Together. Better Health.
November 1, 2016
(This article first appeared in the November-December 2016 issue of The American Postal Worker magazine.)
The 2016 Open Season will run Nov. 14 - Dec. 12.
If you are enrolled in a different plan, consider joining the union-owned APWU Health Plan – a not-for-profit organization, where your health care needs are our #1 priority.
THE HIGH OPTION at a Glance
Since 1960, the High Option has offered comprehensive benefits to postal employees, featuring low co-pays and deductibles, with a vast nationwide network using Cigna’s doctors and hospitals. Members have access to 1 million providers. The High Option is the premier plan in the Federal Employees Health Benefits Program (FEHBP).
The APWU Health Plan’s #1 priority is to serve your family’s health care needs. Advocating on your behalf is what drives us.
Remember: Self Plus One enrollment allows you to cover yourself and one eligible family member.
High Option Highlights
You pay nothing for these services when you choose a network doctor:
- Preventive care and screenings
- Maternity care
- Treatment of accidental injuries within 24 hours
- Lab tests when you use LabCorp and Quest Diagnostics
- Programs to help you manage diabetes, hypertension, weight gain,
pregnancy and tobacco use
Other Plan Highlights:
- $20 co-pay for office visits, including specialist and virtual visits
- $40 co-pay for all urgent care centers
- $10 co-pay for retail generic drugs; for extra savings mail order is available
- $350 deductible for Self Only or $700 for Self Plus One and Self and Family (in-network)
- Routine dental coverage paid at 70%
- Cancer Centers of Excellence paid at 95%
- Discount vision program
- Extra dental discount when you complete a Health Risk Assessment online
The American Postal Worker High Option Rates 2017
YOU PAY |
Self Only |
Self PLUS ONE |
Self AND FAMILY |
APWU Career biweekly |
$85.06 |
$167.90 |
$232.04 |
Retiree monthly |
$204.29 |
$406.75 |
$548.39 |
APWU members benefit from APWU preferred rates. No other federal or postal employees have access to these rates. The Postal Service pays 95% of the premiums for career employees and 75% for Postal Support Employees (PSEs). With other plans, PSEs pay 100% of the premiums.
YOU PAY |
Self Only |
Self PLUS ONE |
Self AND FAMILY |
APWU Career biweekly |
$12.36 |
$27.20 |
$39.01 |
APWU Career (less than 1 year in FEHB) |
$53.77 |
$118.30 |
$129.05 |
APWU Non-career (PSE) biweekly |
$61.81 |
$135.98 |
$148.34 |
Retiree monthly |
$133.92 |
$294.62 |
$321.40 |
Consumer Driven Option Highlights
Your Personal Care Account (PCA):
- Members are given an account on day one of coverage that is fully funded, and provided annually by the Health Plan
- The PCA provides $1,200 for Self Only and $2,400 for Self Plus One or Self and Family enrollment
- The PCA pays for covered medical expenses at 100% as long as there are funds in the account
- Any unused funds will rollover to the next year, provided you remain a Health Plan member
You pay nothing for these services when you choose a network doctor:
- Preventive care and screenings
- Maternity care
- Programs to help you manage diabetes, pregnancy and tobacco use
Other Plan Highlights:
- No upfront deductible, coinsurance or co-pay until your PCA is exhausted
- Virtual visits
- Completing a Health Risk Assessment online adds $50 to your PCA for each
covered individual 18 years of age - Cancer Centers of Excellence paid at 95%
- Dental and vision coverage is available under your PCA
- Prescription drugs paid at 75%