Key Takeaways

• Enrolling in the Postal Service Health Benefits (PSHB) program requires careful consideration of your eligibility, coverage options, and integration with Medicare if applicable.

• Understanding enrollment deadlines, cost-sharing details, and available plan types will help you make informed decisions about your healthcare coverage.

Understanding PSHB Enrollment: What You Need to Know

The Postal Service Health Benefits (PSHB) program is now the primary health insurance system for Postal Service employees, retirees, and eligible family members. If you are preparing to enroll, you need to understand the key steps that will ensure you select the right plan for your needs. With the transition from the Federal Employees Health Benefits (FEHB) program to PSHB now in effect, it’s crucial to stay informed about eligibility requirements, enrollment deadlines, plan options, and cost considerations.

Here’s what you need to know before signing up.

1. Determine Your Eligibility and Who Can Enroll

Before making any decisions, you need to confirm that you are eligible for PSHB. The program is available to:

• Current USPS Employees: Full-time and part-time career employees qualify for PSHB coverage.

• Postal Service Retirees: Those who have retired from USPS and are currently enrolled in FEHB will automatically transition to PSHB unless they opt out.

• Eligible Family Members: Spouses and dependent children under the age of 26 qualify for coverage under a family plan.

• Medicare-Eligible Annuitants: If you are a retired USPS employee and qualify for Medicare, you may need to enroll in Medicare Part B to maintain PSHB coverage.

Understanding Medicare Integration

If you are eligible for Medicare, some PSHB plans may offer cost-saving benefits, such as lower deductibles and reduced out-of-pocket expenses. However, retirees who are required to enroll in Medicare Part B must ensure they do so to avoid losing their PSHB coverage.

2. Review Enrollment Deadlines and Your Available Options

Missing an enrollment deadline could mean losing coverage or delaying benefits, so you need to be aware of the key dates.

Open Season and Special Enrollment Periods

• Annual Open Season: PSHB enrollment takes place during the Open Season, which typically runs from mid-November to mid-December each year. This is when you can enroll in a new plan, switch plans, or make changes to your coverage.

• Special Enrollment Periods (SEPs): Outside of Open Season, you may qualify for a Special Enrollment Period if you experience a qualifying life event, such as marriage, divorce, the birth of a child, or losing other health coverage.

Make sure to mark these dates on your calendar to avoid missing your opportunity to enroll or make changes to your plan.

3. Compare Plans and Understand Cost-Sharing

Selecting the right PSHB plan depends on your healthcare needs and budget. Here’s what you should consider when comparing plans:

Understanding Plan Types

• Self Only: Covers only the USPS employee or retiree.

• Self Plus One: Covers the USPS employee or retiree and one eligible family member.

• Self and Family: Covers the USPS employee or retiree and all eligible family members.

Cost Considerations

Every plan includes premiums, deductibles, copayments, and coinsurance. Understanding these costs will help you determine which plan provides the best value for your medical needs.

• Premiums: The monthly amount you pay for coverage.

• Deductibles: The amount you must pay before the plan starts covering certain medical expenses.

• Copayments and Coinsurance: The percentage of costs you share for covered services after meeting your deductible.

If you are enrolling as a Medicare beneficiary, some PSHB plans may offer enhanced benefits with lower out-of-pocket expenses. Be sure to check how your selected plan coordinates with Medicare to maximize your benefits.

4. Enroll on Time and Confirm Your Coverage

Once you’ve reviewed your options and selected the right plan, the next step is to complete your enrollment and verify that your coverage is in place.

How to Enroll

During Open Season, you can enroll in PSHB by:

• Using the official USPS enrollment system or the designated online platform provided for Postal Service employees and retirees.

• Submitting a paper enrollment form if required by your HR department or retirement office.

Confirm Your Enrollment

After enrolling, check your confirmation details to ensure that:

• You are enrolled in the correct plan.

• Your family members are covered if you selected a family plan.

• Your payroll or retirement system is processing your premiums correctly.

If there are any issues, contact your benefits administrator immediately to resolve them before your coverage takes effect.

Stay Informed and Plan for Future Open Seasons

Enrolling in PSHB is not just a one-time decision. Each year, plan benefits and costs may change, so reviewing your options during Open Season is essential to ensure your coverage continues to meet your needs.

Tips for Future Open Seasons

• Compare Plan Changes: Review plan brochures to see if your current plan has changed benefits, premiums, or provider networks.

• Evaluate Your Healthcare Needs: If your medical needs change, you may need to switch to a different plan.

• Check for Medicare Coordination Benefits: If you become eligible for Medicare, consider how PSHB integrates with Medicare Part B.

Make the Right Choice for Your Health Coverage

Choosing the right PSHB plan requires careful planning and an understanding of how the program works. By determining your eligibility, reviewing deadlines, comparing plans, and enrolling on time, you can ensure that you have the coverage you need for the coming year.

To get personalized assistance with your enrollment, speak with a licensed agent listed on this website. They can help you understand your options and guide you through the process.