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OPM.gov / Insurance / Carriers / PSHB Carriers
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Postal Service Health Benefits (PSHB) Program Carriers

 

Overview

The Postal Service Health Benefits (PSHB) Program was established by the Postal Service Reform Act and will offer health benefits coverage to eligible United States Postal Service employees, annuitants, and their eligible family members beginning January 1, 2025.

The PSHB Program will generally require Postal Service annuitants who are newly entitled to Medicare, and their covered family members who are Medicare-eligible, to enroll in Medicare Part B to continue their health benefits coverage into retirement. PSHB plans are required to integrate Medicare Part D, offering prescription drug coverage through an Employer Group Waiver Plan (EGWP).

Guiding Principles for Carriers

All carriers must be committed to:

  1. Ensuring enrollees have access to healthcare benefits;
  2. Striving to keep premiums affordable;
  3. Ensuring enrollees have access to quality provider networks;
  4. Providing competitive healthcare choices for consumers;
  5. Strengthening information for consumers so they can be more involved and responsible for their own healthcare decisions;
  6. Being well managed and financially secure;
  7. Providing efficient and effective contract administration;
  8. Ensuring the timely and accurate submission of actuarial data and financial accounting information;
  9. Maintaining compliance with laws, regulations, contract requirements and administrative guidance at all times; and
  10. Guaranteeing that enrollee and Government resources are protected.

Carrier Letters

All PSHB Carriers must adhere to the guiding principles inherent in the FEHB Program, including the FEHB Act, chapter 89 of title 5, United States Code, regulations at 5 CFR part 890 and 48 CFR chapter 16, current standard contract terms except as conformed specifically for the PSHB, and OPM instruction and guidance.

All FEHB Carrier Letters, including archives commencing with calendar year 1999, will be in effect for PSHB Program Carriers effective January 1, 2025, unless otherwise inapplicable.

2024 Carrier Letters

Letter Date Subject
2024-04 02/08/24

Federal Employees Health Benefits and Postal Service Health Benefits Programs Call Letter

2024-05 02/12/24

Consolidated Pharmacy Benefits Guidance for the FEHB Program

2023 Carrier Letters

Letter Date Subject
2023-13 07/19/23

Methodology for Crediting Postal Service Health Benefits (PSHB) Program Plan Reserves and Earned FEHB Medical Loss Ratio Credits

Attachment A - Crediting the PSHB Reserves Example

Carrier Application

Types of carriers that qualify for participation in PSHB Program

  • The PSHB Program will only consider applications from comprehensive, prepaid medical plans.
  • Carriers must offer a complete line of medical services, such as doctor's office visits, hospitalization, emergency care, prescription drug coverage, and treatment of mental conditions and substance abuse.
  • We do not have the authority to contract with companies that offer limited services, such as dental and/or vision plans, prescription drug plans, supplemental insurance, and disability insurance.

How to apply

Carriers interested in offering health insurance plans in the PSHB Program should submit an application in Carrier Connect.

  • Applications for the 2025 plan year closed on August 31, 2023.
  • Applications for the 2026 plan year must be received by January 31, 2025.

 

 

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