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Plan Profile

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General Information
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Plan Name: Capital Health Plan
Service Area: Tallahassee area
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: Yes
JCAHO Accreditation: No
URAC Accreditation: No
Plan Type: HMO
Enrollment Code-Self: EA1
Enrollment Code-Self & Family: EA2
Link to Plan Home Page: http://www.capitalhealth.com
Telephone: 850/383-3311
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: $100
RX/ Generic/ Retail: $7
RX/ Brand/ Retail: $20
RX/ Brand/ NonFormulary: $35
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Rates
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Non-Postal
___Twice Biweekly Self: $56.92 Self: & Family: $161.10
___Biweekly Self: $28.46 Self: & Family: $80.55
___Monthly Self: $61.67 Self: & Family: $174.52
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Annuitants
___Monthly Self: $61.67 Self: & Family: $174.52
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U.S. Postal Service Employees (Type A)
___Monthly Self: $27.75 Self: & Family: $87.12
___Biweekly Self: $12.81 Self: & Family: $40.21
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U.S. Postal Service Employees (Type B)
___Monthly Self: $27.75 Self: & Family: $149.11
___Biweekly Self: $12.81 Self: & Family: $68.82
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Worker's Compensation Recipients
___Twice Biweekly Self: $56.92 Self: & Family: $161.10
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Certain Temporary Employees
___Biweekly Self: $113.85 Self: & Family: $303.96
___Monthly Self: $246.68 Self: & Family: $658.58
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Former Spouse Enrollees
___Biweekly Self: $113.85 Self: & Family: $303.96
___Monthly Self: $246.68 Self: & Family: $658.58
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Temporary Continuation of Coverage
___Monthly Self: $251.61 Self: & Family: $671.75
___Biweekly Self: $116.13 Self: & Family: $310.04
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FDIC
___Biweekly Self: $12.81 Self: & Family: $40.21
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