Near the Finish Line and Just Starting
We have all heard the old saying “when one door closes another opens...” Regarding our health benefits we are at that moment. The Special Enrollment Period (SEP) is about to end and soon Open Season for health benefits, the first ever for the Postal Service Health Benefit Plan (PSHB), is about to start. There are a couple of other things to discuss related to these two events. They are as follows:
A) SEP: At the time of this writing, we are less than a month from the end of the SEP which ends on the last minute of September 30,2024. This is for retirees and their spouses who did not sign up for Medicare Part B at age 65. The SEP allows these brothers and sisters to enroll penalty free which normally would be 10% per year past age 65. If you are in this category and have any questions or concerns, call the SEP Hotline at 1-833-712-7742.
B) OPEN SEASON: Open Season for our Health Benefits begins November 11, 2024, and ends on December 9, 2024. The Office of Personnel Management (OPM) has not released benefit premium costs yet. These historically occur in the month of October, and you can keep up to date at www.opm.gov for any updates. Some members have been confused regarding the change from the Federal Employee Health Benefit Plan (FEHB) to the Postal Service Health Benefit Plan (PSHB). One way to think of it is everyone in the Church of Federal Health Benefits are FEHB. The choir is made up solely of PSHB members. They are still part of the same church but seated separately. Only Postal employees and annuitants are able to sign up for the PSHB. Any plans that have been approved by OPM for the PSHB have the same coverages and cost premiums as they do in FEHB. If you need to see if your current plan is approved for the PSHB go to the OPM website and click on the health insurance screen or search for PSHB. The NALC Health Plan is approved and now would be a good time to consider looking at all we have to offer our members.
C) CHANGES THAT WE KNOW OF: In past years if you were happy with your health plan you did not have to do a thing. Your choice rolled into the following year. This is supposed to be the case this year IF your plan has been approved by OPM for the PSHB. OPM says that if your plan is one of the approved plans then they will automatically move you from FEHB to PSHB. Honestly with over 400,000 active postal employees and an untold number of retirees that is quite a task for OPM even in this digital world. I feel that if each of us takes care of this for ourselves it lessens the chance of errors. In addition, if your plan has not been approved for PSHB you must make a choice or OPM will make it for you. They will try to match costs and coverages as closely as possible to your previous plan. Who better to choose than you? Every employee and retiree will receive a new health benefit card because of the change from the FEHB listing to the PSHB listing. For NALC Health Plan (NALCHBP) members your ID number will remain the same, but the choice designation number will be different. For example, High Option Self Only was 321, for PSHB it will be 77-A. Yet another change will be how we address personal changes during the coverage year. Qualifying Life Events or a covered child turning 26 were changed via your health plan. In 2025 those types of changes will only be able to be done via the OPM portal.
D) MEDICARE PART D REQUIREMENT: OPM has decided that part of the Medicare Integration obligation for postal retirees is that all retirees and their covered spouses over 65 must be in a Medicare Part D plan. Failure to do so will cause a loss of all prescription coverage. This includes retirees who were eligible but declined the SEP for Part B coverage. At this time, all retirees and annuitants are to have the Part D coverages automatically included in their coverages for 2025. This includes any NALCHBP members who opted out of the NALC Silver Script plan this year. This rule is in effect for all PSHB plans. Please check everything when the time comes to choose.
E) HEALTH EQUITY REIMBURSEMENTS: All retirees who have Medicare Part B and the NALCHBP High Option in 2024 and stayed in the CVS Caremark Silver Script program are due a reimbursement for their Medicare B premiums. If you are in the NALC Medicare Advantage Plan this does not pertain to you because you already receive a monthly reimbursement. To receive your Health Equity reimbursement the following steps are necessary. Go online to www.healthequity.com/wageworks. Select log in/register. Then select employee registration. After answering a few questions you’ll need to set up a username and password. Then you can log in and see how much your reimbursement is up to $600 for the year. Then print out a claim form. Information you will need to process a claim is the form and a copy of your Medicare Part B expenses. For most of us that would be a copy of your annual Social Security COLA statement for that year, unless you pay by check or automatic bank withdrawal. A copy of that form of payment would be needed. When filling out the claim form the provider’s name you will enter is Medicare B and your ID number is the last four digits of your NALCHBP ID. Any questions or help you may need from them can be had by calling 1-844-768-5644 weekdays from 8AM to 8PM.
F) To all active and retired NALC 6000 members, please make sure you keep and read ALL letters and correspondence regarding open season, Medicare and OPM related whether it’s from USPS or your health plan. Also, when you send or mail anything to any of these entities keep a copy for yourself. I am at the Branch Office on Wednesdays from 5PM – 8PM. Call the office at 631-789-1616.
If you call the branch during the workday leave a message and I will call you back that Wednesday following.
