nalc health benefit plan fredric v. rolando, president brian hellman, director fredric v. rolando,...
TRANSCRIPT
NALC Health Benefit Plan
NALC Health Benefit Plan
Fredric V. Rolando, President
Brian Hellman, Director
Fredric V. Rolando, President
Brian Hellman, Director
NALC Constitution
NALC Constitution
NALC HBP HistoryNALC HBP History
NALC HQ’s BuildingNALC HQ’s Building
History 1960’s (continued)
History 1960’s (continued)
Early 60’s – Became part of the Federal Employees Health Benefit Program with passage of public law PL 86-382. Enrollment quadrupled to 101,503. The Plan used every available office space at the headquarters building. The auditorium became the file room.
In 1963 the NALC added an eight (8) story annex to the NALC Headquarters Building. We occupied four (4) floors in the annex and space in the main building.
Early 60’s – Became part of the Federal Employees Health Benefit Program with passage of public law PL 86-382. Enrollment quadrupled to 101,503. The Plan used every available office space at the headquarters building. The auditorium became the file room.
In 1963 the NALC added an eight (8) story annex to the NALC Headquarters Building. We occupied four (4) floors in the annex and space in the main building.
History 1970’s (continued)
History 1970’s (continued)
1972 – The NALC HBP continued to grow in the Federal program. The entire Plan moved to Reston, Virginia by the end of the year. The entire staff comprised of 229 employees and membership totaled 141,177.
1972 – The NALC HBP continued to grow in the Federal program. The entire Plan moved to Reston, Virginia by the end of the year. The entire staff comprised of 229 employees and membership totaled 141,177.
NALC HBP Reston, VANALC HBP Reston, VA
History 1980’s (continued)
History 1980’s (continued)
1980’s – The computer age hit the Plan. All analysts were equipped with computer terminals and claims were processed through a computerized system.
1980’s – The computer age hit the Plan. All analysts were equipped with computer terminals and claims were processed through a computerized system.
Computer TerminalsComputer Terminals
As technology grew, so did the Plan. If fact, by the late 1980’s the Plan was growing to the point that we needed to locate to an even bigger facility.
History 1990’s (continued)
The NALC HBP was “bustin at the seams” with 520 employees and a membership of 220,000. The Reston building was inadequate, so the Plan moved to Ashburn, Virginia on June 8, 1990.
The NALC HBP was “bustin at the seams” with 520 employees and a membership of 220,000. The Reston building was inadequate, so the Plan moved to Ashburn, Virginia on June 8, 1990.
NALC HBP Ashburn, VANALC HBP Ashburn, VA
Where we are now - 2013
Where we are now - 2013
Over sixty (60) years later we are still going strong. We have endured and prospered. Currently, we have 346 employees at the Plan and we cover a total of 115,932 members or 223,545 lives
2012 Open Season = 3,295 New Members
Over sixty (60) years later we are still going strong. We have endured and prospered. Currently, we have 346 employees at the Plan and we cover a total of 115,932 members or 223,545 lives
2012 Open Season = 3,295 New Members
2012 NALC HBP Facts
We issued $1.2 Billion in benefits.
Processed 4,631,975 claims
Mailed 8,668,435 pieces of mail (includes checks, explanation of benefits , temporary Identification cards and letters).
Answered 858,075 incoming calls from members, physicians and hospitals.
Average tenure of an NALC HBP employee is
20 Years
Employees
NALC HBP wall of 30 year plaques
These three employees have 130 combined years of services
Employees
NALC HBP MissionNALC HBP Mission
The Plan’s mission is to provide our members accessibility to quality medical care while maintaining a comprehensive benefit package.
We pride ourselves in offering excellent benefits with affordable premiums and excellent customer service.
The Plan’s mission is to provide our members accessibility to quality medical care while maintaining a comprehensive benefit package.
We pride ourselves in offering excellent benefits with affordable premiums and excellent customer service.
The Plan is . . .The Plan is . . .
High Option 2014 Plan Partnerships
Cigna
CVS/Caremark
OptumHealth
High Option Plan
PPO Office Visit $20 Copayment
Your office visit copayment for a PPO provider is just $20. When your PPO physician or PPO specialist bills for:
• an office visit
• an office consultation
• a second surgical opinion
• Outpatient individual or group therapy, or
• Outpatient medication management
Lab Services
PPO Benefit Level
Maternity Benefits Cont.
Family Planning Services
Preventive care, adult
Preventive care, adult
Preventive care, children
Preventive care, children
Preventive care, children
Prescription Benefit
Prescription Benefit
Quit for LifeTobacco Cessation
Program
Alere Weight Talk Program®
NEW for 2014
Additional Benefit Highlights for 2014
High Option General Information
CDHP and
Value Option Plan
CDHP and Value Option Plans
Consumer Driven Plan
What is a Consumer Driven Plan?
A health plan that provides coverage for medical/pharmacy expenses, with in-network preventive care services covered at 100%, plus...
A Personal Care Account (PCA) funded by NALC to pay for eligible health care expenses.
Deductible - If you are enrolled in the CDHP/Value Option, you must satisfy your calendar year deductible and exhaust your Personal Care Account (PCA) before the Plan starts paying benefits under the Traditional Health Coverage. Once the deductible is met, you and NALC will share the cost of the eligible expenses.
Consumer Driven Plan
Personal Care Account (PCA)
Personal
Care
Account
Deductible
Traditional Benefit Begin
In-Network Out-of-Network
CDHP Deductible
Self - $2,000Self and Family -$4,000
Self - $4,000Self and Family -$8,000
CDHP Out-of-Pocket
Self - $6,000Self and Family - $12,000
Self - $12,000Self and Family – $24,000
Value OptionDeductible
Self - $2,000Self and Family -$4,000
Self - $4,000Self and Family -$8,000
Value OptionOut-of-Pocket
Self - $6,000Self and Family - $12,000
Self - $12,000Self and Family – $24,000
CDHP and Value Option 2014 Plan Partnerships
2014 Partnerships
CDHP and Value Option
Benefit Structure Highlights
Preventive Care with an In-Network health care professional is covered at 100%When the doctor bills your visit as preventive care, your PCA will not be used.
Examples of Preventive Benefits include but are not limited to:
• Well Baby and Well Child visits• Well Man and Well Woman visits• Routine Immunizations• Routine Screenings:
Cholesterol Screening: Ages 20+, every 5 years Diabetes Screening Mammogram: Once a year for women age 40+ Prostate Screening: Once a year for men age 40+ Colonoscopy: Ages 50+, every 10 years
Note: Benefits will be reduced, if an In-Network provider is not used.
In-Network Out-of-Network
You Pay 20% of Plan Allowance 50% of Plan AllowanceAnd any difference, if any between our allowance and charge
Note: Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
In-Network Out-of-Network
You Pay 20% of Plan Allowance 50% of Plan AllowanceAnd any difference, if any between our allowance and charge
Note: Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
*Not covered - Routine tests except as listed in the official brochure under Preventive Care, Section 5.
In-Network Out-of-Network
You Pay 20% of Plan Allowance 50% of Plan AllowanceAnd any difference, if any between our allowance and charge
Note: Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
In-Network Out-of-Network
You Pay 20% of Plan Allowance(All charges after 50 max visits have been met)
50% of Plan AllowanceAnd any difference, if any between our allowance and charge(All charges after 50 max visits have been met)
Note: Your PCA must be used first and your deductible exhausted before traditional benefits will apply. Your deductible applies to all benefits listed above.
Want to be Tobacco Free?
A voluntary tobacco cessation program offered by the Plan which includes:
Unlimited professional 20 – 30 minute telephonic counseling sessions per quit attempt
Online tools
Over- the Counter nicotine replacement therapy
For more information on the program visit mycigna.com or call 1-855-246-1873
Rate Information
YearBi – Weekly Postal
Premium(Active)
Monthly Annuitant Premium
Self Family Self Family
2011 $51.56 $100.57 $160.64 $327.32
2012 $54.04 $105.16 $161.68 $327.60
2013 $52.95 $103.26 $160.66 $326.04
2014 $58.02 $114.59 $161.22 $327.27
Year CDHP Value Option
Self Family Self Family
2014 $36.19 $78.58 $31.16 $67.66
The above rates only apply to Career Postal employees. City Carrier Assistants (CCA) should contact the HRSSC employing office for premium information at 1-877-477-3273, option 5
Dare to Compare
How USPS Employees How USPS Employees Enroll in NALC HBP?Enroll in NALC HBP?
How USPS Employees How USPS Employees Enroll in NALC HBP?Enroll in NALC HBP?
Open Season November 11 –
December 9
NALC Health Benefit PlanOur objective is to unite fraternally all Letter
Carriers who are members in good standing in the National Association of Letter Carriers.
I belong to both the NALC Union AND the NALC Health Benefit Plan. Do You?????
I’m 100% UNION!!!
NALC Health Benefit PlanOur objective is to unite fraternally all Letter
Carriers who are members in good standing in the National Association of Letter Carriers.
I belong to both the NALC Union AND the NALC Health Benefit Plan. Do You?????
I’m 100% UNION!!!
