PacifiCare Health Plans - San Antonio/Dallas/Ft Worth

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General Information

Plan Name:	PacifiCare Health Plans
Service Area:	San Antonio/Dallas/Ft Worth
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	GF1
Enrollment Code-Self & Family:	GF2
Link to Plan Home Page:	http://www.phs.com
Telephone:	800/531-3341
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:	$15

Rates

Non-Postal
___Biweekly	Self: $24.90	Self: & Family: $65.10
___Monthly	Self: $53.95	Self: & Family: $141.06
___Twice Biweekly	Self: $49.80	Self: & Family: $130.20
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Annuitants
___Monthly	Self: $53.95	Self: & Family: $141.06
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $11.21	Self: & Family: $29.30
___Monthly	Self: $24.28	Self: & Family: $63.48
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $11.21	Self: & Family: $29.30
___Monthly	Self: $24.28	Self: & Family: $63.48
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Worker's Compensation Recipients
___Twice Biweekly	Self: $49.80	Self: & Family: $130.20
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Certain Temporary Employees
___Monthly	Self: $215.82	Self: & Family: $564.24
___Biweekly	Self: $99.61	Self: & Family: $260.42
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Former Spouse Enrollees
___Biweekly	Self: $99.61	Self: & Family: $260.42
___Monthly	Self: $215.82	Self: & Family: $564.24
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Temporary Continuation of Coverage
___Monthly	Self: $220.14	Self: & Family: $575.52
___Biweekly	Self: $101.60	Self: & Family: $265.63
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FDIC
___Biweekly	Self: $11.21	Self: & Family: $29.30
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Department of Defense Demo Project
___Monthly	Self: $70.42	Self: & Family: $170.79
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Department of Defense Demo Project Temporary Continuation of Coverage
___Monthly	Self: $287.30	Self: & Family: $667.95
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