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Plan Profile

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General Information
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Plan Name: HMO Health Ohio
Service Area: Northeast Ohio
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: Yes
JCAHO Accreditation: No
URAC Accreditation: No
Plan Type: HMO
Enrollment Code-Self: L41
Enrollment Code-Self & Family: L42
Link to Plan Home Page: http://www.mmoh.com
Telephone: 800/522-2066
Summary results of the 2001 consumers assessment of health plans survey
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Benefits
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Doctor Care/ Primary Office Visits: $10
Hospital Inpatient Room and Board Charges: None
RX/ Generic/ Retail: $10
RX/ Brand/ Retail: $20
RX/ Brand/ NonFormulary: $20
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Rates
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Non-Postal
___Twice Biweekly Self: $64.40 Self: & Family: $212.08
___Monthly Self: $69.77 Self: & Family: $229.75
___Biweekly Self: $32.20 Self: & Family: $106.04
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Annuitants
___Monthly Self: $69.77 Self: & Family: $229.75
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U.S. Postal Service Employees (Type A)
___Monthly Self: $31.40 Self: & Family: $142.35
___Biweekly Self: $14.49 Self: & Family: $65.70
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U.S. Postal Service Employees (Type B)
___Biweekly Self: $19.57 Self: & Family: $94.31
___Monthly Self: $42.40 Self: & Family: $204.34
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Worker's Compensation Recipients
___Twice Biweekly Self: $64.40 Self: & Family: $212.08
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Certain Temporary Employees
___Biweekly Self: $128.80 Self: & Family: $329.45
___Monthly Self: $279.07 Self: & Family: $713.81
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Former Spouse Enrollees
___Biweekly Self: $128.80 Self: & Family: $329.45
___Monthly Self: $279.07 Self: & Family: $713.81
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Temporary Continuation of Coverage
___Monthly Self: $284.65 Self: & Family: $728.09
___Biweekly Self: $131.38 Self: & Family: $336.04
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FDIC
___Biweekly Self: $14.49 Self: & Family: $65.70
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