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Postal Service Health Benefits (PSHB) for USPS Employees: Breakdown of PSHB’s Official Fact Sheet

Key Takeaways

  • USPS employees must select a health insurance plan under the new PSHB Program during the 2024 open season.
  • Enrollment in Medicare Part B is required for PSHB coverage in retirement, with some exceptions.

Postal Service Health Benefits (PSHB) for USPS Employees: Breakdown of PSHB’s Official Fact Sheet

Introduction

The Postal Service Reform Act of 2022 (PSRA) introduced significant changes to health benefits for USPS employees. A crucial part of this reform is the establishment of the Postal Service Health Benefits (PSHB) Program. This new program, which falls under the Federal Employees Health Benefits (FEHB) Program and is administered by the Office of Personnel Management (OPM), will begin on January 1, 2025.

What is the PSHB Program?

The PSHB Program is a separate health benefits program designed specifically for USPS employees. It aims to provide comprehensive health coverage, ensuring that postal workers have access to essential healthcare services. This program requires active participation from employees during designated enrollment periods.

Key Dates and Enrollment Information

  • Open Season Enrollment: USPS employees must select a health insurance plan under the PSHB Program during the open season period from November 11, 2024, to December 9, 2024.
  • Plan Options and Premiums: Information about PSHB plan options and premiums will be available in October 2024.
  • New Enrollment Platform: OPM will introduce a new enrollment platform for health insurance, with detailed instructions provided before the 2024 open season.

Medicare Part B Enrollment Requirements

The PSHB Program introduces specific requirements related to Medicare Part B enrollment for USPS employees, particularly concerning their retirement status and age.

Employees Age 64 and Older

If you are an active USPS employee who will be 64 or older as of January 1, 2025, you are not required to enroll in Medicare Part B to maintain your PSHB health insurance coverage upon retirement. However, once you retire and become eligible for Medicare Part A (typically at age 65), you have the option to enroll in Medicare Part B during a special enrollment period.

  • Family Members: Covered family members are also not required to enroll in Medicare Part B but doing so may reduce overall healthcare costs and provide better value.

Employees Under Age 64

For active USPS employees under the age of 64 as of January 1, 2025, enrolling in Medicare Part B is mandatory to continue PSHB health insurance coverage upon retirement. This requirement also extends to covered family members.

  • Medicare Part B Enrollment: Upon retirement, you must enroll in Medicare Part B when you become eligible for Medicare Part A (typically at age 65). The Social Security Administration (SSA) will send a notice when you are eligible to enroll in Medicare Part B during your initial enrollment period, which starts three months before your 65th birthday and ends three months after.

Exceptions to Medicare Part B Enrollment

Certain exceptions apply to the requirement to enroll in Medicare Part B. These exceptions also cover family members and require proof of eligibility.

  • Residency Outside the U.S.: Employees residing outside the United States and its territories must follow the Postal Service’s policy and procedure to qualify for this exception.
  • Veterans Affairs Health Benefits: Employees enrolled in health benefits provided by the Department of Veterans Affairs.
  • Indian Health Services: Employees eligible for health services through Indian Health Services.

Coverage Eligibility and Family Members

As a general rule, the eligibility of spousal and family member coverage under the PSHB Program is based on the primary enrollee’s eligibility. If the primary subscriber must enroll in Medicare Part B, dependent family members must also enroll when they become eligible to remain covered.

Conclusion

The new PSHB Program represents a significant shift in how USPS employees will manage their health benefits. Understanding these changes and the associated requirements, especially regarding Medicare Part B enrollment, is crucial for ensuring continuous and comprehensive health coverage. USPS employees should stay informed and prepare for the upcoming open season to make well-informed decisions about their health insurance plans.

For more detailed information, please refer to official resources or connect with one of the licensed insurance agents listed on our website.

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