TOM NELSON
HEALTH BENEFITS REPRESENTATIVE
Outlook November / December 2016
Open Season for the Federal Employees Health Benefit Plan ends on December 12th, 2016. If you haven’t checked out the NALC Health Benefit Plan yet, now is the time to do so!

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 Postal EASE).
• The Blue Page (Intranet) at work.
• Employee Self-Service Kiosks located at some USPS facilities.
• Postal EASE by telephone. Call 877-4PS-EASE (877-477-3273) and enter Option 1.

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 office. If you submit your change by mail, the address is:

OPM, Open Season Processing Center
P.O. Box 5000
Lawrence, KS 66046-0500
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; 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 and $139.35 biweekly for Self and Family. For retired carriers, the rates are $167.70 per month for Self Only and $363.76 per month for Self and Family. For retired carriers, the rates are $167.70 per month for Self Only and $363.76 per month for Self and Family. Different rates and benefits apply to the Value Option and CDHP and to other types of employees; see the Plan’s official brochure for details. 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 877-220-NALC (6252).

The High Option Plan pays for a wide variety of preventative care treatments and tests for adults and children at 100 percent when you use a PPO provider. You pay only a $20 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 formujary 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 payer, 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, copayments and co-insurance charges-for doctor visits, procedures and hospitalization. It also gives Medicare recipients access to lower out-of-pocket costs for prescription drugs.

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 those with chronic illnesses, the healthy 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 benefits. I think you’ll agree that it’s the best plan for you and your family.

Outlook September / October 2016
Health Benefits
It is almost that time of year again, the time to start looking at your Health Insurance and preparing for “Open Season 2017”. There are scheduled Health Fairs to be held in the Bronx and Manhattan. The Bronx Health Fair will be held on October 25, 2016 at Mott Haven Station from 7 am to 10 am, and also from 2 pm to 5 pm. The Manhattan Health Fair will be held on November 2, 2016 and November 3, 2016 at Morgan P & DC Station, and runs from 8 am to 6 pm. I realize some carriers may be working during these hours and unable to attend the Health Fairs. However, the information may also be obtained by calling the NALC Health Benefit Plan at 1-888-636-NALC (6252) to request information by mail or by visiting the website at www.nalchbp.org. You may also leave a message for me at the branch at 212-239-3901; please include your name and number.

The NALC Health Benefit Plan is your Union Plan and run by union members. Cigna is the preferred provider for the plan, which covers over 90% of the doctors and hospitals in the tristate area. In my own personal experience for well over 38 years, the NALC Health Benefit Plan has been there for me and my family. You cannot beat the quality of care or the affordable price in comparison to any other health plan in Federal Employees Health Benefit Program (FEHBP). Do yourself and your family a favor and take a good look at the NALC Health Benefit Plan this Open Season. You will be pleasantly surprised at how much money you will save and the quality of care you will receive. The updated Open Season rates for 2017 have not been released as of this publication date. However, by the next issue of the Outlook, the information will become available. You may also check the Office of Personnel Management at www.opm.gov for the latest updates.

Outlook July / August 2016
Health Benefit Plan
I would like to share a question that is asked quite often and is located under Article 21 of the National Agreement. The question is “How much does the Postal Service pay towards my Health Insurance?

For career employees on the rolls prior to January 12, 2013, the bi-weekly Employer contribution for Self Only and Self and Family Plans were adjusted to an amount equal to 80% in 2013, 78% in 2014, 77% in 2015, and 76% in 2016 of the weighted average biweekly premiums under the FEHBP, as determined by the Office of Personnel Management. For career employees hired on or subsequent to January 12, 2013, the biweekly employer contribution for Self Only and Self and Family Plans was adjusted to an amount equal to 77% in years 2013 through 2015 and 76% in 2016, of the weighted average biweekly premiums under the FEHB, as determined by the Office of Personnel Management. The adjustment begins on the effective date determined by the Office of Personnel Management in January. The employer contributions for plans for new career employees will be an amount equal to 77% of the weighted average biweekly premiums under.

FEHB as determined by the Office of Personnel Management. The adjustment for new career employees began on the effective date determined by the Office of Personnel Management in January 2013 and continued through plan year 2015. Thereafter, the employer contribution for new career employees will be adjusted to 76% effective in January 2016. This method is negotiated through the contract or arbitration, if necessary.

The NALC is presently in contract negotiations with the Postal Service on a new National Agreement. Your cost (premium) towards health insurance depends, of course, on which Health Plan you have chosen. You will find that the best plan and most cost effective plan is your union plan, the NALC Health Benefit Plan. It is run by union members just like you and me.

I hope you are all having a safe and happy summer!

Outlook November / December 2015
Happy Holidays to all my brothers and sisters!

OPEN SEASON ENDS ON DECEMBER 14, 2015! I hope you all had a chance to check out the NALC Health Benefit Plan, which coordinates its benefits with Cigna. I don’t know if you did or didn’t do your homework, but I highly suggest that you do if you haven’t. When you do, you will find that the best and most cost effective plan is your union plan, The NALC Health Benefit Plan. It is run by union members, just like you and me. The other health plans have raised their rates significantly while reducing their benefits. The NALC Health Benefit Plan for High Self Only actually reduced the cost of active members by -$2.22 a pay period to $60.69 and for retirees by -$9.51 to $157.19 monthly. The High Self and Family rates had a minimal increase cost for active members of $7.16 to $131.71 a pay period and for retirees by $6.47 to $343.82 monthly. It is essential for you to check the cost of your health plan. You will be stuck with whatever plan you choose until Open Season of next year, for 2017.

On a personal note, the NALC Health Plan has always been there for my family and me. As a family, we have been through our share of medical issues. The NALC Health Plan has always provided the services and healthcare needed for us to get better and move on with life’s joys. You must be a member of the National Association of Letter Carriers in order to join the NALC Health Benefit Plan! The website for the plan is www.nalchbp.org. Please do yourself and your family a favor, check out the website or call the NALC Health Plan at 1-888-636-6252 where you can talk to a real person instead of automated prompts. The staff is friendly, helpful and are union members just like you and me.

Have a happy, safe, and healthy Holiday Season!

Outlook September / October 2015
Self Plus One Enrollment Type
The FEHB Program introduces the Self Plus One Enrollment Type.

Introduction

The Bipartisan Budget Act of 2013 establishes a Self Plus One enrollment type in the Federal Employees Health Benefits (FEBH) Program. Coverage under a Self Plus One enrollment will be available beginning in January 2016. The first opportunity to enroll in Self Plus One will be during the annual Federal Benefits Open Season beginning in November 2015.

When will OPM release the rates for the Self Plus One enrollment type for each plan?

Rates are announced in early October before Open Season begins. When posted, 2016 rates will be available at www.opm.gov/openseason.

What is Self Plus One?

Self Plus One is a new enrollment type in the Federal Employees Health Benefits (FEHB) Program that allows you to cover yourself and one eligible family member you designate to be covered. Starting in 2016, all FEHB plans (your health insurance plans) will offer a Self Only, a Self Pius One, and a Self and Family enrollment type. Employees and annuitants will be able to select a Self Plus One enrollment beginning in the 2015 Open Season.

Who can be covered under a Self Plus One enrollment?

A Self Plus One enrollment covers the enrollee and one designated eligible family member. The definition of eligible family members has not changed. Your eligible family member can include either a spouse or a child up to age 26. A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.

How is Self Plus One different from Self Only or Self and Family?

A Self Only enrollment covers only the enrollee. A Self and Family enrollment covers the enrollee and all eligible family members. The new Self Plus One enrollment type covers the enrollee and one eligible family member you designate to be covered.

When will a Self Plus One enrollment be effective for annuitants?

If you choose a Self Plus One enrollment during the 2015 Open Season, your enrollment change will be effective on the 1st of January. For annuitants, Open Season enrollments are always effective on the 1st day of the year following the end of the Open Season. If you choose a Self Plus One enrollment outside of Open Season, your enrollment change will be effective on the first day of the first pay period following the one in which you make a change. For example, if you request an allowable change in the middle of February, your change will be effective on March 1st.

How will I know if a Self Plus One enrollment is right for me?

You should determine your eligible family members and decide which enrollment type is best for you. Self Plus One enrollment type will cover you and one eligible family member. During Open Season 2015, you will want to pay close attention to the benefits and rates in both the plan you currently have and other FEHB plans available to you. OPM will release materials in advance of Open Season to help you make this important decision. Visit www.opm.gov/openseason to access these materials.

Will domestic partners/non-married partners be eligible for coverage under a Self Plus One enrollment?

No. Only legally married spouses are considered eligible family members under any FEHB enrollment, including Self Plus One. This has not changed with the addition of the new Self Plus One enrollment type.

When is the first opportunity to change my enrollment to Self Plus One?

You will be able to select a Self Plus One enrollment beginning in the 2015 Open Season. After Open Season, you will have an opportunity to change your enrollment upon experiencing a Qualifying Life Event (QLE).

I am an annuitant. What if I miss the Open Season and I want to change to a Self Plus One enrollment?

Annuitants are allowed to decrease enrollment at any time. This means that if you have a Self and Family enrollment and you decide you would like to change to a Self Plus One enrollment, you may do so throughout the year. No changes to Self Plus One can be made prior to the 2015 Open Season. Changes are effective January 1, 2016. If you have a Self Only enrollment, however, you must experience a Qualifying Life Event in order to change to Self Plus One. These are events such as marriage, divorce, or a family member’s loss of coverage under another health insurance program. For a full list of allowed QLE’s, please view the SF2809.

Reminder: No changes to Self Plus One can be made prior to the 2015 Open Season. Open Season changes for annuitants are effective January 1, 2016.

I am an employee. When will a Self Plus One enrollment be effective?

If you choose a Self Plus One enrollment during the 2015 Open Season, your enrollment change will be effective on the first day of the first full pay period in January 2016. If you choose a Self Plus One enrollment outside of Open Season, your enrollment change will be effective on the first day of the first pay period following the one in which you can make a change. The earliest available effective date for a Self Plus One enrollment is January 1, 2016.

I am an employee. What if I miss Open Season and I want to change to a Self Plus One enrollment?

As an active employee, you must experience a Qualifying Life Event (QLE) in order to change your enrollment outside of Open Season. These are events such as marriage, divorce, the birth or adoption of a child, or a family member’s loss of coverage under another health insurance program. For a full list of allowed QLE’s, please view the SF 2809. Reminder: No changes to Self Plus One can be made prior to the 2015 Open Season.

I am currently enrolled in Self and Family with only one covered eligible family member. Will my employing (or retirement) office automatically change my enrollment to Self Plus One for plan year 2016?

No. In order to decrease your enrollment to Self Plus One you will need to make an enrollment change during Open Season or in conjunction with experiencing a Qualifying Life Event. Your employing (or retirement) office will not change your enrollment unless you request it.

If I enroll in Self Plus One, will I be able to increase/decrease my enrollment type?

You will be able to increase or decrease your enrollment type during the annual Open Season or outside of Open Season if you experience a QLE that is consistent with current FEHB guidelines. A full list of QLE codes and their definitions will be outlined in the updated SF2809, which will available soon. Note: Individuals who do not participate in premium conversion, including annuitants, may decrease their enrollment at any time.

How will OPM determine the weighted average used to set the government contribution for plan year 2016?

The weighted average for self plus one will be based on the 2016 Self Plus One premiums and the 2015 Self and Family headcount.

How do I switch my covered family member?

To switch a covered family member, you must complete a Standard Form 2809. You will not be able to directly contact your carrier to make this change. Contact your agency benefits officer for more information.

Can I switch the family member who is covered under my Self Plus One enrollment?

You are able to switch a covered family member during the annual Open Season and outside of Open Season upon experiencing a change in family status, a change in coverage, or a change in eligibility, as long as switching the family member is consistent with the QLE experienced. For example, if an enrollee has a spouse and a child, but only covers their spouse with a Self Plus One enrollment, in the event that the enrollee and spouse are divorced, the enrollee may choose to stay in the Self Plus One and switch their covered family member to terminate their spouse’s coverage and add their eligible family members, but not to switch from covering their spouse to covering their new child under a Self Plus One enrollment. A full list of QLE codes and their definitions will be outlined in the updated SF2809, which will be available soon. Whether you choose Self Only, Self and Family or Self Plus One enrollment type, the NALC Health Benefit Plan is the insurance that will give you maximum benefits at a reasonable cost. At the time of this print, the 2016 rates have not been released. The rates will be announced in early October before Open Season begins by checking a www.opm.gov/openseason. The NALC Health Benefit Plan is your Union Health Plan operated by union members! Make sure you check it out this Open Season!

Outlook July / August 2015
Breast Cancer Screening
There isn’t a good reason to avoid a Breast Cancer Screening!

Did you know that one in eight women will be diagnosed with Breast Cancer? In fact, Breast Cancer is the second leading cause of death among women. With numbers like that, all women should be screened. The good news is today there are fewer women dying from the disease. This is likely due to the fact that mammograms are helping women find the cancer, early enough to treat. - According to the American Cancer Society, about 1 in every 1,000 men will be diagnosed in their lifetime. Breast Cancer knows no gender.

What exactly is a mammogram?

A mammogram is an x-ray of the breast, which checks for lumps and tumors. During a mammogram, your breast is placed between two plates. The plates flatten the breast for a few seconds, so the technician can take a quick x-ray. This simple procedure can spot Breast Cancer in its earliest stages, making treatment that much easier and the outcome more successful.

Who should get a mammogram?

- Women age 50 through 74 should have a mammogram every two years.
- If you have risk factors. A family history of Breast Cancer or other factors may mean you need a mammogram - even if you’re under 40..

If you have not had a mammogram within the past two years, please schedule your mammogram today. Remember, always get a check-up and if you don’t feel right, don’t walk, but run to the doctor! What you don’t know, can kill you! Stay healthy!

.Outlook March / April 2015
Health Benefit Column
Protect Yourself from the Sun this Summer!

To help reduce rising rates of Skin Cancer from overexposure to the ultraviolet (UV) rays of the sun, the National Council on Skin Cancer Prevention has designated the Friday before Memorial Day as “Don’t Fry Day” to encourage sun safety awareness and to remind everyone to protect their skin while enjoying the outdoors. Because no single step can fully protect you and your family from overexposure to UV radiation, follow as many of the following tips as possible:
- Seek shade.
- Wear sun-protective clothing.
- Generously apply sunscreen.
- Use extra caution near water, snow and sand.
- Get Vitamin D safely.

As warm weather approaches and millions of Americans prepare to enjoy the great outdoors, the risk for ultraviolet (UV) damage of the skin increases. Skin Cancer is on the rise in the United States, and the American Cancer Society estimates that one American dies every hour from Skin Cancer. This year alone, the American Cancer Society estimates there will be more than 73,870 new cases of malignant melanoma, the most serious form of Skin Cancer and more than two million new cases of Basal Cell and Squamous Cell Skin Cancers in the U.S. Fortunately, Skin Cancer is highly curable if found early and can be prevented. Remember to Slip! Slop! Slap! And Wrap! When you’re outdoors - slip on a shirt, slop on broad spectrum sunscreen of SPF 30 or higher, slap on a wide-brimmed hat, and wrap on sunglasses. The best way to detect Skin Cancer early is to examine your skin regularly and recognize changes in moles and skin growths. Most Skin Cancers are caused by overexposure to UV radiation. Individuals with lighter-toned skin are more susceptible to UV damage, although people of all races and ethnicities can be at risk for Skin Cancer. Those who have a family history of Skin Cancer, plenty of moles or freckles, or a history of severe sunburns early in life are at a higher risk of Skin Cancer as well. To minimize the harmful effects of excessive and unprotected sun exposure from intense UV radiation should be a lifelong practice for everyone.

The National Council on Skin Cancer Prevention is the united voice for reducing Skin Cancer incidence morbidly and mortality through awareness, prevention, early detection, research and advocacy. Stay healthy!




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