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NALC Health Benefit Plan

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NALC Health Benefit Plan Fredric V. Rolando, President Brian Hellman, Director In closing let the audience know that all the benefits discussed in the presentation ... – PowerPoint PPT presentation

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Title: NALC Health Benefit Plan


1
NALC Health Benefit Plan
  • Fredric V. Rolando, President
  • Brian Hellman, Director

2
  • This is YOUR Health Benefit Plan

3
NALC Constitution
  • Article 2 
  • Section 1. To unite fraternally all letter
    carriers who are members in good standing in the
    National Association of Letter Carriers.
  •  
  • Section 2. To establish Health Benefit Funds
    from which to pay contributing members holding
    Health Benefit Certificates who become lawfully
    entitled thereto, certain benefits as indemnity
    against loss resulting from the expense of
    hospital, surgical and other medical expense due
    to bodily injuries or sickness of the members and
    enrolled dependent members of his/her family, and
    from which to defray the necessary running
    expenses of the Plan. 

4
NALC HBP History
  • Where we started
  • 1950 NALC started its own independent health
    benefits plan with 2 employees housed in a single
    room. At the close of the initial open enrollment
    membership totaled 4,116.

5
History 1950s (continued)
NALC HQs Building
  • Mid 50s Membership grew to 30,000. The
    independent health plan employed 26 employees and
    occupied 3 rooms located in the NALC Headquarters
    building at 100 Indiana Ave, NW Washington, DC.

6
History 1960s (continued)
  • Early 60s Became part of the Federal Employees
    Health Benefit Program with passage of public law
    PL 86-382. Enrollment quadrupled to 101,503. The
    Plan used every available office space at the
    headquarters building. The auditorium became the
    file room.
  • In 1963 the NALC added an eight (8) story annex
    to the NALC Headquarters Building. We occupied
    four (4) floors in the annex and space in the
    main building.

7
History 1970s (continued)
NALC HBP Reston, VA
  • 1972 The NALC HBP continued to grow in the
    Federal program. The entire Plan moved to Reston,
    Virginia by the end of the year. The entire staff
    comprised of 229 employees and membership totaled
    141,177.

8
History 1980s (continued)
Computer Terminals
  • 1980s The computer age hit the Plan. All
    analysts were equipped with computer terminals
    and claims were processed through a computerized
    system.

9
History 1980s (continued)
As technology grew, so did the Plan. If fact, by
the late 1980s the Plan was growing to the point
that we needed to locate to an even bigger
facility.
10
History 1990s (continued)
  • The NALC HBP was bustin at the seams with 520
    employees and a membership of 220,000. The Reston
    building was inadequate, so the Plan moved to
    Ashburn, Virginia on June 8, 1990.

NALC HBP Ashburn, VA
11
Where we are now - 2013
  • Over sixty (60) years later we are still going
    strong. We have endured and prospered. Currently,
    we have 346 employees at the Plan and we cover a
    total of 115,932 members or 223,545 lives
  • 2012 Open Season 3,295 New Members

12
2012 NALC HBP Facts
  • We issued 1.2 Billion in benefits.
  • Processed 4,631,975 claims
  • Mailed 8,668,435 pieces of mail (includes checks,
    explanation of benefits , temporary
    Identification cards and letters).
  • Answered 858,075 incoming calls from members,
    physicians and hospitals.

13
Average tenure of an NALC HBP employee is 20 Years
14
Employees
NALC HBP wall of 30 year plaques
These three employees have 130 combined years of
services
15
Employees
16
NALC HBP Mission
  • The Plans mission is to provide our members
    accessibility to quality medical care while
    maintaining a comprehensive benefit package.
  • We pride ourselves in offering excellent benefits
    with affordable premiums and excellent customer
    service.

17
The Plan is . . .
  • Union Operated
  • Union Owned
  • Not-for-Profit Plan

18
High Option 2014 Plan Partnerships
19
Cigna
  • The CIGNA Shared Administration Open Access Plus
    network which offers 1,875,900 PPO providers
    nationwide.
  • To locate a PPO provider call 1-877-220-NALC
    (6252) or visit our website at www.nalc.org/depart
    /hbp

20
CVS/Caremark
  • And, CVS/Caremark, our prescription benefit
    manager, provides access to more than 67,800
    network pharmacies. In 2012, Walgreens was added
    to our retail pharmacy network.
  • Call 1-800-933-NALC (6252) to locate the nearest
    network pharmacy.

21
OptumHealth
  • OptumHealth Behavioral Solutions, our mental
    health and substance abuse partner, gives more
    than 7,000 in-network facilities and more than
    120,000 in-network clinicians to choose from to
    receive maximum benefits. Call 1-877-468-1016 to
    locate an in-network provider.

22
  • NALC Health Benefit Plan is the right choice
  • Comprehensive benefits
  • Competitive premiums

23
  • High Option Plan

24
PPO Office Visit 20 Copayment
  • Your office visit copayment for a PPO provider is
    just 20. When your PPO physician or PPO
    specialist bills for
  • an office visit
  • an office consultation
  • a second surgical opinion
  • Outpatient individual or group therapy, or
  • Outpatient medication management

25
Lab Services
  • The NALC Benefit Plan covers 100 of medically
    necessary lab services billed by either Quest
    Diagnostics or LabCorp.

26
Health Risk Assessment (HRA)
  • We will pay the Self Only premium for the
    CignaPlus Savingssm discount dental program when
    you are enrolled in a Self Only option with the
    Plan and you complete the Health Risk Assessment
    (HRA).
  • We will pay the Self and Family premium for the
    CignaPlus Savingssm discount dental program when
    you are enrolled in a Self and Family option with
    the Plan and an HRA is completed for two family
    members.

27
PPO Inpatient 200 Copayment
  • When an illness or injury results in a
    hospitalization, you will pay just 200 per
    admission to a PPO hospital and nothing when
    services are related to the delivery of a
    newborn.

28
PPO Benefit Level
  • You will receive reimbursement at the PPO benefit
    level when non-PPO pathologists, radiologists and
    emergency room physicians bill for services
    rendered at a PPO hospital or a PPO ambulatory
    surgery center.

29
Maternity Benefits
  • The Plans 100 benefit package for maternity
    includes payment in full for
  • Routine prenatal visits
  • Delivery
  • Routine postnatal visits
  • Amniocentesis
  • Anesthesia related to delivery or amniocentesis
  • Group B Streptococcus infection screening
  • Sonograms
  • Fetal monitoring
  • Rental of breastfeeding equipment
  • Tetanus-diptheria, pertussis (Tdap) one dose
    during each pregnancy NEW FOR 2014

30
Maternity Benefits Cont.
  • Screening Tests for Pregnant Women when Billed by
    a PPO Provider
  • Gestational diabetes
  • Hepatitis B
  • Iron deficiency anemia
  • Rh screening
  • Syphilis and
  • Urine culture for bacteria

31
Family Planning Services
  • 100 Coverage for Female Voluntary Family
    Planning Services when rendered by a PPO provider
  • Limited to
  • Voluntary female sterilization
  • Surgical placement of implanted contraceptives
  • Insertion of intrauterine devices (IUDs)
  • Administration of an injectable contraceptive
    drug (such as Depo provera)
  • FDA-approved prescription contraceptive product
  • Removal of a birth control device and for
    services related to follow up management of side
    effects of birth control (NEW for 2014

32
Preventive Benefits
  • We continue to focus and understand that
    preventive care services are significant steps
    that members can take to protect themselves and
    their families. The NALC pays 100 for the
    following when rendered by a PPO provider
  • An annual routine physical,
  • Certain routine screening tests, and
  • Certain routine immunizations

33
Preventive care, adult
  • Some of the preventive screenings the Plan pays
    in full when rendered by a PPO provider include
  • One routine colonoscopy screening (with or
    without polyp removal) every ten years , age 50
    and older.
  • An annual EKG and chest x-ray
  • Mammograms for women age 35 and older as follows
  • Ages 35 through 39 one during this five year
    period
  • Ages 40 and older one every calendar year
  • Osteoporosis screening for women
  • Age 40 -64 at increased risk
  • Age 65 and older
  • PSA testing, one annually for men, age 40 and
    older
  • Annual Biometric Screening (NEW for 2014)

34
Preventive care, adult
  • Certain adult routine immunizations endorsed by
    the Centers for Disease Control and Prevention
    and administered by a PPO provider are paid in
    full by the Plan.
  • Hepatitis A and B are covered for adults age 19
    and older
  • Herpes Zoster (shingles) vaccine for adults age
    60 and older (and Medicare Part D is not the
    primary payor) 
  • Whooping Cough (Tdap) booster one, for adults age
    19 and older

35
Preventive care, adult
  • Adult routine immunizations
  • Varicella (chickenpox) vaccine for adults age 19
    and older
  • Human Papillomavirus (HPV) vaccine for adult
    women age 26 and younger, and
  • Human Papillomavirus (HPV4) vaccine for adult men
    age 26 and younger
  • are just some of the adult immunizations
    covered in the 2014 benefit year.

36
Preventive Benefits (Pneumococcal and Seasonal
Flu)
  • CDC recommends that everyone 6 months of age and
    older get a seasonal flu vaccine. And the NALC
    Health Benefit Plan makes it easier to get your
    flu and pneumococcal vaccines by partnering with
    more than 52,000 local NALCPreferred and NALC
    CareSelect pharmacies (including more than 7,000
    CVS Pharmacies) to provide vaccines at no cost.

37
Preventive care, children
  • Our 100 PPO preventive coverage for childrens
    vaccinations includes
  • an annual camp, school or sports physical,
  • All American Academy of Pediatrics (AAP)
    recommended routine examinations through age 2
    and all routine immunizations recommended by the
    AAP for children through the age of 21,
  • including the meningococcal immunization and the
    HPV4 vaccine for males age 9 through 21
  • Initial hospital examination of newborn child

38
Preventive care, children
  • Also paid in full when rendered by a PPO provider
    are several routine screening tests for children
    which include
  • One vision screening for amblyopia (or its risk
    factors) for children between the ages of 3 and 5
    years,
  • A newborn screening hearing test ,
  • High blood pressure screening,
  • HIV screening
  • Pap test, and
  • An annual urinalysis for children age 5 through
    21.
  • Hemoglobin/hematocrit for females age 11 through
    21

39
Preventive care, children
  • The American Academy of Pediatrics Bright Futures
    is a national health promotion and disease
    prevention initiative that addresses children's
    health needs. The Plan now covers several new
    preventive screenings for children in full as
    recommended by Bright Futures/AAP when rendered
    by a PPO provider. These screenings include

40
Preventive care, children
  • Screenings Recommended by bright futures/AAP
  • Alcohol and drug use assessment age 11 through 21
  • Developmental screening (including screening for
    autism) through age 3
  • Fasting lipoprotein profile (total cholesterol,
    LDL, HDL and triglycerides)
  • One, age 18 through 21
  • Age 17 and younger with medical indications

41
Preventive care, children
  • Screenings recommended by Bright Future/AAP Cont.
  • Hearing screening
  • Lead screening test age 6 and younger , and
  • TB screening through age 21
  • Vision Screening for children age 3 through 18

42
Prescription Benefit
  • It is important that you realize the difference
    between a brand name drug and a generic drug.

43
Prescription Benefit
  • Like most other Fee-For-Service FEHB Plans, the
    Plan classifies all prescription drugs into one
    of four categories, or tiers based on quality,
    safety, clinical effectiveness and cost

44
Prescription Benefit
  • Tier 1 - consists of generic drugs.
  • Tier 2 - drugs are brand drugs that appear on the
    Plans formulary. We call them formulary brand
    drugs..
  • Tier 3 - drugs are brand drugs that do not appear
    on the Plans formulary. We call them
    non-formulary brand drugs. You will pay more for
    these non-formulary brand drugs.
  • Tier 4 - is specialty drugs.

45
Quit for Life Tobacco Cessation Program
  • A free program offered to our members and their
    eligible dependent age 18 or older.  The program
    includes
  • Five professional 30 minute telephonic counseling
    sessions
  • Direct shipment of 8 weeks of nicotine
    replacement therapy (NRT) patch or gum
  • For more information go to www.quitnow.net/nalc
    or call 1-866-784-8454.

46
Alere Weight Talk Program
NEW for 2014
  • The Weight Talk Program through Alere is a
    personal coaching program designed to achieve
    measurable, sustainable weight loss. It is
    delivered through regular phone-based coaching
    sessions with a dedicated coach.
  • Participants set realistic weight goals and
    through small multiple behavior changes learn how
    to achieve and maintain a healthy weight for the
    rest of their lives.

47
Alere Weight Talk Program
  • Individuals can enroll in the Weight Talk
    Program online at www.nalc.org/depart/hbp or
    call the toll-free number at 1-855-948-8255. A
    personal dedicated coach is available Sunday
    through Friday 700 a.m. through 300 a.m. and
    Saturday 900 a.m. through 1200 a.m. Eastern
    Time.

48
Additional Benefit Highlights for 2014
  • We now cover skin cancer preventive medicine
    counseling for adults age 24 and younger and for
    children age 10 and older as recommended by the
    USPSTF.
  • We now cover fall prevention preventive medicine
    counseling for adults age 65 and older.
  • We now cover a combined total of 75
    rehabilitative and habilitative physical,
    occupational and speech therapy visits per
    calendar year.
  • We now cover the initial office visit or
    consultation for acupuncture.
  • You now pay nothing for educational classes and
    nutritional therapy for self-management of
    diabetes, hyperlipidemia, hypertension, and
    obesity when rendered by a PPO provider.

49
Additional Benefit Highlights for 2014
  • We now cover over-the-counter vitamin D
    supplements (600 to 800 IU per day) when
    purchased at a preferred or network retail
    pharmacy for adults age 65 and older as
    recommended by the USPSTF (prescription
    required).
  • We now cover over-the-counter aspirin when
    purchased at a preferred or network retail
    pharmacy for men age 45 through 79 and women age
    55 through 79 as recommended by the USPSTF
    (prescription required).
  • We now cover over-the-counter folic acid (0.4 to
    0.8 mg) when purchased at a preferred or network
    retail pharmacy for women planning a pregnancy or
    capable of becoming pregnant (prescription
    required).

50
Additional Benefit Highlights for 2014
  • We now cover over-the-counter iron supplements
    when purchased at a preferred or network retail
    pharmacy for children age 6 to 12 months
    (prescription required).
  • NOTE The Additional Benefit Highlights do
    not reflect all of the changes for 2014.

51
High Option General Information
  • To obtain claim forms, claims filing advice or
    answers about our benefits, you can contact the
    Plan at
  • NALC Health Benefit Plan
  • 20547 Waverly Court
  • Ashburn, VA 20149
  • 703-729-4677
  • 1-888-636-NALC (6252)
  • or at our website at www.nalc.org/depart/hbp.

52
  • CDHP
  • and
  • Value Option Plan

53
CDHP and Value Option Plans
  • Why add two (2) additional options?
  • The NALC CDHP and Value Option were built for the
    City Carrier Assistants as low cost options since
    they may have to pay entire premiums which
    includes both the employer share and the
    government share.
  • So, how did we keep the premiums low?
  • High Deductible
  • Higher out-of-pocket maximum
  • Benefit structure not as rich

54
Consumer Driven Plan
  • What is a Consumer Driven Plan?
  • A health plan that provides coverage for
    medical/pharmacy expenses, with in-network
    preventive care services covered at 100, plus...
  • A Personal Care Account (PCA) funded by NALC to
    pay for eligible health care expenses.
  • Deductible - If you are enrolled in the
    CDHP/Value Option, you must satisfy your calendar
    year deductible and exhaust your Personal Care
    Account (PCA) before the Plan starts paying
    benefits under the Traditional Health Coverage.
    Once the deductible is met, you and NALC will
    share the cost of the eligible expenses.

55
Consumer Driven Plan Personal Care Account (PCA)
  • Depending on the plan option chosen, each year
    the Plan will add a certain amount to your
    Personal Care Account (PCA)
  • New Option 1 Consumer Driven
    Health Plan
  • 1,200.00 per year for Self Only or
  • 2,400.00 per year for Self and Family
  • New Option 2 Value Option Plan
  • 100.00 per year for Self Only or
  • 200.00 per year for Self and Family

56
Consumer Driven Plan Personal Care Account (PCA)
  • CDHP and Value Option PCA Rollover Maximum
  • Money in the account rolls over each year if you
    do not spend it, up to a maximum of
  • Single - 5,000
  • Family - 10,000

57
Consumer Driven Plan Personal Care Account (PCA)
  • You must use any available PCA benefits,
    including any amounts rolled over from previous
    years, and exhaust any remaining deductible
    before
  • Traditional Health Coverage begins.

58
Consumer Driven Plan Deductible
  • Still confused? Think of it like this..
  • Your deductible is your bridge between your
    Personal Care
  • Account and Traditional Health Coverage.
  • After you exhaust your PCA, you must pay any
    remaining
  • deductible before Traditional Health Coverage
    begins.

Deductible
Traditional Benefit Begin
Personal Care Account
59
Consumer Driven Plan Deductible and Out-of-Pocket
Amounts
In-Network Out-of-Network
CDHP Deductible Self - 2,000 Self and Family -4,000 Self - 4,000 Self and Family -8,000
CDHP Out-of-Pocket Self - 6,000 Self and Family - 12,000 Self - 12,000 Self and Family 24,000
Value Option Deductible Self - 2,000 Self and Family -4,000 Self - 4,000 Self and Family -8,000
Value Option Out-of-Pocket Self - 6,000 Self and Family - 12,000 Self - 12,000 Self and Family 24,000
60
Consumer Driven CDHP Plan Example
61
Consumer Driven Value Option Plan Example
62
CDHP and Value Option 2014 Plan Partnerships
63
2014 Partnerships
  • The NALC Health Benefit Plan CDHP/Value Option
    has partnered with Cigna
  • HealthCare to provide .
  • The Cigna Open Access Plus PPO network which
    offers 1,875,900
  • participating family doctors and specialists, and
    more than 22,600 general
  • acute care hospitals, and facilities nationwide.
  •  
  • And, CVS/Caremark, our prescription benefit
    manager, provides our
  • membership access to more than 67,800 network
    pharmacies.
  •  
  • Chances are your medical provider or pharmacy is
    already
  • eligible to receive In-network benefits from the
    Plan.

64
CDHP and Value Option Benefit Structure Highlights
  • Preventive Care with an In-Network health care
    professional is covered at 100
  • When the doctor bills your visit as preventive
    care, your PCA will not be used.
  • Examples of Preventive Benefits include but are
    not limited to
  • Well Baby and Well Child visits
  • Well Man and Well Woman visits
  • Routine Immunizations
  • Routine Screenings
  • Cholesterol Screening Ages 20, every 5 years
  • Diabetes Screening
  • Mammogram Once a year for women age 40
  • Prostate Screening Once a year for men age 40
  • Colonoscopy Ages 50, every 10 years
  • Note Benefits will be reduced, if an In-Network
    provider is not used.

65
CDHP and Value Option Benefit Structure Highlights
  • Professional Services of physicians (Including
    specialists) or urgent care centers
  • Office or outpatient visits
  • Office or outpatient consultations
  • Second surgical Opinions

In-Network Out-of-Network
You Pay 20 of Plan Allowance 50 of Plan Allowance And any difference, if any between our allowance and charge
Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
66
CDHP and Value Option Benefit Structure Highlights
  • Lab, x-ray, and other diagnostic tests (the below
    list is a summary and not inclusive).
  • Blood tests
  • Urinalysis
  • X-Rays
  • Pathology
  • Bone Density Study

In-Network Out-of-Network
You Pay 20 of Plan Allowance 50 of Plan Allowance And any difference, if any between our allowance and charge
Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Not covered - Routine tests except as listed in the official brochure under Preventive Care, Section 5. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Not covered - Routine tests except as listed in the official brochure under Preventive Care, Section 5. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Not covered - Routine tests except as listed in the official brochure under Preventive Care, Section 5.
67
CDHP and Value Option Benefit Structure Highlights
  • Maternity Care
  • Routine prenatal visits
  • Delivery
  • Routine postnatal visits
  • Amniocentesis
  • Anesthesia related to delivery or amniocentesis
  • Group B streptococcus infection screening
  • Sonograms
  • Fetal Monitoring

In-Network Out-of-Network
You Pay 20 of Plan Allowance 50 of Plan Allowance And any difference, if any between our allowance and charge
Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
68
CDHP and Value Option Benefit Structure Highlights
  • Physical, Speech, and Occupational Therapies
  • A combined total of 50 rehabilitative and
    habilitative visits per calendar year for
    treatment provided by a licensed registered
    therapist or physician for the following
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • The attending physician must - Order the care,
    Identify the specific skills the patient requires
    and the medical necessity for skilled services,
    and Indicate the length of time the services are
    needed.

In-Network Out-of-Network
You Pay 20 of Plan Allowance (All charges after 50 max visits have been met) 50 of Plan Allowance And any difference, if any between our allowance and charge(All charges after 50 max visits have been met)
Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above. Note Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
69
CDHP and Value Option Benefit Structure Highlights
  • The NALC Health Benefit Plan CDHP/Value Option
    includes coverage for hearing aids and related
    examination up to a maximum Plan payment of 500
    per ear with replacements covered every 3 years.
  • We will also cover custom functional foot
    orthotics including the casting up to a Plan
    payment of 200 every 5 years.
  •  Our chiropractic benefit includes coverage for
    12 spinal or extraspinal manipulations per
    calendar year.
  • Note All of these benefits are payable first
    through your Personal Care Account and then
    subject to the calendar year deductible and
    applicable coinsurance.

70
CDHP and Value Option Benefit Structure Highlights
  • Prescription Drug Plan
  • All prescription drugs are classified into one of
    four categories, or tiers,. based on quality,
    safety, clinical effectiveness and cost.
  • Tier 1 consists of generic drugs.
  • Tier 2 drugs are brand drugs that appear on the
    Plans formulary. We call them formulary brand
    drugs.
  • Tier 3 drugs are brand drugs that do not appear
    on the Plans formulary. We call them
    non-formulary brand drugs.
  • Tier 4 is specialty drugs.

71
CDHP and Value Option Benefit Structure Highlights
  • Your 2014 Drug Cost-Share for the NALC CDHP and
    Value Option Plans.
  • Generic Drug You Pay
  • Network Retail up to 30-day supply 10
  • Mail Order 90-day supply 20
  • Formulary Brand Drug
  • Network Retail up to 30-day supply 40
  • Mail Order 90-day supply 80
  • Non-Formulary Brand Drug
  • Network Retail up to 30-day supply 60
  • Mail Order 90-day supply 120
  • Prescription drugs are subject to the calendar
    year deductible. Your PCA must be used
  • first and then you must meet the remainder of
    your deductible before your Traditional
  • Health Coverage begins.

72
CDHP and Value Option Benefit Structure Highlights
  • Specialty Drugs You Pay
  • Caremark Specialty Pharmacy Mail Order
  • 30-day supply 200
  • Caremark Specialty Pharmacy Mail Order
  • 90-day supply 400
  • Prescription drugs are subject to the calendar
    year deductible. Your PCA must be used
  • first and then you must meet the remainder of
    your deductible before your Traditional
  • Health Coverage begins.
  • All specialty drugs require prior
    authorization. Specialty drugs, including
    biotech, biological biopharmaceutical and oral
    chemotherapy drugs, are generally defined as
    high-cost prescription drugs that treat complex
    conditions and require special handling and
    administration and can cost thousands of dollars
    for a single dose. Call CVS Caremark Specialty
    Pharmacy Services at 1-800-237-2767 to obtain
    prior approval.

73
CDHP and Value Option Benefit Structure Highlights
  • Want to be Tobacco Free?
  • A voluntary tobacco cessation program offered by
    the Plan which includes
  • Unlimited professional 20 30 minute telephonic
    counseling sessions per quit attempt
  • Online tools
  • Over- the Counter nicotine replacement therapy
  • For more information on the program visit
    mycigna.com or call
  • 1-855-246-1873

74
Health Risk Assessment (HRA)
  • We will pay the Self Only premium for the
    CignaPlus Savingssm discount dental program when
    you are enrolled in a Self Only option with the
    Plan and you complete the Health Risk Assessment
    (HRA).
  • We will pay the Self and Family premium for the
    CignaPlus Savingssm discount dental program when
    you are enrolled in a Self and Family option with
    the Plan and an HRA is completed for two family
    members.

75
CDHP and Value Option
  • Please keep in mind, the CDHP and Value Option
    benefits highlighted are only a summary of the
    plans. Please see our 2014 NALC Health Benefit
    Plan CDHP/Value Option brochure for a complete
    description of benefits to find out why the NALC
    Health Benefit Plan is the right choice for
    letter carriers.

76
CDHP and Value Option General Information
  • To obtain claim forms, claims filing advice or
    answers about our benefits, you can contact Cigna
    at
  • NALC Consumer Driven Health Plan or Value Option
  • P.O. Box 182223
  • Chattanooga, TN 37422-7223
  • 1-855-511-1893

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Rate Information
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High Option NALC HBP Premiums
Year Bi Weekly Postal Premium (Active) Bi Weekly Postal Premium (Active) Monthly Annuitant Premium Monthly Annuitant Premium
Self Family Self Family
2011 51.56 100.57 160.64 327.32
2012 54.04 105.16 161.68 327.60
2013 52.95 103.26 160.66 326.04
2014 58.02 114.59 161.22 327.27
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CDHP and Value Option NALC HBP Premiums
Year CDHP CDHP Value Option Value Option
Self Family Self Family
2014 36.19 78.58 31.16 67.66
The above rates only apply to Career Postal
employees. City Carrier Assistants (CCA) should
contact the HRSSC employing office for premium
information at 1-877-477-3273, option 5
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Dare to Compare
  • We encourage each individual to take the
    Directors Challenge and Dare to Compare your
    current plan against the NALC Health Benefit
    Plan. You will see that the NALC Health Benefit
    Plan is both a comprehensive plan with quality
    service, benefits, and reasonable premiums.
  • To accept the challenge go to http//www.opm.gov/
    insure

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Dare to Compare http//www.opm.gov/insure
  • On the right side of page click on the QUICK
    LINK Compare Health Plans
  • Insert your Zip Code. Hit Enter. Then Select
    the Plans you wish to compare (up to 4 plans).
  • Choose an Employee Type such as U.S. Postal
    Service or Annuitant. Click Next.
  • Choose a pay frequency such as Bi Weekly or
    Monthly. The comparison will be shown on your
    screen.

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How USPS Employees Enroll in NALC HBP?
  • If you are currently not a member sign up the
    next Open Season.
  • Enroll through PostalEASE
  • On the Intranet (from the blue page)
  • By phone 1-877-477-3273
  • At an Employee Self-Service Kiosk or
  • Visit - http//liteblue.usps.gov

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Open Season November 11 December 9
  • Is the second Monday of November and runs
    through the second Monday of December each year.
  • If you need more information call the
    Plan at 1-888-636-NALC

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NALC Health Benefit Plan Our
objective is to unite fraternally all Letter
Carriers who are members in good standing in the
National Association of Letter Carriers. I belong
to both the NALC Union AND the NALC Health
Benefit Plan. Do You????? Im 100
UNION!!!
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  • This is a summary of some of the features of the
    NALC Health Benefit Plan. Detailed information
    on the benefits for the NALC Health Benefit Plan
    can be found in the official brochure (RI
    71-009). All benefits are subject to the
    definitions, limitations, and exclusions set
    forth in the official brochure.
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