403.70
244.86
158.84
-3.28
874.68
874.68
530.53
344.15
-7.11
Nationwide SAMBA Health Benefit Plan - High Self & Family
442
968.87
968.87
574.13
394.74
-11.88
2099.22
2099.22
1243.95
855.27
-25.74
Nationwide SAMBA Health Benefit Plan - High Self Plus One
443
888.14
888.14
524.63
363.51
-7.17
1924.30
1924.30
1136.70
787.60
-15.54
Nationwide SAMBA Health Benefit Plan - Standard Self
444
323.50
326.74
244.86
81.88
-0.04
700.92
707.94
530.53
177.41
-0.09
Nationwide SAMBA Health Benefit Plan - Standard Self & Family
445
738.06
745.44
559.08
186.36
1.85
1599.13
1615.12
1211.34
403.78
4.00
Nationwide SAMBA Health Benefit Plan - Standard Self Plus One
446
696.28
703.25
524.63
178.62
-0.20
1508.61
1523.71
1136.70
387.01
-0.44
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service