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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 2022 TCC Premium 2023 TCC Monthly Premiums - Total Premium 2023 TCC Monthly Premiums - Government Pays 2023 TCC Monthly Premiums - Employee Pays 2023 TCC Monthly Premiums - Change in Employee Payment 2022 Former Spouse Premium 2023 Former Spouse Monthly Premiums - Total Premium 2023 Former Spouse Monthly Premiums - Government Pays 2023 Former Spouse Monthly Premiums - Employee Pays 2023 Former Spouse Monthly Premiums - Change in Employee Payment
Nationwide APWU Health Plan - CDHP Self 474 615.73 652.66 0.00 652.66 36.93 603.66 639.86 0.00 639.86 36.20
Nationwide APWU Health Plan - CDHP Self & Family 475 1459.89 1547.46 0.00 1547.46 87.57 1431.26 1517.12 0.00 1517.12 85.86
Nationwide APWU Health Plan - CDHP Self Plus One 476 1338.22 1418.51 0.00 1418.51 80.29 1311.98 1390.70 0.00 1390.70 78.72
Nationwide APWU Health Plan - High Self 471 776.26 841.39 0.00 841.39 65.13 761.04 824.89 0.00 824.89 63.85
Nationwide APWU Health Plan - High Self & Family 472 1862.94 2019.23 0.00 2019.23 156.29 1826.41 1979.64 0.00 1979.64 153.23
Nationwide APWU Health Plan - High Self Plus One 473 1630.07 1766.83 0.00 1766.83 136.76 1598.11 1732.19 0.00 1732.19 134.08
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self 111 708.84 765.52 0.00 765.52 56.68 694.94 750.51 0.00 750.51 55.57
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self & Family 112 1737.99 1877.02 0.00 1877.02 139.03 1703.91 1840.22 0.00 1840.22 136.31
Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self Plus One 113 1592.88 1720.31 0.00 1720.31 127.43 1561.65 1686.58 0.00 1686.58 124.93
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self 131 469.80 479.26 0.00 479.26 9.46 460.59 469.86 0.00 469.86 9.27
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self & Family 132 1110.96 1133.24 0.00 1133.24 22.28 1089.18 1111.02 0.00 1111.02 21.84
Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self Plus One 133 1010.01 1030.26 0.00 1030.26 20.25 990.21 1010.06 0.00 1010.06 19.85
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self 104 822.85 888.69 0.00 888.69 65.84 806.72 871.26 0.00 871.26 64.54
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self & Family 105 1963.01 2120.08 0.00 2120.08 157.07 1924.52 2078.51 0.00 2078.51 153.99
Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option - Standard Self Plus One 106 1799.47 1943.41 0.00 1943.41 143.94 1764.19 1905.30 0.00 1905.30 141.11
Nationwide Compass Rose Health Plan - High Self 421 775.75 791.27 0.00 791.27 15.52 760.54 775.75 0.00 775.75 15.21
Nationwide Compass Rose Health Plan - High Self & Family 422 1861.86 1899.10 0.00 1899.10 37.24 1825.35 1861.86 0.00 1861.86 36.51
Nationwide Compass Rose Health Plan - High Self Plus One 423 1706.69 1740.84 0.00 1740.84 34.15 1673.23 1706.71 0.00 1706.71 33.48
Nationwide Foreign Service Benefit Plan - High Self 401 647.00 692.28 0.00 692.28 45.28 634.31 678.71 0.00 678.71 44.40
Nationwide Foreign Service Benefit Plan - High Self & Family 402 1600.52 1712.55 0.00 1712.55 112.03 1569.14 1678.97 0.00 1678.97 109.83
Nationwide Foreign Service Benefit Plan - High Self Plus One 403 1569.34 1679.19 0.00 1679.19 109.85 1538.57 1646.26 0.00 1646.26 107.69
Nationwide GEHA Benefit Plan - High Self 311 772.88 807.67 0.00 807.67 34.79 757.73 791.83 0.00 791.83 34.10
Nationwide GEHA Benefit Plan - High Self & Family 312 1936.80 2023.95 0.00 2023.95 87.15 1898.82 1984.26 0.00 1984.26 85.44
Nationwide GEHA Benefit Plan - High Self Plus One 313 1700.35 1776.86 0.00 1776.86 76.51 1667.01 1742.02 0.00 1742.02 75.01
Nationwide GEHA Benefit Plan - Standard Self 314 553.96 607.97 0.00 607.97 54.01 543.10 596.05 0.00 596.05 52.95
Nationwide GEHA Benefit Plan - Standard Self & Family 315 1457.27 1599.36 0.00 1599.36 142.09 1428.70 1568.00 0.00 1568.00 139.30
Nationwide GEHA Benefit Plan - Standard Self Plus One 316 1191.05 1307.19 0.00 1307.19 116.14 1167.70 1281.56 0.00 1281.56 113.86
Nationwide GEHA HDHP - HDHP Self 341 558.76 613.23 0.00 613.23 54.47 547.80 601.21 0.00 601.21 53.41
Nationwide GEHA HDHP - HDHP Self & Family 342 1476.26 1620.20 0.00 1620.20 143.94 1447.31 1588.43 0.00 1588.43 141.12
Nationwide GEHA HDHP - HDHP Self Plus One 343 1201.34 1318.46 0.00 1318.46 117.12 1177.78 1292.61 0.00 1292.61 114.83
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self 251 699.49 758.25 0.00 758.25 58.76 685.77 743.38 0.00 743.38 57.61
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self & Family 252 1685.19 1814.97 0.00 1814.97 129.78 1652.15 1779.38 0.00 1779.38 127.23
Nationwide GEHA Indemnity Benefit Plan - Elevate Plus Self Plus One 253 1562.78 1653.43 0.00 1653.43 90.65 1532.14 1621.01 0.00 1621.01 88.87
Nationwide GEHA Indemnity Benefit Plan - Elevate Self 254 430.89 448.13 0.00 448.13 17.24 422.44 439.34 0.00 439.34 16.90
Nationwide GEHA Indemnity Benefit Plan - Elevate Self & Family 255 1206.51 1278.91 0.00 1278.91 72.40 1182.85 1253.83 0.00 1253.83 70.98
Nationwide GEHA Indemnity Benefit Plan - Elevate Self Plus One 256 991.05 1050.50 0.00 1050.50 59.45 971.62 1029.90 0.00 1029.90 58.28
Nationwide MHBP Consumer Option - HDHP Self 481 675.35 695.64 0.00 695.64 20.29 662.11 682.00 0.00 682.00 19.89
Nationwide MHBP Consumer Option - HDHP Self & Family 482 1569.30 1616.37 0.00 1616.37 47.07 1538.53 1584.68 0.00 1584.68 46.15
Nationwide MHBP Consumer Option - HDHP Self Plus One 483 1494.58 1539.42 0.00 1539.42 44.84 1465.27 1509.24 0.00 1509.24 43.97
Nationwide MHBP Standard Option - Standard Self 454 691.82 712.57 0.00 712.57 20.75 678.25 698.60 0.00 698.60 20.35
Nationwide MHBP Standard Option - Standard Self & Family 455 1607.73 1655.98 0.00 1655.98 48.25 1576.21 1623.51 0.00 1623.51 47.30
Nationwide MHBP Standard Option - Standard Self Plus One 456 1592.41 1640.22 0.00 1640.22 47.81 1561.19 1608.06 0.00 1608.06 46.87
Nationwide MHBP Value Plan - Value Self 414 494.75 514.53 0.00 514.53 19.78 485.05 504.44 0.00 504.44 19.39
Nationwide MHBP Value Plan - Value Self & Family 415 1195.65 1243.48 0.00 1243.48 47.83 1172.21 1219.10 0.00 1219.10 46.89
Nationwide MHBP Value Plan - Value Self Plus One 416 1172.26 1219.14 0.00 1219.14 46.88 1149.27 1195.24 0.00 1195.24 45.97
Nationwide NALC Health Benefit Plan - CDHP Self 324 483.00 492.63 0.00 492.63 9.63 473.53 482.97 0.00 482.97 9.44
Nationwide NALC Health Benefit Plan - CDHP Self & Family 325 1133.14 1167.12 0.00 1167.12 33.98 1110.92 1144.24 0.00 1144.24 33.32
Nationwide NALC Health Benefit Plan - CDHP Self Plus One 326 1065.57 1086.90 0.00 1086.90 21.33 1044.68 1065.59 0.00 1065.59 20.91
Nationwide NALC Health Benefit Plan - High Self 321 758.34 801.57 0.00 801.57 43.23 743.47 785.85 0.00 785.85 42.38
Nationwide NALC Health Benefit Plan - High Self & Family 322 1715.29 1818.21 0.00 1818.21 102.92 1681.66 1782.56 0.00 1782.56 100.90
Nationwide NALC Health Benefit Plan - High Self Plus One 323 1677.35 1772.97 0.00 1772.97 95.62 1644.46 1738.21 0.00 1738.21 93.75
Nationwide NALC Health Benefit Plan - Value Self KM1 396.41 404.34 0.00 404.34 7.93 388.64 396.41 0.00 396.41 7.77
Nationwide NALC Health Benefit Plan - Value Self & Family KM2 930.39 958.30 0.00 958.30 27.91 912.15 939.51 0.00 939.51 27.36
Nationwide NALC Health Benefit Plan - Value Self Plus One KM3 874.50 891.98 0.00 891.98 17.48 857.35 874.49 0.00 874.49 17.14
Nationwide Panama Canal Area Benefit Plan - High Self 431 720.28 777.90 0.00 777.90 57.62 706.16 762.65 0.00 762.65 56.49
Nationwide Panama Canal Area Benefit Plan - High Self & Family 432 1517.57 1638.96 0.00 1638.96 121.39 1487.81 1606.82 0.00 1606.82 119.01
Nationwide Panama Canal Area Benefit Plan - High Self Plus One 433 1451.02 1567.11 0.00 1567.11 116.09 1422.57 1536.38 0.00 1536.38 113.81
Nationwide Rural Carrier Benefit Plan - High Self 381 830.23 863.45 0.00 863.45 33.22 813.95 846.52 0.00 846.52 32.57
Nationwide Rural Carrier Benefit Plan - High Self & Family 382 1792.35 1888.77 0.00 1888.77 96.42 1757.21 1851.74 0.00 1851.74 94.53
Nationwide Rural Carrier Benefit Plan - High Self Plus One 383 1706.39 1798.19 0.00 1798.19 91.80 1672.93 1762.93 0.00 1762.93 90.00
Nationwide SAMBA Health Benefit Plan - High Self 441 892.17 918.94 0.00 918.94 26.77 874.68 900.92 0.00 900.92 26.24
Nationwide SAMBA Health Benefit Plan - High Self & Family 442 2141.20 2205.44 0.00 2205.44 64.24 2099.22 2162.20 0.00 2162.20 62.98
Nationwide SAMBA Health Benefit Plan - High Self Plus One 443 1962.79 2021.66 0.00 2021.66 58.87 1924.30 1982.02 0.00 1982.02 57.72
Nationwide SAMBA Health Benefit Plan - Standard Self 444 722.10 743.75 0.00 743.75 21.65 707.94 729.17 0.00 729.17 21.23
Nationwide SAMBA Health Benefit Plan - Standard Self & Family 445 1647.42 1696.84 0.00 1696.84 49.42 1615.12 1663.57 0.00 1663.57 48.45
Nationwide SAMBA Health Benefit Plan - Standard Self Plus One 446 1554.18 1600.79 0.00 1600.79 46.61 1523.71 1569.40 0.00 1569.40 45.69
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