4/16/23 – By now the vast majority of postal employees and retirees have at least heard of the Postal Service Health Benefits (PSHB) program, part of the Postal Service Reform Act, that will be forcing them out of the Federal Employee Health Benefits (FEHB) program and into the PSHB program. BUT, only a few, if any, really understand what this will mean for their health coverage starting in, or about, January 2025. I am fairly certain that in actuality only OPM, the Office of Personnel Management, fully understands exactly what this will mean for postal employees and retirees in the long haul. I admit that I do NOT understand how this will unfold in the long term and what it will do to our health coverage.
I do know this for certain. Currently, there are about 9 million employees and retirees, both postal and government, covered under the FEHB plans – this, folks, is a HUGE pool of subscribers. Under the new PSHB plan that pool of subscribers will be reduced to just over 1 million – we all understand how a smaller pool of subscribers can affect rates and benefits. According to Fedweek “Those retiring from the USPS in 2025 or later generally will have to enroll in Medicare Part B—and pay those premiums as well—with Medicare becoming the primary payer.”
As a retired USPS employee, I am not happy with the government taking away benefits that we, as postal retirees, have earned and were promised.
Below are some links to information regarding this change. I hope this will help you with your decision making. BTW – all of the unions backed the change to the PSHB program and the Postal Reform Act.
- OPM: Upcoming Postal Health Program’s Effect on Premiums ‘Highly Uncertain’
- USPS information on the PSHB plan
- FAQ’s regarding the PSHB program – OPM
- Postal Reform Act
- Certain Postal Only Plans Must Be Available for 2025, After That Could Drop Out – Fedweek
- Postal Service Reform Act; Establishment of the Postal Service Health Benefits Program – Federal Register
- OPM PRESS RELEASE: OPM Releases Interim Final Rule for the New Postal Service Health Benefits Program
Rick, I guess no matter what we do or prove to them that we WERE covered by credible insurance before & after retirement, they will continue to to charge that late penalty. Now to wait & see how it pans out with this new PSHB plans SEP. If you sign up for part B, penalty free they better have some form that qualifies you for that so you are NOT charged a penalty because you signed up during a SEP. Going forward I’m sure it will get even more complicated & they won’t have any answers to your questions. They just want people to blindly sign up for things, that they have NO IDEA what they getting into. Boy what a mess !!!
When I signed up for Medicare’s part A, I was told that I could just keep my FEHB as it was similar to Medicare. Then later if I wanted to sign up for part B, I could, no penalty. the reality was, as long as your working your FEHB is considered ” credible ” with Medicare. However, after you retire ( even though it is the EXACT plan) it is then no longer credible insurance. The only thing that changed was that you retired, nothing else. None the less, that FEHB plan became “not credible ” simply because you are now in a ” retired” state. So unfair. So now we are faced with the same choices we had when. we were 1st able to sign up for part B, but with NO PENALITY. However, the plans, coverage, & cost will only be available AFTER that SEP to join part B, so that puts us in yet another quandary of what to do. They seem to making this harder than it has to be.
Janet – thanks. Please read this from SSA Law:
“(b) In the case of an individual whose coverage period began pursuant to an enrollment after his initial enrollment period (determined pursuant to subsection (c) or (d) of section ) and not pursuant to a special enrollment period under subsection (i)(4) or (l)of section 1837, the monthly premium determined under subsection (a) (without regard to any adjustment under subsection (i)) shall be increased by 10 percent of the monthly premium so determined for each full 12 months (in the same continuous period of eligibility) in which he could have been but was not enrolled. For purposes of the preceding sentence, there shall be taken into account (1) the months which elapsed between the close of his initial enrollment period and the close of the enrollment period in which he enrolled, plus (in the case of an individual who reenrolls) (2) the months which elapsed between the date of termination of a previous coverage period and the close of the enrollment period in which he reenrolled, but there shall not be taken into account months for which the individual can demonstrate that the individual was enrolled in a group health plan described in section 1862(b)(1)(A)(v) by reason of the individual’s (or the individual’s spouse’s) current employment status or months during which the individual has not attained the age of 65 and for which the individual can demonstrate that the individual was enrolled in a large group health plan…..”
Read it yourself here:
https://www.ssa.gov/OP_Home/ssact/title18/1839.htm
In my case I WAS enrolled in a large group health plan (FEHB – B/C) both before and after retirement. I told SSA this but they’re still charging me a 30% penalty and will not respond to my calls, letters, or faxes. Rick – PEN
If they could get some of the companies to offer a medicare advantage plan for those who opt to sign up for Medicare’s part B plan, that might be a positive step forward. Perhaps similar to Medicare’s yearly open enrollment, but just different plans under this new PSHB ??? Might that give a lot of us an easier time in picking a plan. But then again, that might be too simple ( & we all know the government never does ANYTHING the easy way )
Too many scenarios they have not addressed to even be able to make a decision. if you sign up for part B, enroll in a Medicare advantage plan, then suspend your PSHB/FEHB, will they continue to pay your part B penalty? Will you even be able to suspend under PSHB, like you could with FEHB? Even then, since the SEP ends In September , when will it become effective? currently it is the month you sign up, so ??? plus since we won’t know what companies will offer a plan, the coverage or the cost until October or November, how are we supposed to make an ” informed” decision? And also, how will you know your Dr will participate in those plans until after the fact ?? Seems to me not near enough thought has gone into this &there will be MANY goof up’s & we will be left with yet more problems to work out because of their ineffective plan that simply has too many loopholes, & no clear path to a resolution. yep, 1 BIG mess is coming.
Janet – you are spot on. It is and will be train wreck and WE will suffer the consequences. You can thank the current admin in DC for this failure. I have been paying a late enrollment penalty to SSA for my Medicare since I enrolled. Yes, I enrolled after I was eligible, but SSA law states that if you’re covered under a large group health policy (like we were while employed at USPS and when we retired) then you will not be charged a late enrollment penalty. I been writing and faxing them for over a 16 months and they refuse to respond to my reconsideration request. What a load of crap.
I am lucky, Years ago, when this scam first was tried by mgmt. and the unions, we switched from my NALC FEHB coverage to my wife’s, how was also a fed employee. I knew sooner or later the crooks in both mgmt and the unions would get it passed; they always do. They just keep trying over and over when they want something passed and sooner or later it will be. When all the right pockets are greased.
So now my wife and I still have our FEHB coverage, still is our choice whether to have Medicare B or not, and the USPS and the NALC have ZERO power over our future.
At the end of the day, the unions will always do what they think is best for their interests, and if that means selling their members down the river, so be it.
Anyone who believes otherwise is denying reality.
Doesn’t matter…as wrong as it is…Unions & Mgt sold us out….nothing we can do now…let the chips fall where they may…