Paul Sanchez
The United States Postal Service (USPS) offers its employees a range of insurance benefits, including health, dental, vision, and life insurance. The Postal Service Health Benefits (PSHB) Program is a new initiative that will provide health insurance to eligible USPS employees, annuitants, and their families starting on January 1, 2025. This program is separate from the Federal Employees Health Benefits (FEHB) Program, which the Postal Service also participates in. Employees may also enroll in the Federal Long-Term Care Insurance Program (FLTCIP) and contribute to the Thrift Savings Plan (TSP). Additionally, the USPS offers coverage through the Federal Employees' Group Life Insurance (FEGLI) Program, with basic coverage costs fully paid by the Postal Service.
| Characteristics | Values |
|---|---|
| Postal Service Health Benefits (PSHB) Program | Provides health insurance to eligible Postal Service employees, Postal Service annuitants, and their eligible family members |
| PSHB Program Eligibility | Postal Service employees, retirees, and eligible family members |
| PSHB Plan Coverage | Includes prescription drug coverage through a Medicare Part D Employer Group Waiver Plan (EGWP) |
| EGWP Premium Costs | Same as the PSHB plan premium with no additional costs |
| EGWP Benefits | $35/month cap on insulin products and an annual $2,000 cap on out-of-pocket Part D drug costs |
| Federal Employees Health Benefits (FEHB) Program | Provides coverage to Postal Service employees and their families with most of the cost paid by the Postal Service |
| FEHB Plan Options | Includes Fee-For-Service, Health Maintenance Organizations (HMOs), and High Deductible & Consumer-Driven Health Plans |
| Other Benefits | Dental and Vision Insurance, Flexible Spending Accounts (FSA), and Long-Term Care Insurance |
| Retirement Benefits | Thrift Savings Plan (TSP), similar to 401(k) plans, and participation in the federal retirement program |
| Spouse Coverage | Former spouses may be eligible for Temporary Continuation of Coverage (TCC) or FEHB under spouse equity provisions |
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What You'll Learn
Postal Service Health Benefits (PSHB) Program
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). The PSHB Program provides health insurance to eligible Postal Service employees, Postal Service annuitants, and their eligible family members. The program offers a range of benefits, including prescription drug coverage and flexible spending accounts, and is designed to provide excellent coverage and flexibility, with most of the cost paid by the Postal Service.
Eligible individuals can enroll, change their current enrollment, or cancel enrollment in the PSHB Program through the PSHBS system, maintained by OPM. The Open Season for enrollment in the PSHB Program typically occurs from the second Monday in November through the second Monday in December. Outside of Open Season, individuals can make enrollment changes if they experience a Qualifying Life Event (QLE).
It's important to note that PSHB is the primary health benefits insurance available through the Postal Service. Medicare Secondary Payer rules apply to the PSHB Program, and individuals are not required to enroll in Medicare Part B to maintain their PSHB enrollment. However, certain individuals, such as those who move back to the United States, may be required to enroll in Medicare Part B to be eligible for a PSHB plan.
In terms of prescription drug coverage, Postal Service annuitants and their family members who are eligible for Medicare Part D will automatically receive this coverage through a Medicare Part D Employer Group Waiver Plan (EGWP) provided by their PSHB plan. This coverage offers advantages such as a cap on out-of-pocket costs for medications. However, individuals can choose to opt out of this coverage if they determine that it aligns with their circumstances.
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Medicare Part D coverage
The Postal Service Health Benefits (PSHB) Program offers insurance to its employees and annuitants. The program provides coverage through the Federal Employees' Group Life Insurance (FEGLI) Program, where the cost of basic coverage is borne by the Postal Service, with the option to purchase additional coverage through payroll deductions. The Postal Service also participates in the Federal Employees Health Benefits (FEHB) Program, which offers a range of plans, including Fee-For-Service, Health Maintenance Organizations (HMOs), and High Deductible & Consumer-Driven Health Plans.
Medicare Part D-eligible annuitants and their eligible family members are automatically provided with prescription drug coverage through a Medicare Part D Employer Group Waiver Plan (EGWP) as part of their PSHB plan. This EGWP is a Medicare Part D plan with no additional premium costs and offers benefits such as a $35 monthly cap on insulin products and a $2,000 annual cap on out-of-pocket Part D drug costs. However, eligible individuals can choose to opt out of this coverage if they determine it is suitable for their circumstances.
It is important to note that a Postal Service annuitant or family member who moves back to the United States may lose eligibility for certain exceptions and may be required to enroll in Medicare Part B to maintain their PSHB plan coverage. Additionally, the Postal Service offers its employees other benefits, such as participation in the Federal Long-Term Care Insurance Program (FLTCIP), the Federal Employees Dental and Vision Insurance Program (FEDVIP), and the Thrift Savings Plan (TSP).
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Federal Employees Health Benefits (FEHB) Program
The Federal Employees Health Benefits (FEHB) Program is a health insurance program that covers eligible Postal Service employees, retirees, and their families. The Postal Service participates in the FEHB Program, which offers a range of plans, including Fee-For-Service, Health Maintenance Organizations (HMOs), and High Deductible & Consumer-Driven Health Plans. The Postal Service covers most of the cost of health insurance under this program, and employee premium contributions are typically not subject to taxes, making it more affordable.
The FEHB Program is administered by the Office of Personnel Management (OPM) and provides flexible and comprehensive health coverage. Employees can choose from various plans to suit their needs, and there is also the option to participate in the Federal Employees Dental and Vision Insurance Program (FEDVIP). While employees pay the full cost of dental and vision insurance, the group insurance rates are made more affordable due to the tax exemption on premium contributions.
It is important to note that the FEHB Program has undergone some changes in recent years. As of January 1, 2025, the Postal Service Health Benefits (PSHB) Program replaced the FEHB Program for Postal Service employees, retirees, and their eligible family members. This new program is also administered by the OPM and provides health insurance to these groups. The PSHB Program offers similar benefits and cost-sharing structures to the FEHB Program, ensuring continuity of quality healthcare coverage for those affected by the transition.
During the transition to the PSHB Program, OPM automatically enrolled claimants/beneficiaries into a 2025 PSHB plan with equivalent benefits and costs to their 2024 FEHB plan. Claimants whose previous FEHB plan was not part of the PSHB Program were enrolled in the lowest-cost nationwide plan. Individuals who wished to choose a different PSHB plan could do so during the Federal Benefits Open Season, which ran from November 11 to December 9, 2024.
The FEHB Program also includes provisions for surviving spouses or survivor annuitants, who may be eligible to continue their enrollment after the death of a Postal Service employee. Additionally, temporary continuation of coverage (TCC) is available for certain individuals, such as former spouses of Postal Service employees who do not meet all the requirements for enrollment. TCC allows them to maintain coverage while awaiting a determination on their eligibility for FEHB under spouse equity provisions.
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Federal Long-Term Care Insurance Program (FLTCIP)
The Federal Long-Term Care Insurance Program (FLTCIP) is a federal employee benefit that provides long-term care insurance to help pay for the costs of care when enrollees need assistance with everyday activities or have severe cognitive impairments, such as Alzheimer's disease. The program is sponsored by the U.S. Office of Personnel Management (OPM) and was launched in 2002.
FLTCIP is available to eligible federal and U.S. Postal Service employees and annuitants, active and retired service members, and certain qualified relatives. This includes Army Reserve Service members on drill status, who are eligible to apply with full underwriting. Eligible qualified relatives include spouses, domestic partners, parents, parents-in-law, stepparents, and survivors of active and retired service members receiving a survivor annuity.
The care can be received in various settings, including at home, in assisted living facilities, nursing homes, adult day care centres, or hospice facilities. FLTCIP also covers home care provided by informal caregivers, such as friends and family members who did not live with the enrollee before they became eligible for benefits. However, benefits for family care are limited to 500 days.
FLTCIP offers four pre-packaged plans based on popular options, as well as customizable plans to suit individual needs. It is important to note that FLTCIP is medically underwritten, and certain medical conditions may prevent some people from being approved for coverage.
As of December 19, 2022, the U.S. Office of Personnel Management (OPM) has suspended applications for coverage under FLTCIP for a period of 24 months, with a possibility of extension. During this suspension, individuals cannot apply for coverage or increase their current coverage.
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Federal Employees' Group Life Insurance (FEGLI) Program
The Federal Employees Group Life Insurance (FEGLI) Program was established on August 29, 1954, and is the largest group life insurance program in the world, covering over 4 million federal employees, retirees, and their family members. The program is administered by the Office of Personnel Management (OPM) and underwritten by several private insurance companies, including the Office of Federal Employees' Group Life Insurance (a unit of Metropolitan Life Insurance Company).
FEGLI provides group term life insurance with no cash or paid-up value. It consists of Basic life insurance coverage, which is provided to new federal employees by default, and three forms of Optional insurance that can be elected (provided the employee has Basic coverage). The cost of Basic coverage is paid by the employer (in this case, the Postal Service), with the option to purchase additional coverage through payroll deductions. The cost of Option C insurance depends on an employee's age and the number of multiples elected, with premiums increasing as the employee moves into a new age group.
Employees can elect to reduce or cancel coverage at any time (unless they have assigned their coverage), and there are no regularly scheduled open enrollment periods. Open seasons are only held when specifically scheduled by OPM. Employees can also assign their FEGLI coverage to another person, firm, or trust, although they must continue to pay the premiums.
The FEGLI program also includes benefits such as tax-free purchase of public transportation and parking, up to IRS maximums, to reduce out-of-pocket costs for employees who choose to participate.
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Frequently asked questions
The PSHB Program is a new, separate program within the Federal Employees Health Benefits (FEHB) Program, administered by the Office of Personnel Management (OPM). It provides health insurance to eligible Postal Service employees, retirees, and their eligible family members.
The PSHB Program covers prescription drug coverage through a Medicare Part D Employer Group Waiver Plan (EGWP). It also includes coverage for long-term care, such as nursing home or assisted living expenses, which are typically not covered by health insurance or Medicare.
If you are a Postal Service employee or retiree, you will be automatically enrolled in the PSHB version of your current FEHB plan for the 2025 plan year. You can also choose to change your plan during the Federal Benefits Open Season, which usually falls between November and December.
Yes, Postal Service employees are eligible for coverage under the Federal Employees' Group Life Insurance (FEGLI) Program. They can also participate in the Federal Employees Dental and Vision Insurance Program (FEDVIP) and the Federal Long-Term Care Insurance Program (FLTCIP).
