KeystoneBlue - Pittsburgh/Altoona/Erie areas

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General Information

Plan Name:	KeystoneBlue
Service Area:	Pittsburgh/Altoona/Erie areas
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	EF1
Enrollment Code-Self & Family:	EF2
Link to Plan Home Page:	http://www.highmark.com
Telephone:	800/421-0959
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$10
Hospital Inpatient Room and Board Charges:	$100
RX/ Generic/ Retail:	$8
RX/ Brand/ Retail:	$14
RX/ Brand/ NonFormulary:	$14

Rates

Non-Postal
___Biweekly	Self: $47.63	Self: & Family: $208.21
___Monthly	Self: $103.20	Self: & Family: $451.12
___Twice Biweekly	Self: $95.26	Self: & Family: $416.42
_
Annuitants
___Monthly	Self: $103.20	Self: & Family: $451.12
_
U.S. Postal Service Employees (Type A)
___Biweekly	Self: $29.97	Self: & Family: $167.87
___Monthly	Self: $64.94	Self: & Family: $363.72
_
U.S. Postal Service Employees (Type B)
___Monthly	Self: $78.56	Self: & Family: $425.71
___Biweekly	Self: $36.26	Self: & Family: $196.48
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $95.26	Self: & Family: $416.42
_
Certain Temporary Employees
___Biweekly	Self: $145.49	Self: & Family: $431.62
___Monthly	Self: $315.23	Self: & Family: $935.18
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Former Spouse Enrollees
___Biweekly	Self: $145.49	Self: & Family: $431.62
___Monthly	Self: $315.23	Self: & Family: $935.18
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Temporary Continuation of Coverage
___Monthly	Self: $321.53	Self: & Family: $953.88
___Biweekly	Self: $148.40	Self: & Family: $440.25
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FDIC
___Biweekly	Self: $29.97	Self: & Family: $167.87
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