U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

RI 70 -1

Revised November 2002

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OFFICE OF THE DIRECTOR

UNITED STATES
OFFICE OF PERSONNEL MANAGEMENT
WASHINGTON, DC 20415-0001

Dear Federal Employees Health Benefits Program Participant:

I am pleased to present the Federal Employees Health Benefits (FEHB) Program Guide for the FEHB Open Season. I would like to take this opportunity to encourage you to become informed about your health plan choices this year. In keeping with the President's health care agenda, we are committed to providing FEHB Program members with affordable, quality health care choices. Fundamentally, I believe that FEHB participants are wise enough to determine the care options best suited for themselves and their families.

Our strategy to maintain quality and cost this year rested on four initiatives. First, I met with FEHB carriers and challenged them to contain costs, maintain quality, and keep this program a model of consumer choice and on the cutting edge of employer-provided health benefits. I reminded them of President Bush's principles for health care: patient-centered health care, preservation of choice, and excellent quality. I encouraged each plan to explore all reasonable options to hold down premium increases while maintaining a benefits package that is highly valued by our employees and retirees, as well as attractive to prospective Federal employees. Second, I met with our own FEHB negotiating team here at OPM and I challenged them to conduct tough negotiations on your behalf. Third, OPM initiated a comprehensive outside audit to review the potential costs of federal and state mandates over the past decade, so that this agency is better prepared to tell you, the Congress and others the true cost of mandated services. Fourth, we have maintained a respectful and full engagement with the OPM Inspector General (IG) and have supported all of his efforts to investigate fraud and waste within the FEHB and other programs. Positive relations with the IG are essential and I am proud of our strong relationship.

The FEHB Program is market-driven. The health care marketplace has experienced significant increases in health care cost trends in recent years. Despite its size, the FEHB Program is not immune to such market forces. We have worked with the plans to provide health plan choices this year that maintain competitive benefit packages and yet keep health care affordable. We will continue on this path.

Now, it is your turn. This is the time to reevaluate your personal needs and to change plans, if necessary, based on those needs. The Guide provides a comparison of the plans, benefits, premiums, results of a customer satisfaction survey and quality information. If you review the Guide and the health plan brochures you will have the information you need to make an informed choice. We suggest you also visit our web site at www.opm.gov/insure.

Sincerely,

Kay Coles James
Director

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Table of Contents

• Patient Safety
• FEHB and You
• Getting Information and Selecting a Health Plan
• Quality
• Member Survey Results
• Accreditation
• Benefits
• Cost
• How the Plan Works
• Web Resources
• Program Features
• Definitions You May Need To Know
• Long Term Care Insurance
• Stop Health Care Fraud
• Quality and Safety Links
• Plan Comparisons
• Nationwide Fee-For-Service Plans Open to All
• Nationwide Fee-For-Service Plans Open Only to Specific Groups
• Health Maintenance Organization Plans and Plans Offering a Point of Service Product

Things to Remember

• The plan you choose can make a difference in your health.
• Be aware of benefit changes for 2003.
• Check the premium for 2003.

The information in this Guide gives you an overview of the FEHB Program and its participating plans. Read the plan brochures before you make any final decisions about health plans.

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Patient Safety

A 1999 report from the Institute of Medicine estimates that up to 98,000 Americans die every year from medical mistakes in hospitals alone. That's about 3,230 preventable deaths in the FEHB Program a year. While death is the most tragic outcome, medical mistakes cause other problems such as permanent disabilities, extended hospital stays, longer recoveries, and even additional treatments. By asking questions, learning more and understanding your risks, you can improve the safety of your own health care, and that of your family members. Take these simple steps:

1

Speak up if you have questions or concerns. Choose a doctor who you feel comfortable talking to about your health and treatment. Take a relative or friend with you if this will help you ask questions and understand the answers. It's okay to ask questions and to expect answers you can understand.

2

Keep a list of all the medicines you take. Tell your doctor and pharmacist about the medicines that you take, including over-the-counter medicines such as aspirin, ibuprofen, and dietary supplements like vitamins and herbals. Tell them about any drug allergies you have. Ask the pharmacist about side effects and what foods or other things to avoid while taking the medicine. When you get your medicine, read the label, including warnings. Make sure it is what your doctor ordered, and you know how to use it. If the medicine looks different than you expected, ask the pharmacist about it.

3

Make sure you get the results of any test or procedure. Ask your doctor or nurse when and how you will get the results of tests or procedures. If you do not get them when expected -- in person, on the phone, or in the mail - don't assume the results are fine. Call your doctor and ask for them. Ask what the results mean for your care.

4

Talk with your doctor and health care team about your options if you need hospital care. If you have more than one hospital to choose from, ask your doctor which one has the best care and results for your condition. Hospitals do a good job of treating a wide range of problems. However, for some procedures (such as heart bypass surgery), research shows results often are better at hospitals doing a lot of these procedures. Also, before you leave the hospital, be sure to ask about follow-up care, and be sure you understand the instructions.

5

Make sure you understand what will happen if you need surgery. Ask your doctor and surgeon: Who will take charge of my care while I'm in the hospital? Exactly what will you be doing? How long will it take? What will happen after the surgery? How can I expect to feel during recovery? Tell the surgeon, anesthesiologist, and nurses if you have allergies or have ever had a bad reaction to anesthesia. Make sure you, your doctor, and your surgeon all agree on exactly what will be done during the operation.

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The Federal Employees Health Benefits (FEHB) Program began operating in July 1960. It is the nation's largest employer-sponsored health insurance program. Almost 8.5 million people are in the Program, including 2.2 million Federal employees, 1.85 million retirees, and eligible family members.

Getting information and selecting a health plan

Use this Guide and plan brochures to make your health plan decision. The Guide summarizes FEHB plans' benefits, costs, and quality performance; the plan brochures give complete benefit and cost information. You can get brochures from the health plans or your human resources office. Our web site www.opm.gov/insure provides the Guide, brochures, and other helpful information.

Before selecting a health plan:

• Consider quality ratings of each plan (look for accreditation and survey results)
• Compare benefits in the brochures
• Review costs (premiums, deductibles, copayments, etc.)
• Understand how the plan works

Quality

Quality is how well health plans keep their members healthy or treat them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person -- and getting the best possible results. Health plan quality can be measured from the enrollees' viewpoint (member surveys) and by the independent evaluations (accreditation) in this Guide.

Member survey results in this Guide were collected, scored, and reported by an independent organization - not by the health plans. Here are the survey categories:

Getting Needed Care. Were you satisfied with the choices your health plan gave you to select a personal doctor? Were you satisfied with the time it takes to get a referral to a specialist?

Getting Care Quickly. Did you get the advice or help you needed when you called your doctor during regular office hours? Could you get an appointment for regular or routine care when you wanted?

How Well Doctors Communicate. Did your doctor listen carefully to you and explain things in a way you could understand? Did your doctor spend enough time with you?

Customer Service. Was your plan helpful when you called its customer service department? Did you have paperwork problems? Were the plan's written materials understandable?

Claims Processing. Did your plan pay your claims correctly and in a reasonable time?

Overall Plan Satisfaction. How would you rate your overall experience with your health plan?

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Accreditation is an approval by a private, independent organization. This approval is given after a nationally recognized organization carefully reviews a health plan and decides if it meets the organization's quality standards.

The National Committee for Quality Assurance (NCQA), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and URAC (URAC) are independent, private, not-for-profit organizations dedicated to measuring the quality of health care organizations.

Compare the accreditation status of different health plans with the following key (a lower number means a better accredited plan).
NCQA (www.ncqa.org):
1 = Excellent (HMO) or Full (PPO)
2 =Commendable (HMO only)
3 = Accredited (HMO) or One-Year (PPO) 4 = Provisional (HMO and PPO)
6 = New Health Plan
JCAHO (www.jcaho.org):
1 = Accreditation with Full Compliance
2 = Accreditation with Requirements for Improvement 3 = Provisional
4 = Conditional
URAC (www.urac.org):
1 = Full Accreditation
2 = Conditional Accreditation
3 = Provisional Accreditation

Also, you should check your health plan's provider directory to see which provider networks are accredited or credentialed.

Benefits

What type of services do you think you and your family will need? Are there limits on the number of visits for the services you want or the types of services you want? All FEHB plans cover major medical benefits -hospital costs, doctors' inpatient and outpatient visits -but your share of the costs vary by plan. Don't assume benefits will be the same as they were last year.

• Read plan brochures and the Change page carefully.

• Know what services are covered
• Know what services are not covered

Cost

The premium you pay is an important consideration. What can you afford biweekly or monthly? Plans that offer two options distinguish the difference between the two by the benefits or services provided, and this in turn affects the premium and out-of-pocket costs you pay. What benefits and services do you need, and how much do you have to pay?

You also need to consider other costs: Check to see how you are protected by the plan's annual out-of-pocket maximum. If you need to go to the hospital, how much will you pay? What will you pay for an emergency room visit? If you have children, what will you pay for a well-child visit? What will you pay for your prescription?

Do you pay a deductible for the services you need? You share medical expenses by paying a coinsurance (a percentage of the bill) or a copayment (a fixed dollar amount). Which option do you prefer? Does the plan limit the dollar amount it pays for certain services, making you pay the rest?

• Review the benefit summary in this Guide.
• Check plan brochures for specific information.

How the Plan Works

Different types of plans help you get and pay for care differently. Fee-For-Service (FFS) plans generally use two approaches. In the first approach, you use a Fee-For-Service plan's Preferred Provider Organization (PPO), which offers you a choice of doctors and hospitals within a network. Most networks are quite wide, but they may not have the specific doctor or hospital you want. Using PPO providers usually will save you money and reduce your paperwork.

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In the second approach, you choose any doctor and hospital. This may be more expensive for you and require extra paperwork.

Enrolling in a FFS plan does not guarantee that a PPO will be available in your area. PPOs have a stronger presence in some regions than others, and in areas where there is no PPO, the non-PPO benefit is the only benefit. In a PPO-only option, you must use the PPO's providers to receive benefits.

Health Maintenance Organizations (HMOs) generally limit their networks of physicians and facilities. You must use their network to get covered services and follow their guidance for referrals, prior authorizations, and other services. HMOs limit your out-of-pocket costs to the relatively low amounts shown in the benefit brochures.

Some plans are Point Of Service (POS) plans and have features similar to both FFS plans and HMOs. POS plans are identified in the charts by lines for "In-Network" and "Out-of-Network."

Be sure to look at the primary care physicians, specialists, and hospitals with whom your health plan contracts (the provider network). Does it have the specialists to treat your chronic condition? Does it contract with primary doctors and hospitals that are convenient to you?

You are in a FFS plan and�

You use the PPO:

• You will generally pay less when you get care
• More preventive health care services may be covered
• You may have less paperwork

You do not use the PPO (or one is not available):

• You will generally pay more when you get care
• Fewer preventative health care services may be covered
• You will have to file your own claims for services you receive

NOTE: APWU's Consumer Driven Option differs from its FFS option in many important ways. Read the brochure for details.

You are in a FFS plan's �PPO-only� option:

• You must use network providers to receive benefits.

You belong to an HMO:

• You will have limitations on the doctors, providers, and facilities you can use
• You will usually pay less when you get care
• You will have little, if any, paperwork
• More preventive health care services may be covered

You belong to a POS plan and...

You use only the providers in that network:

• You will pay less when you get care
• You will get full network benefits and coverage

You will have very little paperwork

You do not use the network providers or referral

procedures:

• You will pay more when you get care
• You generally have to file claims for services yourself
• Some services may not be covered out of network at all

Things to do to make a plan work best for you

• When you need care, use your brochure to find out about the plan's rules and coverage. Know what services require precertification, prior approval, or referral before you use them. Verify physician participation.
• Request generic drugs instead of brand name drugs. A generic medication is a copy of a brand name drug. It has the same active ingredients and receives the same Food and Drug Administration approval but costs less. Most plans charge you a lower copay if you use generic drugs.
• If you're in a FFS plan, use the plan's PPO if it has one. (Be aware, however, that some of the services provided in a PPO hospital may not be covered by PPO arrangements. Room and board will be covered, but anesthesia and radiology, for instance, will probably be covered under non-PPO benefits.)
• Ask questions. You deserve a voice in your own health care.

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FEHB Web Resources

Use the FEHB web site for additional help in choosing the health plan that is right for you.

The FEHB web site at www.opm.gov/insure/archive/health can help you to choose your health plan and enroll. In addition to the information found in this Guide you will find:

• An interactive tool that will allow you to find the health plans that service your area and will allow you to make side-by-side comparisons of the costs, benefits, and quality indicators of the plans that interest you.

• Electronic versions of all plan brochures.

• Information on enrolling, with the ability to enroll online for annuitants and employees of selected agencies.

• Information on how plans in the FEHB Program coordinate benefit payments with Medicare.

• A comprehensive set of Frequently Asked Questions and answers on all aspects of the Program.

• An online version of the FEHB Handbook for detailed guidance on FEHB policies and procedures.

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Program Features

• No Waiting Periods. You can use your benefits as soon as your coverage becomes effective. There are no pre-existing condition limitations even if you change plans.
• A Choice of Coverage. Choose between self only or self and family.
• A Choice of Plans and Options. Select from Fee-For-Service (with the option of a PPO), Health Maintenance Organization, or Point of Service plans.
• A Government Contribution The Government pays 72 percent of the average premium toward the total cost of the your premium, but not more than 75 percent of the total premium for any plan.
• Salary Deduction. You pay your share of the premium through a payroll deduction and have the choice of doing so using pretax dollars.
• Annual Enrollment Opportunity. Each year you can enroll or change your health plan enrollment. This year the Open Season runs from November 11, 2002, through December 9, 2002. Other events allow for certain types of changes throughout the year; see your human resources office or retirement system for details.
• Continued Group Coverage. Eligible participants can continue coverage following retirement, divorce, death, or changes in employment status. See your human resources office for more information.
• Coverage after FEHB Ends. You or your family members may be eligible for temporary continuation of FEHB coverage or for conversion to non-group (private) coverage when FEHB coverage ends. See your human resource office for more information.

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Definitions

Accreditation - A rigorous and comprehensive evaluation performed by independent organizations that includes a review of records as well as on-site reviews of managed care organizations. Accreditation also includes an assessment of the care and service plans are delivering in important areas of public concern such as immunization rates, mammography rates, and member satisfaction. The following three organizations perform accreditation reviews we recognize:

NCQA - The National Committee for Quality Assurance. These are NCQA's accreditation levels.

• Excellent - NCQA's highest status. Levels of service and clinical quality that meet or exceed NCQA's requirements for consumer protection and quality improvement AND achieve health plan performance results that are in the highest range of national or regional performance.
• Commendable - Meets or exceeds NCQA's requirements for consumer protection and quality improvement.
• Accredited - Meets most of NCQA's requirements for consumer protection and quality improvement.
• Provisional - Meets some but not all of NCQA's requirements for consumer protection and quality improvement.
• New Health Plan - Applies to health plans that are less than two years old.

JCAHO - The Joint Commission on Accreditation of Healthcare Organizations. These are JCAHO's accreditation levels:

• Accreditation with Full Compliance -

Demonstrates satisfactory compliance with JCAHO standards in all performance areas.

• Accreditation with Requirements for Improvement - Demonstrates satisfactory compliance with JCAHO standards in most performance areas.
• Provisional - Demonstrates a previously unaccredited plan's satisfactory compliance with a subset of standards.
• Conditional - Demonstrates failure to meet standard(s) or specific policy requirement(s) but is believed capable to do so in a specified time period.

URAC - Formerly known as the American Accreditation Healthcare Commission. These are URAC's accreditation levels.

• Full Accreditation - Demonstrates full compliance with standards.
• Conditional Accreditation - Meets most of the standards but needs some improvement before achieving full compliance.
• Provisional Accreditation - A plan that has otherwise complied with all standards but has been in operation for less than 6 months.

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Coinsurance - The amount you pay as your share of the medical services you receive, like for a doctor's visit. Coinsurance is a percentage of the cost of the service (e.g., 20%).

Consumer Driven Option - A fee-for-service option under the FEHB that offers you greater control over choices of your health care expenditures. You decide which health care services will be reimbursed under the health plan funded Personal Care Account. Unused funds from the account will roll over at the end of the year. If you spend the entire account fund before the end of the year, then you must satisfy a member responsibility/deductible before benefits are payable under the traditional type of insurance covered by your plan. You decide whether to use PPO or Non-PPO providers to reach the maximum fund allowed under your account.

Copayment - The amount you pay as your share of the medical services you receive, like for a doctor's visit. Copayment is a fixed dollar amount (e.g., $15).

Fee-For-Service (FFS) - Health coverage in which doctors and other providers receive a fee for each service such as an office visit, test, procedure, or other health care service. The health plan will either pay the medical provider directly or reimburse you for covered services after you have paid the bill and filed an insurance claim. When you need medical attention, you visit the doctor or hospital of your choice.

Health Maintenance Organization (HMO)- A health plan that provides care through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Your eligibility to enroll in an HMO is determined by where you live or, in some plans, where you work.

In-Network - You receive treatment from the doctors, clinics, health centers, hospitals, medical practices, and other providers with whom your plan has an agreement to care for its members. Examples include

a Fee-For-Service plan's PPO or a Health Maintenance Organization. Members have fewer out-of-pocket costs when they use in-network providers.

Managed care - A very broad term that generally refers to a system that manages the quality of health care, access to care, and the cost of that care. For example, a formulary controls the quality of medications dispensed to enrollees; a referral ensures that you see the right specialist for your condition; and going to a hospital that has an agreement with your plan can save both you and the plan money.

Out-of-Network - You receive treatment from doctors, hospitals, and medical practitioners other than those with whom the plan has an agreement, and pay more to do so. Members in a PPO-only option who receive services outside the PPO network generally pay all charges.

Point of Service (POS) - A product offered by an HMO or FFS plan that has both in-network and out-of-network features. In a POS you don't have to use the plan's network of providers, but there are advantages if you do.

Preferred Provider Organization (PPO) - The PPO is similar to FFS insurance except it uses a network of providers. PPOs give you the choice of using doctors and other providers within the plan's network (the PPO benefit), or using ones outside the plan's network. You don't have to use the PPO, but there are advantages if you do. (Be aware, however, that some of the services provided in a PPO hospital may not be covered by PPO arrangements. Room and board will be covered, but anesthesia and radiology, for instance, will probably be covered under non-PPO benefits.) Note that some FFS plans may offer an enrollment option that is �PPO-only.� Under this option you must use network providers to receive benefits.

Provider - A doctor, hospital, health care practitioner, pharmacy, or health care facility.

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Long Term Care Insurance is Still Available!

Open Season for Long Term Care Insurance

• You can protect yourself against the high cost of long term care by applying for insurance in the Federal Long Term Care Insurance Program.
• Open Season to apply for long term care insurance through LTC Partners ends on December 31, 2002.
• If you're a Federal employee, you and your spouse need only answer a few questions about your health during Open Season.
• If you apply during the Open Season, your premiums will be based on your age as of July 1, 2002. After Open Season, your premiums will be based on your age at the time LTC Partners receives your application.

FEHB Doesn't Cover It

• Neither FEHB plans nor Medicare cover the cost of long term care. Also called "custodial care", long term care helps you perform the activities of daily living such as bathing or dressing yourself. It can also provide help you may need due to a severe cognitive impairment such as Alzheimer's disease.

You Can Also Apply Later, But�

• Employees and their spouses can still apply for coverage after the Federal Long Term Care Insurance Program Open Season ends, but they will have to answer more health-related questions.
• For annuitants and other qualified relatives, the number of health-related questions that you need to answer is the same during and after the Open Season.

You Must Act to Receive an Application

• Unlike other benefit programs, YOU have to take action - you won't receive an application automatically. You must request one through the toll-free number or website listed below.
• Open Season ends December 31, 2002 - act NOW so you won't miss the abbreviated underwriting available to employees and their spouses, and the July 1 �age freeze!�

Find Out More -- Contact LTC Partners by calling 1-800-LTC-FEDS (1-800-582-3337) (TDD for the hearing impaired: 1-800-843-3557) or visiting www.ltcfeds.com to get more information and to request an application.

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Fraud increases the cost of health care for everyone and increases your Federal Employees Health Benefits Program (FEHBP) premium. OPM's Office of the Inspector General investigates all allegations of fraud, waste, and abuse in the FEHBP regardless of the agency that employs you or from which you retired.

Protect Yourself From Fraud - Here are some things you can do to prevent fraud:

• Be wary of giving your health plan identification number over the telephone or to people you do not know, except to your doctor, other provider, or authorized plan or OPM representative.
• Let only the appropriate medical professionals review your medical record or recommend services.
• Avoid health care providers who say that an item or service is not usually covered, but they know how to bill your health plan to get it paid.
• Carefully review explanations of benefits (EOBs) that you receive from your health plan.
• Do not ask your doctor to make false entries on certificates, bills or records in order to get your health plan to pay for an item or service.
• If you suspect that a provider has charged you for services you did not receive, billed you twice for the same service, or misrepresented any information, do the following:
• Call the provider and ask for an explanation. There may be an error.
• If the provider does not resolve the matter, call your health plan and explain the situation.
• If they do not resolve the issue:

• Do not maintain as a family member under your FEHB coverage:
• your former spouse after a divorce decree or annulment is final (even if a court orders it); or
• your child over age 22 unless he/she is incapable of self support.
• If you have any questions about the eligibility of a dependent, check with your human resource office if you are employed or with OPM if you are retired.
• You can be prosecuted for fraud and your agency may take action against you if you falsify a claim to obtain FEHBP benefits or try to obtain services for someone who is not an eligible family member or who is no longer enrolled in the Plan.

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Quality and Safety Links

Want more information on health care quality and safety? The following web sites have information consumers can use when considering health plans, doctors and hospitals, medications, and more.

www.ihealthcoalition.org/content/tips.html

• This site offers tips on what to look for when searching for health information on the Internet.

www.ahrq.gov/consumer/pathqpack.htm

• The Agency for Healthcare Research and Quality has made available a wide-ranging list of topics to help consumers choose quality healthcare providers and improve the quality of care they receive.

www.npsf.org

• The National Patient Safety Foundation has information for patients on how to ensure safer healthcare for you and your family.

www.talkaboutrx.org/consumer.html

• The National Council on Patient Information and Education is dedicated to improving communication about the safe, appropriate use of medicines.

http://medlineplus.gov

• The world's largest medical library offering health information from the National Library of Medicine/National Institutes of Health.

www.leapfroggroup.com

• The Leapfrog Group is active in promoting safe practices in hospital care.

www.ahqa.org

• The American Health Quality Association represents organizations and healthcare professionals working to improve patient safety and the quality of healthcare nationwide.

www.quic.gov/report

• Find out what Federal agencies are doing to identify threats to patient safety and help prevent mistakes in the Nation's healthcare delivery system.

www.nchc.org/releases/medical_error.pdf

• The National Coalition on Health Care and the Institute for Healthcare Improvement offer profiles on what institutions and organizations are doing to reduce medical errors and improve patient safety.

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Nationwide Fee-For-Service Plans

Open to All

(Pages 12 through 14)

Fee-For-Service (FFS) Plans with a Preferred Provider Organization (PPO) - A FFS option that allows you to see medical providers who reduce their charges to the plan; you pay less money out-of-pocket when you use a PPO provider. When you visit a PPO you usually won't have to file claims or paperwork. However, going to a PPO hospital does not guarantee PPO benefits for all services received within that hospital. For instance, lab work and radiology services from independent practitioners within the hospital may not be covered by the PPO agreement.

Fee-For-Service (FFS) Plans (non-PPO) - A traditional type of insurance in which the health plan will either pay the medical provider directly or reimburse you after you have filed an insurance claim for each covered medical expense. When you need medical attention, you visit the doctor or hospital of your choice.

In PPO-only options, you must use PPO providers to receive benefits.

Consumer Driven Option offers three major benefit elements.

A) In-Network Preventive Care - you pay nothing for preventive services provided in PPO. Your in-network preventive care does not count against your Personal Care Account.

B) Personal Care Account - you pay nothing for the first $1,000 ($2,000 for self and family enrollment) in covered services by your FFS plan. A PPO or Non-PPO provider may provide your service. These services may include limited dental and vision care that you select.

C) Traditional Health Care - you pay stated coinsurance after spending the amount allowed in the Personal Care Account and satisfy the member responsibility/deductible. A PPO or Non-PPO provider may provide your service.

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Nationwide Fee-for-Service Plans Open to All

How to read this chart:

The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. The chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

The Deductibles shown are the amount of covered expenses that you pay before your health plan begins to pay. Calendar Year deductibles for families are two or more times the per person amount shown.

In some plans your combined Prescription Drug purchases from Home delivery and local pharmacies count toward the deductible. In other plans only purchases from local pharmacies count. Some plans require each family member to meet a per person deductible.

The Per Stay Hospital Inpatient deductible is what you pay each time you are admitted to a hospital.

What you pay for Doctors (inpatient visits and surgical services) and Outpatient Tests (provided, or ordered, and billed by a physician or physicians' group).

Continue this description.

Plan name	Telephone number	Enrollment code		Your share of premium
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Alliance Health Plan (AHP)	202/939-6325	1R1	1R2	157.06	294.19	72.49	135.78
APWU Health Plan-High (APWU)	800/222-2798	471	472	112.84	226.49	52.08	104.53
APWU Health Plan-Consumer Driven (APWU)	800/222-2798	474	475	78.87	186.99	36.40	86.30
Blue Cross and Blue Shield Service Benefit Plan-Std (BCBS)	Local phone #	104	105	98.93	227.98	45.66	105.22
Blue Cross and Blue Shield Service Benefit Plan-Basic (BCBS)	Local phone #	111	112	75.82	178.26	34.99	82.27
GEHA Benefit Plan-High (GEHA)	800/821-6136	311	312	145.53	291.29	67.17	134.44
GEHA Benefit Plan-Std (GEHA)	800/821-6136	314	315	59.58	135.42	27.50	62.50
Mail Handlers-High (MH)	800/410-7778	451	452	139.29	252.51	64.29	116.54
Mail Handlers-Std (MH)	800/410-7778	454	455	60.86	132.11	28.09	60.97
NALC	888/636-6252	321	322	104.95	189.48	48.44	87.45
PBP Health Plan-High (PBP)	800-544-7111	361	362	346.27	717.21	159.82	331.02
PBP Health Plan-Std (PBP)	800-544-7111	364	365	104.97	233.35	48.45	107.70

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Your share of Hospital Inpatient Room and Board and Other (e.g., nursing, supplies, and medications) covered charges are shown, usually after any per stay deductible. Services provided and billed by the hospital for outpatient care (other than surgery) are shown as Hospital Outpatient Other expenses.

A Generic drug is a copy of the manufacturer's Brand Name drug and is approved by the Food and Drug Administration. Non-formulary drugs are Brand Names that are not on your health plan's list of preferred drugs.

Prescription drug benefits have become more complex as you can see from the many variations below. Multiple numbers for a plan mean there are different levels of cost sharing. For instance, you may pay one amount for your first prescription (e.g., 10% or $5) and then a different amount for some refills (e.g., 50%). You may have to pay the greater of a dollar amount or a percentage (e.g., $10 or 20%). In some cases, you'll pay less for a Brand Name drug that has no Generic equivalent than for a Brand Name that has a Generic (e.g., $15 versus $30). A few plans have lower copays for Medicare members. Plans vary in the number of days supply of drugs you get for the copays shown, and you'll almost always pay more if you use a non-PPO pharmacy (e.g., the + sign means you pay the amount shown plus a differential.) Read the brochures for details.

Plan	Benefit type	Medical Surgical - You pay
		Deductible			Copay ($)/Coinsurance (%)
		Per Person		Per stay Hospital inpatient	Doctors & Outpatient Tests	Hospital			Prescription drugs
						Inpatient		Outpatient Other	Generic	Brand Name	Non- Formulary	Home Delivery
		Calendar Year	Prescription Drug			R&B	Other					Generic	Brand Name
AHP	PPO	$200	$200	$150	10%	10%	10%	10%	10%/50%	15%/50%	15%/50%	20%	25%
	Non-PPO	$400	$200	$250	30%	30%	30%	30%	10%/50% +	15%/50%+	15%/50%+	20%	25%
APWU-High	PPO	$275	None	None	10%	10%	10%	10%	$7	25%	25%	$10	20%
	Non-PPO	$350	None	$200	30%	30%	30%	30%	45%	45%	45%	$10	20%
APWU	See pages 7 and 11 of this Guide for a benefit description, and carefully read the APWU brochure for details.
BCBS-Std	PPO	$250	None	$100	10%	Nothing	Nothing	10%	25%	25%	25%	$10/25%	$35/25%
	Non-PPO	$250	None	$300	25%	30%	30%	25%	45%+	45%+	45%+	45%+	45%+
BCBS-Basic	PPO	None	None	$100 day/x5	$20/$30	Nothing	Nothing	$30	$10	$25	$35 or 50%	$10*	$25*
GEHA-High	PPO	$350	None	$100	10%	Nothing	10%	10%	$5/50%	$25/50%	$20/$35/50%	$10	$40/$55
	Non-PPO	$350	None	$300	25%	Nothing	25%	25%	$5/50% +	$20/50% +	$20/$35/50% +	$10	$40/$55
GEHA-Std	PPO	$450	None	None	15%	15%	15%	15%	$5	50%	50%	$15	50%
	Non-PPO	$450	None	None	35%	35%	35%	35%	$5 +	50% +	50% +	$15	50%
MH-High	PPO	$250	$250	None	10%	Nothing	Nothing	10%	$7	$23	$35	$10	$30/$45
	Non-PPO	$250	$250	$250	30%	Nothing	Nothing	30%	50%	50%	50%	$10	$30/$45
MH-Std	PPO	$300	$600	$150	10%	Nothing	Nothing	10%	$8	$28	$40	$10	$40/$55
	Non-PPO	$300	$600	$300	30%	Nothing	Nothing	30%	50%	50%	50%	$10	$40/$55
NALC	PPO	$250	None	None	15%	10%	10%	15%	25%	25%	25%	$10	$30
	Non-PPO	$300	$25 for Retail	$100	30%	30%	30%	30%	40%+	40%+	40%+	$10	$30
PBP-High	PPO	$200	$90	None	10%	10%	10%	10%	$3	$25 or 20%	$40 or 20%	$6	$25/
	Non-PPO	$450	$90	$150	15%-25%	25%	25%	25%	20%+	20%+	20%+	$6	$40 or 20%
PBP-Std	PPO	$250	$90	None	9%	9%	9%	9%	$4	$30 or 20%	$40 or 20%	$8	$30/
	Non-PPO	$500	$90	$250	30%	30%	30%	30%	30%+	30%+	30%+	$8	$40 or 20%

* Home delivery is available from Internet pharmacies and may be available from certain retail pharmacies. The Mail Service Program is not available under Basic Option.

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Nationwide Fee-for-Service Plans Open to All

Member Survey Results - See page 1 for a description.

Plan name	Member Survey Results
	Plan code	Overall plan satisfaction	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Alliance Health Plan	1R	Average	Average	Above Average	Above Average	Average	Average
APWU Health Plan-High	47	Above Average	Average	Average	Average	Above Average	Above Average
APWU Health Plan-Consumer Driven	47
Blue Cross and Blue Shield Service Benefit Plan-Std	10	Below Average	Average	Below Average	Average	Average	Below Average
Blue Cross and Blue Shield Service Benefit Plan-Basic	11		:	:	:	:	:
GEHA Benefit Plan-High	31	Above Average	Average	Below Average	Below Average	Above Average	Above Average
GEHA Benefit Plan-Std	31	Above Average	Average	Below Average	Below Average	Above Average	Above Average
Mail Handlers-High	45	Below Average	Below Average	Below Average	Average	Average	Below Average
Mail Handlers-Std	45	Below Average	Below Average	Below Average	Average	Average	Below Average
NALC	32	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
PBP Health Plan-High	36	Below Average	Average	Above Average	Above Average	Below Average	Below Average
PBP Health Plan-Std	36	Below Average	Average	Above Average	Above Average	Below Average	Below Average

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Plan Comparisons

Nationwide Fee-For-Service Plans

Open Only to Specific Groups

(Pages 16 through 18)

Fee-For-Service (FFS) Plans with a Preferred Provider Organization (PPO) - A FFS option that allows you to see medical providers who reduce their charges to the plan; you pay less money out-of-pocket when you use a PPO provider. When you visit a PPO you usually won't have to file claims or paperwork. However, going to a PPO hospital does not guarantee PPO benefits for all services received within that hospital. For instance, lab work and radiology services from independent practitioners within the hospital may not be covered by the PPO agreement.

Fee-For-Service (FFS) Plans (non-PPO) - A traditional type of insurance in which the health plan will either pay the medical provider directly or reimburse you after you have filed an insurance claim for each covered medical expense. When you need medical attention, you visit the doctor or hospital of your choice.

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Nationwide Fee-for-Service Plans Open Only to Specific Groups

How to read this chart:

The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. The chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

The Deductibles shown are the amount of covered expenses that you pay before your health plan begins to pay. Calendar Year deductibles for families are two or more times the per person amount shown. Some plans apply Prescription Drug purchases to the Calendar Year deductible.

The Per Stay Hospital Inpatient deductible is what you pay each time you are admitted to a hospital.

What you pay for Doctors (inpatient visits and surgical services) and Outpatient Tests (provided, or ordered, and billed by a physician or physicians' group).

Plan name	Telephone number	Enrollment code		Your share of premium
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Association Benefit Plan (ABP)	800/634-0069	421	422	118.19	276.99	54.55	127.84
Foreign Service Benefit Plan (FS)	202/833-4910	401	402	85.06	240.92	39.26	111.19
Panama Canal Area Benefit Plan (PCA)	800/548-8969	431	432	78.52	163.90	36.24	75.65
Rural Carrier Benefit Plan (Rural)	800/638-8432	381	382	153.14	253.46	70.68	116.98
SAMBA	800/638-6589	441	442	159.59	392.73	73.66	181.26
Secret Service (SS)	800/424-7474	Y71	Y72	80.49	211.17	37.15	97.46

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Your share of Hospital Inpatient Room and Board and Other (e.g., nursing, supplies, and medications) covered charges are shown, usually after any per stay deductible. Services provided and billed by the hospital for outpatient care (other than surgery) are shown as Hospital Outpatient Other expenses.

A Generic drug is a copy of the manufacturer's Brand Name drug and is approved by the Food and Drug Administration. Non-formulary drugs are Brand Names that are not on your health plan's list of preferred drugs.

Prescription drug benefits have become more complex as you can see from the many variations below. Multiple numbers for a plan mean there are different levels of cost sharing. For instance, you may pay one amount for your first prescription (e.g., 10% or $5) and then a different amount for some refills (e.g. 50%). You may have to pay the greater of a dollar amount or a percentage (e.g., $10 or 20%). In some cases, you'll pay less for a Brand Name drug that has no Generic equivalent than for a Brand Name that has a Generic (e.g., $15 versus $30). A few plans have lower copays for Medicare members. Plans vary in the number of days supply of drugs you get for the copays shown, and you'll almost always pay more if you use a non-PPO pharmacy (e.g., the + sign means you pay the amount shown plus a differential). Read the brochures for details.

Plan	Benefit type	Medical Surgical - You pay
		Deductible			Copay ($)/Coinsurance (%)
		Per Person		Per stay Hospital inpatient	Doctors & Outpatient Tests	Hospital			Prescription drugs
						Inpatient		Outpatient Other	Generic	Brand Name	Non- Formulary	Home Delivery
		Calendar Year	Prescription Drug			R&B	Other					Generic	Brand Name
ABP	PPO	$300	None	$100	10%	Nothing	Nothing	10%	$10	$20	$30/30%	$20	$40/
	Non-PPO	$300	None	$200	30%	30%	30%	30%	$10	$20	$30/30%	$20	$45 or 30%
FS	PPO	$300	None	Nothing	10%	Nothing	Nothing	10%	$10/25%	$20/25%	$20/25%	$20	$40
	Non-PPO	$300	None	$200	30%	20%	20%	30%	$10/25%	$20/25%	$20/25%	$20	$40
PCA	POS	None	$400	$50	Nothing	Nothing	Nothing	Nothing	50%	50%	50%	N/A	N/A
	FFS	None	$400	$125	50%	50%	50%	50%	50%	50%	50%	50%	N/A
Rural	PPO	$350	CY Applies	Nothing	10%	Nothing	Nothing	15%	25%	25%	25%	$15	$25
	Non-PPO	$350	CY Applies	$200	15%	15%	15%	25%	25%	25%	25%	$15	$25
SAMBA	PPO	$350	None	$200	10%	Nothing	10%	$100/10%	$10	$25	$40	$10	$35/$50
	Non-PPO	$350	None	$300	30%	30%	30%	$150/30%	$10	$25	$40	$10	$35/$50
SS	No PPO	$200	None	$100	20%	Nothing	Nothing	Nothing	$10	$20	$20	$20	$40

*The Panama Canal Area Plan provides a point-of-service product within the Republic of Panama.

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Nationwide Fee-for-Service Plans Open Only to Specific Groups

Member Survey Results - See page 1 for a description.

Plan name	Member Survey Results
	Plan code	Overall plan satisfaction	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Association Benefit Plan	42	Above Average	Average	Average	Below Average	Above Average	Average
Foreign Service Benefit Plan	40	Average	Below Average	Average	Below Average	Below Average	Average
Panama Canal Area Benefit Plan	43
Rural Carrier Benefit Plan	38	Above Average	Above Average	Above Average	Average	Above Average	Above Average
SAMBA	44	Average	Below Average	Average	Average	Below Average	Below Average
Secret Service	Y7	Below Average	Above Average	Below Average	Average	Below Average	Below Average

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Plan Comparisons

Health Maintenance Organization Plans and Plans Offering a Point of Service Product

(Pages 20 through 45)

Health Maintenance Organization (HMO) - A health plan that provides care through a network of physicians and hospitals in particular geographic or service areas. HMOs coordinate the health care service you receive and free you from completing paperwork or being billed for covered services. Your eligibility to enroll in an HMO is determined by where you live or, for some plans, where you work. Some HMOs are affiliated with or have arrangements with HMOs in other service areas for non-emergency care if you travel or are away from home for extended periods. Plans that offer reciprocity discuss it in their brochure.

• The HMO provides a comprehensive set of services - as long as you use the doctors and hospitals affiliated with the HMO. HMOs charge a copayment for primary physician and specialist visits and generally no deductible or coinsurance for inhospital care.
• Most HMOs ask you to choose a doctor or medical group to be your primary care physician (PCP). Your PCP provides your general medical care. In many HMOs, you must get authorization or a �referral� from your PCP to see other providers. The referral is a recommendation by your physician for you to be evaluated and/or treated by a different physician or medical professional. The referral ensures that you see the right provider for the care most appropriate to your condition.
• Care received from a provider not in the plan's network is not covered unless its emergency care or the plan has a reciprocity arrangement.

Plans Offering a Point of Service (POS) Product - A product similar to an HMO and FFS plan.

The POS product lets you use providers who are not part of the HMO network. However, you pay more for using these non-network providers. You usually pay higher deductibles and coinsurances than you pay with a plan provider. You will also need to file a claim for reimbursement, like in a FFS plan. The HMO plan wants you to use its network of providers, but recognizes that sometimes enrollees want to choose their own provider.

The POS plans have two rows for �In Network� and �Out of Network� benefits. In Network shows what you pay if you go to the plan's providers; Out of Network shows what you pay if you decide not to go to the plan's providers.

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Health Maintenance Page 20   To Next Page   To Previous Page

Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

20

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Alabama
PrimeHealth of Alabama, Inc. - Southern Alabama and the Montgomery Area	800/236-9421	AA1	AA2	57.64	147.70	26.60	68.17
The Oath - A Health Plan for Alabama, Inc. - Birmingham/Other Areas	800/947-5093	DF1	DF2	97.22	314.28	44.87	145.05
Arizona
Aetna Health Inc. - Phoenix/Tucson Areas	800/537-9384	WQ1	WQ2	56.58	155.40	26.11	71.72	NCQA 1
Health Net of Arizona, Inc. - Maricopa/Pima/Other AZ counties	800/289-2818	A71	A72	69.11	175.10	31.90	80.82	NCQA 2
PacifiCare Health Plans - Maricopa/Pima/parts of Apache Junction	800/531-3341	A31	A32	70.39	232.53	32.49	107.32	NCQA 1
California
Aetna Health Inc. - Southern California Area	800/537-9384	2X1	2X2	58.49	138.75	26.99	64.04	NCQA 2
Blue Cross- HMO - Most of California	800/235-8631	M51	M52	72.25	196.46	33.34	90.67	NCQA 2
Blue Shield of CA Access+ - Most of California	800/880-8086	SJ1	SJ2	70.92	175.93	32.73	81.20	NCQA 2
CIGNA HealthCare of California - Northern/Southern California	800/244-6224	9T1	9T2	72.54	159.61	33.48	73.67	NCQA 2
Health Net - Most of California	800/522-0088	LB1	LB2	68.19	161.43	31.47	74.50	NCQA 2
Kaiser Permanente - Northern California	800/464-4000	591	592	74.81	178.58	34.53	82.42	NCQA 1
Kaiser Permanente - Southern California	800/464-4000	621	622	70.04	161.90	32.33	74.72	NCQA 1
PacifiCare Health Plans - Most of California	800/531-3341	CY1	CY2	57.20	148.04	26.40	68.32	NCQA 1
UHP Healthcare - LA/Orange/San Bernardino Counties	800/544-0088	C41	C42	57.09	121.57	26.35	56.11	JCAHO 1
Universal Care - Southern California	800/257-3087	6Q1	6Q2	56.36	148.81	26.01	68.68	NCQA 2
Colorado
Kaiser Permanente - Denver/Colorado Springs Areas	800/632-9700	651	652	72.75	221.57	33.58	102.26	NCQA 1
PacifiCare of Colorado-High -Denver/Colorado Springs/Ft.Collins	800/877-9777	D61	D62	78.69	277.53	36.32	128.09	NCQA 1
PacifiCare of Colorado-Std - Denver/Colorado Springs/Ft.Collins	800/877-9777	D64	D65	56.21	146.14	25.94	67.45	NCQA 1

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Alabama
PrimeHealth of Alabama, Inc.	$15	$25	$150/day x 4	$10	$20	$40	Average	Average	Above Average	Above Average	Average	Average
The Oath - A Health Plan for Alabama, Inc.	$20	$20	$100	$10	$20	$30	Above Average	Average	Above Average	Above Average	Average	Average
Arizona
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Below Average	Below Average	Below Average	Below Average	Average
Health Net of Arizona, Inc.	$10	$10	$100/day x 5	$10	$30	$45	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Below Average	Below Average	Below Average	Average	Average	Average
California
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
Blue Cross- HMO	$10	$10	None	$5	$10	50%	Below Average	Below Average	Below Average	Average	Average	Average
Blue Shield of CA Access+	$10	$10	None	$5	$10	$25	Average	Below Average	Below Average	Average	Average	Average
CIGNA HealthCare of California	$15	$25	$250	$7	$15	$35	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
Health Net	$10	$10	$100	$10	$20	$35	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
Kaiser Permanente	$15	$15	None	$10	$25	$25	Average	Average	Below Average	Below Average	Average	Average
Kaiser Permanente	$10	$10	None	$10	$25	$25	Average	Average	Above Average	Below Average	Above Average	Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Average	Below Average	Below Average	Below Average	Below Average	Average
UHP Healthcare	$10	$10	None	$10	$20	$20
Universal Care	$10	$10	$100/day x 3	$10	$20	$30	Average	Below Average	Below Average	Average	Average	Average
Colorado
Kaiser Permanente	$10	$20	$100	$10	$20	$20	Average	Average	Below Average	Below Average	Average	Average
PacifiCare of Colorado-High	$10	$20	$100	$10	$20	$30	Below Average	Below Average	Average	Average	Average	Average
PacifiCare of Colorado-Std	$15	$30	$300	$10	$30	$40	Below Average	Below Average	Average	Average	Average	Average

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Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Connecticut
ConnectiCare - All of Connecticut	800/251-7722	TE1	TE2	72.95	223.28	33.67	103.05	NCQA 1
District of Columbia
Aetna Health Inc.-High -Washington, DC Area	800/537-9384	JN1	JN2	76.61	172.55	35.36	79.64	NCQA 1
Aetna Health Inc.-Std - Washington, DC Area	800/537-9384	JN4	JN5	57.27	134.04	26.43	61.86	NCQA 1
CareFirst BlueChoice - Washington, D.C. Metro Area	866/520-6099	2G1	2G2	111.39	242.58	51.41	111.96	NCQA 1
Kaiser Permanente - Washington, DC Area	301/468-6000	E31	E32	66.75	158.86	30.81	73.32	NCQA 2
MD-IPA - Washington, DC Area	800/251-0956	JP1	JP2	75.18	181.03	34.70	83.55	NCQA 1
Florida
Av-Med Health Plan (North Florida) - Tampa	800/882-8633	EM1	EM2	76.87	304.81	35.48	140.68	NCQA 2
Av-Med Health Plan (South Florida) - Broward, Dade and Palm Beach	800/882-8633	ML1	ML2	67.98	206.92	31.38	95.50	NCQA 2
Capital Health Plan - Tallahassee Area	850/383-3311	EA1	EA2	76.93	277.14	35.50	127.91	NCQA 1
Foundation Health - Southern Florida	800/441-5501	5E1	5E2	49.32	135.65	22.76	62.61	NCQA 2
Healthplan Southeast - North Florida	850/668-3000	RK1	RK2	70.10	207.87	32.35	95.94
Humana Medical Plan - South Florida	888/393-6765	EE1	EE2	64.38	160.96	29.71	74.29	URAC 1
JMH Health Plan - Broward-Dade counties	800/721-2993	J81	J82	52.49	129.13	24.23	59.60
Total Health Choice - Broward/Dade/Palm Beach Counties	305/408-5823	4A1	4A2	63.27	157.63	29.20	72.75
Vista Healthplan - South Florida	866/847-8235	3N1	3N2	74.62	292.01	34.44	134.77	NCQA 2
Georgia
Aetna Health Inc. - Atlanta and Athens Areas	800/537-9384	2U1	2U2	75.57	188.31	34.88	86.91	NCQA 1
Kaiser Permanente - Atlanta Area	800/611-1811	F81	F82	62.38	158.38	28.79	73.10	NCQA 1

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Connecticut
ConnectiCare	$10	$10	None	$10	$20	$35	Above Average	Above Average	Above Average	Average	Above Average	Above Average
District of Columbia
Aetna Health Inc.-High	$15	$20	$150/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
Aetna Health Inc.-Std	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
CareFirst BlueChoice	$20	$30	None	$10	$20	$35	Average	Average	Below Average	Below Average	Below Average	Below Average
Kaiser Permanente	$10	$20	$100	$10 $20Net	$20 $40Net	$20 $40Net	Average	Average	Average	Below Average	Above Average	Average
MD-IPA	$10	$20	None	$8	$17	$33	Above Average	Above Average	Average	Average	Above Average	Average
Florida
Av-Med Health Plan (North Florida)	$20	$30	$100/day x 5	$15	$30	$50	Average	Below Average	Below Average	Average	Average	Average
Av-Med Health Plan (South Florida)	$15	$15	$100	$10	$20	$30	Average	Below Average	Below Average	Average	Average	Average
Capital Health Plan	$10	$10	$100	$7	$20	$35	Above Average	Above Average	Average	Average	Above Average	Above Average
Foundation Health	$10	$15	$200	$7	$14	$34	Below Average	Below Average	Below Average	Below Average	Below Average	Average
Healthplan Southeast	$10	$10	Nothing	$7	$20	$35
Humana Medical Plan	$10	$20	$100/day x 3	$5/$20	$20/$40	$100	Average	Below Average	Below Average	Below Average	Average	Average
JMH HEALTH PLAN	$10	$10	None	$5	50%	50%
Total Health Choice	$10	$10	$100	$5	$15	$15
Vista Healthplan	$10	$20	$250	$10	$20	$40	Below Average	Average	Below Average	Average	Average	Average
Georgia
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Below Average	Below Average	Average	Average	Average
Kaiser Permanente	$10	$10	None	$10 $16Com	$10 $16Com	$10 $16Com	Above Average	Above Average	Average	Average	Above Average	Average

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Page 24   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Guam
PacifiCare Asia Pacific-High -Guam/N. Mariana Islands/Palau	671/647-3526	JK1	JK2	64.19	168.66	29.62	77.84
PacifiCare Asia Pacific-Std - Guam/N. Mariana Islands/Palau	671/647-3526	JK4	JK5	54.76	144.60	25.27	66.74
Hawaii
HMSA - All of Hawaii	808/948-6499	871	872	65.25	145.26	30.12	67.04	NCQA 1
Kaiser Permanente-High -Islands of Hawaii/Maui/Oahu/Kauai	808/432-5955	631	632	77.56	166.76	35.80	76.96	NCQA 1
Kaiser Permanente-Std - Islands of Hawaii/Maui/Oahu/Kauai	808/432-5955	634	635	58.89	126.61	27.18	58.44	NCQA 1
Idaho
Group Health Cooperative - Kootenai and Latah	888/901-4636	VR1	VR2	78.52	265.85	36.24	122.70	NCQA 1
Illinois
BlueCHOICE - Madison and St. Clair counties	800/634-4395	9G1	9G2	75.62	163.72	34.90	75.56	NCQA 1
Group Health Plan - Southern/Metro East/Central	800/755-3901	MM1	MM2	123.15	236.69	56.84	109.24	URAC 1
Health Alliance HMO - Central/E.Central/N.West/South/West IL	800/851-3379	FX1	FX2	90.89	224.02	41.95	103.39	NCQA 1
Humana Health Plan Inc.-High -Chicago Area	888/393-6765	751	752	72.86	174.76	33.63	80.66
Humana Health Plan Inc.-Std - Chicago Area	888/393-6765	754	755	55.31	132.65	25.53	61.22
John Deere Health Plan - Bloomingtn/Joliet/Moline/Peoria/RockIsld	800/247-9110	YH1	YH2	67.26	164.78	31.04	76.05	NCQA 1
Mercy Health Plans/Premier Health Plans - Southwest Illinois	800/327-0763	7M1	7M2	140.70	337.29	64.94	155.67
OSF HealthPlans - Central/Central-Northwestern Illinois	800/673-5222	9F1	9F2	61.53	161.80	28.40	74.68	NCQA 1
PersonalCare's HMO - Central Illinois	800/431-1211	GE1	GE2	63.81	164.13	29.45	75.75	NCQA 1
Unicare HMO - Chicagoland Area	888/234-8855	171	172	66.20	217.91	30.55	100.57	NCQA 1
Union Health Service - Chicago Area	312/829-4224	761	762	58.11	144.09	26.82	66.50

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

2

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Guam
PacifiCare Asia Pacific-High	$10	$10	None	$5	$20	$20	Average	Average	Below Average	Above Average	Average	Average
PacifiCare Asia Pacific-Std	$15	$15	$150	$5	$20	$20	Average	Average	Below Average	Above Average	Average	Average
Hawaii
HMSA -In-Network	20%	20%	None	$5	$15	$15 or 50%	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
- Out-of-Network	30%	30%	30%	Above Average	$5+20%+$15+20%+$15	or 50%+
Kaiser Permanente-High	$10	$10	None	$10	$10	$10	Above Average	Average	Average	Average	Above Average	Average
Kaiser Permanente-Std	$15	$15	None	$10	$10	$10	Above Average	Average	Average	Average	Above Average	Average
Idaho
Group Health Cooperative	$15	$15	$200/day x 3	$15	$25	$50	Average	Average	Above Average	Average	Above Average	Above Average
Illinois
BlueCHOICE	$10	$10	None	$7	$12	$25
Group Health Plan	$10	$20	$100	$8	$20	$35	Average	Average	Above Average	Average	Average	Average
Health Alliance HMO	$15	$15	$100	$10	$20	$40	Above Average	Average	Above Average	Above Average	Above Average	Above Average
Humana Health Plan Inc.-High	$10	$20	$100/day x 3	$5/$15	$15/$35	25%	Below Average	Average	Below Average	Average	Below Average	Below Average
Humana Health Plan Inc.-Std	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Below Average	Average	Below Average	Average	Below Average	Below Average
John Deere Health Plan	$15	$15	$100	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Mercy Health Plans/Premier Health Plans - In-Network	$10	$20	None	$10	$20	$35	Above Average	Average	Above Average	Above Average	Above Average	Above Average
Mercy Health Plans/Premier Health Plans - Out-of-Network	30%	30%	30%	N/A	N/A	N/A
OSF HealthPlans	$20	$20	$500	$10	$20	$40	Above Average	Above Average	Above Average	Above Average	Average	Above Average
PersonalCare's HMO	$20	$20	$100/day X 5	$10	$20	$50	Above Average	Above Average	Above Average	Average	Above Average	Average
Unicare HMO	$15	$15	None	$5	$15	$25	Below Average	Below Average	Average	Average	Below Average	Below Average
Union Health Service	$10	$10	None	$15	$15	N/A

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Page 26   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Indiana
Advantage Health Plan, Inc. - Most of Indiana	800/553-8933	6Y1	6Y2	79.56	202.00	36.72	93.23	NCQA 6
Aetna Health Inc. - Southeastern Indiana	800/537-9384	RD1	RD2	75.82	204.47	34.99	94.37	NCQA 1
Arnett HMO - Lafayette Area	765/448-7440	G21	G22	75.73	246.90	34.95	113.95	NCQA 1
Health Alliance HMO - Fountain/Vermillion/Warren Counties	800/851-3379	FX1	FX2	90.89	224.02	41.95	103.39	NCQA 1
Humana Health Plan - Southern Indiana	888/393-6765	D21	D22	81.01	253.85	37.39	117.16	URAC 1
Humana Health Plan Inc.-High -Lake/Porter/LaPorte Counties	888/393-6765	751	752	72.86	174.76	33.63	80.66
Humana Health Plan Inc.-Std - Lake/Porter/LaPorte Counties	888/393-6765	754	755	55.31	132.65	25.53	61.22
M*Plan - Indiana Metropolitan Areas	317/571-5320	IN1	IN2	130.52	302.23	60.24	139.49	NCQA 1
Physicians Health Plan of Northern Indiana - Northeast Indiana	260/432-6690	DQ1	DQ2	70.16	157.67	32.38	72.77
Unicare HMO - Lake/Porter Counties	888/234-8855	171	172	66.20	217.91	30.55	100.57	NCQA 1
Iowa
Avera Health Plans - Northwestern Iowa	888/322-2115	AV1	AV2	64.01	149.49	29.54	68.99
Coventry Health Care of Iowa - Central Iowa/Cedar Rapids/Sioux City	800/257-4692	SV1	SV2	63.18	170.63	29.16	78.75
Health Alliance HMO - Central and Eastern Iowa	800/851-3379	FX1	FX2	90.89	224.02	41.95	103.39	NCQA 1
John Deere Health Plan - Central/Eastern Iowa	800/247-9110	YH1	YH2	67.26	164.78	31.04	76.05	NCQA 1
Kansas
Coventry Health Care of Kansas - Wichita/Salina Areas	800/664-9251	7W1	7W2	102.24	323.75	47.19	149.42
Coventry Health Care of Kansas - Kansas City - Kansas City Area	800/969-3343	HA1	HA2	61.74	159.29	28.49	73.52
Humana Health Plan, Inc.-High -Kansas City Area	888/393-6765	MS1	MS2	76.27	191.10	35.20	88.20	URAC 1
Humana Health Plan, Inc.-Std - Kansas City Area	888/393-6765	MS4	MS5	44.35	106.39	20.47	49.10	URAC 1
Preferred Plus of Kansas - S. Central Area	800/660-8114	VA1	VA2	79.86	301.54	36.86	139.17	JCAHO 2
Kentucky
Humana Health Plan - Louisville Area	888/393-6765	D21	D22	81.01	253.85	37.39	117.16	URAC 1
United Healthcare of Ohio, Inc. - Northern Kentucky	800/231-2918	3U1	3U2	148.46	345.33	68.52	159.38	NCQA 1

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Indiana
Advantage Health Plan, Inc.	$15	$30	$400	$10	$30	$50	Below Average	Average	Average	Average	Below Average	Below Average
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
Arnett HMO	$10	$10	None	$5	$15	$30	Above Average	Above Average	Above Average	Average	Above Average	Above Average
Health Alliance HMO	$15	$15	$100	$10	$20	$40	Above Average	Average	Above Average	Above Average	Above Average	Above Average
Humana Health Plan	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Average	Below Average	Below Average	Below Average	Average	Below Average
Humana Health Plan Inc.-High	$10	$20	$100/day x 3	$5/$15	$15/$35	25%	Below Average	Average	Below Average	Average	Below Average	Below Average
Humana Health Plan Inc.-Std	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Below Average	Average	Below Average	Average	Below Average	Below Average
M*Plan	$10	$15	$250	$5/$10	$15	$50	Average	Average	Above Average	Above Average	Average	Aaverage
Physicians Health Plan of Northern Indiana	$10	$10	20% of $2500	$5	$15	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Unicare HMO	$15	$15	None	$5	$15	$25	Below Average	Below Average	Average	Average	Below Average	Below Average
Iowa
Avera Health Plans	$10	$15	$100/dayx3	$10	$20	$35 or 50%
Coventry Health Care of Iowa	$10	$10	None	$5	$15	$30	Below Average	Above Average	Above Average	Average	Below Average	Average
Health Alliance HMO	$15	$15	$100	$10	$20	$40	Above Average	Average	Above Average	Above Average	Above Average	Above Average
John Deere Health Plan	$15	$15	$100	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Kansas
Coventry Health Care of Kansas	$15	$15	$100/day x 3	$5	$15	$45
Coventry Health Care of Kansas - Kansas City	$15	$15	$100/day x 3	$10	$20	$50	Below Average	Average	Average	Average	Below Average	Below Average
Humana Health Plan, Inc.-High	$10	$20	$100/day x 3	$5/$20	$20/$40	25%	Below Average	Average	Average	Below Average	Below Average	Below Average
Humana Health Plan, Inc.-Std	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Below Average	Average	Average	Below Average	Below Average	Below Average
Preferred Plus of Kansas	$10	$10	$50/day x 10	$5	$15	$15
Kentucky
Humana Health Plan	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Average	Below Average	Below Average	Below Average	Average	Below Average
United Healthcare of Ohio, Inc.	$15	$15	$250	$10	$15	$30	Average	Above Average	Above Average	Average	Average	Average

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Page 28   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Louisiana
Coventry Healthcare Louisiana - New Orleans Area	800/341-6613	BJ1	BJ2	70.36	163.39	32.47	75.41
Coventry Healthcare Louisiana - Baton Rouge Area	800/341-6613	JA1	JA2	74.16	172.24	34.23	79.49
Vantage Health Plan - Monroe Area	888/823-1910	AQ1	AQ2	95.07	349.57	43.88	161.34
Vantage Health Plan - Shreveport/Alexandria Areas	888/823-1910	MV1	MV2	114.94	402.94	53.05	185.97
Maryland
Aetna Health Inc.-High -North/Central/Southern Maryland	800/537-9384	JN1	JN2	76.61	172.55	35.36	79.64	NCQA 1
Aetna Health Inc.-Std - North/Central/Southern Maryland	800/537-9384	JN4	JN5	57.27	134.04	26.43	61.86	NCQA 1
CareFirst BlueChoice - All of Maryland	866/520-6099	2G1	2G2	111.39	242.58	51.41	111.96	NCQA 1
Kaiser Permanente - Baltimore/Washington, DC Areas	301/468-6000	E31	E32	66.75	158.86	30.81	73.32	NCQA 2
MD-IPA - All of Maryland	800/251-0956	JP1	JP2	75.18	181.03	34.70	83.55	NCQA 1
Massachusetts
Blue Chip, Coord Hlth Partners - Southeastern Massachusetts	401/459-5500	DA1	DA2	115.03	360.02	53.09	166.16	NCQA 1
ConnectiCare - Counties Hampden, Hampshire, Franklin	800/251-7722	TE1	TE2	72.95	223.28	33.67	103.05	NCQA 1
Fallon Community Health Plan - Central/Eastern Massachusetts	800/868-5200	JV1	JV2	76.54	245.99	35.32	113.53	NCQA 1

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Page 29   To Next Page   To Previous Page

Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Louisiana
Coventry Healthcare Louisiana	$15	$15	$100/day x 3	$10	$20	$45	Below Average	Below Average	Below Average	Average	Below Average	Below Average
Coventry Healthcare Louisiana	$15	$15	$100/day x 3	$10	$20	$45	Below Average	Below Average	Below Average	Average	Below Average	Below Average
Vantage Health Plan	$15	$15	$250	$10	$20	$35
Vantage Health Plan	$15	$15	$250	$10	$20	$35
Maryland
Aetna Health Inc.-High	$15	$20	$150/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
Aetna Health Inc.-Std	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
CareFirst BlueChoice	$20	$30	None	$10	$20	$35	Average	Average	Below Average	Below Average	Below Average	Below Average
Kaiser Permanente	$10	$20	$100	$10 $20Net	$10 $40Net	$20 $40Net	Average	Average	Average	Below Average	Above Average	Average
MD-IPA	$10	$20	None	$8	$17	$33	Above Average	Above Average	Average	Average	Above Average	Average
Massachusetts
Blue Chip, Coord Hlth Partners - In-Network	$15	$25	$500	$7	$25	$40	Average	Above Average	Above Average	Average	Average	Average
Blue Chip, Coord Hlth Partners Out-of-Network	30%	30%	None	$40 + 20%	$40 + 20%	$40 + 20%	Average	Above Average	Above Average	Average	Average	Average
ConnectiCare	$10	$10	None	$10	$20	$35
Fallon Community Health Plan	$10	$10	None	$5	$15	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Average

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Page 30   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Michigan
Bluecare Network of MI - Cheboygan and Roscommon Counties Area	800/662-6667	G71	G72	287.69	785.46	132.78	362.52	NCQA 1
Bluecare Network of MI - Midland County Area	800/662-6667	K51	K52	71.67	260.46	33.08	120.21	NCQA 1
Bluecare Network of MI - Kalamazoo County Area	800/662-6667	KF1	KF2	140.94	499.18	65.05	230.39	NCQA 1
Bluecare Network of MI - Genesee County Area	800/662-6667	KN1	KN2	76.64	316.01	35.37	145.85	NCQA 1
Bluecare Network of MI - Kent County Area	800/662-6667	KR1	KR2	79.54	372.89	36.71	172.10	NCQA 1
Bluecare Network of MI - Mid Michigan	800/662-6667	LN1	LN2	148.18	386.19	68.39	178.24	NCQA 1
Bluecare Network of MI - Southeast MI	800/662-6667	LX1	LX2	55.62	166.32	25.67	76.76	NCQA 1
Grand Valley Health Plan - Grand Rapids Area	616/949-2410	RL1	RL2	72.92	278.12	33.65	128.36	NCQA 1
Health Alliance Plan - Southeastern Michigan/Flint Area	800/422-4641	521	522	66.90	177.26	30.88	81.81	NCQA 1
HealthPlus MI - Flint/Saginaw Areas	800/332-9161	X51	X52	88.33	256.30	40.77	118.29	NCQA 1
M-Care - Mid and Southeastern Michigan	800/658-8878	EG1	EG2	64.54	171.05	29.79	78.95	NCQA 1
OmniCare - Southeastern Michigan	800/477-6664	KA1	KA2	65.08	160.10	30.04	73.89	NCQA 4
The Wellness Plan - Detroit/Flint Areas	800/875-9355	K31	K32	53.44	144.43	24.66	66.66
Total Health Care - Greater Detroit/Flint Areas	800/826-2862	N21	N22	64.19	163.26	29.62	75.35
Minnesota
Avera Health Plans - Southwestern Minnesota	888/322-2115	AV1	AV2	64.01	149.49	29.54	68.99
HealthPartners Classic - Minneapolis/St. Paul/St. Cloud Areas	952/883-5000	531	532	116.63	307.43	53.83	141.89	NCQA 1
HealthPartners Primary Clinic Plan - Minneapolis/St. Paul/St. Cloud Areas	952/883-5000	HQ1	HQ2	203.12	515.00	93.75	237.69

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Page 31   To Next Page   To Previous Page

Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Michigan
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Bluecare Network of MI	$15	$15	$250	$10	$20	$20	Average	Average	Above Average	Average	Average	Average
Grand Valley Health Plan	$10	$10	None	$5	$5	$5	Above Average	Average	Above Average	Average	Above Average	Average
Health Alliance Plan	$10	$10	None	$10	$20	$30	Average	Average	Average	Above Average	Average	Average
HealthPlus MI	$10	$10	None	$5	$10	$10	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
M-Care	$10	$10	None	$10	$20	$30	Above Average	Average	Average	Average	Above Average	Above Average
OmniCare	$10	$10	None	$2	$2	$2	Below Average	Below Average	Below Average	Average	Average	Below Average
The Wellness Plan	$10	$10	None	$5	$5	$5	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
Total Health Care	$10	Nothing	None	Nothing	Nothing	Nothing	Below Average	Below Average	Below Average	Below Average	Below Average	Average
Minnesota
Avera Health Plans	$10	$15	$100/dayx3	$10	$20	$35 or 50%
HealthPartners Classic	$15	$15	$100	$12	$12	$24	Average	Average	Average	Average	Average	Average
HealthPartners Primary	$20	$20	$200	$12	$12	$24	Average	Average	Average	Average	Average	Average

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Page 32   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Missouri
BlueCHOICE - StLouis/Central/SW Areas	800/634-4395	9G1	9G2	75.62	163.72	34.90	75.56	NCQA 1
Coventry Health Care of Kansas - Kansas City - Kansas City Area	800-969-3343	HA1	HA2	61.74	159.29	28.49	73.52
Group Health Plan - St. Louis Area	800/755-3901	MM1	MM2	123.15	236.69	56.84	109.24	URAC 1
Humana Health Plan, Inc.-High -Kansas City Area	888/393-6765	MS1	MS2	76.27	191.10	35.20	88.20	URAC 1
Humana Health Plan, Inc.-Std - Kansas City Area	888/393-6765	MS4	MS5	44.35	106.39	20.47	49.10	URAC 1
Mercy Health Plans/Premier Health Plans - East/Central;Southwest Missouri	800/327-0763 800/836-0402	7M1	7M2	140.70	337.29	64.94	155.67
Montana
New West Health Plan - Most of Montana	800/290-3657	NV1	NV2	72.14	160.53	33.29	74.09
Nevada
Health Plan of Nevada - Las Vegas/Reno Areas	800/777-1840	NM1	NM2	52.98	135.67	24.45	62.62	NCQA 3
PacifiCare Health Plans - Clark County	800/531-3341	K91	K92	67.43	183.35	31.12	84.62	NCQA 2
New Jersey
Aetna Health Inc. - All of New Jersey	800/537-9384	P31	P32	84.95	235.56	39.21	108.72	NCQA 1
AmeriHealth HMO - All of New Jersey	800/454-7651	FK1	FK2	82.27	219.66	37.97	101.38	NCQA 1
GHI Health Plan - Northern New Jersey	212/501-4444	801	802	128.59	372.63	59.35	171.98	URAC 1
New Mexico
Cimarron Health Plan - All of New Mexico	800/473-0391	PX1	PX2	70.66	202.46	32.61	93.44	NCQA 2
Lovelace Health Plan - All of New Mexico	800/244-6224	Q11	Q12	72.50	213.12	33.46	98.36	NCQA 2 JCAHO 1
Presbyterian Health Plan - All NM counties except Otero & S. Eddy	505/923-5678	P21	P22	67.23	175.33	31.03	80.92	NCQA 2

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Missouri
BlueCHOICE	$10	$10	None	$7	$12	$25	Average	Average	Above Average	Above Average	Average	Average
Coventry Health Care of Kansas - Kansas City	$15	$15	$100/day x 3	$10	$20	$50	Below Average	Average	Average	Average	Below Average	Below Average
Group Health Plan	$10	$20	$100	$8	$20	$35	Average	Average	Above Average	Average	Average	Average
Humana Health Plan, Inc.-High	$10	$20	$100/day x 3	$5/$20	$20/$40	25%	Below Average	Average	Average	Below Average	Below Average	Below Average
Humana Health Plan, Inc.-Std	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Below Average	Average	Average	Below Average	Below Average	Below Average
Mercy Health Plans/Premier - In-Network	$10	$20	None	$10	$20	$35	Above Average	Average	Average	Average	Above Average	Above Average
Mercy Health Plans/Premier - Out-of-Network	30%	30%	30%	N/A	N/A	N/A	Above Average	Average	Average	Average	Above Average	Above Average
Montana
New West Health Plan	$15	$15	$100	$10	$20	$20
Nevada
Health Plan of Nevada	$10	$10	$100	$5	$20	$35	Below Average	Below Average	Below Average	Below Average	Below Average	Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Below Average	Below Average	Below Average	Below Average	Below Average	Average
New Jersey
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
AmeriHealth HMO	$30	$35	$200/day x 3	$20	$40	50%	Below Average	Above Average	Average	Average	Average	Below Average
GHI Health Plan - In-Network	$15	$15	None	$10	$20	$50	Average	Above Average	Average	Average	Average	Average
GHI Health Plan - Out-of-Network	50% of sch.	50% of sch.	None	N/A	N/A	N/A	Average	Above Average	Average	Average	Average	Average
New Mexico
Cimarron Health Plan	$10	$10	None	$5	$10	$25	Average	Below Average	Below Average	Average	Average	Average
Lovelace Health Plan	$15	$25	$250	$7	$15	$35	Average	Average	Average	Average	Average	Average
Presbyterian Health Plan	$10	$10	None	$5	$15	$35	Average	Average	Below Average	Below Average	Average	Above Average

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Page 34   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
New York
Aetna Health Inc. - NYC Area and Dutchess/Sullivan/Ulster	800/537-9384	JC1	JC2	71.70	179.45	33.09	82.82	NCQA 1
Blue Choice - Rochester Area	800/462-0108	MK1	MK2	73.25	193.05	33.81	89.10	NCQA 2
Capital District Physicians Health Plan - Albany/Cooperstown Areas	518/641-3700	PW1	PW2	74.53	221.65	34.40	102.30	NCQA 1
Capital District Physicians Health Plan - Hudson Valley Area	518/641-3700	QB1	QB2	71.66	195.68	33.07	90.31	NCQA 1
Capital District Physicians Health Plan - Capital District Area	518/641-3700	SG1	SG2	69.71	178.47	32.17	82.37	NCQA 1
GHI Health Plan - All of New York	212/501-4444	801	802	128.59	372.63	59.35	171.98	URAC 1
GHI HMO Select - Brnx/Brklyn/Manhat/Queen/Richmon/Westche	877/244-4466	6V1	6V2	97.19	313.67	44.86	144.77	NCQA 6
GHI HMO Select - Capital/Hudson Valley Regions	877/244-4466	X41	X42	75.86	182.11	35.01	84.05	NCQA 6
HIP of Greater New York-High -New York City Area	800/HIP-TALK	511	512	72.80	275.97	33.60	127.37	NCQA 2
HIP of Greater New York-Std - New York City Area	800/HIP-TALK	514	515	58.23	163.05	26.87	75.25	NCQA 2
HMO Blue - Utica/Rome/Central New York Areas	800/722-7884	AH1	AH2	104.71	329.38	48.33	152.02	NCQA 1
HMO-CNY - Syracuse/Binghamton/Elmira Areas	800/828-2887	EB1	EB2	106.97	370.14	49.37	170.83	NCQA 1
Independent Health Assoc - Western New York	800/453-1910	QA1	QA2	54.88	152.21	25.33	70.25	NCQA 1
MVP Health Care - Eastern Region	888/687-6277	GA1	GA2	64.34	166.20	29.70	76.71	NCQA 2
MVP Health Care - Central Region	888/687-6277	M91	M92	69.36	179.15	32.01	82.68	NCQA 2
MVP Health Care - Mid-Hudson Region	888/687-6277	MX1	MX2	74.03	223.97	34.17	103.37	NCQA 2
Preferred Care - Rochester Area	800/950-3224	GV1	GV2	58.96	157.42	27.21	72.66	NCQA 1
Univera Healthcare - Western New York (Southern Counties)	716/847-0881	KQ1	KQ2	71.47	217.06	32.98	100.18
Univera Healthcare - Western New York	716/847-0881	Q81	Q82	60.14	170.53	27.76	78.70	NCQA 1
Vytra Health Plans - Queens/Nassau/Suffolk Counties	800/406-0806	J61	J62	75.61	251.86	34.90	116.24

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
New York
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Below Average	Average	Average
Blue Choice	$10	$10	None	$5	$15	$30	Above Average	Above Average	Above Average	Above Average	Average	Above Average
Capital District Physicians Health Plan	$10	$10	$100	$5	$20	$20	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Capital District Physicians Health Plan	$10	$10	$100	$5	$20	$20	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Capital District Physicians Health Plan	$10	$10	$100	$5	$20	$20	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
GHI Health Plan - In-Network	$15	$15	None	$10	$20	$50	Average	Above Average	Average	Average	Average	Average
GHI Health Plan - Out-of-Network	50% of sch.	50% of sch.	None	N/A	N/A	N/A	Average	Above Average	Average	Average	Average	Average
GHI HMO Select	$10	$10	None	$10	$20	$30	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
GHI HMO Select	$10	$10	None	$10	$20	$30	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
HIP of Greater New York-High	$10	$10	None	$10	$15	$40	Average	Average	Below Average	Average	Average	Below Average
HIP of Greater New York-Std	$10	$20	$500	$10	$20	$40	Average	Average	Below Average	Average	Average	Below Average
HMO Blue	$15	$15	$240	$10	$25	$40	Average	Above Average	Above Average	Above Average	Average	Average
HMO-CNY	$10	$10	None	$5	$20	$35	Below Average	Above Average	Above4 Average	Average	Below Average	Average
Independent Health Assoc	$15	$15	None	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
MVP Health Care	$15	$15	$240	$5	$20	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
MVP Health Care	$15	$15	$240	$5	$20	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
MVP Health Care	$15	$15	$240	$5	$20	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Preferred Care	$15	$15	None	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Univera Healthcare	$15	$15	$250	$5	$15	$35
Univera Healthcare	$15	$15	$250	$5	$15	$35	Average	Above Average	Above Average	Above Average	Average	Above Average
Vytra Health Plans	$10	$10	None	$5	$10	$10	Above Average	Above Average	Average	Average	Above Average	Average

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Page 36   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
North Dakota
Heart of America HMO - Northcentral North Dakota	701/776-5848	RU1	RU2	63.19	156.07	29.16	72.03
Ohio
Aetna Health Inc. - Cleveland Area	800/537-9384	7D1	7D2	75.69	188.35	34.93	86.93	NCQA 1
Aetna Health Inc. - Greater Cincinnati Area	800/537-9384	RD1	RD2	75.82	204.47	34.99	94.37	NCQA 1
AultCare HMO - Stark/Carroll/Holmes/Tuscarawas/Wayne Co	330/438-6360	3A1	3A2	89.09	284.55	41.12	131.33
Blue HMO - Most of Ohio	800/228-4375	R51	R52	86.23	261.54	39.80	120.71	NCQA 1
Health Plan of the Upper Ohio Valley-High -Eastern Ohio	800/624-6961	U41	U42	86.86	349.29	40.09	161.21	NCQA 1
Health Plan of the Upper Ohio Valley-Std - Eastern Ohio	800/624-6961	U44	U45	75.19	286.31	34.70	132.14	NCQA 1
HMO Health Ohio - Northeast Ohio	800/522-2066	L41	L42	72.41	200.07	33.42	92.34	NCQA 1
Kaiser Permanente - Cleveland/Akron Areas	800/686-7100	641	642	74.21	187.55	34.25	86.56	NCQA 1
Paramount Health Care - Northwest/North Central Ohio	800/462-3589	U21	U22	75.94	263.41	35.05	121.57	NCQA 2
SummaCare Health Plan - Cleveland, Akron Areas	330/996-8700	5W1	5W2	71.83	249.26	33.15	115.04	NCQA 1
SuperMed HMO - Northeast Ohio	800/522-2066	5M1	5M2	98.15	315.97	45.30	145.83	NCQA 1
United Healthcare of Ohio, Inc. - Cincinnati/Dayton/Springfield Areas	800/231-2918	3U1	3U2	148.46	345.33	68.52	159.38	NCQA 1
Oklahoma
PacifiCare Health Plans - Central/Northeastern Oklahoma	800/531-3341	2N1	2N2	84.45	270.88	38.98	125.02	NCQA 1
Oregon
Kaiser Permanente-High -Portland/Salem Areas	800/813-2000	571	572	95.33	221.42	44.00	102.19	NCQA 1
Kaiser Permanente-Std - Portland/Salem Areas	800/813-2000	574	575	74.24	170.39	34.26	78.64	NCQA 1
PacifiCare Health Plans - Metro Portland/Salem/Corvalis/Eugene	800/531-3341	7Z1	7Z2	114.35	237.21	52.78	109.48	NCQA 1

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
North Dakota
Heart of America HMO	$10	Nothing	None	50%	50%	50%
Ohio
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
AultCare HMO	$10	$10	None	$5	$10	$10	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Blue HMO	$10	$10	None	$10	$20	$30	Average	Average	Above Average	Average	Average	Average
Health Plan of the Upper Ohio Valley-High	$10	$10	None	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Health Plan of the Upper Ohio Valley-Std	$10	$20	None	$15	$30	$50	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
HMO Health Ohio	$10	$10	None	$10	$20	$20	Average	Average	Average	Average	Below Average	Below Average
Kaiser Permanente	$10	$10	None	$5	$15	$15	Above Average	Above Average	Average	Average	Above Average	Average
Paramount Health Care	$10	$20	$300	$5	$15	$25	Above Average	Above Average	Average	Average	Above Average	Above Average
SummaCare Health Plan	$10	$10	None	$8	$15	$30	Above Average	Above Average	Above Average	Above Average	Above Average	Below Average
SuperMed HMO	$10	$10	None	$10	$20	$20	Average	Average	Average	Average	Below Average	Below Average
United Healthcare of Ohio, Inc.	$15	$15	$250	$10	$15	$30	Average	Above Average	Above Average	Average	Average	Average
Oklahoma
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Average	Below Average	Below Average	Average	Below Average	Above Average
Oregon
Kaiser Permanente-High	$10	$10	None	$10	$20	$20	Average	Average	Below Average	Below Average	Above Average	Average
Kaiser Permanente-Std	$15	$15	None	$15	$30	$30	Average	Average	Below Average	Below Average	Above Average	Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Below Average	Below Average	Average	Average	Below Average	Average

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Page 38   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Pennsylvania
Aetna Health Inc. - Philadelphia and Southeastern PA	800/537-9384	P31	P32	84.95	235.56	39.21	108.72	NCQA 1
Health Net of Pennsylvania - Scranton/Wilkes Barre Areas	877/747-9585	2K1	2K2	80.58	238.08	37.19	109.88
HealthAmerica Pennsylvania - Greater Pittsburgh Area	800/735-4404	261	262	74.22	231.10	34.26	106.66	NCQA 1
HealthAmerica Pennsylvania - Central Pennsylvania	800/788-8445	SW1	SW2	76.82	258.12	35.45	119.13	NCQA 1
HealthGuard - Berks/Cmbrlnd/Dauphine/Lanc/Lebanon/York	800/822-0350	NQ1	NQ2	65.43	170.43	30.20	78.66	NCQA 1
Keystone Health Plan Central - Harrisburg/Northern Region/Lehigh Valley	800/622-2843	S41	S42	101.64	278.94	46.91	128.74	NCQA 1
Keystone Health Plan East - Philadelphia Area	800/227-3115	ED1	ED2	80.88	296.99	37.33	137.07	NCQA 1
UPMC Health Plan - Western Pennsylvania Area	888/876-2756	8W1	8W2	75.24	226.79	34.72	104.67
Puerto Rico
Humana Health Plans of Puerto Rico - Puerto Rico	800/314-3121	ZJ1	ZJ2	41.12	94.57	18.98	43.65
Triple-S - All of Puerto Rico	787/749-4777	891	892	51.84	111.34	23.92	51.39
Rhode Island
Blue Chip, Coord Hlth Partners - All of Rhode Island	401/459-5500	DA1	DA2	115.03	360.02	53.09	166.16	NCQA 1
South Dakota
Avera Health Plans - Eastern and Central South Dakota	888/322-2115	AV1	AV2	64.01	149.49	29.54	68.99
Sioux Valley Health Plan - Eastern/Central/Rapid City Areas	800/752-5863	AU1	AU2	125.21	288.21	57.79	133.02	NCQA 6 JCAHO 1

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Page 39   To Next Page   To Previous Page

Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Pennsylvania
Aetna Health Inc.	$20	$25	$250/day 3	$10	$25	$40	Average	Above Average	Above Average	Average	Average	Average
Health Net of Pennsylvania	$10	$10	None	$10	$20	$35	Below Average	Average	Above Average	Above Average	Below Average	Below Average
HealthAmerica Pennsylvania	$10	$15	None	$8	$14	$35	Above Average	Above Average	Above Average	Above Average	Average	Above Average
HealthAmerica Pennsylvania	$10	$15	None	$8	$14	$35	Above Average	Above Average	Above Average	Above Average	Average	Above Average
HealthGuard	$10	$20	None	$10	$25	$40	Above Average	Above Average	Above Average	Average	Average	Above Average
Keystone Health Plan Central	$10	$10	None	$10	$25	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Keystone Health Plan East	$10	$15	None	$5	$15	$25	Below Average	Above Average	Average	Average	Average	Average
UPMC Health Plan	$10	$10	None	$5	$15	$35	Average	Above Average	Average	Average	Average	Average
Puerto Rico
Humana Health Plans of Puerto Rico- In-Network	$5	$5	None	$2.50	$5	$5
Humana Health Plans of Puerto Rico - Out-of-Network	$8	$8	$50	N/A	N/A	N/A
Triple-S - In-Network	$7.50	$10	None	$2	$5/$10	$10 or 20%	Above Average	Above Average	Below Average	Above Average	Average	Average
Triple-S - Out-of-Network	$7.50 + 10%	$10 + 10%	None	25%	25%	25%	Above Average	Above Average	Below Average	Above Average	Average	Average
Rhode Island
Blue Chip, Coord Hlth Partners - In-Network	$15	$25	$500	$7	$25	$40	Average	Above Average	Above Average	Average	Average	Average
Blue Chip, Coord Hlth Partners - Out-of-Network	30%	30%	None	$40 + 20%$40	+ 20%	$40 + 20%	Average	Above Average	Above Average	Average	Average	Average
South Dakota
Avera Health Plans	$10	$15	$100/dayx3	$10	$20	$35 or 50%
Sioux Valley Health Plan - In-Network	$20	$20	$100	$10	$20	$35	Below Average	Above Average	Above Average	Above Average	Average	Average
Sioux Valley Health Plan - Out-of-Network	40%	40%	40%	N/A	N/A	N/A	Below Average	Above Average	Above Average	Above Average	Average	Average

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Page 40   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Tennessee
Aetna Health Inc. - Nashville/Middle Tennessee Areas	800/537-9384	6J1	6J2	64.08	173.55	29.57	80.10	NCQA 1
Aetna Health Inc. - Memphis Area	800/537-9384	UB1	UB2	69.75	205.71	32.19	94.94	NCQA 1
HealthSpring-High -Nashville/Middle Tennessee Area	615/291-5030	6K1	6K2	84.48	354.54	38.99	163.63
HealthSpring-Std - Nashville/Middle Tennessee Area	615/291-5030	6K4	6K5	67.05	206.57	30.95	95.34
Texas
Amcare Health Plans - Houston/El Paso Areas	800/782-8373	2V1	2V2	74.84	237.56	34.54	109.64	NCQA 6
Amcare Health Plans - Austin/San Antonio/Dallas/Ft Worth Areas	800/782-8373	ZG1	ZG2	64.23	167.01	29.64	77.08	NCQA 6
FIRSTCARE - Waco Area	800/884-4901	6U1	6U2	66.92	143.76	30.89	66.35
FIRSTCARE - West Texas	800/884-4901	CK1	CK2	145.62	280.61	67.21	129.51
HMO Blue Texas - Houston	800/833-5318	YM1	YM2	75.01	193.66	34.62	89.38	NCQA 2
Humana Health Plan of Texas-High -San Antonio Area	888/393-6765	UR1	UR2	72.46	204.19	33.44	94.24
Humana Health Plan of Texas-Std - San Antonio Area	888/393-6765	UR4	UR5	58.26	149.74	26.89	69.11
Mercy Health Plans/Premier Health Plans - Webb/Zapata/Duval/Jim Hogg Counties	800/617-3433	HM1	HM2	140.42	402.29	64.81	185.67
PacifiCare Health Plans - San Antonio/Dallas/Ft Worth	800/531-3341	GF1	GF2	77.51	264.79	35.77	122.21	NCQA 2
Utah
Altius Health Plans - Wasatch Front	800/377-4161	9K1	9K2	116.26	235.95	53.66	108.90

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Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Tennessee
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Below Average	Below Average	Average	Average	Average	Below Average
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Below Average	Below Average	Average	Average	Average	Below Average
HealthSpring-High	$15	$25	$250	$10	$20	$35
HealthSpring-Std	$20	$20	$250	$10	$20	50%
Texas
Amcare Health Plans	$10	$10	None	$5	$15	50%	Below Average	Below Average	Below Average	Average	Below Average	Below Average
Amcare Health Plans	$10	$10	None	$5	$15	50%	Below Average	Below Average	Below Average	Average	Below Average	Below Average
FIRSTCARE	$15	$25	$100	$10	$20	$40	Average	Average	Average	Above Average	Above Average	Average
FIRSTCARE	$15	$25	$100	$10	$20	$40	Average	Above Average	Average	Above Average	Above Average	Above Average
HMO Blue Texas	$20	$20	$100/dayx4	$10	$25	$40	Below Average	Below Average	Below Average	Below Average	Below Average	Below Average
Humana Health Plan of Texas-High	$10	$20	$100/day x 3	$5/$20	$20/$40	25%	Average	Below Average	Below Average	Below Average	Average	Average
Humana Health Plan of Texas-Std	$15	$25	$250/day x 3	$10/$25	$25/$45	25%	Average	Below Average	Below Average	Below Average	Average	Average
Mercy Health Plans/Premier - In-Network	$10	$10	None	$7	$12	$25	Above Average	Average	Below Average	Above Average	Average	Average
Mercy Health Plans/Premier - Out-of-Network	40%	40%	40%	N/A	N/A	N/A
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Below Average	Below Average	Below Average	Average	Below Average	Below Average
Utah
Altius Health Plans	$10	$15	None	$10	$20	$40	Average	Average	Average	Average	Below Average	Below Average

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Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
Vermont
MVP Health Care - All of Vermont	888/687-6277	VW1	VW2	145.29	446.06	67.06	205.87	NCQA 2
Virginia
Aetna Health Inc.-High -N.VA/Fredericksburg Areas	800/537-9384	JN1	JN2	76.61	172.55	35.36	79.64	NCQA 1
Aetna Health Inc.-Std - N.VA/Fredericksburg Areas	800/537-9384	JN4	JN5	57.27	134.04	26.43	61.86	NCQA 1
CareFirst BlueChoice - Northern Virginia	866/520-6099	2G1	2G2	111.39	242.58	51.41	111.96	NCQA 1
Kaiser Permanente - Washington, DC Area	301/468-6000	E31	E32	66.75	158.86	30.81	73.32	NCQA 2
MD-IPA - N.VA/Cntrl VA/Richmond/Tidewater/Roanoke	800/251-0956	JP1	JP2	75.18	181.03	34.70	83.55	NCQA 1
Optima Health Plan - Peninsula/Southside Hampton Roads	800/206-1060	9R1	9R2	113.96	289.17	52.60	133.46	NCQA 1
Piedmont Community Healthcare - Lynchburg Area	888/674-3368	2C1	2C2	111.71	257.27	51.56	118.74
Washington
Aetna Health Inc. - Western/Southeast Washington	800-537-9384	8J1	8J2	68.21	173.46	31.48	80.06
Group Health Cooperative - Most of Western Washington	888/901-4636	541	542	95.74	209.95	44.19	96.90	NCQA 1
Group Health Cooperative - Central WA/Spokane/Pullman	888/901-4636	VR1	VR2	78.52	265.85	36.24	122.70	NCQA 1
Kaiser Permanente-High -Vancouver/Longview	800/813-2000	571	572	95.33	221.42	44.00	102.19	NCQA 1
Kaiser Permanente-Std - Vancouver/Longview	800/813-2000	574	575	74.24	170.39	34.26	78.64	NCQA 1
KPS Health Plans-High -Most of Western Washington	800/552-7114	VT1	VT2	245.57	490.99	113.34	226.61
KPS Health Plans-Std - Most of Western Washington	800/552-7114	VT4	VT5	102.24	200.03	47.19	92.32
PacifiCare Health Plans - Clark County	800/531-3341	7Z1	7Z2	114.35	237.21	52.78	109.48	NCQA 1
PacifiCare Health Plans - Puget Sound/Most West WA	800/531-3341	WB1	WB2	82.35	219.42	38.01	101.27	NCQA 1

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Page 43   To Next Page   To Previous Page

Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See pages 2 and 6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
Vermont
MVP Health Care	$15	$15	$240	$5	$20	$40	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Virginia
Aetna Health Inc.-High	$15	$20	$150/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
Aetna Health Inc.-Std	$20	$25	$250/day x 3	$10	$25	$40	Average	Average	Average	Average	Average	Average
CareFirst BlueChoice	$20	$30	None	$10	$20	$35	Average	Average	Below Average	Below Average	Below Average	Below Average
Kaiser Permanente	$10	$20	$100	$10 $20 Net	$20 $40 Net	$20 $40 Net	Average	Average	Average	Below Average	Above Average	Average
MD-IPA	$10	$20	None	$8	$17	$33	Above Average	Above Average	Average	Average	Above Average	Average
Optima Health Plan	$10	$20	$250	$10	$20	$40	Average	Above Average	Average	Average	Above Average	Above Average
Piedmont Community Healthcare - In-Network	$20	$20	None	$10	$20	$20
Piedmont Community Healthcare - Out-of-Network	40%	30%	None	$10	$20	$20
Washington
Aetna Health Inc.	$20	$25	$250/day x 3	$10	$25	$40	Below Average	Below Average	Average	Average	Below Average	Average
Group Health Cooperative	$15	$15	$200/day x 3	$15	$25	$50	Average	Average	Above Average	Average	Above Average	Above Average
Group Health Cooperative	$15	$15	$200/day x 3	$15	$25	$50	Average	Average	Above Average	Average	Above Average	Above Average
Kaiser Permanente-High	$10	$10	None	$10	$20	$20	Average	Average	Below Average	Below Average	Above Average	Average
Kaiser Permanente-Std	$15	$15	None	$15	$30	$30	Average	Average	Below Average	Below Average	Above Average	Average
KPS Health Plans-High	$10	$10	$100/day x 10	$5	50%	50%	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
KPS Health Plans-Std	$20	$20	None	$5	$20	$100 or 50%	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Average	Below Average	Average	Average	Average	Average
PacifiCare Health Plans	$10	$20	None	$10	$20	$20	Average	Below Average	Average	Average	Average	Average

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Page 44   To Next Page   To Previous Page

Health Maintenance Organization (HMO) and Point of Service (POS) Plans

How to read this chart: The table below highlights selected features that may help you narrow your choice of health plans. Always consult plan brochures before making your final decision. This chart does not show all of your possible out-of-pocket costs.

The Premium shown is not for part-time employees. See your human resources office for details.

Primary Care Doctor Office shows what you pay for each office visit to your primary care doctor.

Specialist Office Copay shows what you pay for each office visit to a specialist. Contact your plan to find out what providers it considers specialists. Hospital per Stay Deductible/Copay is the amount you pay when you are admitted into a hospital.

Plan name - location	Telephone number	Enrollment code		Your share of premium				Accredited
				Monthly		Biweekly
		Self only	Self & family	Self only	Self & family	Self only	Self & family
West Virginia
Health Plan of the Upper Ohio Valley-High -Northern/Central West Virginia	800/624-6961	U41	U42	86.86	349.29	40.09	161.21	NCQA 1
Health Plan of the Upper Ohio Valley-Std - Northern/Central West Virginia	800/624-6961	U44	U45	75.19	286.31	34.70	132.14	NCQA 1
Wisconsin
Dean Health Plan - South Central Wisconsin	800/279-1301	WD1	WD2	68.89	203.11	31.79	93.74	NCQA 1
Group Health Cooperative - South Central Wisconsin	608/251-3356	WJ1	WJ2	70.57	216.24	32.57	99.80	NCQA 1
Group Health Cooperative/Eau Claire - West Central Wisconsin	715/552-4300	WT1	WT2	161.78	487.07	74.67	224.80
HealthPartners Classic - West Central Wisconsin	952/883-5000	531	532	116.63	307.43	53.83	141.89	NCQA 1
HealthPartners Primary Clinic Plan - West Central Wisconsin	952/883-5000	HQ1	HQ2	203.12	515.00	93.75	237.69
Wyoming
WINhealth Partners - Wyoming	307/638-7700	PV1	PV2	66.95	188.27	30.90	86.89

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Page 45   

To Previous Page

Prescription drugs - Generic, Brand Name, and Non-formulary shows what you pay for prescriptions when you use a plan pharmacy. Non-formulary refers to prescriptions that are not on the plan's preferred list. Some plans charge different amounts for some drugs and for mail orders. In many plans, if you get the brand name instead of the generic drug, you also pay the difference between the two.

Member Survey Results - See

page 1 for a description.

Accredited - The National Committee for Quality Assurance (N); the Joint Commission on Accreditation of Healthcare Organizations (J); and/or URAC (U). See

pages 2 and

6 for details. A lower number means a better accreditation.

Plan name	Primary care doctor office copay	Specialist office copay	Hospital per stay deductible/copay	Prescription drugs			Member Survey Results
				Generic	Brand Name	Non- formulary	Overall plan satisfactioni	Getting needed care	Getting care quickly	How well doctors communicate	Customer service	Claims processing
West Virginia
Health Plan of the Upper Ohio Valley-High	$10	$10	None	$10	$20	$35	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Health Plan of the Upper Ohio Valley-Std	$10	$20	None	$15	$30	$50	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
Wisconsin
Dean Health Plan	$10	$10	None	$10	30% to 1500	N/A	Above Average	Above Average	Above Average	Average	Above Average	Above Average
Group Health Cooperative	$20	$20	None	$6	$12	$12	Above Average	Above Average	Above Average	Average	Above Average	Above Average
Group Health Cooperative/Eau Claire	$10	$10	None	$10	$20	$20	Above Average	Above Average	Above Average	Above Average	Above Average	Above Average
HealthPartners Classic	$15	$15	$100	$12	$12	$24	Average	Average	Average	Average	Average	Average
HealthPartners Primary	$20	$20	$200	$12	$12	$24	Average	Average	Average	Average	Average	Average
Wyoming
WINhealth Partners	$10	$10	None	$10	$15	$40