John Deere Health Plan - Central/Eastern Iowa

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General Information

Plan Name:	John Deere Health Plan
Service Area:	Central/Eastern Iowa
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	YH1
Enrollment Code-Self & Family:	YH2
Link to Plan Home Page:	http://www.johndeerehealth.com
Telephone:	800/247-9110

Benefits

Doctor Care/ Primary Office Visits:	$15
Hospital Inpatient Room and Board Charges:	$100
RX/ Generic/ Retail:	$10
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	$35

Rates

Non-Postal
___Biweekly	Self: $31.70	Self: & Family: $103.35
___Monthly	Self: $68.69	Self: & Family: $223.92
___Twice Biweekly	Self: $63.40	Self: & Family: $206.70
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Annuitants
___Monthly	Self: $68.69	Self: & Family: $223.92
_
U.S. Postal Service Employees (Type A)
___Monthly	Self: $30.91	Self: & Family: $136.52
___Biweekly	Self: $14.27	Self: & Family: $63.01
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $17.59	Self: & Family: $91.62
___Monthly	Self: $38.11	Self: & Family: $198.51
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Worker's Compensation Recipients
___Twice Biweekly	Self: $63.40	Self: & Family: $206.70
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Certain Temporary Employees
___Biweekly	Self: $126.82	Self: & Family: $326.76
___Monthly	Self: $274.78	Self: & Family: $707.98
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Former Spouse Enrollees
___Monthly	Self: $274.78	Self: & Family: $707.98
___Biweekly	Self: $126.82	Self: & Family: $326.76
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Temporary Continuation of Coverage
___Monthly	Self: $280.28	Self: & Family: $722.14
___Biweekly	Self: $129.36	Self: & Family: $333.30
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FDIC
___Biweekly	Self: $14.27	Self: & Family: $63.01
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