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 NALC Postal premium will increase by 3.7% for Self Only or 0.9% for Self and Family.
- Your share of the non-Postal premium will increase by 6.7% for Self Only or 6.1% for Self and Family.
- Your catastrophic protection out-of-pocket maximum is $4000 per person or family for PPO providers and $6000 per person or family for PPO and non-PPO providers combined. Previously, it was $3000 and $3500. (Section 4)
- We now cover osteoporosis screening for women with increased risk, age 60 and older. (Section 5(a))
- We now cover an annual influenza vaccine for all adults. Previously, coverage was limited to age 65 and older. (Section 5(a))
- Our coverage for a smoking cessation program no longer requires that the calendar year deductible be met before we consider the charges. (Section 5(a))
- We changed the copayment for mail order prescription drugs and supplies. For a 60-day supply, you pay $8 for generic drugs and $24 for brand name; for a 90-day supply, you pay $12 for generic drugs and $35 for brand name. Previously, you paid $7 for generic drugs and $20 for brand name for a 60-day supply, and $10 for generic and $30 for brand name for a 90-day supply. (Section 5(f))
- If you have Medicare, your mail order copayment for a 60-day supply is $5 $7 for generic drugs and $17 $20 for brand name. For a 90-day supply, you pay $10 for generic drugs and $30 for brand name. Previously, you paid $5 for generic drugs and $17 for brand brand for a 60-day supply, and $7.50 for generic and $25 for brand name for a 90-day supply. (Section 5(f))
- Your coinsurance for non-network retail drugs and supplies is 50%. Previously, you paid 40%. (Section 5(f))