Changes to Your Health Insurance this Open Season
By Terry Sims
Alec has asked me to give some basic information about the upcoming changes in health benefits for the USPS. These changes will take effect January 1, 2025, but there are things you may need to do before that takes place. The changes include ALL Postal employees, both active and retired. Preparation for the move has been in process since the Postal Reform Act was passed in 2022. I won't bore you with the reasons for the change, but if you want to know, look up the PSRA. It was absolutely necessary to keep the USPS on better financial footing for the future. That being said, I am going to give you some bits and pieces of articles that have been published or sent out to everyone and some important dates and information to watch for in the near future.
OPM put this out September 2024: “AUTOMATIC ENROLLMENT IN POSTAL SERVICE HEALTH BENEFITS (PSHB)”
“OPM is working to make the transition to PSHB as simple as possible by automatically enrolling Postal Service members into a PSHB plan based on their current FEHB enrollment. The following table lists the plan options into which individuals will be automatically enrolled. Postal Service enrollees, annuitants, and their family members who are currently enrolled in any FEHB plan not listed below will be automatically enrolled in the PSHB nationwide plan option with the lowest self-only premium that is not a high deductible health plan and does not charge a membership fee.
Postal Service enrollees always have the right to choose their PSHB plan during the Federal Benefits Open Season. This year, Open Season will run from November 11, 2024, through December 9, 2024.”
A couple of things I want to explain about this statement put out by OPM. #1—they use the word 'automatically' a couple of times. Some info I have seen says 'they' will be automatically enrolling you and then sending each enrollee a 'crosswalk' letter telling them which plan they were 'crosswalked' into. You would then be able to review and do nothing if you were happy with the plan you were put into, or change during Open Season. Other information that has been put out says that you will need to choose the plan yourself. I am more inclined to think that we will be 'automatically' enrolled and then have a chance to review and change during Open Season. #2—The 'Crosswalk' Table they refer to can be found on keepingposted.org or myhr.gov? Or opm.gov. About halfway down the page on keepingposted.org, there is a box of PSHB Resources that has all of the information that is currently available, including new rates for 2025. The 'Crosswalk' also has the new enrollment codes that you will need to use if you change your plan during Open Season. #3—the reference to 'nationwide' plans is what we often refer to as PPO where your plan covers doctors and hospitals nationwide as opposed to an HMO which is typically a regional health plan or health maintenance organization that patients are restricted to in order to get benefits. And #4—just for future reference—Open Season is always the 2nd Monday in November through the 2nd Monday in December, whatever the date or year. That just helps you know when Open Season will be from year to year.
Individual Plan information and the platform we will all use to make Health Benefit 'only' changes, are the main two important bits of information not yet available. The latest I have heard is the first week of November for these two things which will be right before Open Season. You should get something in the mail when this information is available. In the meantime, watch your mailbox and don't throw anything away without reading it, if it's from OPM or USPS. Remember, also, these changes are for Health Benefits only and do not pertain to anything else—retirement, life insurance, tsp, and vision and dental benefits. These will be accessed in the current way—either Lite Blue and PostalEase for active employees or through OPM for annuitants, There is a lot more information out there concerning future Medicare Part B requirements for most active employees that are under the age of 64 and requirements to keep Medicare Part B if you have it as of January 1, 2025, in order to keep your PSHB coverage. Remember, whatever the requirement is for the primary enrollee, is also true for his/her spouse. For those who are Medicare eligible—typically at age 65 (unless you have a qualifying disability) you will be automatically enrolled in Medicare Part D for your prescription drug coverage at no extra cost. Beginning in 2025, you will no longer be able to opt out of Part D coverage and stay with your health plan coverage like they allowed you to do this year in their trial run of Silver Script. Unless they change their mind, you may be able to opt out, but if you do, you won't have any prescription drug coverage at all until next Open Season. Most of the information I have seen has this footnote: “This PSHB auto-enrollment plan option is subject to change based on finalization of OPM's Notice of Proposed Rulemaking, “Postal Service Health Benefits Program:Additional Requirements and Clarifications,” issued May 24, 2024. That pretty much says it all.
The best advice I can give is to pay attention, do your research, and don't make any big changes without making sure that what you are doing isn't going to cause you to lose your health benefit coverage. There are a lot of options out there that I'm not going to go into here, but if you need someone to talk things through with, you can always call me—Terry Sims, NALC HBR at 417-224-4544. I don't have all of the answers, but together, we can find someone who can help.