Here are the 12/1 rates again thanks rick 6172937772
Tufts Health Plan
Benefit Summary
Monthly Premium
Company
Plan Name
Office Visit
In Patient
Out Patient Rx
ER Room
*Ind
*Family
Total
HMO
Premium with Rx
$10
$0
$10/25/45
$50
$615.00
$0.00
$1,230.00
Value with Rx
$15
(a)$350
$510.00
$1,020.00
Value no Rx
none
$435.00
$870.00
Basic 20 with Rx
$20
(a)$500
$10/30/45
$75
$489.00
$978.00
Basic 25 with Rx
$25
(a)$600
**$10/30/45
$465.00
$930.00
Basic 25 no Rx
$403.00
$806.00
Basic 35 with Rx
$35
(a)$1000
$100
$447.00
$894.00
Basic 50 with Rx
***$10/30/45
$200
$421.00
$842.00
Advantage HMO 1000 with Rx
$1000/2000 deductible
$445.00
$890.00
Advantage HMO 1000 no Rx
$389.00
$778.00
Advantage HMO 2000 no Rx
$2000/4000 deductible
$362.00
$724.00
PPO
Advantage PPO with Rx
$479.00
$958.00
*Rates include an NBT administrative fee
**($100 Individual deductible, $200 Family deductible then co-payments)
(a) Per hospital admission
***($250 Individual deductible, $500 Family deductible then co-payments)
(b)(Most In-Network benefits $25) (Some In-Network benefits at 100% after Plan Deductibles [ i.e. Therapeutic procedures, Diagnostic X-Rays, Lab Tests])
(c)($1000 Ind. and $2000 Family Plan deductible) (80% Out-of-Network coverage after Plan deductible) ($2000 Ind. and $4000 Family Calendar year Out-of-pocket Maximums)
(d) $1000 Ind. and $2000 Family Plan deductible
(e) $2000 Ind. and $4000 Family Plan deductible
provides:
Rates apply if enrolled on 12/1/2006 and will renew on 4/1/2007
Harvard Pilgrim Health Care
Premier with Rx
$10/25/40
$613.20
$1,226.40
***$250
$530.68
$1,061.36
$459.12
$918.24
Affordable with Rx
***$500
$497.48
$994.96
Affordable no Rx
$425.92
$851.84
Affordable 25 with Rx
***$1000
$15/30/50
$460.92
$921.84
Affordable 25 no Rx
$398.09
$796.18
Best Buy 500 with Rx
**$500 deductible
$100 after ded
$476.49
$952.98
Best Buy 500 no Rx
$404.93
$809.86
Best Buy 1000 with Rx
**$1000 deductible
$448.17
$896.34
Best Buy 1000 no Rx
$376.61
$753.22
Best Buy 2000 with Rx
**$2000 deductible
$420.83
$841.66
Best Buy 2000 no Rx
$349.27
$698.54
Best Buy HSA 1500 (GJ)
**$1500/3000 deductible
(a) 10/25/40
subject to deductible
$406.23
$812.46
Best Buy HSA 1500 (GM)
(b)$1500/3000 deductible
(b)subject to deductible
$395.40
$790.80
Best Buy HSA 2000 (GK)
**$2000/4000 deductible
$382.68
$765.36
Best Buy HSA 2000 (GN)
(b)$2000/4000 deductible
$366.72
$733.44
Best Buy HSA 3000 (GL)
**$3000/6000 deductible
$368.27
$736.54
Best Buy HSA 3000 (GO)
(b)$3000/6000 deductible
$352.87
$705.74
**Covered in full after calender year deductible
***Per admission
(a) Rx copay after deductible
(b) coinsurance of 80/20 after deductible
This proposal does not constitute a guarantee of benefits, coverage, or rates. Final rates are based on actual enrollment.
Neighborhood Health Plan
2 Tier Rates
NHP Care Classic (Classic)
$5/10/25
$357.06
$714.12
NHP Care 5 (Option 1)
$5
$352.41
$704.82
NHP Care 10 (Option 2)
(a)$50/day
$10/15/30
$336.24
$672.48
NHP Care 15 (Value)
(b)$200
$10/20/40
$323.31
$646.62
NHP Care 20/75
(c)$250/admission
$317.48
$634.96
NHP Care 20/100
(d)$500/admission
$314.19
$628.38
NHP Care 25
(e)$1000/admission
$307.75
$615.50
NHP Care 1000
**$10/20/40
$295.14
$590.28
NHP Care 10/75 (Option3)
(f)$100/day
$282.13
$564.26
3 Tier Rates
*2 Person
(a)$250 max per person per admission
(b)$800 max per person per calendar year
(c)$1000 max per person per calendar year
(d)$1000 max per person per calendar year
(e)$2000 max per person per calendar year
(f)$500 max per person per admission
(g) $1000 Ind. and $2000 Family Plan deductible
**$100 Individual deductible, $200 Family deductible then co-payments
Fallon Select Care HMO Health Plan
Standard w/Rx
$424.00
$848.00
Standard no/Rx
$368.00
$736.00
Premium Saver w/Rx
(b)$250
$10/25/50
$398.00
$796.00
Premium Saver no/Rx
$344.00
$688.00
Premium Saver Value RX
(e)$20/35
(b)$500
$386.00
$772.00
Premium Saver Basic RX
(e)$25/40
(b)$1000 copayment
$370.00
$740.00
Premium Saver 500 w/Rx
(h)$500/1000 deductible
Premium Saver 1000 w/Rx
(h)$1000/2000 deductible
$338.00
$676.00
Care Choice $1250
(h)$1250/2500 deductible
(i)$10/25/50
subject to ded
$322.00
$644.00
Care Choice $2000
(h)$2000/4000 deductible
$294.00
$588.00
(a)$100 Ind/$200 Fam deductible
(b)Per admission
(e) primary care/specialty care
(h) covered in full after deductible
(i) Rx copay after deductible
Fallon Preferred Care PPO Health Plan
In Network
Out Network
Preferred Care w/Rx
(k)$300/600 deductible
$10/20/45
$556.00
$1,112.00
Preferred Care 500 w/Rx
(m)$500/1000 deductible
(g)$500/1000
$488.00
$976.00
*Rates include an NBT administrative fee (b)Per admission
(g) coinsurance of 90/10 after deductible (h) covered in full after deductible
(k) coinsurance of 80/20 after deductible
(m) coinsurance of 70/30 after deductible
Fallon Direct Care HMO Health Plan
$372.00
$744.00
$324.00
$648.00
$350.00
$700.00
$304.00
$608.00
$340.00
$680.00
$326.00
$652.00
$318.00
$636.00
$298.00
$596.00
(g)$20
$284.00
$568.00
$258.00
$516.00