Open Season: Nov. 14-Dec. 12

November 1, 2016

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(This article first appeared in the November-December 2016 issue of The American Postal Worker magazine.)

With Open Season for enrolling in Federal Employees Health Benefits (FEHB) plans set for Nov. 14 through Dec. 12, I urge everyone to compare the APWU Health Plan options to your current coverage.

The APWU High Option is best compared to a high or standard coverage plan and the Consumer Driven Option is best compared to consumer and basic plans. For those of you with Medicare Part B, the APWU High Option integrates with Medicare Part B. As a result, most doctor’s visits cost you nothing.

The APWU Health Plan is owned collectively by all APWU brothers and sisters. Therefore, unlike most insurance plans, it’s not driven by profit. Its sole purpose is to provide you and your family with expansive health care coverage at the most affordable price. The APWU Health Plan also offers locals, states and chapters a great organizing tool.

Setting the Record Straight

I want to clarify some points that have caused confusion.

The USPS Postal Support Employee (PSE) insurance plan is not the same as the APWU Consumer Driven Option plan. What has caused some misunderstanding is that both the rudimentary USPS PSE insurance plan and the comprehensive Consumer Driven Option use the same network, the United Health Care network.

Some Postal Support Employees have signed up for the USPS PSE insurance and have been shocked at the high cost of Self Plus One and Self and Family coverage. There is a cap on the amount of money the USPS may contribute toward the USPS PSE health insurance plan, which makes family coverage under the plan effectively unaffordable.

The APWU Health Plan, as a Federal Employee Health Benefits (FEHB) provider, cannot offer insurance to PSEs until they serve a 360-day appointment with a break in service of no more than five days. Once PSEs have met this requirement, they have 60 days to sign up for the APWU Consumer Driven Option (CDO) plan, with the USPS paying 75 percent of the premiums. If they choose another FEHB plan, the USPS will pay nothing.

Can I Enroll or Change My Enrollment?

According to the Office of Personnel Management (OPM), to be eligible for FEHB enrollment, non-career employees must meet three requirements:

  1. Complete one full year (365 calendar days) of continuous employment with no breaks in service of more than 5 days.
  2. Have a regular scheduled tour of duty, arranged in advance and expected to last for at least 6 months, and
  3. Maintain sufficient earnings each biweekly pay period to have the total cost of premiums withheld from pay after mandatory deductions for Social Security, Medicare and federal tax.

Some of the advantages of switching to the CDO from USPS PSE insurance are:

  • More comprehensive coverage
  • A lower deductible
  • Affordable rates for families
  • 100 percent coverage for preventive care, maternity care and tobacco cessation programs.

PSEs can retain APWU Consumer Driven Option insurance upon conversion to career status. If they do, the USPS will pay 95 percent of the premiums for career employees with more than a year of coverage by an FEHB plan, such as the APWU Consumer Driven Option.

Finally, if a PSE has USPS PSE insurance and upon conversion to career doesn’t choose a FEHB plan within the allotted timeframe, the PSE’s USPS insurance will be dropped, leaving the employee without any insurance.

Unfortunately, the USPS is doing a poor job of educating employees about their benefits. Our union will do the best we can to educate and serve the membership.

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