Arnett HMO - Lafayette area

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General Information

Plan Name:	Arnett HMO
Service Area:	Lafayette area
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	G21
Enrollment Code-Self & Family:	G22
Link to Plan Home Page:	http://www.arnettplans.com
Telephone:	765/448-7440
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$10
Hospital Inpatient Room and Board Charges:	None
RX/ Generic/ Retail:	$5
RX/ Brand/ Retail:	$15
RX/ Brand/ NonFormulary:	$30

Rates

Non-Postal
___Twice Biweekly	Self: $62.62	Self: & Family: $204.52
___Monthly	Self: $67.84	Self: & Family: $221.56
___Biweekly	Self: $31.31	Self: & Family: $102.26
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Annuitants
___Monthly	Self: $67.84	Self: & Family: $221.56
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U.S. Postal Service Employees (Type A)
___Monthly	Self: $30.53	Self: & Family: $134.16
___Biweekly	Self: $14.09	Self: & Family: $61.92
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $16.02	Self: & Family: $90.53
___Monthly	Self: $34.71	Self: & Family: $196.15
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Worker's Compensation Recipients
___Twice Biweekly	Self: $62.62	Self: & Family: $204.52
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Certain Temporary Employees
___Biweekly	Self: $125.25	Self: & Family: $325.67
___Monthly	Self: $271.38	Self: & Family: $705.62
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Former Spouse Enrollees
___Biweekly	Self: $125.25	Self: & Family: $325.67
___Monthly	Self: $271.38	Self: & Family: $705.62
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Temporary Continuation of Coverage
___Monthly	Self: $276.81	Self: & Family: $719.73
___Biweekly	Self: $127.76	Self: & Family: $332.18
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FDIC
___Biweekly	Self: $14.09	Self: & Family: $61.92
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