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 decrease by -3.7% Self Only and -44.9% for Self and Family.

• IMPORTANT: We are offering only the Standard Option for 2004. If you are currently enrolled in the High Option and do nothing, your enrollment will automatically transfer to the Standard Option for 2004. If you are currently enrolled in the Standard Option and do nothing, you will remain in the Standard Option for 2004. See pages 14-40 for the benefits.

• Your catastrophic protection out-of-pocket maximum for coinsurance and copayments has increased to $2,000 per self enrollment and $6,000 per family enrollment in calendar year 2004. Previously it was $1,500 per self enrollment and $3,000 per family enrollment. See page 13.

• Your calendar year deductible is $250 per self enrollment and $750 per family enrollment. You must meet the deductible for most medical services. Previously, there was no calendar year deductible. See pages 15, 26, 30, 33, and 35.

• Your copayment for infertility services will be 30% of our allowance. Previously, it was $10 per PCP office visit or $20 per specialist office visit. See page 18.

• Your copayment for hearing aids will be 30% of our allowance. Previously, it was no charge. See page 21.

• Your copayment for inpatient hospital services is $250 per admission. Previously, it was no charge. See page 30.

• You may obtain maintenance prescription drugs through our Home Delivery mail order program. You pay two retail copays for a 90-day supply. See page 37.