GHI HMO Select - Capital/Hudson Valley Regions

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General Information

Plan Name:	GHI HMO Select
Service Area:	Capital/Hudson Valley Regions
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	X41
Enrollment Code-Self & Family:	X42
Link to Plan Home Page:	http://www.ghihmo.com/
Telephone:	877/244-4466
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:	$10
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	$30

Rates

Non-Postal
___Monthly	Self: $61.87	Self: & Family: $159.51
___Twice Biweekly	Self: $57.12	Self: & Family: $147.24
___Biweekly	Self: $28.56	Self: & Family: $73.62
_
Annuitants
___Monthly	Self: $61.87	Self: & Family: $159.51
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $12.85	Self: & Family: $33.13
___Monthly	Self: $27.84	Self: & Family: $71.78
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $12.85	Self: & Family: $59.35
___Monthly	Self: $27.84	Self: & Family: $128.59
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $57.12	Self: & Family: $147.24
_
Certain Temporary Employees
___Biweekly	Self: $114.23	Self: & Family: $294.49
___Monthly	Self: $247.50	Self: & Family: $638.06
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Former Spouse Enrollees
___Monthly	Self: $247.50	Self: & Family: $638.06
___Biweekly	Self: $114.23	Self: & Family: $294.49
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Temporary Continuation of Coverage
___Monthly	Self: $252.45	Self: & Family: $650.82
___Biweekly	Self: $116.51	Self: & Family: $300.38
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FDIC
___Biweekly	Self: $12.85	Self: & Family: $33.13
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