Mercy Health Plans/Premier - Webb/Zapata/Duval/Jim Hogg Counties

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General Information

Plan Name:	Mercy Health Plans/Premier
Service Area:	Webb/Zapata/Duval/Jim Hogg Counties
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	POS
Enrollment Code-Self:	HM1
Enrollment Code-Self & Family:	HM2
Link to Plan Home Page:	http://www.mercyhealthplans.com
Telephone:	800/617-3433
Summary results of the 2001 consumers assessment of health plans survey

Benefits

In Network - Doctor Care/ Primary Office Visits:	$10
In Network - Hospital Inpatient Room and Board Charges:	Nothing
In Network - RX/ Generic/ Retail:	$7
In Network - RX/ Brand/ Retail:	$12
In Network - RX/ Brand/ NonFormulary:	$25
Out of Network - Doctor Care/ Primary Office Visits:	40%
Out of Network - Hospital Inpatient Room and Board Charges:	40%
Out of Network - RX/ Generic/ Retail:	N/A
Out of Network - RX/ Brand/ Retail:	N/A
Out of Network - RX/ Brand/ NonFormulary:	N/A

Rates

Non-Postal
___Twice Biweekly	Self: $63.54	Self: & Family: $188.64
___Biweekly	Self: $31.77	Self: & Family: $94.32
___Monthly	Self: $68.84	Self: & Family: $204.36
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Annuitants
___Monthly	Self: $68.84	Self: & Family: $204.36
_
U.S. Postal Service Employees (Type A)
___Monthly	Self: $30.98	Self: & Family: $116.96
___Biweekly	Self: $14.30	Self: & Family: $53.98
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U.S. Postal Service Employees (Type B)
___Monthly	Self: $38.69	Self: & Family: $178.95
___Biweekly	Self: $17.86	Self: & Family: $82.59
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Worker's Compensation Recipients
___Twice Biweekly	Self: $63.54	Self: & Family: $188.64
_
Certain Temporary Employees
___Biweekly	Self: $127.09	Self: & Family: $317.73
___Monthly	Self: $275.36	Self: & Family: $688.42
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Former Spouse Enrollees
___Biweekly	Self: $127.09	Self: & Family: $317.73
___Monthly	Self: $275.36	Self: & Family: $688.42
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Temporary Continuation of Coverage
___Monthly	Self: $280.87	Self: & Family: $702.19
___Biweekly	Self: $129.63	Self: & Family: $324.08
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FDIC
___Biweekly	Self: $14.30	Self: & Family: $53.98
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