Kitsap Physicians Service-Std - Most of Western Washington

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General Information

Plan Name:	Kitsap Physicians Service-Std
Service Area:	Most of Western Washington
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	VT4
Enrollment Code-Self & Family:	VT5
Link to Plan Home Page:	http://www.kpshealthplans.com
Telephone:	800/552-7114
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	20%
Hospital Inpatient Room and Board Charges:	None
RX/ Generic/ Retail:	$5
RX/ Brand/ Retail:	$15
RX/ Brand/ NonFormulary:	$100 or 50%

Rates

Non-Postal
___Monthly	Self: $78.41	Self: & Family: $158.66
___Twice Biweekly	Self: $72.38	Self: & Family: $146.46
___Biweekly	Self: $36.19	Self: & Family: $73.23
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Annuitants
___Monthly	Self: $78.41	Self: & Family: $158.66
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $18.53	Self: & Family: $32.95
___Monthly	Self: $40.15	Self: & Family: $71.40
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $24.82	Self: & Family: $57.77
___Monthly	Self: $53.77	Self: & Family: $125.17
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Worker's Compensation Recipients
___Twice Biweekly	Self: $72.38	Self: & Family: $146.46
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Certain Temporary Employees
___Biweekly	Self: $134.05	Self: & Family: $292.91
___Monthly	Self: $290.44	Self: & Family: $634.64
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Former Spouse Enrollees
___Biweekly	Self: $134.05	Self: & Family: $292.91
___Monthly	Self: $290.44	Self: & Family: $634.64
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Temporary Continuation of Coverage
___Biweekly	Self: $136.73	Self: & Family: $298.77
___Monthly	Self: $296.25	Self: & Family: $647.33
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FDIC
___Biweekly	Self: $18.53	Self: & Family: $32.95
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