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Plan Profile

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You are here: FEHB Home > 2002 Plan Comparison > Louisiana > Plan Profile: Vantage Health Plan

General Information
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Plan Name: Vantage Health Plan
Service Area: Monroe area
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: No
JCAHO Accreditation: No
URAC Accreditation: No
Plan Type: HMO
Enrollment Code-Self: AQ1
Enrollment Code-Self & Family: AQ2
Link to Plan Home Page: http://www.vhpla.com
Telephone: 888/823-1910
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Benefits
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Doctor Care/ Primary Office Visits: $15
Hospital Inpatient Room and Board Charges: $250
RX/ Generic/ Retail: $10
RX/ Brand/ Retail: $20
RX/ Brand/ NonFormulary: $35
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Rates
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Non-Postal
___Twice Biweekly Self: $80.32 Self: & Family: $293.74
___Biweekly Self: $40.16 Self: & Family: $146.87
___Monthly Self: $87.01 Self: & Family: $318.21
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Annuitants
___Monthly Self: $87.01 Self: & Family: $318.21
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U.S. Postal Service Employees (Type A)
___Biweekly Self: $22.50 Self: & Family: $106.53
___Monthly Self: $48.75 Self: & Family: $230.81
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U.S. Postal Service Employees (Type B)
___Biweekly Self: $28.79 Self: & Family: $135.14
___Monthly Self: $62.37 Self: & Family: $292.80
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Worker's Compensation Recipients
___Twice Biweekly Self: $80.32 Self: & Family: $293.74
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Certain Temporary Employees
___Biweekly Self: $138.02 Self: & Family: $370.28
___Monthly Self: $299.04 Self: & Family: $802.27
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Former Spouse Enrollees
___Biweekly Self: $138.02 Self: & Family: $370.28
___Monthly Self: $299.04 Self: & Family: $802.27
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Temporary Continuation of Coverage
___Monthly Self: $305.02 Self: & Family: $818.32
___Biweekly Self: $140.78 Self: & Family: $377.69
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FDIC
___Biweekly Self: $22.50 Self: & Family: $106.53
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