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Plan Profile

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General Information
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Plan Name: GHI Health Plan
Service Area: Northern New Jersey
Brochure: PDF Version
Brochure: Text Version
NCQA Accreditation: No
JCAHO Accreditation: No
URAC Accreditation: No
Plan Type: POS
Enrollment Code-Self: 801
Enrollment Code-Self & Family: 802
Link to Plan Home Page: http://www.ghi.com
Telephone: 212/501-4444
Summary results of the 2001 consumers assessment of health plans survey
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Benefits
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In Network - Doctor Care/ Primary Office Visits: 50% of sch.
In Network - Hospital Inpatient Room and Board Charges: None
In Network - RX/ Generic/ Retail: N/A
In Network - RX/ Brand/ Retail: N/A
In Network - RX/ Brand/ NonFormulary: N/A
Out of Network - Doctor Care/ Primary Office Visits: 50% of sch.
Out of Network - Hospital Inpatient Room and Board Charges: None
Out of Network - RX/ Generic/ Retail: N/A
Out of Network - RX/ Brand/ Retail: N/A
Out of Network - RX/ Brand/ NonFormulary: N/A
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Rates
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Non-Postal
___Twice Biweekly Self: $92.56 Self: & Family: $273.86
___Biweekly Self: $46.28 Self: & Family: $136.93
___Monthly Self: $100.27 Self: & Family: $296.68
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Annuitants
___Monthly Self: $100.27 Self: & Family: $296.68
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U.S. Postal Service Employees (Type A)
___Monthly Self: $62.01 Self: & Family: $209.28
___Biweekly Self: $28.62 Self: & Family: $96.59
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U.S. Postal Service Employees (Type B)
___Biweekly Self: $34.91 Self: & Family: $125.20
___Monthly Self: $75.63 Self: & Family: $271.27
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Worker's Compensation Recipients
___Twice Biweekly Self: $92.56 Self: & Family: $273.86
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Certain Temporary Employees
___Biweekly Self: $144.14 Self: & Family: $360.34
___Monthly Self: $312.30 Self: & Family: $780.74
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Former Spouse Enrollees
___Monthly Self: $312.30 Self: & Family: $780.74
___Biweekly Self: $144.14 Self: & Family: $360.34
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Temporary Continuation of Coverage
___Biweekly Self: $147.02 Self: & Family: $367.55
___Monthly Self: $318.55 Self: & Family: $796.35
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FDIC
___Biweekly Self: $28.62 Self: & Family: $96.59
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