U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

This is a general description of the plan changes. This page is not an official statement of benefits. For that, go to the Benefits descriptions in the Plan Brochure. Also, we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.

• Your share of the non-Postal premium will increase by 11.1% for Self Only or 10.9% for Self and Family.

• We changed the Plan's catastrophic protection out of pocket maximum for PPO services from $2,500 per person/$3,000 per family to $3,000 per person/$3,500 per family and for non-PPO services from $3,000 per person/$3,500 per family to $3,500 per person/$4,000 per family.

• We now provide benefits for one influenza vaccine shot per person each calendar year.

• We increased the calendar year deductible for non-PPO services from $350 per person/$700 per family to $400 per person/$800 per family.

• We added a copayment of $100 for each stay in a PPO hospital.

• We increased the copayment for a stay in a non-PPO hospital from $200 to $300 for each hospital stay.

• We decreased the coinsurance amount that the Plan pays from 75% to 70% for services and supplies in a non-PPO outpatient hospital or ambulatory surgical center.

• We decreased the coinsurance amount that the Plan pays from 85% to 80% for room and board and other hospital charges for a stay in a non-PPO hospital.

• We decreased the coinsurance amount that the Plan pays from 85% to 80% for surgery, reconstructive surgery, oral and maxillofacial surgery, organ/tissue transplant, and anesthesia when provided by a non-PPO provider.

• We added a retail prescription drug card program with a separate $200 deductible per person each calendar year. After the prescription drug deductible, you pay 30% of the cost of prescription drugs purchased at a network or non-network retail pharmacy. Prescriptions purchased at a retail pharmacy have a limit of a 34-day supply of medication and two refills. Caremark, Inc., will process all prescription drug claims for the Plan, beginning January 1, 2004.

• We changed the copayments for prescription drugs ordered through our mail order prescription program from $15 generic or $25 brand name to $15 generic, $25 preferred brand name, or $40 non-preferred brand name. For Plan members with Medicare Part B (pays first), the copayments changed from $6 generic or $12 brand name to $8 generic, $15 preferred brand name, or $30 non-preferred brand name.

• The Plan now has a PPO network in Wyoming.