Mhbp Health Plan

Mhbp Health Plan – 1 MHBP (Postal Employees Benefit Plan) Fee for Service Plan (Standard Option and Value Plan), Sponsored by: National Association of Postal Administrators, AFL-CIO, LIUNA Chapter. Who can enroll in this plan: All federal employees and retirees who are eligible to enroll in the Federal Employees Health Benefits Program and who are affiliated or members of the National Association of Postal Administrators, AFL-CIO, LIUNA. . To change benefits, see page 9. To become a member or associate member: If you are a non-postal employee/retiree, you will automatically become an associate member of the National Association of Postal Workers after you enroll in the MHBP. There is no membership fee for members of the AFL-CIO National Union of Postal Administrators, a chapter of LIUNA. Membership fee: $42 per year for association membership except by law. New Association members will be billed annually by the Association of Administrators for the annual mailing fee upon receipt of their enrollment notice. Continuing association members will be billed by the National Postmasters Association for the annual membership fee. Access codes for this plan: 414 Value Plan – Only 415 Value Plan – Self and Family Other URAC Accreditations: Caremark, Inc.: Pharmacy Benefit Management, Medication Management Caremark Rx, LLC: Specialty Pharmacy, Mail Service Pharmacy 454 Standard Option – Only Behavioral Health Care of Houston: Health Utilization Management 455 Standard Option – See the 2012 manual for more information on self and family accreditation. Special Notice: Information about the MHBP Consumer Option is in a separate brochure for RI RI

2 Important notice from MHBP about our prescription drug coverage and Medicare OPM has determined that MHBP prescription drug coverage will pay the average Medicare prescription drug cost for all plan participants and is considered safe coverage. Therefore, there is no need to enroll in Medicare Part D and pay extra for prescription drugs. If you decide to enroll in Medicare Part D later, you won’t have to pay the late enrollment penalty if 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 working and cancel your FEHB coverage, you cannot re-enroll in the FEHB Program. Please be advised that if you lose or drop your FEHB coverage and go 63 days or more without a top-notch prescription drug, such as a Medicare prescription drug, your premium will increase by at least 1% per month for each month. no such information. For example, if you go 19 months without a Medicare Part D prescription drug, your premium will always be at least 19 percent higher than what other people pay. If you have a Medicare prescription drug, you will have to pay this higher fee. You may also have to wait until the next annual coordinated election period (October 15 to December 7) to sign up for Medicare Part D. For people with limited income and resources, there is a Medicare Prescription Drug Supplemental Assistance Plan. Information about this program is available online through the Social Security Administration (SSA) or by calling SSA (TTY). You can learn more about Medicare prescription drug plans and coverage in your area by visiting: For personal help, call MEDICARE (), (TTY). MHBP Notice of Privacy Practices We protect the privacy of your protected health information as described in the current MHBP Notice of Privacy Practices. You can obtain a copy of our notice by calling us or visiting our website:

Mhbp Health Plan

Mhbp Health Plan

3 Contents Introduction… 3 Plain Language… 3 Stop Healthcare Fraud! … 3 Avoid medical errors … 4 Section 1. The facts about this fee-based plan … 7 Section 2. How we change some services for Section 3 … 13 Section 4. Your costs for covered services … 18 Transferring … 18 Cost Sharing … 18 Deductible … 18 Payment Insurance … 18 If Your Provider Continually Deducts Your Expenses … 19 Transfers … 19 Billing Differences … 19 Your Catastrophic Protection, Best for Insurance High Maximum … 20 Transportation … 21 If We Overpay You … 21 When Government Agencies Pay Us … 21 When You Have an Original Medicare Plan (Part A, Part B, or Both) … 22 Section 5. Standard Option and Price Plan Benefits … 24 Non-FEHB Benefits Available to Plan Members … 74 Section 6. Common Deductibles Don’t Cover Important to Us .. .77 Section 7. Claiming Covered Services . .. 79 Section 8. Disputes process … 82 Section 9. Combining benefits with other cover … 84 If you have another part of your health. ..84 What is Medicare? … 84 Should I Enroll in Medicare? … 85 Original Medicare Plan (Part A or Part B) … 85 Individual Agreement with a Doctor … 86 Medicare Advantage (Part C) … 86 Medicare Prescription Drug (Part D) … 86 TRICARE and CHAMPVA … 89 Workers’ Compensation … 89 Medicaid … 89 When Other Government Agencies Are Responsible for Your Care … 89 When Others Are Responsible for Your Injuries … 89 Chapter 10. In This Booklet definitions of the terms we use … 92 Chapter 11. FEHB Facts … 97 Background information … 0 No pre-existing condition restrictions … 97 Where to get information about enrolling in the FEHB Program MHBP (Postal Employees’ Benefit Plan) 1 Table of Contents

The Mail Handler Magazine Summer 2020 By National Postal Mail Handlers Union

4 Ways to Access You and Your Family… 97 The Child Equity Act… 98 When Benefits and Premiums Begin… 99 When You Retire… 99 When You Lose Benefits… 0 When FEHB-Coverage Ends… 99 After Separation… . ) 2 Contents

5 Introduction This brochure describes the benefits of the Postal Work Benefit Plan (MHBP). LIUNA Chapter The National Union of Postal Administrators, AFL-CIO, LIUNA Chapter, entered into an agreement with the United States Office of Personnel Management under the authority of the Federal Employee Health Benefits Act (CS1146). This plan is underwritten by First Health Life and Health Insurance Company / Cambridge Life Insurance Company. Administrative address: MHBP PO Box 8402 London, KY This booklet is the official description of benefits. No oral statement shall modify or otherwise affect the benefits, limitations and exclusions of this brochure. It is your responsibility to report the health benefits. If you are enrolled in this plan, you are entitled to the benefits described in this brochure. If you subscribe to Self & Family coverage, every member of your family also benefits from these benefits. You are not entitled to benefits available before January 1, 2012, unless these benefits are listed in this booklet. OPM negotiates benefits and rates with each plan each year. The benefit change is effective January 1, 2012, and the changes are summarized on pages xxx-xxx. Prices are listed at the end of this booklet. Clear language All FEHB brochures are written in easy-to-understand language. Here are some examples: In addition to the necessary technical terms, we use general terms. For example, you mean an enrollee or a family member, we say MHBP. We limit the acronyms to those you know. FEHB is a federal employee health benefit program. OPM is the US Office of Personnel Management. If we use others, we first say what they mean. Our brochure and other FEHB plan brochures have the same format and similar descriptions to help you compare plans. If you have comments or suggestions about how to improve the structure of this booklet, please let OPM know. Visit OPM’s comments section or OPM at fehbwebcomments@opm.gov. You can also write to OPM at the US Personnel Management Office of Health and Insurance, Federal Employees Insurance Operations, Program Analysis and System Support, 1900 E Street NW, Washington, DC! Fraud raises health care costs for everyone and raises the Federal Employees Health Insurance Program premiums. OPM’s Inspector General investigates allegations of fraud, waste, and abuse in the FEHB program, regardless of the agency that employs you or the retiree. Protect against fraud Here are some things you can do to prevent fraud: Do not give your plan identification (ID) number over the phone or to a doctor, other provider or plan authority, or anyone else you don’t know OPM. representative Review your medical records or recommend services only to qualified medical professionals. Avoid using health care providers who tell you that an item or service is not covered, but they know how to pay for it. Carefully review your Explanation of Benefits (EOB) from us. Please review your claim history

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