U.S. Office of Personnel Management www.opm.gov - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People

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 18.7% for Self Only or 25.5% for Self and Family.

• We changed the maternity office visits copay to the specialist from no copay to $20 for the initial visit only.

• We changed the inpatient hospital admission copay from $250 per admission to $100 per day for the first 3 days.

• We reduced the hospital emergency room copay from $100 to $50.

• We reduced the urgent care center copay from $25 to $20.

• We no longer cover dental services as part of our contract with the Federal Government. We provide for preventive dental care as a Non-Federal Employees Health Benefits Program benefit.

• If you were enrolled in RK1 or RK2, your share of the non-Postal premium will increase by 22.6% for Self Only or 52.7% for Self and Family.

• We have split the North Florida service area into 3 separate enrollment codes. If you live in the Gainesville area or Tallahassee area, you must elect the new enrollment code during Open Season in order to pay the lower premium rates.

• Your office visit copay has increased from $10 to $20 per visit.

• You pay an office visit copay for the initial maternity office visit only. Previously, you paid an office visit copay for each maternity visit.

• You no longer pay an office visit copay for well-child care visits.

• We have reduced the outpatient surgery copay from $100 to $50.

• We changed the copay for specialized testing such as allergy tests, ultrasound, etc. from $25 per test to the applicable office visit or freestanding facility copay.

• We changed the copay for extensive testing such as MRI, CAT scan, etc. from $100 per test to the applicable office visit or freestanding facility copay.

• You now pay an inpatient hospital admission copay which is $100 per day for the first 3 days up to $300 maximum per admission.

• The urgent care center copay has increased from $10 to $20.

• Your retail pharmacy prescription drug copays have increased to $10 generic, $20 name brand formulary and $40 non-formulary. The copay for drugs to treat sexual dysfunction has changed to $15. The mail-order prescription drug copays have changed to $15 generic, $30 name brand formulary, and $60 non-formulary.

• Plan pharmacies will charge you the price difference between generic drugs and name brand drugs when generic substitution is medically appropriate but you choose the name brand drug over the generic.

• Your vision care benefits have changed and you now pay higher copays for all vision care services.

• You now pay nothing for accidental dental services.

• The copay for infertility testing and treatment has decreased from $25 to $20.

• The copay for sterilization has changed from $100 to the applicable office visits or hospital setting copay.

• We removed the limit on prosthetic devices.

• We added coverage for hearing aids - first hearing aid and test only when necessitated by accidental injury.

• We removed the $100 limit from the smoking cessation benefit.