PacifiCare Asia Pacific-Std - Guam/N. Mariana Islands/Palau

You are here: FEHB Home > 2002 Plan Comparison > Guam > Plan Profile: PacifiCare Asia Pacific-Std

General Information

Plan Name:	PacifiCare Asia Pacific-Std
Service Area:	Guam/N. Mariana Islands/Palau
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	JK4
Enrollment Code-Self & Family:	JK5
Link to Plan Home Page:	http://www.phs.com
Telephone:	671/647-3526
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$15
Hospital Inpatient Room and Board Charges:	$150
RX/ Generic/ Retail:	$5
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	$20

Rates

Non-Postal
___Biweekly	Self: $27.60	Self: & Family: $72.88
___Monthly	Self: $59.79	Self: & Family: $157.90
___Twice Biweekly	Self: $55.20	Self: & Family: $145.76
_
Annuitants
___Monthly	Self: $59.79	Self: & Family: $157.90
_
U.S. Postal Service Employees (Type A)
___Biweekly	Self: $12.42	Self: & Family: $32.79
___Monthly	Self: $26.91	Self: & Family: $71.06
_
U.S. Postal Service Employees (Type B)
___Biweekly	Self: $12.42	Self: & Family: $56.37
___Monthly	Self: $26.91	Self: & Family: $122.14
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $55.20	Self: & Family: $145.76
_
Certain Temporary Employees
___Biweekly	Self: $110.39	Self: & Family: $291.51
___Monthly	Self: $239.18	Self: & Family: $631.61
_
Former Spouse Enrollees
___Biweekly	Self: $110.39	Self: & Family: $291.51
___Monthly	Self: $239.18	Self: & Family: $631.61
_
Temporary Continuation of Coverage
___Monthly	Self: $243.96	Self: & Family: $644.24
___Biweekly	Self: $112.60	Self: & Family: $297.34
_
FDIC
___Biweekly	Self: $12.42	Self: & Family: $32.79
_