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Plan Profile

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You are here: FEHB Home > 2002 Plan Comparison > Iowa > Plan Profile: Health Alliance HMO

General Information
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Plan Name: Health Alliance HMO
Service Area: Central/E.Iowa
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: Yes
JCAHO Accreditation: No
URAC Accreditation: No
Plan Type: HMO
Enrollment Code-Self: FX1
Enrollment Code-Self & Family: FX2
Link to Plan Home Page: http://www.healthalliance.org
Telephone: 800/851-3379
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Benefits
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Doctor Care/ Primary Office Visits: $10.00
Hospital Inpatient Room and Board Charges: $100.00
RX/ Generic/ Retail: $7.00
RX/ Brand/ Retail: $14.00
RX/ Brand/ NonFormulary: $25.00
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Rates
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Non-Postal
___Biweekly Self: $40.39 Self: & Family: $99.27
___Monthly Self: $87.51 Self: & Family: $215.08
___Twice Biweekly Self: $80.78 Self: & Family: $198.54
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Annuitants
___Monthly Self: $87.51 Self: & Family: $215.08
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U.S. Postal Service Employees (Type A)
___Biweekly Self: $22.73 Self: & Family: $58.93
___Monthly Self: $49.25 Self: & Family: $127.68
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U.S. Postal Service Employees (Type B)
___Monthly Self: $62.87 Self: & Family: $189.67
___Biweekly Self: $29.02 Self: & Family: $87.54
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Worker's Compensation Recipients
___Twice Biweekly Self: $80.78 Self: & Family: $198.54
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Certain Temporary Employees
___Biweekly Self: $138.25 Self: & Family: $322.68
___Monthly Self: $299.54 Self: & Family: $699.14
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Former Spouse Enrollees
___Biweekly Self: $138.25 Self: & Family: $322.68
___Monthly Self: $299.54 Self: & Family: $699.14
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Temporary Continuation of Coverage
___Monthly Self: $305.53 Self: & Family: $713.12
___Biweekly Self: $141.02 Self: & Family: $329.13
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FDIC
___Biweekly Self: $22.73 Self: & Family: $58.93
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