Open Season

(This article first appeared in the November/December 2018 issue of the American Postal Worker magazine) 

By Health Plan Director John Marcotte

This year’s Federal Employee Health Benefits (FEHB) Open Season is Nov. 12–Dec. 10. Now is the time to take advantage of a union-owned health plan, staffed by union employees, whose singular focus is serving you, the member.

At the APWU Health Plan we are driven to provide comprehensive health insurance at an affordable price. Now is the time to compare your current yearly out of pocket costs and the coverage your family needs with what the APWU Health Plan has to offer. Whether you desire proactive wellness coverage, are managing current heath care conditions, or looking for peace of mind and financial security if an illness or injury strikes, the APWU Health Plan (APWUHP) is here for you.

Consumer Driven Option

With free preventative care, low out of pocket maximums and a prefunded personal care account that you can use immediately, this is a health care plan designed with postal workers in mind. If you are a career member of the APWU with over a year in FEHB, the USPS pays 95% of your premium cost for the Consumer Driven Option. This is by far the best value in FEHB Health Insurance.

• Some of the lowest premium costs available for APWU members.
• Superior health benefits and lower overall costs for our PSE members.
• Your Personal Care Account (PCA)
  • Members are given an account on day one of coverage that is fully funded by the APWUHP. Medical expenses get paid out of this account before members contribute to their deductible.
  • The PCA provides $1,200 for Self Only and $2,400 for Self Plus One or Family enrollment.
  • The PCA pays for covered medical expenses at 100% as long as there are funds in the account.
  • APWUHP pays the first $1,200 of Self and $2,400 of Self+1 or Family deductibles, making our members portion of the deductible a very affordable $800 for Self and $1,600 for Self+1 and Family.
  • The PCA account money used counts toward your out of pocket maximum, which are a low $5,000 for Self and $10,000 for Self+1 and Family. Making your out of pocket maximum a low $3,400 for Self and $7,600 for Self+1 or Family.
  • Unused PCA funds will rollover to the next year, provided you remain a Health Plan member.
• Increased chiropractic visits to 24 visits per year
• Coverage for skilled nursing facilities for non-custodial care
• 100% coverage for in-network preventive care
• 100% coverage for in-network maternity care

High Option

• Premium costs that are an excellent value for expansive benefit coverage.
• Increased Chiropractic visits to 24 visits a year
• Coverage for skilled nursing care for non-custodial care
• No deductible on prescriptions
• Generic drugs at retail pharmacy $10 for 30-day supply, $20 for a 90-day supply
• Members can obtain a 90-day prescription of maintenance medication from Walgreens and CVS without penalty for not using mail order
• Preferred brand name drugs are capped at $300 per prescription with a 90-day prescription.
• 100% coverage for in-network preventive care including colon cancer screening.
• 100% coverage for labs when you use Quest Diagnostics or LabCorp
• 100% coverage for accidental injury within 72 hours
• $25 copayment to see an in-network doctor, including specialists
• $15 virtual visits in-network through American Well
• Diabetes Management Program that offers 100% coverage for generic drugs, blood glucose test strips and lancets through mail order
• Weight Management Program, 100% in-network coverage at dieticians or nutritionists.
• 100% coverage for in-network maternity care

Compare and join a health plan that works for you. Together Better Health.