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POSTAL SERVICE HEALTH BENEFITS (PSHB) PROGRAM

 * Overview
 * Medicare Part B
 * Pharmacy Benefits
 * Special Populations
 * Automatic Enrollment in PSHB
 * Cost Savings with Medicare Part B or Medicare Advantage
 * Carrier Customer Service Numbers


OVERVIEW

Update: OPM has extended Open Season for the Postal Service Health Benefits
Program through Friday, December 13th at 11:59 pm EST.

This extension is only for the PSHBP. This does not extend to FEHB or other
benefits programs. The deadline for FEHB remains 11:59 pm, in the location of
your electronic enrollment system, on Monday, December 9th.



Thank you for your interest in the Postal Service Health Benefits Program!

If you received an auto-enrollment letter and reviewed the PSHB enrollment
information, but do not need to make changes, you do not need to take action
during Open Season.

Get coverage or change your enrollment information. To make changes by phone,
call the PSHB Helpline at 844-451-1261.

 * For questions about Medicare Parts A, B, and D, Medicare Advantage Plans, and
   general benefits information, please reference these Carrier Customer Service
   Numbers or plan brochures.
 * For current Postal Service employees, you may also call the USPS Human
   Resources Shared Service Center directly at 877-477-3273.
 * If you have technical issues with your Login.gov account, Login.gov operates
   a 24/7 contact center via phone or website contact form.


POSTAL SERVICE HEALTH BENEFITS (PSHB) PROGRAM QUICK FACTS

 * The Postal Service Health Benefits (PSHB) Program is a new, separate program
   within the Federal Employees Health Benefits (FEHB) Program, administered by
   the Office of Personnel Management (OPM).
 * PSHB will provide health benefits plans to eligible Postal Service employees,
   Postal Service annuitants, and their eligible family members starting on
   January 1, 2025.
 * Postal Service employees and Postal Service annuitants will no longer be
   eligible to enroll or continue enrollment in an FEHB plan as of January 1,
   2025, and must enroll in a PSHB plan to maintain health coverage through the
   Postal Service.
 * If a Postal Service employee or Postal Service annuitant is covered under a
   family member’s FEHB plan not through the Postal Service, they can continue
   that coverage after January 1, 2025.
 * Former Postal Service employees and their family members who are on Temporary
   Continuation of Coverage prior to January 1, 2025, through their FEHB plan
   will continue with that FEHB plan after January 1, 2025.
 * Health insurance premiums are representative of the cost of the benefits
   provided. For 2025, the cost of many health plans in both PSHB and FEHB have
   increased more than in previous years. Enrollees received an auto-enrollment
   letter listing the plan they will automatically be enrolled in if no changes
   are made during the Open Season. If an enrollee is considering making a plan
   change due to the increased cost of their premium, they:
   * can browse plan costs and information online without signing in to their
     PSHB account, by visiting health-benefits.opm.gov and clicking on Compare
     Plans Without Signing In,
   * may review general information on PSHB premiums; or
   * for specific questions about premiums, they may contact a Carrier.


PSHB BECOMES EFFECTIVE JANUARY 1, 2025

 * Postal Service employees, Postal Service annuitants, and eligible family
   members will remain enrolled in their 2024 FEHB plans through December 31,
   2024.
 * Enrollees will get a letter prior to the 2024 Open Season that provides
   information on the PSHB plan they’ll automatically be enrolled in. Enrollees
   can make changes to that plan enrollment during the Transitional PSHB Open
   Season, which runs the same time as the 2024 Federal Benefits Open Season:
   November 11 through December 9, 2024. Enrollees are encouraged to review all
   available plans to choose a plan that best fits their needs.


PSHB PLANS VS. FEHB PLANS:

 * As part of the FEHB Program, PSHB plans will cover the same set of
   comprehensive health benefits included in FEHB plans. PSHB plans will be
   offered by many of the same carriers that offer FEHB plans.
 * There are a few important differences for PSHB enrollees:
   * The PSHB plan year will run from January 1 through December 31 each year.
     This is the same for annuitants covered by FEHB, but different from the
     FEHB plan year for employees, which begins on the first day of the first
     full pay period in January each year.
   * As required by the Postal Service Reform Act of 2022 (PSRA), certain
     Medicare-eligible Postal Service annuitants and their Medicare-eligible
     family members must enroll in Medicare Part B to remain enrolled in a PSHB
     plan. There are some exceptions to this requirement described here. 


ENROLLMENT AND OPEN SEASON

 * In October 2024, Postal Service employees and Postal Service annuitants who
   are enrolled in an FEHB plan for 2024 will be automatically enrolled in a
   2025 PSHB plan by OPM.
 * Enrollees can make changes, including selecting a different plan, during the
   2024 Open Season (November 11 through December 9, 2024).
 * To prepare for enrollment, view PSHB auto-enrollment plan
   information and 2025 PSHB premiums.


MEDICARE PART B SPECIAL ENROLLMENT PERIOD (SEP)

 * The PSRA authorized a six-month Special Enrollment Period (SEP) for Medicare
   Part B from April 1 through September 30, 2024, for USPS annuitants and
   family members that are not currently enrolled in Medicare Part B.
 * During this SEP, those Postal annuitants and their family members who, as of
   January 1, 2024, are entitled to Medicare Part A but are not enrolled in
   Medicare Part B may enroll in Medicare Part B.
 * Those who enroll in Medicare Part B during this SEP will not have to pay any
   Medicare late enrollment penalty. Instead, the Postal Service will pay the
   penalty.
 * A Postal Service annuitant or their family member may be subject to a
   Medicare Part B late enrollment penalty if they enroll in Medicare Part B
   outside of the SEP.
 * Those eligible for the SEP should have received information about it from the
   Postal Service before April 1, 2024.
 * If you have questions about eligibility for the Medicare SEP, please contact
   USPS by calling (833) 712-7742.


COST SAVINGS FOR MEDICARE PART B AND MEDICARE ADVANTAGE ENROLLEES

 * Many 2025 PSHB plans will offer cost savings to their enrollees who are also
   enrolled in Medicare.
 * Examples of cost savings may include Part B premium reimbursement, waived
   deductibles, and waived cost-sharing for certain medical services.
 * More cost savings information is available here.


OTHER INSURANCE AND BENEFITS PROGRAMS

Enrollment in a PSHB plan will not change availability of or enrollment in other
insurance and benefits programs, including:

 * Federal Employees Dental and Vision Insurance Program (FEDVIP)
 * Federal Employees’ Group Life Insurance (FEGLI)
 * Long Term Care Insurance Program (FLTCIP)


MEDICARE PART B ENROLLMENT REQUIREMENTS


MEDICARE PART B ENROLLMENT REQUIREMENTS

 * Certain Medicare-eligible Postal Service annuitants and their
   Medicare-eligible family members must enroll in Medicare Part B to keep PSHB
   coverage, with some exceptions. See below.
 * This is different from the FEHB Program, where there is no Medicare Part B
   enrollment requirement.
 * Information about how to enroll in Medicare Part B is available here.


EXCEPTIONS TO THE MEDICARE PART B ENROLLMENT REQUIREMENTS

These Postal Service annuitants and family members are not required to enroll in
Medicare Part B to be enrolled in a PSHB plan:

 * Postal Service annuitants who retired on or before January 1, 2025, and are
   not already enrolled in Medicare Part B
   * Family members of these Postal annuitants are also not required to enroll
     in Medicare Part B to be covered by a PSHB plan.
 *  Postal Service employees who are age 64 or older on January 1, 2025
   * These employees are not required to enroll in Medicare Part B after they
     retire to enroll in PSHB as an annuitant.
   * Family members of these employees also are not required to enroll in
     Medicare Part B after the employee retires to be covered by a PSHB plan.
 * Postal Service annuitants or family members who live outside the United
   States and its territories. This includes the States, the District of
   Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American
   Samoa, and the Northern Mariana Islands.
   * These annuitants and family members will need to document their residency.
   * A Postal Service annuitant or family member who moves back to the United
     States may lose eligibility for this exception and could be required to
     enroll in Medicare Part B to be enrolled in a PSHB plan.
   * More information about Medicare Part B enrollment is available here.
 * Postal Service annuitants or their family members eligible for or enrolled in
   certain health benefits through the Department of Veterans Affairs (VA)
   (subchapter II of chapter 17 of title 38, United States Code)
   * When a Postal Service annuitant is eligible for this exception, a family
     member of the annuitant is not required to enroll in Medicare Part B,
     whether or not the family member is eligible for VA benefits.
 * Postal Service annuitants or their family members eligible for health
   services from the Indian Health Service (IHS)
   * When a Postal Service annuitant is eligible for this exception, a family
     member of the annuitant is not required to enroll in Medicare Part B,
     whether or not the family member is eligible for IHS services.


PHARMACY BENEFITS FOR POSTAL SERVICE ANNUITANTS

Postal Service annuitants and covered family members eligible for Medicare Part
D will automatically receive prescription drug coverage through a Medicare Part
D Employer Group Waiver Plan (EGWP) provided by their PSHB plan.

 * An EGWP is a Medicare Part D Plan that is only available to certain
   individuals.
 * The Part D EGWP doesn’t cost any more in premiums and no action is needed to
   get this coverage.

A PSHB plan Part D EGWP offers a number of advantages:

 * The amount of out-of-pocket costs for covered drugs, medications, and
   supplies won’t be any more (and could be less) than what a person would pay
   under the regular prescription drug coverage. More often the benefits are
   less costly and/or more generous than PSHB plan prescription drug coverage.
 * In a PSHB plan Part D EGWP, members will receive benefits such as a $35/month
   cap on insulin products and an annual $2,000 cap on out-of-pocket Part D drug
   costs.
 * In a PSHB plan Part D EGWP, members may have greater access to pharmacy
   services including in-network and out-of-network pharmacies.

Medicare Part D-eligible annuitants and their Part D-eligible family members may
choose to opt out of the PSHB plan’s Part D EGWP prescription drug coverage. If
they do, they will not receive any prescription drug coverage through PSHB even
though they will pay the same premium for the plan.

 * OPM strongly encourages anyone considering opting out to make sure that
   opting out makes sense for their individual circumstance. Members can call
   their PSHB plan for more information.
 * If a Postal Service annuitant or family member opts out or is disenrolled
   from the EGWP due to an error, a limited grace period to re-enroll may be
   available. They may contact the PSHB plan within 90 days to be eligible to
   have coverage reinstated retroactive to the coverage effective date.
 * If a family member of a Postal Service annuitant is not eligible for Medicare
   Part D, they will receive prescription drug coverage through the PSHB plan
   prescription drug coverage and not through the PSHB plan Part D EGWP.

Other Considerations

 * While every PSHB plan offers a Prescription Drug Plan (PDP) EGWP, only some
   PSHB plans offer a Medicare Advantage Prescription Drug (MAPD) EGWP. An MAPD
   EGWP offers comprehensive coverage, and often added benefits that are not
   covered under the regular PSHB plan. Because of these important differences,
   anyone currently enrolled or considering enrolling in an MAPD EGWP should
   contact the PSHB plan directly for any questions.
 * A Postal Service annuitant or family member already enrolled in a separate
   Medicare Part D plan should notify the PSHB plan as soon as possible if they
   want to keep that plan. Under Medicare rules, no one can be enrolled in two
   Part D plans at the same time.
 * A Postal Service annuitant or family member living outside of the 50 states,
   D.C., and the U.S. territories will not receive drug benefits through
   Medicare Part D, as that benefit is not available overseas. Instead, they
   will receive prescription drug coverage through the PSHB plan’s regular
   pharmacy benefits, not through the PSHB plan Part D EGWP.


SPECIAL POPULATIONS


POSTAL SERVICE COMPENSATIONERS

 * Postal Service compensationers getting monthly payments from the Department
   of Labor’s Office of Workers’ Compensation Programs (OWCP) will be
   automatically enrolled in a PSHB plan before the 2024 Federal Benefits Open
   Season, which runs from November 11 to December 9, 2024. OPM will send a
   letter to the compensationer with this plan information.
 * Postal Service compensationers can make changes to this automatic enrollment
   during the 2024 Federal Benefits Open Season.
 * As with all Postal Service enrollees, FEHB plan enrollment for these Postal
   Service compensationers will terminate after December 31, 2024.
 * Postal Service compensationers are not required to enroll in Medicare Part B
   to enroll in a PSHB plan, regardless of Medicare Part A entitlement. At
   retirement, compensationers may have to enroll in Medicare Part B, if
   eligible, unless they meet an exception described here.
 * PSHB is the primary health benefits insurance available through the Postal
   Service for Postal Service compensationers. Medicare Secondary Payer rules
   apply to the PSHB Program.
 * Please contact Department of Labor’s Office of Workers’ Compensation Programs
   (OWCP) at (202) 513-6860 for questions about self-payment of PSHB premiums if
   required.


SURVIVING SPOUSES OF POSTAL SERVICE EMPLOYEES AND ANNUITANTS

 * A surviving spouse, or survivor annuitant, may be eligible to continue PSHB
   enrollment after the death of a Postal Service employee or annuitant.
 * Eligibility for a surviving spouse’s PSHB enrollment will be made according
   to the same rules as for FEHB enrollment.


TEMPORARY CONTINUATION OF COVERAGE

 * Temporary Continuation of Coverage (TCC) allows certain people to temporarily
   continue their PSHB coverage after regular coverage ends. TCC enrollees must
   pay the full premium for the plan they select (that is, both the employee and
   government shares of the premium), plus a 2 percent administrative charge.
 * If a Postal Service employee loses coverage because they separate from
   federal service, they may be eligible to enroll under TCC and continue
   coverage for up to 18 months from the date of separation.
 * If a family member of a Postal Service employee or annuitant loses coverage
   because they are no longer eligible family members, they may be eligible to
   enroll under TCC to continue coverage for up to 36 months.
 * Premiums are paid directly to the National Finance Center.


FORMER SPOUSES

 * If a former spouse of a Postal Service employee or annuitant loses PSHB
   coverage due to divorce, they may be eligible to enroll in a FEHB plan under
   the spouse equity provisions of law.
 * If a former spouse of a Postal Service employee or annuitant doesn’t meet all
   the requirements for enrollment under the spouse equity provisions, they may
   be eligible for Temporary Continuation of Coverage (TCC). Or they may also
   choose to enroll in TCC to avoid a gap in coverage while they wait for the
   Office of Personnel Management to determine their eligibility for FEHB under
   the spouse equity provisions.


DIRECT PREMIUM PAYMENTS

 * Premium payments are made directly to the National Finance Center (NFC) for
   all spouse equity and TCC enrollments.
 * If an annuitant’s annuity is not enough to pay PSHB premiums, they may elect
   to pay premiums directly to NFC. Once this option is chosen, the annuitant
   will always pay premiums directly to NFC even if the annuity increases enough
   to cover the premium costs.


NON-PAY STATUS/LWOP POSTAL SERVICE EMPLOYEES

 * Most Postal Service employees in a non-pay status, such as leave without pay
   (LWOP), who are enrolled in an FEHB plan in 2024 will be automatically
   enrolled in a PSHB plan for 2025.
 * OPM will permit Open Season changes for eligible Postal Service employees in
   non-pay status only during the 2024 Open Season.


AUTOMATIC ENROLLMENT IN POSTAL SERVICE HEALTH BENEFITS (PSHB)

The PSHB Program is a new, separate program within the Federal Employees Health
Benefits (FEHB) Program, which will provide health insurance to eligible Postal
Service employees, Postal Service annuitants, and their eligible family members
starting January 1, 2025. Learn more about PSHB.

OPM is working to make the transition to PSHB as simple as possible by
automatically enrolling Postal Service members into a PSHB plan based on their
current FEHB enrollment. The following table lists the plan options into which
individuals will be automatically enrolled. Postal Service enrollees,
annuitants, and their family members who are currently enrolled in any FEHB plan
not listed below will be automatically enrolled in the PSHB nationwide plan
option with the lowest self-only premium that is not a high deductible health
plan and does not charge a membership fee. For the 2025 PSHB benefit year, this
plan is the Blue Cross Blue Shield Service Benefit Plan FEP Blue Focus
(35A/35B/35C).

Postal Service enrollees always have the right to choose their PSHB plan during
the Federal Benefits Open Season. This year, Open Season will run from November
11, 2024, through December 9, 2024.

The FEHB enrollment codes listed in this table may be found on a member's
insurance card and/or the cover page of the plan's FEHB brochure. These codes
correspond to the following enrollment types: (Self-Only / Self and Family /
Self Plus One.)

Carrier 2024 FEHB Plan Option 2024 FEHB Enrollment Codes (Self-Only / Self and
Family / Self Plus One) 2025 PSHB Auto-Enrollment Plan Option 2025 PSHB
Enrollment Codes (Self-Only / Self and Family / Self Plus One) Aetna: CDHP and
Value Aetna HealthFund CDHP EP1 / EP2 / EP3 Aetna HealthFund CDHP KDA / KDB /
KDC Aetna Value Plan EP4 / EP5 / EP6 Aetna Value Plan KDD / KDE / KDF Aetna
HealthFund CDHP F51 / F52 / F53 Aetna HealthFund CDHP L7A / L7B / L7C Aetna
Value Plan F54 / F55 / F56 Aetna Value Plan L7D / L7E / L7F Aetna HealthFund
CDHP G51 / G52 / G53 Aetna HealthFund CDHP GRA / GRB / GRC Aetna Value Plan G54
/ G55 / G56 Aetna Value Plan GRD / GRE / GRF Aetna HealthFund CDHP H41 / H42 /
H43 Aetna HealthFund CDHP HHA / HHB / HHC Aetna Value Plan H44 / H45 / H46 Aetna
Value Plan HHD / HHE / HHF Aetna HealthFund CDHP JS1 / JS2 / JS3 Aetna
HealthFund CDHP JDA / JDB / JDC Aetna Value Plan JS4 / JS5 / JS6 Aetna Value
Plan JDD / JDE / JDF Aetna: HDHP, Aetna Direct, Aetna Advantage Aetna HealthFund
HDHP 224 / 225 / 226 Aetna HealthFund HDHP G3D / G3E / G3F Aetna Direct N61 /
N62 / N63 Aetna Direct G3A / G3B / G3C Aetna Advantage Z24 / Z25 / Z26 Aetna
Advantage HLD / HLE / HLF Aetna: Open Access HMO and Aetna Saver Aetna Open
Access - High Option JN1 / JN2 / JN3 Aetna Open Access - High Option G8A / G8B /
G8C Aetna Open Access - Basic Option JN4 / JN5 / JN6 Aetna Open Access - Basic
Option G8D / G8E / G8F Aetna Saver QQ4 / QQ5 / QQ6 Aetna Saver HXD / HXE / HXF
American Postal Workers Union Health Plan High Option 471 / 472 / 473 High
Option 23A / 23B / 23C Consumer Driven Option 474 / 475 / 476 Consumer Driven
Option 23D / 23E / 23F Blue Cross and Blue Shield Standard Option 104 / 105 /
106 Standard Option 33D / 33E / 33F Basic Option 111 / 112 / 113 Basic Option
33A / 33B / 33C FEP Blue Focus 131 / 132 / 133 FEP Blue Focus 35A / 35B / 35C
CareFirst BlueChoice Standard Option 2G4 / 2G5 / 2G6 Blue Value Plus K4D / K4E /
K4F HDHP B61 / B62 / B63 HDHP K4A / K4B / K4C Blue Value Plus B64 / B65 / B66
Blue Value Plus K4D / K4E / K4F Government Employees Health Association High
Option 311 / 312 / 313 High Option 37A / 37B / 37C Standard Option 314 / 315 /
316 Standard Option 37D / 37E / 37F HDHP 341 / 342 / 343 HDHP 39A / 39B / 39C
Government Employees Health Association - Indemnity Elevate Plus Option 251 /
252 / 253 Elevate Plus Option 58A / 58B / 58C Elevate Option 254 / 255 / 256
Elevate Option 58D / 58E / 58F Health Alliance Plan of Michigan High Option 521
/ 522 / 523 High Option J5A / J5B / J5C Standard Option GY4 / GY5 / GY6 Standard
Option J5D / J5E / J5F HealthPartners High Option V31 / V32 / V33 High Option
KGA / KGB / KGC Standard Option V34 / V35 / V36 Standard Option KGD / KGE / KGF
Hawaii Medical Service Association High Option 871 / 872 / 873 High Option M6A /
M6B / M6C Standard Option 874 / 875 / 876 Standard Option M6D / M6E / M6F Kaiser
Permanente – Colorado High Option 651 / 652 / 653 High Option M8A / M8B / M8C
Standard Option 654 / 655 / 656 Standard Option M8D / M8E / M8F Prosper N41 /
N42 / N43 Prosper NCA / NCB / NCC Kaiser Permanente – Fresno California High
Option NZ1 / NZ2 / NZ3 High Option NNA / NNB / NNC Standard Option NZ4 / NZ5 /
NZ6 Standard Option NND / NNE / NNF Kaiser Permanente – Georgia High Option F81
/ F82 / F83 High Option PFA / PFB / PFC Standard Option F84 / F85 / F86 Standard
Option PFD / PFE / PFF Prosper LA1 / LA2 / LA3 Prosper QZA / QZB / QZC Kaiser
Permanente – Hawaii High Option 631 / 632 / 633 High Option PKA / PKB / PKC
Standard Option 634 / 635 / 636 Standard Option PKD / PKE / PKF Kaiser
Permanente – Mid-Atlantic States High Option E31 / E32 / E33 High Option RAA /
RAB / RAC Standard Option E34 / E35 / E36 Standard Option RAD / RAE / RAF
Prosper T71 / T72 / T73 Prosper NWA / NWB / NWC Kaiser Permanente – Northern
California High Option 591 / 592 / 593 High Option TBA / TBB / TBC Standard
Option 594 / 595 / 596 Standard Option TBD / TBE / TBF Prosper KC1 / KC2 / KC3
Prosper UDA / UDB / UDC Kaiser Permanente – Northwest High Option 571 / 572 /
573 High Option UZA / UZB / UZC Standard Option 574 / 575 / 576 Standard Option
UZD / UZE / UZF Prosper AM1 / AM2 / AM3 Prosper YRA / YRB / YRC Kaiser
Permanente – Southern California High Option 621 / 622 / 623 High Option Y3A /
Y3B / Y3C Standard Option 624 / 625 / 626 Standard Option Y3D / Y3E / Y3F
Prosper FL1 / FL2 / FL3 Prosper MBA / MBB / MBC Kaiser Permanente – Washington
Core High Option 541 / 542 / 543 High Option PRA / PRB / PRC Standard Option 544
/ 545 / 546 Standard Option PRD / PRE / PRF Prosper PT4 / PT5 / PT6 Prosper DWD
/ DWE / DWF Kaiser Permanente Washington Options Federal Standard Option L11 /
L12 / L13 Standard Option H9A / H9B / H9C HDHP L14 / L15 / L16 HDHP H9D / H9E /
H9F Mail Handlers Benefit Plan Value 414 / 415 / 416 Value 73A / 73B / 73C
Standard Option 454 / 455 / 456 Standard Option 73D / 73E / 73F Consumer Option
481 / 482 / 483 Consumer Option 74A / 74B / 74C Medical Mutual of Ohio Standard
Option 644 / 645 / 646 Standard Option D3D / D3E / D3F Basic Option UX1 / UX2 /
UX3 Basic Option D3A / D3B / D3C National Association of Letter Carriers Health
Benefit Plan High Option 321 / 322 / 323 High Option 77A / 77B / 77C CDHP 324 /
325 / 326 CDHP 77D / 77E / 77F Rural Carrier Benefit Plan High Option 381 / 382
/ 383 High Option 79A / 79B / 79C TakeCare Insurance Company High Option JK1 /
JK2 / JK3 High Option G4A / G4B / G4C Standard Option JK4 / JK5 / JK6 Standard
Option G4D / G4E / G4F HDHP KX1 / KX2 / KX3 HDHP HJA / HJB / HJC Triple-S Salud
High Option 851 / 852 / 853 High Option 14A / 14B / 14C High Option 891 / 892 /
893 High Option 83A / 83B / 83C UnitedHealthcare Choice Plus Primary - East High
Option AS1 / AS2 / AS3 High Option JYA / JYB / JYC UnitedHealthcare Choice Plus
Primary - West High Option WF1 / WF2 / WF3 High Option KEA / KEB / KEC UPMC
Health Plan HDHP 8W4 / 8W5 / 8W6 HDHP G9A / G9B / G9C Standard Option UW4 / UW5
/ UW6 Standard Option G9D / G9E / G9F



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PSHB COST SAVINGS WITH MEDICARE PART B OR MEDICARE ADVANTAGE


MEDICARE PART B SPECIAL ENROLLMENT PERIOD (SEP)

As part of the transition from coverage under the Federal Employees Health
Benefits (FEHB) Program to the Postal Service Health Benefits (PSHB) Program,
Postal Service annuitants not already enrolled in Medicare Part B may be
eligible for a one-time SEP, which began on April 1, 2024 and will end on
September 30, 2024. Eligibility notices for the SEP were mailed by the Postal
Service to annuitants and eligible family members in early 2024. Individuals who
enroll in Part B during the SEP will have any applicable Part B Late Enrollment
Penalty (LEP) paid by the Postal Service.


COST SAVINGS FOR PSHB ENROLLEES ENROLLED IN MEDICARE

Many 2025 PSHB plans will offer cost savings to their enrollees who are also
enrolled in Medicare. While the SEP is for Part B enrollment, these charts also
include Medicare Advantage enrollee cost savings since enrollment in Part A and
Part B is required in order to enroll in a Medicare Advantage plan.

Examples of cost savings may include Part B premium reimbursement, waived
deductibles, and waived cost-sharing for certain medical services.

Enrollees are encouraged to review plan brochures for more information.


BENEFIT COMPARISON TABLES: NOTES ABOUT THE CHARTS

 * Benefits that have reduced member costs (such as deductibles and copays) with
   Medicare Part B or a Medicare Advantage plan accessed through your PSHB plan
   enrollment are italicized and noted with asterisks (***).
 * Medicare Advantage  plans accessed through your PSHB plan are listed in the
   tables. An 'N/A' is used for plan options where access to Medicare Advantage
   plans isn't offered.
 * Medicare Part D prescription drug coverage information is not included in
   these charts.
 * A full glossary of health insurance terms can be found here.
 * Deductibles and out-of-pocket limits are listed with the “Self Only” value to
   the left of the slash and the “Self Plus One” and “Self and Family” value to
   the right of the slash. For example, “$2,000/$4,000” means the Self Only
   deductible is $2,000 and the Self Plus One and Family deductible is $4,000.
   There are some plan options in which the Self Plus One deductible or
   out-of-pocket limit differs from the Self and Family amount. In these
   instances, the Self Plus One amount is the middle value (e.g.,
   $2,000/$4,000/$6,000).
 * FEHB 2024 enrollment codes are listed under each plan option name with the
   corresponding PSHB 2025 enrollment codes. The third digit of the enrollment
   code indicates the enrollment type. Enrollment codes ending in “1” or “4” in
   FEHB, or “A” or “D” in PSHB, represent Self Only. Enrollment codes ending in
   “2” or “5” (FEHB) or “B” or “E” (PSHB) represent Self and Family. Enrollment
   codes ending in “3” or “6” (FEHB) or “C” or “F” (PSHB) represent Self Plus
   One
 * The Medicare Part B premium reimbursement amounts listed in the charts are
   the maximum per person dollar amounts members would be reimbursed for their
   Part B premiums annually.
 * Cost-sharing amounts are for in-network services only; out-of-network costs
   are not included in the charts.
 * The out-of-pocket limits listed in the charts are for medical services only.
   Plans may have separate out-of-pocket limits for prescription drugs.
 * All plan and cost-sharing information listed is for the 2025 plan year. Plans
   are listed in alphabetical order by Carrier, and all 2025 PSHB Plans are
   included regardless of whether they offer cost savings for Medicare
   enrollees.


2025 MEDICARE PART B AND MEDICARE ADVANTAGE BENEFIT COMPARISON TABLES


AETNA ADVANTAGE

(FEHB 2024 enrollment codes Z24, Z25, Z26; PSHB 2025 enrollment codes HLD, HLE,
HLF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $1,200 max *** Deductible $2,000/$4,000 $2,000/$4,000 *** Deductible
waived *** Out-of-Pocket Limit $7,500/$15,000 $7,500/$15,000 *** $0 *** Primary
Care Office Visit 30% 30% *** $0 *** Specialty Office Visit 30% 30% *** $0 ***


AETNA HEALTHFUND HDHP

(FEHB 2024 enrollment codes 224, 225, 226; PSHB 2025 enrollment codes G3D, G3E,
G3F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $1,800/$3,600 $1,800/$3,600 N/A Out-of-Pocket Limit
$6,900/$13,800 $6,900/$13,800 N/A Primary Care Office Visit 15% 15% N/A
Specialty Office Visit 15% 15% N/A


AETNA DIRECT

(FEHB 2024 enrollment codes N61, N62, N63; PSHB 2025 enrollment codes G3A, G3B,
G3C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $900 max *** N/A Deductible $1,600/$3,200 *** Deductible waived *** N/A
Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 N/A Primary Care Office Visit
20% *** $0 *** N/A Specialty Office Visit 20% *** $0 *** N/A


AETNA VALUE PLAN

(FEHB 2024 enrollment codes G54, G55, G56, H44, H45, H46, JS4, JS5, JS6, EP4,
EP5, EP6, F54, F55, F56; PSHB 2025 enrollment codes GRD, GRE, GRF, HHD, HHE,
HHF, JDD, JDE, JDF, KDD, KDE, KDF, L7D, L7E, L7F) Plan Details Member Cost-share
Without Medicare With Medicare Part B as Primary With PSHB Medicare Advantage as
Primary Part B Premium Reimbursement No No N/A Deductible $700/$1,400
$700/$1,400 N/A Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 N/A Primary
Care Office Visit $25 $25 N/A Specialty Office Visit $40 $40 N/A


AETNA HEALTHFUND CDHP

(FEHB 2024 enrollment codes G51, G52, G53, H41, H42, H43, JS1, JS2, JS3, EP1,
EP2, EP3, F51, F52, F53; PSHB 2025 enrollment codes GRA, GRB, GRC, HHA, HHB,
HHC, JDA, JDB, JDC, KDA, KDB, KDC, L7A, L7B, L7C) Plan Details Member Cost-share
Without Medicare With Medicare Part B as Primary With PSHB Medicare Advantage as
Primary Part B Premium Reimbursement No *** Yes; $1,000 max *** N/A Deductible
$1,000/$2,000 $1,000/$2,000 N/A Out-of-Pocket Limit $5,000/$10,000
$5,000/$10,000 N/A Primary Care Office Visit 15% 15% N/A Specialty Office Visit
15% 15% N/A


AETNA OPEN ACCESS: BASIC OPTION

(FEHB 2024 enrollment codes JN4, JN5, JN6; PSHB 2025 enrollment codes G8D, G8E,
G8F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $6,000/$12,000
$6,000/$12,000 N/A Primary Care Office Visit $25 $25 N/A Specialty Office Visit
$55 $55 N/A


AETNA OPEN ACCESS: HIGH OPTION

(FEHB 2024 enrollment codes JN1, JN2, JN3; PSHB 2025 enrollment codes G8A, G8B,
G8C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $5,000/$10,000
$5,000/$10,000 N/A Primary Care Office Visit $15 $15 N/A Specialty Office Visit
$30 $30 N/A


AETNA SAVER

(FEHB 2024 enrollment codes QQ4, QQ5, QQ6; PSHB 2025 enrollment codes HXD, HXE,
HXF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $1,000/$2,000 $1,000/$2,000 N/A Out-of-Pocket Limit
$6,500/$13,000 $6,500/$13,000 N/A Primary Care Office Visit 30% 30% N/A
Specialty Office Visit 30% 30% N/A


APWU HEALTH PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 471, 472, 473; PSHB 2025 enrollment codes 23A, 23B,
23C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $1,200 max *** Deductible $450/$800 *** Deductible waived *** ***
Deductible waived *** Out-of-Pocket Limit $6,500/$13,000 $6,500/$13,000 *** $0
*** Primary Care Office Visit $25 *** $0 *** *** $0 *** Specialty Office Visit
$25 *** $0 *** *** $0 ***


APWU HEALTH PLAN: CONSUMER DRIVEN OPTION

(FEHB 2024 enrollment codes 474, 475, 476; PSHB 2025 enrollment codes 23D, 23E,
23F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $1,200 max *** N/A Deductible $2,200/$4,400 $2,200/$4,400 N/A
Out-of-Pocket Limit $6,500/$13,000 $6,500/$13,000 N/A Primary Care Office Visit
15% 15% N/A Specialty Office Visit 15% 15% N/A


BLUE CROSS AND BLUE SHIELD SERVICE BENEFIT PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes 104, 105, 106; PSHB 2025 enrollment codes 33D, 33E,
33F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $350/$700 *** Deductible Waived *** N/A Out-of-Pocket Limit
$6,000/$12,000 $6,000/$12,000 N/A Primary Care Office Visit $30 *** $0 *** N/A
Specialty Office Visit $40 *** $0 *** N/A


BLUE CROSS AND BLUE SHIELD SERVICE BENEFIT PLAN: BASIC OPTION

(FEHB 2024 enrollment codes 111, 112, 113; PSHB 2025 enrollment codes 33A, 33B,
33C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $800 max *** N/A Deductible None None N/A Out-of-Pocket Limit
$7,500/$15,000 $7,500/$15,000 N/A Primary Care Office Visit $35 *** $0 *** N/A
Specialty Office Visit $50 *** $0 *** N/A


BLUE CROSS AND BLUE SHIELD SERVICE BENEFIT PLAN: FEP BLUE FOCUS

(FEHB 2024 enrollment codes 131, 132, 133; PSHB 2025 enrollment codes 35A, 35B,
35C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $500/$1,000 $500/$1,000 N/A Out-of-Pocket Limit $9,000/$18,000
$9,000/$18,000 N/A Primary Care Office Visit $10 *** $0 *** N/A Specialty Office
Visit $10 *** $0 *** N/A


CAREFIRST BLUE VALUE PLUS

(FEHB 2024 enrollment codes B64, B65, B66; PSHB 2025 enrollment codes K4D, K4E,
K4F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $6,000/$12,000
$6,000/$12,000 N/A Primary Care Office Visit $15 *** $0 *** N/A Specialty Office
Visit $50 *** $0 *** N/A


CAREFIRST BLUECHOICE ADVANTAGE HDHP

(FEHB 2024 enrollment codes B61, B62, B63; PSHB 2025 enrollment codes K4A, K4B,
K4C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $1,650/$3,300 *** Deductible waived *** N/A Out-of-Pocket
Limit $5,000/$10,000 $5,000/$10,000 N/A Primary Care Office Visit $0 $0 N/A
Specialty Office Visit $35 *** $0 *** N/A


GEHA BENEFIT PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 311, 312, 313; PSHB 2025 enrollment codes 37A, 37B,
37C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $1,000 max *** *** Yes; $1,200 max *** Deductible $350/$700 ***
Deductible waived *** *** Deductible waived *** Out-of-Pocket Limit
$5,000/$10,000 $5,000/$10,000 *** $0 *** Primary Care Office Visit $20 *** $0
*** *** $0 *** Specialty Office Visit $20 *** $0 *** *** $0 ***


GEHA BENEFIT PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes 314, 315, 316; PSHB 2025 enrollment codes 37D, 37E,
37F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $900 max *** Deductible $350/$700 *** Deductible waived *** ***
Deductible waived *** Out-of-Pocket Limit $6,500/$13,000 $6,500/$13,000 *** $0
*** Primary Care Office Visit $20 *** $0 *** *** $0 *** Specialty Office Visit
$35 *** $0 *** *** $0 ***


GEHA BENEFIT PLAN: HDHP

(FEHB 2024 enrollment codes 341, 342, 343; PSHB 2025 enrollment codes 39A, 39B,
39C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $1,000 max *** N/A Deductible $1,600/$3,200 $1,600/$3,200 N/A
Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 N/A Primary Care Office Visit
5% 5% N/A Specialty Office Visit 5% 5% N/A


GEHA INDEMNITY BENEFIT PLAN: ELEVATE OPTION

(FEHB 2024 enrollment codes 254, 255, 256; PSHB 2025 enrollment codes 58D, 58E,
58F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $500/$1,000 $500/$1,000 N/A Out-of-Pocket Limit $8,500/$17,000
$8,500/$17,000 N/A Primary Care Office Visit $10 $10 N/A Specialty Office Visit
$30 $30 N/A


GEHA INDEMNITY BENEFIT PLAN: ELEVATE PLUS OPTION

(FEHB 2024 enrollment codes 251, 252, 253; PSHB 2025 enrollment codes 58A, 58B,
58C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $200/$400 *** Deductible waived *** N/A Out-of-Pocket Limit
$7,000/$14,000 $7,000/$14,000 N/A Primary Care Office Visit $30 *** $0 *** N/A
Specialty Office Visit $50 *** $0 *** N/A


HEALTH ALLIANCE PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 521, 522, 523; PSHB 2025 enrollment codes J5A, J5B,
J5C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $800 max *** *** Yes; $1,800 max *** Deductible None None None
Out-of-Pocket Limit $6,350/$12,700 $6,350/$12,700 $6,350/$12,700 Primary Care
Office Visit $20 $20 $20 Specialty Office Visit $40 $40 $40


HEALTH ALLIANCE PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes GY4, GY5, GY6; PSHB 2025 enrollment codes J5D, J5E,
J5F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $800 max *** *** Yes; $1,200 max *** Deductible $350/$700 $350/$700
$350/$700 Out-of-Pocket Limit $6,350/$12,700 $6,350/$12,700 $6,350/$12,700
Primary Care Office Visit $20 $20 $20 Specialty Office Visit $50 $50 $50


HEALTHPARTNERS: HIGH OPTION

(FEHB 2024 enrollment codes V31, V32, V33; PSHB 2025 enrollment codes KGA, KGB,
KGC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $1,200 max *** N/A Deductible None None N/A Out-of-Pocket Limit
$6,500/$13,000 $6,500/$13,000 N/A Primary Care Office Visit $45 *** $0 *** N/A
Specialty Office Visit $45 *** $0 *** N/A


HEALTHPARTNERS: STANDARD OPTION

(FEHB 2024 enrollment codes V34, V35, V36; PSHB 2025 enrollment codes KGD, KGE,
KGF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $750/$1,500 *** Deductible waived *** N/A Out-of-Pocket Limit
$7,500/$15,000 $7,500/$15,000 N/A Primary Care Office Visit 20% *** $0 *** N/A
Specialty Office Visit 20% *** $0 *** N/A


HMSA PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 871, 872, 873; PSHB 2025 enrollment codes M6A, M6B,
M6C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $3,000/$6,000/$9,000
$3,000/$6,000/$9,000 N/A Primary Care Office Visit $15 $15 N/A Specialty Office
Visit $15 $15 N/A


HMSA PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes 874, 875, 876; PSHB 2025 enrollment codes M6D, M6E,
M6F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $150/$300 $150/$300 N/A Out-of-Pocket Limit $5,000/$10,000
$5,000/$10,000 N/A Primary Care Office Visit $20 $20 N/A Specialty Office Visit
$20 $20 N/A


KAISER PERMANENTE – COLORADO: HIGH OPTION

(FEHB 2024 enrollment codes 651, 652, 653; PSHB 2025 enrollment codes M8A, M8B,
M8C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$4,000/$8,000 $4,000/$8,000 *** $2,950/$5,900 *** Primary Care Office Visit $20
$20 *** $15 *** Specialty Office Visit $30 $30 *** $25 ***


KAISER PERMANENTE – COLORADO: STANDARD OPTION

(FEHB 2024 enrollment codes 654, 655, 656; PSHB 2025 enrollment codes M8D, M8E,
M8F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible $150/$300 $150/$300 *** Deductible waived
*** Out-of-Pocket Limit $5,500/$11,000 $5,500/$11,000 *** $3,300/$6,600 ***
Primary Care Office Visit $30 $30 $30 Specialty Office Visit $40 $40 $40


KAISER PERMANENTE – COLORADO: PROSPER

(FEHB 2024 enrollment codes N41, N42, N43; PSHB 2025 enrollment codes NCA, NCB,
NCC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $300/$600 $300/$600 *** Deductible waived *** Out-of-Pocket
Limit $7,000/$14,000 $7,000/$14,000 *** $3,600/$7,200 *** Primary Care Office
Visit $10 $10 $10 Specialty Office Visit $35 $35 $35


KAISER PERMANENTE – FRESNO CALIFORNIA: HIGH OPTION

(FEHB 2024 enrollment codes NZ1, NZ2, NZ3; PSHB 2025 enrollment codes NNA, NNB,
NNC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $3,000 max *** Deductible None None None Out-of-Pocket Limit
$2,000/$4,000 $2,000/$4,000 $2,000/$4,000 Primary Care Office Visit $15 $15 ***
$10 *** Specialty Office Visit $25 $25 *** $10 ***


KAISER PERMANENTE – FRESNO CALIFORNIA: STANDARD OPTION

(FEHB 2024 enrollment codes NZ4, NZ5, NZ6; PSHB 2025 enrollment codes NND, NNE,
NNF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible None None None Out-of-Pocket Limit $3,000/$6,000 $3,000/$6,000
*** $2,000/$4,000 *** Primary Care Office Visit $30 $30 *** $15 *** Specialty
Office Visit $40 $40 *** $15 ***


KAISER PERMANENTE – HAWAII: HIGH OPTION

(FEHB 2024 enrollment codes 631, 632, 633; PSHB 2025 enrollment codes PKA, PKB,
PKC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,100 max *** Deductible None None None Out-of-Pocket Limit
$3,000/$6,000/$9,000 $3,000/$6,000/$9,000 $3,000/$6,000/$9,000 Primary Care
Office Visit $15 $15 *** $10 *** Specialty Office Visit $15 $15 *** $10 ***


KAISER PERMANENTE – HAWAII: STANDARD OPTION

(FEHB 2024 enrollment codes 634, 635, 636; PSHB 2025 enrollment codes PKD, PKE,
PKF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible None None None Out-of-Pocket Limit $3,000/$6,000/$9,000
$3,000/$6,000/$9,000 *** $2,500/$7,500 *** Primary Care Office Visit $25 $25 ***
$15 *** Specialty Office Visit $25 $25 *** $20 ***


KAISER PERMANENTE – NORTHERN CALIFORNIA: HIGH OPTION

(FEHB 2024 enrollment codes 591, 592, 593; PSHB 2025 enrollment codes TBA, TBB,
TBC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $3,000 max *** Deductible None None None Out-of-Pocket Limit
$2,000/$4,000 $2,000/$4,000 $2,000/$4,000 Primary Care Office Visit $15 $15 ***
$10 *** Specialty Office Visit $25 $25 *** $10 ***


KAISER PERMANENTE – NORTHERN CALIFORNIA: STANDARD OPTION

(FEHB 2024 enrollment codes 594, 595, 596; PSHB 2025 enrollment codes TBD, TBE,
TBF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $3,000 max *** Deductible $100/$200 $100/$200 *** Deductible waived
*** Out-of-Pocket Limit $3,000/$6,000 $3,000/$6,000 *** $2,000/$4,000 ***
Primary Care Office Visit $30 $30 *** $25 *** Specialty Office Visit $40 $40 ***
$25 ***


KAISER PERMANENTE – NORTHERN CALIFORNIA: PROSPER

(FEHB 2024 enrollment codes KC1, KC2, KC3; PSHB 2025 enrollment codes UDA, UDB,
UDC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $500/$1,000 $500/$1,000 *** Deductible waived *** Out-of-Pocket
Limit $5,500/$11,000 $5,500/$11,000 *** $2,000/$4,000 *** Primary Care Office
Visit $25 $25 $25 Specialty Office Visit $35 $35 *** $25 ***


KAISER PERMANENTE – NORTHWEST: HIGH OPTION

(FEHB 2024 enrollment codes 571, 572, 573; PSHB 2025 enrollment codes UZA, UZB,
UZC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$5,000/$10,000 $5,000/$10,000 *** $1,000/$2,000 *** Primary Care Office Visit
$20 $20 *** $15 *** Specialty Office Visit $30 $30 *** $15 ***


KAISER PERMANENTE – NORTHWEST: STANDARD OPTION

(FEHB 2024 enrollment codes 574, 575, 576; PSHB 2025 enrollment codes UZD, UZE,
UZF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible $150/$300 $150/$300 *** Deductible waived
*** Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 *** $2,000/$4,000 ***
Primary Care Office Visit $25 $25 *** $20 *** Specialty Office Visit $35 $35 ***
$20 ***


KAISER PERMANENTE – NORTHWEST: PROSPER

(FEHB 2024 enrollment codes AM1, AM2, AM3; PSHB 2025 enrollment codes YRA, YRB,
YRC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $300/$600 $300/$600 *** Deductible waived *** Out-of-Pocket
Limit $7,000/$14,000 $7,000/$14,000 *** $3,000/$6,000 *** Primary Care Office
Visit $10 $10 $10 Specialty Office Visit $20 $20 $20


KAISER PERMANENTE – SOUTHERN CALIFORNIA: HIGH OPTION

(FEHB 2024 enrollment codes 621, 622, 623; PSHB 2025 enrollment codes Y3A, Y3B,
Y3C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $3,000 max *** Deductible None None None Out-of-Pocket Limit
$2,000/$4,000 $2,000/$4,000 $2,000/$4,000 Primary Care Office Visit $15 $15 ***
$10 *** Specialty Office Visit $25 $25 *** $10 ***


KAISER PERMANENTE – SOUTHERN CALIFORNIA: STANDARD OPTION

(FEHB 2024 enrollment codes 624, 625, 626; PSHB 2025 enrollment codes Y3D, Y3E,
Y3F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $3,000 max *** Deductible None None None Out-of-Pocket Limit
$3,000/$6,000 $3,000/$6,000 *** $2,500/$5,000 *** Primary Care Office Visit $30
$30 *** $20 *** Specialty Office Visit $40 $40 *** $30 ***


KAISER PERMANENTE – SOUTHERN CALIFORNIA: PROSPER

(FEHB 2024 enrollment codes FL1, FL2, FL3; PSHB 2025 enrollment codes MBA, MBB,
MBC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $100/$200 $100/$200 *** Deductible waived *** Out-of-Pocket
Limit $5,000/$10,000 $5,000/$10,000 *** $3,000/$6,000 *** Primary Care Office
Visit $30 $30 *** $25 *** Specialty Office Visit $40 $40 *** $35 ***


KAISER PERMANENTE – WASHINGTON CORE: HIGH OPTION

(FEHB 2024 enrollment codes 541, 542, 543; PSHB 2025 enrollment codes PRA, PRB,
PRC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $600 max *** *** Yes; $2,100 max *** Deductible None None None
Out-of-Pocket Limit $3,000/$6,000 *** $2,000/$4,000 *** *** $2,000/$4,000 ***
Primary Care Office Visit $25 *** $15 *** *** $15 *** Specialty Office Visit $25
*** $15 *** *** $15 ***


KAISER PERMANENTE – WASHINGTON CORE: STANDARD OPTION

(FEHB 2024 enrollment codes 544, 545, 546; PSHB 2025 enrollment codes PRD, PRE,
PRF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,100 max *** Deductible None None None Out-of-Pocket Limit
$5,000/$5,000 $5,000/$5,000 *** $3,000/$6,000 *** Primary Care Office Visit $25
$25 *** $20 *** Specialty Office Visit $35 $35 *** $25 ***


KAISER PERMANENTE – WASHINGTON CORE: PROSPER

(FEHB 2024 enrollment codes PT4, PT5, PT6; PSHB 2025 enrollment codes DWD, DWE,
DWF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $250/$500 $250/$500 *** Deductible waived *** Out-of-Pocket
Limit $6,000/$12,000 $6,000/$12,000 *** $5,000/$10,000 *** Primary Care Office
Visit $15 $15 *** $10 *** Specialty Office Visit $40 $40 *** $35 ***


KAISER PERMANENTE – WASHINGTON OPTIONS FEDERAL: STANDARD OPTION

(FEHB 2024 enrollment codes L11, L12, L13; PSHB 2025 enrollment codes H9A, H9B,
H9C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $350/$700 *** Deductible waived *** N/A Out-of-Pocket Limit
$5,000/$10,000 $5,000/$10,000 N/A Primary Care Office Visit $25 *** $0 *** N/A
Specialty Office Visit $35 *** $0 *** N/A


KAISER PERMANENTE – WASHINGTON OPTIONS FEDERAL: HDHP

(FEHB 2024 enrollment codes L14, L15, L16; PSHB 2025 enrollment codes H9D, H9E,
H9F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $1,650/$3,300 $1,650/$3,300 N/A Out-of-Pocket Limit
$5,000/$10,000 $5,000/$10,000 N/A Primary Care Office Visit 20% 20% N/A
Specialty Office Visit 20% 20% N/A


KAISER PERMANENTE – GEORGIA: HIGH OPTION

(FEHB 2024 enrollment codes F81, F82, F83; PSHB 2025 enrollment codes PFA, PFB,
PFC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$4,000/$8,000 $4,000/$8,000 *** $2,000/$4,000 *** Primary Care Office Visit $15
$15 *** $10 *** Specialty Office Visit $30 $30 *** $25 ***


KAISER PERMANENTE – GEORGIA: STANDARD OPTION

(FEHB 2024 enrollment codes F84, F85, F86; PSHB 2025 enrollment codes PFD, PFE,
PFF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$5,000/$10,000 $5,000/$10,000 *** $2,500/$5,000 *** Primary Care Office Visit
$20 $20 $20 Specialty Office Visit $40 $40 *** $30 ***


KAISER PERMANENTE – GEORGIA: PROSPER

(FEHB 2024 enrollment codes LA1, LA2, LA3; PSHB 2025 enrollment codes QZA, QZB,
QZC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $300/$600 $300/$600 *** Deductible waived *** Out-of-Pocket
Limit $6,500/$13,000 $6,500/$13,000 *** $3,250/$6,500 *** Primary Care Office
Visit $20 $20 $20 Specialty Office Visit $40 $40 *** $30 ***


KAISER PERMANENTE – MID-ATLANTIC STATES: HIGH OPTION

(FEHB 2024 enrollment codes E31, E32, E33; PSHB 2025 enrollment codes RAA, RAB,
RAC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$2,250/$4,500 $2,250/$4,500 $2,250/$4,500 Primary Care Office Visit $10 $10 ***
$5 *** Specialty Office Visit $20 $20 *** $15 ***


KAISER PERMANENTE – MID-ATLANTIC STATES: STANDARD OPTION

(FEHB 2024 enrollment codes E34, E35, E36; PSHB 2025 enrollment codes RAD, RAE,
RAF) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $2,400 max *** Deductible None None None Out-of-Pocket Limit
$3,500/$7,000 $3,500/$7,000 *** $3,400/$7,000 *** Primary Care Office Visit $20
$20 *** $15 *** Specialty Office Visit $30 $30 *** $20 ***


KAISER PERMANENTE – MID-ATLANTIC STATES: PROSPER

(FEHB 2024 enrollment codes T71, T72, T73; PSHB 2025 enrollment codes NWA, NWB,
NWC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $100/$200 $100/$200 *** Deductible waived *** Out-of-Pocket
Limit $4,000/$8,000 $4,000/$8,000 $4,000/$8,000 Primary Care Office Visit $30
$30 *** $20 *** Specialty Office Visit $40 $40 *** $30 ***


MAIL HANDLERS BENEFIT PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes 454, 455, 456; PSHB 2025 enrollment codes 73D, 73E,
73F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $900 max *** Deductible $350/$700 *** Deductible waived *** ***
Deductible waived *** Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 *** $0
*** Primary Care Office Visit $20 *** $0 *** *** $0 *** Specialty Office Visit
$30 *** $0 *** *** $0 ***


MAIL HANDLERS BENEFIT PLAN: VALUE PLAN

(FEHB 2024 enrollment codes 414, 415, 416; PSHB 2025 enrollment codes 73A, 73B,
73C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $600/$1,200/$1,800 $600/$1,200/$1,800 N/A Out-of-Pocket Limit
$6,600/$13,200 $6,600/$13,200 N/A Primary Care Office Visit $30 $30 N/A
Specialty Office Visit $50 $50 N/A


MAIL HANDLERS BENEFIT PLAN: CONSUMER OPTION

(FEHB 2024 enrollment codes 481, 482, 483; PSHB 2025 enrollment codes 74A, 74B,
74C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $2,000/$4,000 *** Deductible waived *** N/A Out-of-Pocket
Limit $6,000/$12,000 $6,000/$12,000 N/A Primary Care Office Visit $15 *** $0 ***
N/A Specialty Office Visit $15 *** $0 *** N/A


MEDICAL MUTUAL OF OHIO: STANDARD OPTION

(FEHB 2024 enrollment codes 644, 645, 646; PSHB 2025 enrollment codes D3D, D3E,
D3F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $850 max *** *** Yes; $850 max *** Deductible None None None
Out-of-Pocket Limit $6,000/$12,000 $6,000/$12,000 *** $0 *** Primary Care Office
Visit $25 $25 *** $0 *** Specialty Office Visit $45 $45 *** $0 ***


MEDICAL MUTUAL OF OHIO: BASIC OPTION

(FEHB 2024 enrollment codes UX1, UX2, UX3; PSHB 2025 enrollment codes D3A, D3B,
D3C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $850 max *** Deductible $750/$1,500 $750/$1,500 *** Deductible
waived *** Out-of-Pocket Limit $6,500/$13,000 $6,500/$13,000 *** $0 *** Primary
Care Office Visit $30 $30 *** $0 *** Specialty Office Visit $60 $60 *** $0 ***


NALC HEALTH BENEFIT PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 321, 322, 323; PSHB 2025 enrollment codes 77A, 77B,
77C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $900 max *** Deductible $300/$600 *** Deductible waived *** ***
Deductible waived *** Out-of-Pocket Limit $3,500/$7,000 *** $0 *** *** $0 ***
Primary Care Office Visit $25 *** $0 *** *** $0 *** Specialty Office Visit $25
*** $0 *** *** $0 ***


NALC HEALTH BENEFIT PLAN: CDHP

(FEHB 2024 enrollment codes 324, 325, 326; PSHB 2025 enrollment codes 77D, 77E,
77F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $2,000/$4,000 $2,000/$4,000 N/A Out-of-Pocket Limit
$6,600/$12,000 $6,600/$12,000 N/A Primary Care Office Visit 20% 20% N/A
Specialty Office Visit 20% 20% N/A


RURAL CARRIER BENEFIT PLAN: HIGH OPTION

(FEHB 2024 enrollment codes 381, 382, 383; PSHB 2025 enrollment codes 79A, 79B,
79C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $900 max *** Deductible $350/$700 *** Deductible waived *** ***
Deductible waived *** Out-of-Pocket Limit $5,000/$10,000 $5,000/$10,000 *** $0
*** Primary Care Office Visit $20 *** $0 *** *** $0 *** Specialty Office Visit
$35 *** $0 *** *** $0 ***


TAKECARE INSURANCE COMPANY: HIGH OPTION

(FEHB 2024 enrollment codes JK1, JK2, JK3; PSHB 2025 enrollment codes G4A, G4B,
G4C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $2,000/$4,000/$6,000
$2,000/$4,000/$6,000 N/A Primary Care Office Visit $20 *** $0 *** N/A Specialty
Office Visit $40 *** $0 *** N/A


TAKECARE INSURANCE COMPANY: STANDARD OPTION

(FEHB 2024 enrollment codes JK4, JK5, JK6; PSHB 2025 enrollment codes G4D, G4E,
G4F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible None None N/A Out-of-Pocket Limit $3,000/$6,000 $3,000/$6,000
N/A Primary Care Office Visit $25 *** $0 *** N/A Specialty Office Visit $40 ***
$0 *** N/A


TAKECARE INSURANCE COMPANY: HDHP

(FEHB 2024 enrollment codes KX1, KX2, KX3; PSHB 2025 enrollment codes HJA, HJB,
HJC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No N/A Deductible $2,000/$4,000 $2,000/$4,000 N/A Out-of-Pocket Limit
$3,000/$6,000 $3,000/$6,000 N/A Primary Care Office Visit 20% *** $0 *** N/A
Specialty Office Visit 20% *** $0 *** N/A


TRIPLE-S: HIGH OPTION

(FEHB 2024 enrollment codes 851, 852, 853 for USVI; 891, 892, 893 for Puerto
Rico; PSHB 2025 enrollment codes 14A, 14B, 14C for USVI; 83A, 83B, 83C for
Puerto Rico) Plan Details Member Cost-share Without Medicare With Medicare Part
B as Primary With PSHB Medicare Advantage as Primary Part B Premium
Reimbursement No No No Deductible None None None Out-of-Pocket Limit
$6,600/$13,200 $6,600/$13,200 $6,600/$13,200 Primary Care Office Visit $7.50 ***
$0 *** $7.50 Specialty Office Visit $7.50 *** $0 *** $7.50


UNITEDHEALTHCARE INSURANCE COMPANY, INC. - CHOICE PLUS PRIMARY POSTAL EAST: HIGH
OPTION

(FEHB 2024 enrollment codes AS1, AS2, AS3; PSHB 2025 enrollment codes JYA, JYB,
JYC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $1,800 max *** Deductible $500/$1,000 $500/$1,000 *** Deductible
waived *** Out-of-Pocket Limit $7,350/$14,700 $7,350/$14,700 *** $0 *** Primary
Care Office Visit $0 $0 $0 Specialty Office Visit $60 $60 *** $0 ***


UNITEDHEALTHCARE INSURANCE COMPANY, INC. - CHOICE PLUS PRIMARY POSTAL WEST: HIGH
OPTION

(FEHB 2024 enrollment codes WF1, WF2, WF3; PSHB 2025 enrollment codes KEA, KEB,
KEC) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No *** Yes; $1,800 max *** Deductible $500/$1,000 $500/$1,000 *** Deductible
waived *** Out-of-Pocket Limit $7,350/$14,700 $7,350/$14,700 *** $0 *** Primary
Care Office Visit $0 $0 $0 Specialty Office Visit $60 $60 *** $0 ***


UPMC HEALTH PLAN: STANDARD OPTION

(FEHB 2024 enrollment codes UW4, UW5, UW6; PSHB 2025 enrollment codes G9D, G9E,
G9F) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
*** Yes; $800 max *** *** Yes; $800 max *** Deductible $850/$1,700 ***
$700/$1,400 *** *** Deductible waived *** Out-of-Pocket Limit $6,000/$12,000
$6,000/$12,000 *** $3,400/$6,800 *** Primary Care Office Visit $20 $20 *** $0
*** Specialty Office Visit $50 $50 *** $25 ***


UPMC HEALTH PLAN: HDHP

(FEHB 2024 enrollment codes 8W4, 8W5, 8W6; PSHB 2025 enrollment codes G9A, G9B,
G9C) Plan Details Member Cost-share Without Medicare With Medicare Part B as
Primary With PSHB Medicare Advantage as Primary Part B Premium Reimbursement No
No No Deductible $2,000/$4,000 $2,000/$4,000 $2,000/$4,000 Out-of-Pocket Limit
$6,000/$12,000 $6,000/$12,000 $6,000/$12,000 Primary Care Office Visit 15% 15%
15% Specialty Office Visit 15% 15% 15%

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CARRIER CUSTOMER SERVICE NUMBERS

Carrier Customer Service Number Aetna 833-497-2412 APWU Health Plan 800-222-2798
Blue Cross Blue Shield 800-411-2583 CareFirst BlueChoice 833-489-1316 GEHA
800-821-6136 Health Alliance Plan of Michigan 800-556-9765 HealthPartners
844-440-1900 HMSA Plan 800-776-4672 Kaiser Permanente - Colorado 303-338-3800
(local)
800-632-9700 (toll-free) Kaiser Permanente - Fresno California 800-464-4000
(toll-free) Kaiser Permanente - Georgia 404-261-2590 (local)
888-865-5813 (long distance) Kaiser Permanente - Hawaii 800-966-5955 Kaiser
Permanente - Mid-Atlantic States 800-777-7902 Kaiser Permanente - Northern
California 800-464-4000 (toll-free) Kaiser Permanente - Northwest 800-813-2000
Kaiser Permanente - Southern California 800-464-4000 (toll-free) Kaiser
Permanente - Washington Core 888-901-4636 (toll-free) Medical Mutual of Ohio
800-315-3144 MHBP 833-497-2415 NALC Health Benefit Plan 888-636-6252 Rural
Carrier Benefit Plan 800-638-8432 TakeCare Insurance Company 671-647-3526
877-484-2411 (toll-free) Triple-S Salud, Inc. 787-474-5219 UnitedHealthcare
Insurance Company 877-835-9861 UPMC Health Plan 833-869-6924


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