just keeps getting better by pushing the envelope.
That’s how the NALC
Health Benefit Plan works to
keep letter carriers and their families healthy—each year, the Plan seeks to
make changes that keep up with the latest medical advances and keep your
The Plan has been pushing the envelope since it was created, by letter
carriers, for letter carriers, in 1950. Since then, the Plan has never
stopped providing the high level of service you expect from a plan that
works not for a profit, but for its members. The Health Plan’s director,
Brian Hellman, is a member of New York City Branch 36 and has been a letter
carrier since 1982, and he assures that the Health Benefit Plan keeps your
health at the top of its list of priorities.
Open Season for choosing a health plan through the Federal Employee Health
Benefits (FEHB) Program is Nov. 14 through Dec. 12. Whether
you are starting your career, have a few years of carrying the mail under
your belt, or have retired, please take a few minutes to look at the special
NALC Health Benefit Plan insert in the November issue of The
“Our health care plan never stops looking for better ways to provide the
best care at a great price,” NALC President Fredric Rolando said. “Medicine
is advancing and so are we.”
The Plan offers a comprehensive High Option health benefit package, a
fee-for-service plan with a preferred provider (PPO) network that offers
generous benefits with low out-of-pocket costs. In partnership with Cigna,
the Plan is able to offer access to nearly 2.5 million doctors and
specialists and thousands of medical facilities. Chances are your doctor
already is part of the network, but to make sure, call the Plan at
The High Option Plan pays for a wide variety of preventive care treatments
and tests for adults and children at 100 percent when you use a PPO
provider. You pay only a $20 co-payment for each primary care or specialist
office visit when the services are rendered by a PPO provider. The
calendar-year deductible for the High Option Plan is $300 per person and
$600 per family.
Prescription medication is also covered under the High Option Plan at
reasonable rates. For generics bought from a network retail pharmacy, you
pay just 20 percent of the cost; when ordering by mail, you pay $8 for up to
a 60-day supply or between $5 and $12 for a 90-day supply. You pay just 30
percent for formulary brand drugs at a retail network pharmacy, $43 for up
to a 60-day supply by mail and $65 for up to a 90-day supply by mail.
Non-formulary and specialty drugs have different rates; see the Plan
brochure for more information.
If Medicare is your primary payor, the High Option Plan also offers great
benefits. Signing up for the NALC Health Benefit Plan in addition to your
Medicare Parts A and B coverage is a good way to assure that you won’t be
surprised by unexpected costs. The Plan pays for most out-of-pocket medical
costs that Medicare doesn’t—deductibles, co-payments and co-insurance
charges—for doctor visits, procedures and hospitalization. It also gives
Medicare recipients access to lower out-of-pocket costs for prescription
With the Health Benefit Plan, you also get access to a wealth of programs to
help you maintain or improve your health outside the doctor’s office. They
include the Health Assessment, an online tool that analyzes your
health-related responses and gives you a personalized plan to achieve your
specific health goals; the Quit for Life smoking cessation program; the
Weight Talk weight-loss coaching program; Your Health First disease
management program, with personalized medical care programs for people with
chronic illnesses; and the Healthy Rewards discount program for savings of
up to 60 percent on vision and hearing care, fitness clubs and other
The Consumer Driven Health Plan (CDHP) and the Value Option Plan are
alternatives to the High Option Plan.
Carriers who choose the CDHP or the Value Option Plan are provided a
personal care account (PCA). A PCA allows the member to control medical
costs while enjoying the protection of an affordable health plan that will
cover major medical costs if they arise. The Health Benefit Plan adds money
to each enrollee’s PCA each year to pay for medical costs, including
medication, and uses the same PPO network as the High Option Plan.
For instance, if you go to an in-network doctor who charges $50 for the
visit, the doctor will submit your claim to the Plan and $50 will be
deducted from your PCA. You pay nothing. If there is money left over in a
PCA at the end of the year, it is carried over to the next year (subject to
On the other hand, if you use all of the funds in a PCA, further medical
expenses are covered just as they are under a traditional insurance plan,
including a deductible that you pay out of your pocket. The maximum annual
amount you pay out of pocket (when you use In-Network providers), including
deductibles, co-payments, etc., is $6,600 for Self Only enrollment and
$13,200 for Self and Family. Some costs are excluded from these limits.
The annual amount added to a CDHP PCA is $1,200 for Self Only enrollment or
$2,400 for Self Plus One or Self and Family enrollment. For the Value
Option, the PCA amount is $100 for Self Only and $200 for Self Plus One or
Self and Family.
Both the CDHP and the Value Option Plan include a wide range of benefits,
including 100 percent coverage of preventive care when rendered by a PPO
provider. They also use the same PPO network—Cigna HealthCare’s Cigna Open
Access Plus PPO—as the High Option Plan, and both provide access to
in-network pharmacies through the prescription benefit manager CVS/caremark.
These great benefits come at reasonable rates. In 2017, the active letter
carrier’s share of the High Option premium will be $65.09 biweekly for Self
Only, $149.76 for Self Plus One and $139.35 biweekly for Self and Family.
For retired carriers, the rates are $167.70 per month for Self Only, $381.74
for Self Plus One and $363.76 per month for Self and Family. Different rates
and benefits apply to the Value Option Plan and CDHP and to other types of
employees; see the Plan’s official brochure for details.
Comparing the Plan’s benefits to other plans is simple. Just go to opm.gov/healthcare-insurance/healthcare/plan-information.
Active letter carriers have four ways to enroll in the NALC Health Benefit
Plan during Open Season:
Go to liteblue.usps.gov.
You must have your employee ID number (it’s the eight-digit number
printed on your earnings statement just above the words “employee ID”).
You will also need your USPS PIN (it’s the same one you use to access
The Blue Page (Intranet) at work.
Employee Self-Service Kiosks located at some USPS facilities.
PostalEASE by telephone. Call 877-4PS-EASE (877-477-3273) and enter
Annuitants and retirees can enroll by calling Employee Express at
800-332-9798, by going to OPM’s Open Season website at retireefehb.opm.gov if
you are a retiree, or by submitting a Standard 2809 to your retirement
If you submit your change by mail, the address is: OPM, Open Season
Processing Center, P.O. Box 5000, Lawrence, KS 66046-0500.
The information in this article is just a summary of some of the features of
the NALC Health Benefit Plan. Detailed information on the NALC Health
Benefit Plan can be found in the official 2017 brochure (RI 71-009) at nalchbp.org.
All benefits are subject to the definitions, limitations and exclusions set
forth in the official brochure.
“This Open Season is your chance to check out the many benefits of the NALC
Health Benefit Plan,” President Rolando said. “I think you’ll agree that
it’s the best plan for you and your family.”
A special insert about the Health Benefit Plan can be found in the November
issue of The
Postal Record. The official 2017 HBP brochure (RI 71-009) is available
Last day to register for the State Election is
Wednesday, October 19, 2016
ast day to register for the State Election is
Wednesday, October 19, 2016
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