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. Provide modern, high-quality, competitive benefits
   Ensure broad access to care through strong provider networks and benefits that keep pace with leading private‑sector employers and place enrollees at the center of the experience.
2. Maintain affordability and deliver value
   Manage premium growth through efficient benefit design, value‑based care, and clear cost information for enrollees.
3. Protect program integrity, taxpayer resources, and affordability
   Actively prevent, detect, and address fraud, waste, and abuse (FWA); monitor claims, utilization, and pricing to continuously manage total costs without sacrificing quality or access; support all eligibility and oversight activities.
4. Comply fully with PSHB requirements
   Meet all legal, regulatory, contractual, and administrative obligations and respond promptly to OPM oversight.
5. Modernize through secure digital capabilities and data
   Provide intuitive digital capabilities (e.g., enrollment, claims, provider search, appeals, cost transparency) that are secure by design, and maintain robust data governance standards to ensure data submitted to OPM is accurate, complete, and timely data.
6. Empower consumers
   Offer clear, plain language, and accessible information on benefits, costs, rights, and price and quality data to support informed choices.
7. Ensure financial strength and operational excellence
   Deliver value consistently by maintaining sound financial practices and resilient operations, with efficient claims, responsive customer service, and reliable performance.

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.

*This document will be uploaded soon.

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.