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Gerard Gallagher, our Director of Health Benefits will attend the Health Benefit Plan seminar—October 18-21 at the Flamingo Las Vegas. More | HBP : NALC HBP Director Tim O'Malley will announced plans for the open season. Participants will have the opportunity to learn about the enhanced benefits being added to the NALC Health Plan for the 2010 benefit year.
Our branch president, Jim McCullough continues to send our members to appropriate training. With that training, our branch continues to be one of the most educated in the country. For any questions on the NALC Health Plan, contact Gerry at the union office! (610) 461-8333
Labor Day Telethon
At this year's telethon, the Union presented pledges and donations totaling $2.1 million to MDA, helping the telethon attain a record $65,031,393 in donations and pledges.
Our running total towards next year's MDA Telethon now stands at $226.00. Thanks for your continued support for this most worthy cause.
by Gerry Gallagher
How to Enroll in the NALC Health Benefit Plan
If you have access to PostalEASE through the Employee Web on the Intranet or through an Employee Self-Service Kiosk, you may enroll in the NALC Health Benefit Plan by following the screen instructions. Otherwise, call PostalEASE at 1-877-477-3273.
Simply follow the prompt and script: select "Federal Employees Health Benefits," enter your EID, your USPS PIN, and other required information.
When you have successfully entered all of your enrollment information, you will be given a Confirmation Number. Please make sure to write the number down and keep it in a safe place in case there is a question about the transaction. If you are not given a Confirmation Number, your enrollment has not been processed.
If you have difficulty using PostalEASE, if PostalEASE does not accept some of your dependent information because certification is required, or if you have questions about health benefit regulations, contact the Human Resources Shared Service Center (HRSSC) for assistance. When prompted,select 5 for the HRSSC. Then select Benefits to speak with a representative who will assist you.
A note for annuitants: You may call OPM's Open Season Express line at 1-800-332-9798, or you can log onto OPM's Open Season online service at http://retireefehb.opm.gov to make an open season health benefits enrollment change, to request information on cancelling or suspending your health benefit coverage or to request information on paying your premiums directly. To speak with a health benefits representative at OPM's Retirement Information Center, dial 1-888-767-6738 (1-800-878-5705 for OPM's TTY line for the hearing impaired), or, in the Washington, DC local calling area, dail 202-606-0500 (202-606-0551 for TTY).
You may also complete an Open Season transaction by sending an e-mail to Retire@opm.gov or by writing to OPM at this address: U.S. Office of Personnel Management, 1900 E. Street, NW, Washington, DC 20415. If you write to OPM, be sure to clearly state your Open Season request, If you are changing enrollment codes or options, indicate the name and/or code of yuor present plan and the name and/or code of the plan you want, the option(high, astandard or basic) and the type of coverage (self Only or Self and Family). Remember to include your annuity claim number and your Social Security Number (SSN) on your request. If you choose Self and Family coverage, include each eligible family member's name, date of birth, SSN, and the relationship to the annuitant.
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How the NALC Health Benefit Plan Arrives at Premiums and Benefits
Every year, usually at the end of March, the Plan receives a "Call Letter" from the U.S. Office of Personnel Management. This letter gives us guidance on benefits, coverage issues and how and when to submit our proposal for the next year's benefits. The process to be followed is extremely precise and all benefit changes must begin with OPM. If all goes well, these negotiations are generally completed by mid-August.
Writing benefit changes and clarifications is an extremely tedious process, one that takes months to complete. The U.S. Office of Personnel Management madates that our submissions must be in a specific format and in clear, precise language that can be fully understood by our membership and by any employee interested in joining the Plan.
When our proposal is submitted, we also must submit a proposal for our premium rates. Through the negotiatiion process, OPM looks at our proposed benefit structure and the reserves held. During the planning stages and the actual negotiations, it has always been the Plan's intention to put ourselves in a position to stabilize premiums for our membership as well as provide them with the benefits necessary to lead a healthy lifestyle.
The NALC Health Benefit Plan was able to negotiate twenty (20) new benefits into the Plan for the upcoming Benefit year. We feel that you and your Branch members will be really pleased with the direction the NALC Health Benefit Plan is taking to provide our members with the best health care coverage possible!
Excellent Performance Within the FEHB System
The NALC Health Benefit Plan performs magnificently with respect to our quality of care. In a random survey performed each year called the Consumer Assessment of Health Plans Study, sanctioned by the Office of Personnel Management and the National Commitee for Quality Assurance, the NALC Health Benefit Plan continues its excellent ratings.
While we focus on providing our members with excellent health care for their families and themselves, we also realize that letter carriers have to receive the best possible coverage for their health care dollars. We are happy to report that we have once again been able to hold down the cost of this excellent coverage.
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How the Plan Changes for the 2009 Benefit Year
Do not rely on these change descriptions; this page is not an official statement of benefits. For that, go to your brochures. They are most current. Also,we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.
- In Section 3, under Covered providers, Illinois has been added to the list of medically underserved areas for 2009.
Changes to this Plan
- Your share of the NALC Postal premium will increase for Self Only and increase for Self and Family.
- Your share of the non-Postal premium will decrease for Self Only and increase for Self and Family.
- We added a $4,000 catastrophic protection out-of-pocket maximum for retail prescription drugs.
- You now pay $15 for office or outpatient visits rendered by a PPO provider. Previously, you paid $20.
- You now pay $15 for office or outpatient consultations rendered by a PPO provider. Previously you paid 15%.
- You now pay 10% for covered services rendered by PPO physicians and other health care professional. Previously you paid 15%/
- You now pay 25% for covered services rendered by non PPO physicians and other health care professionals. Previously, you paid 30%.
We no longer apply the PPO calendar year deductible to covered adult preventive care services rendered by a PPO provider. Previously, the PPO calendar year deductible applied.
- You now pay nothing for adult preventive immunizations and screenings rendered by a PPO physician. Previously, you paid 10% or 15%.
- We now cover a routine general health panel blood test, basic or comprehensive metabolic panel blood test, complete blood count (CBC), urinallysis, electrocardiogram (ECG/EKG), and chest x-ray for adults, one annually.
- We now cover an annual pneumococcal vaccine for adults with medical indications as recommended by the CDC.
- We now cover a routine annual mammogram for women ages 65 and older. Previously, we covered one every two (2) consecutive calendar years.
- We now cover an annual routine physical (including camp, school, and sports physicals) for children ages 3 through 21.
- You now pay a $15 copayment for each physical, occupational, or speech therapy visit rendered by a PPO provider. Previously you paid 15%.
- We now limit physical, occupational and speech therapy to a combined total of 75 visits per calendar year. Previously, our limitation was 50 physical and occupational therapy visits (combined) and 30 speech therapy visits per calendar year.
- We now cover a hearing aid and related examination for neurosensoral hearing loss, with a maximum payment of $1,000 per lifetime.
- You now pay only a $100 copayment per admission for non-maternity inpatient room and board and other hospital services and supplies in a PPO hospital. Previously, you paid 10% for other hospital services and supplies in a PPO hospital.
- You now pay nothing for immobilization by casting of a sprain, strain, or fracture, and simple repair of a laceration (stiches) when you receive care within 72 hours of an accidental injury. Previously, when you need a PPO provider, you paid 10% of Plan allowance for the surgery and 15% of Plan allowance for the outpatient facility. If you used a non-PPO provider then you previously paid 30%.
- You can now purchase up to a 90-day supply of covered drugs and supplies at a local CVS/Caremark pharmacy and you pay our applicable mail order copayment. Previously, you had to utilize our Mail Order Prescription Drug Program to receive the Plan's maximum prescription benefit.
- We now cover prescription medications for smoking cessation.
- We now cover dental care necessary to repair sound natural teeth resulting from an accidental injury when treatment is obtained within 72 hours.
- We now offer a Weight Management Program that offers guidance and information to create an individual living plan that will lead to a healthy weight for life.
- We updated our information on accreditations.
- We updated our list of covered providers.
- We updated our definition of a freestanding ambulatory facility.
- We clarified that the Herpes Zoster (shingles) vaccine can be purchased at a local Preferred Network or NALC CareSelect Network pharmacy.
- We clarified that we would cover a varicella (chickenpox) vaccine for adults age 19 and older.
- We clarified that osteoporosis screening is covered for all women age 60 and older.
- We clarified that we cover medically necessary maternity tests.
- We clarified that we only cover a standard intraocular lens prosthesis, such as for cataract surgery.
- We updated the address for filing Caremark paper claims.
- We updated the address for obtaining mail order prescriptions from Caremark.
- We added Healthy Rewards to our Special features.
- We clarified how to file a claim.