Temporary Continuation of Coverage (TCC) Premium Rates for ...



Temporary Continuation of Coverage (TCC) Premium Rates for the Federal Employees Health Benefit PlanThe premium rates listed below are for employees hired on or before 9/30/1987 and entitled to the Federal Health Benefit Plan (FEHB). TYPEENROLLMENT CODE 2012 MONTHLY TCC PREMIUM AETNA OPEN ACCESS HIGH OPTIONSelfJN1$ 755.23FamilyJN2$ 1,691.65AETNA OPEN ACCESS BASIC OPTIONSelfJN4$ 507.82FamilyJN5$ 1,188.43APWU HEALTH PLAN HIGH OPTIONSelf471$ 520.68Family472$ 1,177.31BLUE CROSS BLUE SHIELD STANDARDSelf104$ 599.64Family105$ 1,354.36BLUE CROSS BLUE SHIELD BASICSelf111$ 497.29Family112$ 1,164.53CAREFIRST BLUECHOICE HIGH OPTIONSelf2G1$ 553.30Family2G2$ 1,244.72GEHA BENEFIT PLAN HIGH OPTIONSelf311$ 599.24Family312$ 1,362.86GEHA BENEFIT PLAN STANDARD OPTIONSelf314$ 378.31Family315$ 860.33KAISER FOUNDATION HEALTH PLAN HIGH OPTIONSelfE31$ 561.47FamilyE32$ 1,291.43TYPEENROLLMENT CODE 2012 MONTHLY TCC PREMIUM KAISER FOUNDATION HEALTH PLAN STANDARD OPTIONSelfE34$ 365.94FamilyE35$ 841.65MAIL HANDLERS BENEFIT PLAN VALUE OPTIONSelf414$ 349.95Family415$ 834.32MAIL HANDLERS BENEFIT PLAN STANDARD OPTIONSelf454$623.42Family455$1,426.74MDIPA HIGH OPTIONSelfJP1$ 579.62FamilyJP2$ 1,336.57NALCSelf321$ 575.52Family322$1,249.87 ................
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