It's a significant milestone when you become eligible for health insurance as a Postal Support Employee (PSE). Congratulations! The Federal Employees Health Benefit Program (FEHB) opens up a world of choices, and while many options exist, the APWU Health Insurance Plan often stands out as a particularly strong contender for PSEs.
What makes the APWU Consumer Driven Health Plan so appealing? A big part of it is affordability. Through dedicated negotiations, the APWU has secured a fantastic arrangement where the USPS covers a substantial 72% of the total premium for this specific plan. This is a significant advantage, especially when you consider that for most other FEHB plans, PSEs are responsible for the entire premium cost.
So, how do you know if you're eligible? The Office of Personnel Management (OPM) has laid out some clear requirements. You'll need to have completed one full year (that's 365 calendar days) of continuous employment without any breaks longer than five days. On top of that, your earnings each pay period must be sufficient to cover the premium costs after all mandatory deductions are taken out.
When you reach that one-year mark, specifically after an initial 360-day term and upon reappointment to another 360-day term, you'll likely receive a letter from the Postal Service. This letter is crucial; it will contain all the important details about enrolling in the FEHB program.
Once you're eligible, don't delay! You have a 60-day window from the date you become eligible to sign up. Missing this window means you'll have to wait for the annual Open Season or experience a Qualifying Life Event (QLE) to enroll. You can apply through various channels: fax, US Mail, or via LiteBlue. It's worth noting that online enrollment might not be available for all PSEs at this time.
When you reach out to Shared Services (HRSSC) for enrollment, it's wise to document everything. Keep a record of the date and time of your calls, and make sure you get a confirmation number. For faxes, hold onto the confirmation page, and if you're sending mail, use a Return Receipt. The HRSSC Compensation/Benefits office can be reached at PO Box 970400, Greensboro, NC 27497-4000, or by phone at (877) 477-3273 (option 5) or TTY at (866) 260-7507. Their fax number is (202) 268-0359.
To get the necessary forms, you can head to PostalEASE on liteblue.usps.gov, use an Employee Self Service Kiosk, access the Intranet from the Blue Page, or request them by mail from HRSSC.
Your coverage typically begins on the first day of the pay period that starts after Shared Services receives and processes your enrollment forms, provided you are in a pay status during that subsequent pay period. Your insurance cards will follow once everything is processed.
Making changes to your plan after enrollment is generally restricted to Open Season or a QLE. A QLE can include changes in your family or employment status, or if you or a family member lose other health coverage. You can find more information on OPM.gov/healthcare. Remember, federal law prohibits dual enrollment in more than one FEHB plan.
What happens if you lose coverage? The FEHB Program does offer continuation options, either temporary or through permanent conversion to a private policy, in situations like a child reaching age 26, insufficient pay, separation, divorce, death, or relocation.
Non-payment of premiums is another area to be mindful of. After two pay periods in a "no-pay" status or two instances of insufficient earnings, you'll receive a statement for the total amount due. This must be paid within 30 days to keep your coverage. If you lose coverage due to non-payment, you'll have to wait until the next Open Season to re-enroll.
And here's a smart tip: paying your FEHB premiums with pre-tax money can save you money. If you prefer to pay with after-tax dollars, you'll need to complete PS Form 8202, available on liteblue.usps.gov. This election must be made within your initial 60-day enrollment period; otherwise, you'll have to wait for Open Season or a QLE.
Let's touch on the Personal Care Account (PCA) within the APWU Consumer Driven Health Plan. This is a benefit amount funded by the APWU HP that you can use for various covered medical expenses, including hospital, medical, prescriptions, dental, and vision care. For 2023, the PCA amounts were $1,200 for self-only coverage and $2,400 for self-plus-one and self-and-family. Once the PCA is exhausted, members will face deductibles ($1,000 for self, $2,000 for self-plus-one and self-and-family) and then cost-sharing (15% in-network, 50% out-of-network, and 25%-40% for prescription drugs depending on the tier). The annual out-of-pocket maximums are also in place to protect you from extremely high costs.
