Mail Handlers Benefit Plan

Mail Handlers Benefit Plan – 1 MHBP (Mail Operators Benefit Plan) Fee for service plan (Standard Option and Value Plan) with preferred union and sponsor by: National Union of Postal Workers, AFL-CIO, a division of LIUNA. Who can enroll in the program: All federal employees and payees who are eligible to enroll in the federal employee health benefits program and who are, or are, members or affiliates of the Association of Ma’ National Postal Workers Union, AFL-CIO, a division of LIUNA. For changes in benefits, see page 9. To become a member or associate: If you are a non-postal employee, you will automatically become a member of the National Association of Postmen when you Register at MHBP. There is no membership fee for members of the National Association of Postal Administrators, AFL-CIO, a division of LIUNA. Membership fee: $42 per year for membership unless otherwise specified by law. New members will be billed by the National Association of Postal Administrators for annual fees when the program receives notice of enrollment. The National Association of Postal Administrators will charge affiliate members for an annual membership. Enrollment codes for this program: 414 Value Plan – Self Only 415 Value Plan – Self and Family Other URAC Trustees: Caremark, Inc.: Pharmacy Benefit Management, Prescription Management Caremark Rx, LLC: Specialty Pharmacy, Mail Service Pharmacy 454 Position Level – Integrative Behavioral Health Only, Houston Care Skills: Health Utilization Management 455 Standard Choice – Self and Family See the 2012 Guide for more information on skills. Special Information: Information on the MHBP Consumer Choice is in a separate brochure to see RI RI

2 Important notices from MHBP about our drug coverage and Medicare OPM has determined that MHBP coverage, on average, is expected to pay as much as standard Medicare coverage would pay for all plan participants and is considered premium coverage. . . So you don’t need to enroll in Medicare Part D and pay more for prescription drug benefits. If you decide to enroll in Medicare Part D later, you won’t pay the enrollment penalty as long as you keep your FEHB coverage. However, if you choose to enroll in Medicare Part D, you can keep your FEHB coverage and coordinate benefits with Medicare. Remember: If you are a subscriber and cancel your FEHB coverage, you may not be able to re-enroll in the FEHB plan. Please be advised that if you lose or drop FEHB coverage and go 63 days or more without medical coverage that is at least equivalent to Medicare coverage, your premium will go up by at least 1% in every month of every month you have. This coverage could not be found. For example, if you go 19 months without a Medicare Part D prescription, your premium will always be at least 19 percent higher than what most people pay. You must pay this higher rate as long as you have Medicare drug coverage. Additionally, you may also have to wait until the next annual adjustment period (October 15 to December 7) to enroll in Medicare Part D. Low-income Medicare benefits For people with limited income and resources, there is more help to pay for the Medicare prescription drug program. Information about this program is available through the Social Security Administration (SSA) online or by calling SSA at (TTY). You can get more information about Medicare drug plans and coverage offered in your area from these places: Visit For personalized help, call MEDICARE ( ), (TTY). MHBP Notice of Privacy Practices We keep your personal health information protected as described in the current MHBP Notice of Privacy Practices. You can obtain a copy of our notice by calling us or by visiting our website:

Mail Handlers Benefit Plan

Mail Handlers Benefit Plan

3 Content-rich introduction…3 Plain language…3 Stop healthcare fraud!…3 Prevent medical errors…4 Part 1. Information about payment for services.. .7 Part 2. How We’ve Changed Part 3. How you get benefits… 11 Identification card… 11 Where to get covered care… 11 What you need to do to get covered care closed… -1 You need program approval before any specifics. services… 13 Section 4. Your cost of covered services… 18 Payments… 18 Cost sharing… 18 Deductible… 18 Copayments… 18 If your provider waives the cost you … 19 Waivers .. 19 Payment Differences … 19 Your Greater Out-of-Pocket Protection for Money … 20 Transfers … 21 If We Pay You … Original Medicare Plans (Part A, Part B, or Both) … 22 Section 5. Standard Choices and Plan Benefits … 24 Non-PEHB Benefits Available to Plan Members … 74 Section 6. General exceptions do not cover. … 77 Section 7. Making claims for covered services … 79 Section 8. Disputed claims process … 82 Section 9. Coordination of benefits with other coverage … 84 When you have other coverage. ..84 What is Medicare? … 84 Should I enroll in Medicare? … 85 Basic Medicare Plan (Part A or Part B) … 85 Personal Contract with Your Doctor … 86 Medicare Benefits (Part C) ) … 86 TRICARE and CHAMPVA…Compensation Employers 89…89 Medicaid…89 When Other Government Agencies Are Responsible for Your Care…89 When Others Are Responsible for Your Injury…89 Section 10. Definition of Terms We Use and In this brochure … 92 Section 11. FEHB Fax … 97 Coverage information … 0 No pre-existing conditions … 97 Where to find information about enrolling in the program FEHB MHBP (Mail Handlers Benefit Program) 1 Table of Contents

Federal Employees’ Health Benefits (fehb) Program

4 Types of Writs Available for You and Your Family … 97 Child Support Law … 98 When Benefits and Money Begin … .. 99 On Divorce … 99 Continued Temporary Coverage (TCC) … 99 Converting to Individual Coverage … 99 Obtaining Group Health Plan Certification Section 12. Other Federal Programs MHBP Plan Summary For MHBP Benefits Correct Fa Benefits of Option Options for MHBP MHBP (Mailers Benefit Program) 2 Table of Contents

5 Introduction This brochure describes the benefits of the Mail Handler Benefit Program (MHBP). The National Association of Postal Administrators, a division of LIUNA, AFL-CIO, a division of LIUNA, has entered into a contract (CS1146) with the United States Office of Labor Management as required by the Federal Occupational Health and Safety Act. give permission. The plan is underwritten by Life Insurance Company/Cambridge Life Insurance Company. The administrative office address is: MHBP PO Box 8402 London, KY This brochure is the official benefits information. No oral statement may change or otherwise affect the benefits, limitations and exclusions of this brochure. It is your responsibility to be informed about your health benefits. If you are enrolled in this program, you are entitled to the benefits described in this brochure. If you are enrolled in personal and family coverage, each family member is also entitled to these benefits. You are not entitled to benefits earned before January 1, 2012, unless those benefits are shown in this brochure. OPM negotiates benefits and rates with each program each year. The benefit changes are effective January 1, 2012, and the changes are summarized on pages XXX-XXXX. The rating is shown at the end of this brochure. Clear language All PHAB brochures are written in clear language to make them easy to understand. Here are some examples: In addition to technical terms, we use common terms. For example, you mean registrant or family member, we mean MHBP. We have limited the opportunities to those you know. FEHB is the federal employee health benefits system. OPM is the United States Office of Personnel Management. If we use others, we will tell you what they mean first. Our brochure and other FEHB plan documents have the same layout and illustrations to help you compare plans. If you have comments or suggestions about how to improve the format of this brochure, let OPM know. Visit OPM’s course comments section or OPM at You can also write to OPM in the US. Fraud increases health care costs for everyone and increases the cost of the Federal Employees Health Benefits Program. OPM’s Office of Inspector General investigates all allegations of fraud, embezzlement, and abuse in the PEHB program, regardless of the agency that employed you or from which you retired. Protect yourself from fraud Here are some things you can do to prevent fraud: Do not give your plan identification number over the phone or to people you do not know, except to your doctor, another service provider, or an authorized process or OPM. Agent. Let only qualified medical professionals review your medical records or recommend services. Avoid using health care providers who say an item or service is usually not covered, but they know how to bill us to make money. Carefully review the Statements of Benefits (EOBs) you receive from us. Please review your claim history

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