FEDVIP_Premium_Submission_Format.xls
XLS spreadsheet 44 KB Posted
- Attached to
- Dental and Vision Services
- Solicitation number
- OPM01-FEDVIP-01AP
About this file
FEDVIP Premium Submission Format
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Text version
Premium Submission
| Rating Region | Premium Level* | Self Premium | Self Plus One | Self and Family |
| AK | ||||
| AL | ||||
| AR | ||||
| AZ | ||||
| CA | ||||
| CO | ||||
| DE | ||||
| FL | ||||
| GA | ||||
| HI | ||||
| IA | ||||
| ID | ||||
| IL | ||||
| IN | ||||
| KS | ||||
| KY | ||||
| LA | ||||
| MA | ||||
| MD | ||||
| ME | ||||
| MI | ||||
| MN | ||||
| MO | ||||
| MS | ||||
| MT | ||||
| NC | ||||
| ND | ||||
| NE | ||||
| NH | ||||
| NM | ||||
| NV | ||||
| NY | ||||
| OH | ||||
| OK | ||||
| OR | ||||
| PA | ||||
| PR | ||||
| SC | ||||
| SD | ||||
| TN | ||||
| TX | ||||
| UT | ||||
| VA | ||||
| VT | ||||
| WA | ||||
| WI | ||||
| WV | ||||
| WY | ||||
| LPA02 | ||||
| LPA05 | ||||
| LPA06 | ||||
| LPA08 | ||||
| LPA11 | ||||
| LPA14 | ||||
| LPA15 | ||||
| LPA17 | ||||
| LPA20 | ||||
| LPA23 | ||||
| LPA26 | ||||
| LPA28 | ||||
| LPA29 | ||||
| LPA32 | ||||
| LPA35 | ||||
| LPA41 | ||||
| LPA45 | ||||
| LPA42 | ||||
| LPA43 | ||||
| LPA47 | ||||
| LPA56 | ||||
| LPA54 | ||||
| LPA55 | ||||
| LPA57 | ||||
| LPA60 | ||||
| LPA58 | ||||
| LPA59 | ||||
| LPA71 | ||||
| LPA74 | ||||
| LPA77 | ||||
| LPA80 | ||||
| *Premium Level as defined by the Financial Section of the Application (pg. C-21) |
LPA Key
| LPA Code | LPA Name |
| 02 | Atlanta-Sandy Springs-Gainesville, GA-AL |
| 05 | Boston-Worcester-Manchester, MA-NH-RI-ME |
| 06 | Buffalo-Niagara-Cattaraugus, NY |
| 08 | Chicago-Naperville-Michigan City, IL-IN-WI |
| 11 | Cincinnati-Middletown-Wilmington, OH-KY-IN |
| 14 | Cleveland-Akron-Elyria, OH |
| 15 | Columbus-Marion-Chillicothe, OH |
| 17 | Dallas-Fort Worth, TX |
| 20 | Dayton-Springfield-Greenville, OH |
| 23 | Denver-Aurora-Boulder, CO |
| 26 | Detroit-Warren-Flint, MI |
| 28 | Hartford-West Hartford-Willimantic, CT-MA |
| 29 | Houston-Baytown-Huntsville, TX |
| 32 | Huntsville-Decatur, AL |
| 35 | Indianapolis-Anderson-Columbus, IN |
| 41 | Los Angeles-Long Beach-Riverside, CA |
| 45 | Miami-Fort Lauderdale-Pompano Beach, FL |
| 42 | Milwaukee-Racine-Waukesha, WI |
| 43 | Minneapolis-St. Paul-St. Cloud, MN-WI |
| 47 | New York-Newark-Bridgeport, NY-NJ-CT-PA |
| 56 | Philadelphia-Camden-Vineland, PA-NJ-DE-MD |
| 54 | Phoenix-Mesa-Scottsdale, AZ |
| 55 | Pittsburgh-New Castle, PA |
| 57 | Portland-Vancouver-Beaverton, OR-WA |
| 60 | Raleigh-Durham-Cary, NC |
| 58 | Richmond, VA |
| 59 | Sacramento--Arden-Arcade--Yuba City, CA-NV |
| 71 | San Diego-Carlsbad-San Marcos, CA |
| 74 | San Jose-San Francisco-Oakland, CA |
| 77 | Seattle-Tacoma-Olympia, WA |
| 80 | Washington-Baltimore-Northern Virginia, DC-MD-VA-WV-PA |
File details come from the government source that posted it. Updated .