Coventry Health Care of Iowa - Central Iowa/Cedar Rapids/Sioux City

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General Information

Plan Name:	Coventry Health Care of Iowa
Service Area:	Central Iowa/Cedar Rapids/Sioux City
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	SV1
Enrollment Code-Self & Family:	SV2
Link to Plan Home Page:	http://www.chciowa.com
Telephone:	800/257-4692
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:	$5
RX/ Brand/ Retail:	$15
RX/ Brand/ NonFormulary:	$30

Rates

Non-Postal
___Monthly	Self: $63.18	Self: & Family: $198.48
___Biweekly	Self: $29.16	Self: & Family: $91.61
___Twice Biweekly	Self: $58.32	Self: & Family: $183.22
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Annuitants
___Monthly	Self: $63.18	Self: & Family: $198.48
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $13.12	Self: & Family: $51.27
___Monthly	Self: $28.43	Self: & Family: $111.08
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U.S. Postal Service Employees (Type B)
___Monthly	Self: $28.43	Self: & Family: $173.07
___Biweekly	Self: $13.12	Self: & Family: $79.88
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Worker's Compensation Recipients
___Twice Biweekly	Self: $58.32	Self: & Family: $183.22
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Certain Temporary Employees
___Biweekly	Self: $116.65	Self: & Family: $315.02
___Monthly	Self: $252.74	Self: & Family: $682.54
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Former Spouse Enrollees
___Monthly	Self: $252.74	Self: & Family: $682.54
___Biweekly	Self: $116.65	Self: & Family: $315.02
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Temporary Continuation of Coverage
___Biweekly	Self: $118.98	Self: & Family: $321.32
___Monthly	Self: $257.79	Self: & Family: $696.19
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FDIC
___Biweekly	Self: $13.12	Self: & Family: $51.27
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Department of Defense Demo Project
___Monthly	Self: $44.23	Self: & Family: $223.60
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Department of Defense Demo Project Temporary Continuation of Coverage
___Monthly	Self: $180.47	Self: & Family: $721.81
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