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Plan Profile

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General Information
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Plan Name: HealthSpring
Service Area: Nashville/Middle Tennessee area
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: No
JCAHO Accreditation: No
URAC Accreditation: Yes
Plan Type: HMO
Enrollment Code-Self: 6K1
Enrollment Code-Self & Family: 6K2
Link to Plan Home Page: http://www.myhealthspring.com/feds
Telephone: 615/291-5030
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Benefits
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Doctor Care/ Primary Office Visits: $10
Hospital Inpatient Room and Board Charges: None
RX/ Generic/ Retail: $10
RX/ Brand/ Retail: $20
RX/ Brand/ NonFormulary: $35
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Rates
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Non-Postal
___Monthly Self: $63.04 Self: & Family: $218.59
___Biweekly Self: $29.09 Self: & Family: $100.89
___Twice Biweekly Self: $58.18 Self: & Family: $201.78
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Annuitants
___Monthly Self: $63.04 Self: & Family: $218.59
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U.S. Postal Service Employees (Type A)
___Monthly Self: $28.37 Self: & Family: $131.19
___Biweekly Self: $13.09 Self: & Family: $60.55
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U.S. Postal Service Employees (Type B)
___Monthly Self: $28.37 Self: & Family: $193.18
___Biweekly Self: $13.09 Self: & Family: $89.16
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Worker's Compensation Recipients
___Twice Biweekly Self: $58.18 Self: & Family: $201.78
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Certain Temporary Employees
___Biweekly Self: $116.38 Self: & Family: $324.30
___Monthly Self: $252.16 Self: & Family: $702.65
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Former Spouse Enrollees
___Monthly Self: $252.16 Self: & Family: $702.65
___Biweekly Self: $116.38 Self: & Family: $324.30
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Temporary Continuation of Coverage
___Monthly Self: $257.20 Self: & Family: $716.70
___Biweekly Self: $118.71 Self: & Family: $330.79
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FDIC
___Biweekly Self: $13.09 Self: & Family: $60.55
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