Plans Open to All
Alliance Health Plan PPO
Non PPO 		$100
$300		 $200
$200		 $150
$250		 10%
30%		 10%
30%		 10%
30%		 10%
30%		 10%/ 50%
10%/ 50% +		 10%/ 50%
10%/ 50% +		 10%/ 50%
10%/ 50% +		 20%
20%		 20%
20%
APWU Health Plan PPO
Non PPO 		$275
$350		 0
0		 0
$200		 10%
30%		 10%
30%		 10%
30%		 10%
30%		 $7
45%		 25%
45%		 25%
45%		 $10
$10		 20%
20%
Blue Cross and Blue Shield Service Benefit Plan-Basic PPO 0 0 $100/ day; $500 $20/$30 0 0 $30 $10 $25 $35 or 50% $10-I $25-I
Blue Cross and Blue Shield Service Benefit Plan-Std PPO
Non PPO 		$250
$250		 0
0		 $100
$300		 10%
25%		 0
30%		 0
30%		 10%
25%		 25%
45%		 25%
45%		 25%
45%		 $10-M/ 25%-I
45%-I		 $35-M/ 25%-I
45%-I
GEHA Benefit Plan-High PPO
Non PPO 		$300
$300		 0
0		 0
0		 10%
25%		 0
0		 10%
25%		 10%
25%		 $5/ 50%
$5 or 50%		 $15/ $30/ 50%
$15/ $30/ 50%		 $15/ $30/ 50%
$15/ $30/ 50%		 $10
$10		 $35/ $50
$35/ $50
GEHA Benefit Plan-Std PPO
Non PPO 		$450
$450		 0
0		 0
0		 15%
35%		 15%
35%		 15%
35%		 15%
35%		 $5
$5 +		 50%
50% +		 50%
50% +		 $15
$15		 50%
50%
Mail Handlers-High PPO
Non PPO 		$200
$200		 $250
$250		 0
$250		 10%
30%		 0
0		 0
0		 10%
30%		 25%
50%		 25%
50%		 25%
50%		 $10
$10		 $30
$45
Mail Handlers-Std PPO
Non PPO 		$250
$250		 $600
$600		 $150
$300		 10%
30%		 0
0		 0
0		 10%
30%		 30%
50%		 30%
50%		 30%
50%		 $10
$10		 $40
$55
NALC PPO
Non PPO 		$250
$300		 0
$25 for Retail		 0
$100		 15%
30%		 10%
30%		 10%
30%		 15%
30%		 25%
40%+		 25%
40%+		 25%
40%+		 $12
$12		 $25
$25
PBP Health Plan-High PPO
Non PPO 		$200
$400		 $100
$150		 0
$150		 10%
20%		 10%
25%		 10%
25%		 10%
20%		 $10 or 20%
20%+		 $25 or 20%
20%+		 $40 or 20%
20%+		 $10
$10		 $25
$25
PBP Health Plan-Std PPO
Non PPO 		$250
$500		 $100
$150		 0
$250		 10%
30%		 10%
30%		 10%
30%		 10%
30%		 $15 or 20%
30%+		 $30 or 20%
30%+		 $40 or 20%
30%+		 $15
$15		 $30
$30
Plans Open Only To Specific Groups
Association Benefit Plan PPO
Non PPO 		$300
$300		 0
0		 $100
$200		 10%
25%		 0
25%		 0
25%		 10%
25%		 $10
$10		 $20
$20		 $30
$30		 $15
$15		 $30
$45
Foreign Service PPO
Non PPO 		$300
$300		 0
0		 0
$200		 10%
30%		 0
20%		 0
20%		 10%
30%		 $10
$10		 $20
$20		 $20
$20		 $15
$15		 $25
$25
Panama Canal Area No PPO 0 $400 $125 50% 50% 50% 50% 50% 50% 50% N/ A N/ A
Rural Carrier Benefit Plan PPO
Non PPO 		$350
$350		 CY Applies
CY Applies		 0
$200		 10%
15%		 0
0		 0
20%		 0
0		 25%
25%		 25%
25%		 25%
25%		 $13
$13		 $18
$18
SAMBA PPO
Non PPO 		$300
$300		 0
0		 $200
$300		 10%
30%		 0
30%		 10%
30%		 10%
30%		 $15
$15		 $25/ $30
$25/ $30		 $25/ $30
$25/ $30		 $15
$15		 $25/ $30
$25/ $30
Secret Service No PPO $200 $200 $100 20% 0 0 0 $10 $20 $20 $20 $40
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