OPM.

GOV 2018 FEHBP RATES BRIEFING

2019 Federal Employees

Dental and Vision Insurance
Program Information
November 12 through December 10, 2018
Healthcare and Insurance
Office of Personnel Management
Welcoming Military Families and Retirees to FEDVIP
The Federal Employees Dental and Vision Insurance Program (FEDVIP) is welcoming TRICARE-
eligible individuals in 2019. Uniformed services retirees and their families will have access to
dental and vision benefits under FEDVIP. Most active duty family members and uniformed
services retirees and their family members will be able to enroll in FEDVIP vision, if they are
enrolled in a TRICARE health plan. OPM has worked closely with the Department of Defense
Health Agency to expand FEDVIP coverage to this group as provided in the 2017 National
Defense Authorization Act. Visit TRICARE.BENEFEDS.com to learn more.
What Uniformed Services Retirees and Active Duty Family Members Need to Know

 The TRICARE Retiree Dental Program (TRDP) is ending on December 31, 2018.
 This newly eligible population must enroll during the 2018 Federal Benefits Open
Season, if they would like dental and/or vision coverage beginning on January 1, 2019.
o Enrollment in FEDVIP is NOT automatic for an individual enrolled in TRDP.
Key Dates

 October 1, 2018 - Begin shopping for coverage with the plan comparison tool on
TRICARE.BENEFEDS.com.
 Late October 2018 - Full FEDVIP benefits information is available on
TRICARE.BENEFEDS.com
 November 12- December 10, 2018 - Enroll in dental and vision plans during Open
Season.
 January 1, 2019 – Coverage is effective.

The Federal Employees Dental and Vision Program (FEDVIP)

The Federal Employees Dental and Vision Insurance Program (FEDVIP) is a voluntary program
providing supplemental dental and vision benefits on an enrollee-pay-all basis to Federal
civilian employees, retirees, and their families. OPM is welcoming uniformed service retirees
and their families to enroll in dental and vision coverage and active duty family members to
enroll in vision coverage for the 2019 plan year. Currently, there are approximately 2 million
enrollees in dental plans and approximately 1.4 million enrollees in vision plans.
FEDVIP allows dental and vision insurance to be purchased on a group basis with competitive
premiums and no pre-existing condition limitations. There are 15 dental plan choices available
across the Program with at least 10 dental plan choices available to each potential enrollee.
There are 8 vision plan choices available to all potential enrollees.
FEDVIP Rates

Dental
 Overall 2019 average gross premium increased 1.2% for dental plans
 Average biweekly rates:
o Self $17.41
o Self Plus One $34.14
o Self & Family $49.23
 The average monthly rates are:
o Self $37.73
o Self Plus One $73.97
o Self & Family $106.68

These 2019 dollar amounts and rate increases are weighted by plan size based on 2018
enrollment.

Vision
 Overall 2019 average gross premium decreased 2.8% for vision plans
 Average biweekly rates:
o Self $5.10
o Self Plus One $10.23
o Self & Family $14.75
 The average monthly Vision rates are:
o Self $11.05
o Self Plus One $22.16
o Self & Family $31.96

These 2019 dollar amounts and rate increases are weighted by plan size based on 2018
enrollment.
 Federal Employees Dental and Vision Insurance Program (FEDVIP) 2019 Dental
Premium Rate Charts
2019 Biweekly premium rates 2019 Monthly premium rates

Rating
Plan - Option Self-Only Self Plus One Self & Family Self-Only Self Plus One Self & Family
Region

Please note: Rating areas for each carrier are not the same for all plans. Please referto the Dental Rating Chart to
determine your specific region.
Aetna PPO -High Option
1 $15.04 $30.07 $45.11 $32.59 $65.15 $97.74
2 $16.56 $33.12 $49.67 $35.88 $71.76 $107.62
(In and Out-of-Network Benefits) 3 $17.62 $35.26 $52.86 $38.18 $76.40 $114.53
4 $19.45 $38.89 $58.33 $42.14 $84.26 $126.38
5 $21.11 $42.23 $63.34 $45.74 $91.50 $137.24
Delta Dental PPO - Standard Option
1 $8.68 $17.35 $26.03 $18.81 $37.59 $56.40
2 $9.45 $18.91 $28.35 $20.48 $40.97 $61.43
(In and Out-of-Network Benefits) 3 $10.18 $20.37 $30.56 $22.06 $44.14 $66.21
4 $10.74 $21.47 $32.21 $23.27 $46.52 $69.79
5 $12.27 $24.54 $36.81 $26.59 $53.17 $79.76
Delta Dental PPO - High Option
1 $16.74 $33.48 $50.22 $36.27 $72.54 $108.81
2 $18.36 $36.71 $55.07 $39.78 $79.54 $119.32
(In and Out-of-Network Benefits) 3 $20.13 $40.26 $60.39 $43.62 $87.23 $130.85
4 $21.41 $42.83 $64.25 $46.39 $92.80 $139.21
5 $24.90 $49.81 $74.71 $53.95 $107.92 $161.87
FEP BlueDental PPO - Standard Option
1 $9.17 $18.34 $27.52 $19.87 $39.74 $59.63
2 $10.05 $20.11 $30.16 $21.78 $43.57 $65.35
(In and Out-of-Network Benefits) 3 $11.43 $22.85 $34.25 $24.77 $49.51 $74.21
4 $12.34 $24.66 $36.97 $26.74 $53.43 $80.10
5 $13.64 $27.28 $40.92 $29.55 $59.11 $88.66
 Federal Employees Dental and Vision Insurance Program (FEDVIP) 2019 Dental
Premium Rate Charts
2019 Biweekly premium rates 2019 Monthly premium rates

Rating
Plan - Option Self-Only Self Plus One Self & Family Self-Only Self Plus One Self & Family
Region

FEP BlueDental PPO - High Option

1 $17.32 $34.65 $51.97 $37.53 $75.08 $112.60
2 $19.41 $38.79 $58.19 $42.06 $84.05 $126.08
(In and Out-of-Network Benefits) 3 $21.13 $42.25 $63.38 $45.78 $91.54 $137.32
4 $22.89 $45.74 $68.62 $49.60 $99.10 $148.68
5 $25.61 $51.19 $76.80 $55.49 $110.91 $166.40
GEHA PPO - Standard Option
1 $9.78 $19.57 $29.34 $21.19 $42.40 $63.57
2 $10.74 $21.47 $32.20 $23.27 $46.52 $69.77
(In and Out-of-Network Benefits) 3 $12.20 $24.36 $36.54 $26.43 $52.78 $79.17
4 $13.16 $26.30 $39.45 $28.51 $56.98 $85.48
5 $14.60 $29.18 $43.78 $31.63 $63.22 $94.86
GEHA PPO - High Option
1 $16.55 $33.11 $49.66 $35.86 $71.74 $107.60
2 $18.19 $36.38 $54.60 $39.41 $78.82 $118.30
(In and Out-of-Network Benefits) 3 $20.65 $41.31 $61.95 $44.74 $89.51 $134.23
4 $22.30 $44.59 $66.91 $48.32 $96.61 $144.97
5 $24.74 $49.51 $74.31 $53.60 $107.27 $161.01
MetLife PPO - Standard Option
1 $9.77 $19.55 $29.32 $21.17 $42.36 $63.53
2 $10.60 $21.19 $31.79 $22.97 $45.91 $68.88
(In and Out-of-Network Benefits) 3 $11.76 $23.52 $35.28 $25.48 $50.96 $76.44
4 $13.04 $26.08 $39.13 $28.25 $56.51 $84.78
5 $14.34 $28.67 $43.01 $31.07 $62.12 $93.19
 Federal Employees Dental and Vision Insurance Program (FEDVIP) 2019 Dental
Premium Rate Charts
2019 Biweekly premium rates 2019 Monthly premium rates

Rating
Plan - Option Self-Only Self Plus One Self & Family Self-Only Self Plus One Self & Family
Region

MetLife PPO - High Option

1 $17.84 $35.69 $53.53 $38.65 $77.33 $115.98
2 $19.98 $39.96 $59.94 $43.29 $86.58 $129.87
(In and Out-of-Network Benefits) 3 $21.76 $43.53 $65.29 $47.15 $94.32 $141.46
4 $23.57 $47.14 $70.70 $51.07 $102.14 $153.18
5 $26.38 $52.75 $79.13 $57.16 $114.29 $171.45
United Concordia PPO
1 $14.10 $28.20 $42.28 $30.55 $61.10 $91.61
2 $15.82 $31.67 $47.49 $34.28 $68.62 $102.90
(In and Out-of-Network Benefits) 3 $17.56 $35.12 $52.69 $38.05 $76.09 $114.16
4 $19.30 $38.60 $57.89 $41.82 $83.63 $125.43
5 $21.03 $42.05 $63.07 $45.57 $91.11 $136.65
Dominion Dental HMO - Standard Option
1 $6.01 $12.02 $18.03 $13.02 $26.04 $39.07
(In-Network Benefits Only except for
2 $6.27 $12.54 $18.81 $13.59 $27.17 $40.76
emergency
services)
3 $6.99 $13.99 $20.98 $15.15 $30.31 $45.46
4 $7.76 $15.51 $23.27 $16.81 $33.61 $50.42
5 $8.89 $17.79 $26.68 $19.26 $38.55 $57.81
Dominion Dental HMO - High Option
1 $9.98 $19.96 $29.94 $21.62 $43.25 $64.87
(In-Network Benefits Only except for 2 $10.35 $20.70 $31.05 $22.43 $44.85 $67.28
emergency 3 $10.73 $21.46 $32.19 $23.25 $46.50 $69.75
services) 4 $11.13 $22.27 $33.40 $24.12 $48.25 $72.37
5 $14.80 $29.59 $44.40 $32.07 $64.11 $96.20
 Federal Employees Dental and Vision Insurance Program (FEDVIP) 2019 Dental
Premium Rate Charts
2019 Biweekly premium rates 2019 Monthly premium rates

Rating
Plan - Option Self-Only Self Plus One Self & Family Self-Only Self Plus One Self & Family
Region

Humana - High Option

1 $11.18 $22.36 $33.54 $24.22 $48.45 $72.67
(In-Network Benefits Only except for 2 $11.85 $23.68 $35.52 $25.68 $51.31 $76.96
emergency 3 $12.82 $25.66 $38.47 $27.78 $55.60 $83.35
services) 4 $15.56 $31.12 $46.67 $33.71 $67.43 $101.12
5 $16.65 $33.30 $49.95 $36.08 $72.15 $108.23
EmblemHealth PPO
1 $20.21 $40.40 $60.61 $43.79 $87.53 $131.32
(In and Out-of-Network Benefits)

Triple S Salud PPO

(In-Network Benefits Only except for
services rendered by orthodontists)
1 $4.59 $9.18 $12.04 $9.95 $19.89 $26.09
Federal Employees Dental and Vision Insurance Program
(FEDVIP) 2019 Vision Premium Rate Charts
2019 Biweekly premium 2019 Monthly premium
rates rates

Self Plus Self & Self Plus Self &

Plan - Option Self-Only Self-Only
One Family One Family

Blue Cross Blue Shield - High Option

$5.40 $10.79 $16.19 $11.70 $23.38 $35.08
Blue Cross Blue Shield - Standard Option
$3.51 $7.01 $10.52 $7.61 $15.19 $22.79
United Healthcare - High Option
$4.64 $9.03 $13.45 $10.05 $19.57 $29.14
United Healthcare - Standard Option
$3.09 $6.03 $8.98 $6.70 $13.07 $19.46
VSP - High Option
$6.66 $13.34 $20.02 $14.43 $28.90 $43.38
VSP - Standard Option
$3.52 $7.03 $10.56 $7.63 $15.23 $22.88
Aetna - High Option
$5.63 $11.24 $16.87 $12.20 $24.35 $36.55
Aetna - Standard Option
$3.11 $6.22 $9.34 $6.74 $13.48 $20.24
 Federal Employees Dental and Vision Insurance Program (FEDVIP)
Rating Areas
FEP FEP
Delta Delta BlueDental BlueDental GEHA GEHA MetLife MetLife United Dominion* Dominion* Triple S*
State State/ZIP(first 3) Aetna Std High Std high Std High Std High Concordia Std High Humana* Emblem* Salud
AK entire state 5 5 5 5 5 5 5 5 5 5 N/A N/A N/A N/A N/A
AL 356-358 1 1 1 1 1 1 1 1 1 1 N/A N/A 3 N/A N/A
AL rest of state 2 1 1 1 1 1 1 1 1 1 N/A N/A 2 N/A N/A
AR entire state 2 2 2 1 1 1 1 1 1 1 N/A N/A 3 N/A N/A
AZ 850-853 3 5 5 2 2 2 2 1 1 1 N/A N/A 4 N/A N/A
AZ rest of state 3 5 5 3 3 2 2 1 1 1 N/A N/A 3 N/A N/A
CA 900-908, 910-918, 922-931 3 5 5 4 4 4 4 5 5 3 N/A N/A 5 N/A N/A
CA 919-921 3 5 5 5 5 4 4 4 4 4 N/A N/A 5 N/A N/A
CA 939-941, 943-952, 954 4 5 5 5 5 5 5 5 5 5 N/A N/A 5 N/A N/A
CA 942, 956-958 4 5 5 5 5 4 4 4 4 4 N/A N/A 5 N/A N/A
CA rest of state 4 5 5 3 3 4 4 5 5 4 N/A N/A 4 N/A N/A
CO 800-806 3 4 4 3 3 4 4 4 4 3 N/A N/A 5 N/A N/A
CO rest of state 3 4 4 3 3 4 4 4 4 3 N/A N/A 5 N/A N/A
CT 060-063 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
CT 064-069 3 5 5 5 5 5 5 5 5 5 N/A N/A N/A 1 N/A
DC entire area 2 5 5 3 3 4 4 4 4 4 4 4 3 N/A N/A
DE entire state 2 4 4 3 3 3 3 3 3 2 5 5 N/A N/A N/A
FL 330-334 2 4 4 3 3 3 3 3 3 3 N/A N/A 2 N/A N/A
FL rest of state 3 4 4 1 1 2 2 1 1 1 N/A N/A 2 N/A N/A
GA 300-303, 305, 311, 399 3 2 2 2 2 3 3 2 2 1 N/A N/A 2 N/A N/A
GA rest of state 4 2 2 1 1 2 2 1 1 1 N/A N/A 2 N/A N/A
GU entire area 5 5 5 5 5 1 1 1 1 5 N/A N/A N/A N/A N/A
HI entire state 4 5 5 5 5 3 3 4 4 4 N/A N/A N/A N/A N/A
IA entire state 3 4 4 2 2 1 1 1 1 1 N/A N/A N/A N/A N/A
ID entire state 4 5 5 3 3 2 2 1 1 2 N/A N/A N/A N/A N/A
IL 600-608 2 2 2 3 3 3 3 4 4 3 N/A N/A 2 N/A N/A
IL rest of state 3 2 2 1 1 1 1 1 1 1 N/A N/A 1 N/A N/A
IN 460-462, 472 2 1 1 1 1 2 2 1 1 1 N/A N/A 3 N/A N/A
IN 463-464 2 2 2 3 3 3 3 4 4 3 N/A N/A 2 N/A N/A
IN 470 2 1 1 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
IN rest of state 3 1 1 1 1 1 1 1 1 1 N/A N/A 2 N/A N/A
KS entire state 3 4 4 1 1 2 2 1 1 2 N/A N/A 1 N/A N/A
KY 410, 452, 459 2 1 1 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
KY rest of state 1 1 1 1 1 1 1 1 1 1 N/A N/A 1 N/A N/A
LA entire state 2 1 1 1 1 2 2 1 1 1 N/A N/A 3 N/A N/A
MA 010-011, 013 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
MA 014-027, 055 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
MA rest of state 5 5 5 3 3 4 4 5 5 5 N/A N/A N/A N/A N/A
MD 200,202-212, 214, 217 2 5 5 3 3 4 4 4 4 4 4 4 3 N/A N/A
MD 219 2 4 4 3 3 3 3 3 3 2 5 5 N/A N/A N/A
MD rest of state 2 5 5 2 2 2 2 4 4 4 2 2 3 N/A N/A
ME 038 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
 Federal Employees Dental and Vision Insurance Program (FEDVIP)
Rating Areas
FEP FEP
Delta Delta BlueDental BlueDental GEHA GEHA MetLife MetLife United Dominion* Dominion* Triple S*
State State/ZIP(first 3) Aetna Std High Std high Std High Std High Concordia Std High Humana* Emblem* Salud
ME rest of state 5 5 5 3 3 3 3 2 2 3 N/A N/A N/A N/A N/A
MI 480-485 3 4 4 3 3 3 3 3 3 2 N/A N/A N/A N/A N/A
MI rest of state 3 4 4 2 2 2 2 2 2 2 N/A N/A N/A N/A N/A
MN 550-555, 563 2 4 4 4 4 3 3 4 4 3 N/A N/A N/A N/A N/A
MN rest of state 3 4 4 2 2 2 2 2 2 2 N/A N/A N/A N/A N/A
MO entire state 3 4 4 1 1 2 2 1 1 1 N/A N/A 2 N/A N/A
MS entire state 2 1 1 1 1 1 1 1 1 1 N/A N/A 3 N/A N/A
MT entire state 4 1 1 1 1 2 2 1 1 1 N/A N/A N/A N/A N/A
NC 275-277, 283 4 2 2 2 2 2 2 1 1 2 N/A N/A 5 N/A N/A
NC rest of state 4 2 2 1 1 2 2 1 1 2 N/A N/A 4 N/A N/A
ND entire state 3 1 1 4 4 1 1 1 1 1 N/A N/A N/A N/A N/A
NE entire state 1 1 1 1 1 1 1 1 1 1 N/A N/A N/A N/A N/A
NH 030-033, 038 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
NH rest of state 5 5 5 4 4 4 4 5 5 5 N/A N/A N/A N/A N/A
NJ 070,072-075, 077-079, 085-089 3 5 5 5 5 5 5 5 5 5 N/A N/A N/A 1 N/A
NJ 080-084 2 4 4 3 3 3 3 3 3 2 5 5 N/A N/A N/A
NJ rest of state 3 5 5 4 4 5 5 5 5 5 N/A N/A N/A 1 N/A
NM entire state 3 4 4 1 1 3 3 1 1 2 N/A N/A N/A N/A N/A
NV entire state 2 5 5 1 1 3 3 2 2 4 N/A N/A N/A N/A N/A
NY 005, 100-119, 124-126 3 5 5 5 5 5 5 5 5 5 N/A N/A N/A 1 N/A
NY 063 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A 1 N/A
NY 140-143 4 5 5 3 3 2 2 2 2 3 N/A N/A N/A 1 N/A
NY rest of state 4 5 5 3 3 2 2 2 2 3 N/A N/A N/A 1 N/A
OH 430-432 2 1 1 1 1 2 2 1 1 2 N/A N/A 2 N/A N/A
OH 440-443 2 1 1 1 1 2 2 1 1 3 N/A N/A 2 N/A N/A
OH 450-452 2 1 1 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
OH 453-455, 459 2 1 1 1 1 2 2 1 1 2 N/A N/A 1 N/A N/A
OH rest of state 3 1 1 1 1 1 1 1 1 1 N/A N/A 1 N/A N/A
OK entire state 2 3 3 1 1 2 2 1 1 1 N/A N/A 3 N/A N/A
OR 970-973 4 5 5 3 3 3 3 4 4 5 N/A N/A N/A N/A N/A
OR rest of state 5 5 5 2 2 3 3 3 3 4 N/A N/A N/A N/A N/A
PA 153-154, 156, 160-162 1 2 2 1 1 1 1 1 1 1 1 1 N/A N/A N/A
PA 173-174 2 5 5 3 3 4 4 4 4 4 4 4 N/A N/A N/A
PA 183 3 5 5 5 5 5 5 5 5 5 1 1 N/A 1 N/A
PA 189-196 2 4 4 3 3 3 3 3 3 2 5 5 N/A N/A N/A
PA rest of state 3 2 2 1 1 1 1 1 1 1 1 1 N/A N/A N/A
PR entire area 3 1 1 1 1 1 1 1 1 1 N/A N/A N/A N/A 1
RI entire state 5 5 5 5 5 4 4 5 5 5 N/A N/A N/A N/A N/A
SC entire state 4 5 5 1 1 2 2 1 1 1 N/A N/A 4 N/A N/A
SD entire state 3 5 5 1 1 1 1 1 1 1 N/A N/A N/A N/A N/A
TN 422 1 1 1 1 1 1 1 1 1 1 N/A N/A 1 N/A N/A
TN rest of state 1 1 1 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
 Federal Employees Dental and Vision Insurance Program (FEDVIP)
Rating Areas
FEP FEP
Delta Delta BlueDental BlueDental GEHA GEHA MetLife MetLife United Dominion* Dominion* Triple S*
State State/ZIP(first 3) Aetna Std High Std high Std High Std High Concordia Std High Humana* Emblem* Salud
TX 739 2 3 3 1 1 2 2 1 1 1 N/A N/A 3 N/A N/A
TX 750-754, 760-762 2 2 2 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
TX 770, 772-775 2 2 2 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
TX rest of state 2 2 2 1 1 2 2 1 1 1 N/A N/A 1 N/A N/A
UT entire state 2 5 5 1 1 1 1 1 1 3 N/A N/A 3 N/A N/A
VA 200-205, 220-227 2 5 5 3 3 4 4 4 4 4 4 4 3 N/A N/A
VA 231-232, 238 3 3 3 2 2 2 2 1 1 2 3 3 3 N/A N/A
VA rest of state 3 3 3 1 1 2 2 1 1 1 4 4 4 N/A N/A
VI entire state 2 5 5 5 5 1 1 1 1 5 N/A N/A N/A N/A N/A
VT entire state 5 5 5 4 4 2 2 2 2 3 N/A N/A N/A N/A N/A
WA 980-985 5 5 5 5 5 5 5 5 5 5 N/A N/A N/A N/A N/A
WA 986 4 5 5 3 3 3 3 4 4 5 N/A N/A N/A N/A N/A
WA rest of state 5 5 5 4 4 4 4 4 4 4 N/A N/A N/A N/A N/A
WI 530-532, 534 3 5 5 3 3 2 2 2 2 3 N/A N/A N/A N/A N/A
WI 540 2 4 4 4 4 3 3 4 4 3 N/A N/A N/A N/A N/A
WI rest of state 3 5 5 3 3 2 2 2 2 2 N/A N/A N/A N/A N/A
WV 254 2 5 5 3 3 4 4 4 4 4 N/A N/A 3 N/A N/A
WV rest of state 4 2 2 1 1 2 2 1 1 1 N/A N/A 2 N/A N/A
WY 834 4 5 5 3 3 2 2 1 1 2 N/A N/A N/A N/A N/A
WY rest of state 4 5 5 1 1 1 1 1 1 2 N/A N/A N/A N/A N/A
Inter-
INTER 2 5 5 5 5 1 1 5 5 5 N/A N/A N/A N/A N/A
national

*Please note that regional plans may not cover the entirety of the State/Zip shown in Appendix J. For further detail regarding service area, see plan specific brochures.