Vantage Health Plan - Shreveport/Alexandria areas

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General Information

Plan Name:	Vantage Health Plan
Service Area:	Shreveport/Alexandria areas
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	MV1
Enrollment Code-Self & Family:	MV2
Link to Plan Home Page:	http://www.vhpla.com
Telephone:	888/823-1910

Benefits

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

Rates

Non-Postal
___Twice Biweekly	Self: $96.88	Self: & Family: $338.18
___Monthly	Self: $104.95	Self: & Family: $366.36
___Biweekly	Self: $48.44	Self: & Family: $169.09
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Annuitants
___Monthly	Self: $104.95	Self: & Family: $366.36
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U.S. Postal Service Employees (Type A)
___Monthly	Self: $66.69	Self: & Family: $278.96
___Biweekly	Self: $30.78	Self: & Family: $128.75
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $37.07	Self: & Family: $157.36
___Monthly	Self: $80.31	Self: & Family: $340.95
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Worker's Compensation Recipients
___Twice Biweekly	Self: $96.88	Self: & Family: $338.18
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Certain Temporary Employees
___Biweekly	Self: $146.30	Self: & Family: $392.50
___Monthly	Self: $316.98	Self: & Family: $850.42
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Former Spouse Enrollees
___Biweekly	Self: $146.30	Self: & Family: $392.50
___Monthly	Self: $316.98	Self: & Family: $850.42
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Temporary Continuation of Coverage
___Biweekly	Self: $149.23	Self: & Family: $400.35
___Monthly	Self: $323.32	Self: & Family: $867.43
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FDIC
___Biweekly	Self: $30.78	Self: & Family: $128.75
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