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UPMC Health Plan Rate Information

To compare your FEHB health plan options please go to opm.gov/fehbcompare.

Premiums for Tribal employees are shown under the monthly non-Postal column. The amount shown under employee contribution is the maximum you will pay. Your Tribal employer may choose to contribute a higher portion of your premium. Please contact your Tribal Benefits Officer for exact rates.

PA Service Area Rates

Pennsylvania service area counties include: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Centre, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Somerset, Venago, Warren, Washington, and Westmoreland.

Type of Enrollment Enrollment Code Premium Rate
Biweekly Monthly
Gov't Share Your Share Gov't Share Your Share
HDHP Option Self Only 8W4 $231.23 $77.07 $500.59 $166.99
HDHP Option Self Plus One 8W6 $512.13 $170.71 $1,109.62 $369.87
HDHP Option Self and Family 8W5 $532.80 $177.60 $1,154.40 $384.80
Standard Option Self Only UW4 $244.86 $88.93 $530.53 $192.68
Standard Option Self Plus One UW6 $524.63 $225.92 $1,136.70 $489.49
Standard Option Self and Family UW5 $574.13 $209.98 $1,243.95 $454.96
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Attention

It is important to know that when you enroll in this plan, services are provided through UPMC Health Plan's participating providers as described in UPMC Health Plan's federal brochure — but the continued participation of any one doctor, hospital, or other provider cannot be guaranteed.

Continue to UPMC Health Plan online provider search
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