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 33.9% for Self Only or 36.9% for Self and Family.
- The Prescription Drug retail copayment will increase from $8/$20/$35 (Generic/Brand name/Non-formulary) respectively to $10/$20/$35. The Prescription drug mail order 90 day supply copayment will increase from $16/$40/$70 (Generic/Brand name/Non-formulary) respectively to $20/$40/$70. Please see page 39 for prescription benefit.