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150

 
 
Document Number:
PFBF25-150
Revision #:
v1.0
Date Published:
1/1/2025
 

 

2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
2025 Rate Information for the Blue Cross and Blue Shield Service Benefit Plan
Page 150

 

2025 Rate Information for the Blue Cross and Blue Shield Service Benefit Plan

 

To compare your PSHB health plan options please go to https://health-benefits.opm.gov/PSHB/.

To review premium rates for all PSHB health plan options, please go to https://www.opm.gov/healthcare-insurance/pshb/premiums/.

 

FEP Blue Focus Option, Self Only, Enrollment Code 35A:
Premium Rate
Biweekly government share: $177.53
Biweekly your share: $59.17
Monthly government share: $384.64
Monthly your share: $128.21

FEP Blue Focus Option, Self Plus One, Enrollment Code 35C:
Premium Rate
Biweekly government share: $381.65
Biweekly your share: $127.21
Monthly government share: $826.90
Monthly your share: $275.63

FEP Blue Focus Option, Self and Family, Enrollment Code 35B:
Premium Rate
Biweekly government share: $419.78
Biweekly your share: $139.92
Monthly government share: $909.51
Monthly your share: $303.17

 

Go to page 147.
 

Blue Cross Blue Shield Federal Employee Program
Confidential - Internal Plan use only

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