Temporary Continuation of Coverage (TCC) Premium Rates for the Federal Employees Health

Temporary Continuation of Coverage (TCC) Premium Rates for the Federal Employees Health Benefit Plan

The premium rates listed below are for employees hired on or before 9/30/1987 and entitled to the Federal Health Benefit Plan (FEHB).

TYPE / ENROLLMENT CODE / 2012 MONTHLY TCC PREMIUM
AETNA OPEN ACCESS HIGH OPTION
Self / JN1 / $ 755.23
Family / JN2 / $ 1,691.65
AETNA OPEN ACCESS BASIC OPTION
Self / JN4 / $ 507.82
Family / JN5 / $ 1,188.43
APWU HEALTH PLAN HIGH OPTION
Self / 471 / $ 520.68
Family / 472 / $ 1,177.31
BLUE CROSS BLUE SHIELD STANDARD
Self / 104 / $ 599.64
Family / 105 / $ 1,354.36
BLUE CROSS BLUE SHIELD BASIC
Self / 111 / $ 497.29
Family / 112 / $ 1,164.53
CAREFIRST BLUECHOICE HIGH OPTION
Self / 2G1 / $ 553.30
Family / 2G2 / $ 1,244.72
GEHA BENEFIT PLAN HIGH OPTION
Self / 311 / $ 599.24
Family / 312 / $ 1,362.86
GEHA BENEFIT PLAN STANDARD OPTION
Self / 314 / $ 378.31
Family / 315 / $ 860.33
KAISER FOUNDATION HEALTH PLAN HIGH OPTION
Self / E31 / $ 561.47
Family / E32 / $ 1,291.43
TYPE / ENROLLMENT CODE / 2012 MONTHLY TCC PREMIUM
KAISER FOUNDATION HEALTH PLAN STANDARD OPTION
Self / E34 / $ 365.94
Family / E35 / $ 841.65
MAIL HANDLERS BENEFIT PLAN VALUE OPTION
Self / 414 / $ 349.95
Family / 415 / $ 834.32
MAIL HANDLERS BENEFIT PLAN STANDARD OPTION
Self / 454 / $623.42
Family / 455 / $1,426.74
MDIPA HIGH OPTION
Self / JP1 / $ 579.62
Family / JP2 / $ 1,336.57
NALC
Self / 321 / $ 575.52
Family / 322 / $1,249.87

1200 First Street, NE | Washington, DC 20002 | T 202.442.4090 | F 202.442.5317 | E