Fedweek

1.7 million individuals must change their health enrollment from an FEHB plan to a PSHB plan by January 2025. Image: Matt Gush/Shutterstock.com

OPM has said that it “anticipates a significant spike in demand for customer-facing services” from Postal Service employees and retirees ahead of their move effective in 2025 out of the FEHB and into what will be a new Postal Service Health Benefits Program.

“Fully 100% of postal employees and annuitants – all 1.7 million individuals – must change their health enrollment from an FEHB plan to a PSHB plan by January 2025. By contrast, a normal health benefits open season typically results in just 5-6% of enrollees making a change in enrollment – and that within a system they already have experience operating within,” OPM said in a budget document

“Change is often difficult, and we expect many postal employees and annuitants will need extra advice and assistance to understand their choices and actions that must be taken,” it said in asking Congress for some $38 million for 2024 to continue setting up that program, including nearly $10 million to build up customer support capacity.

That is to include a new, contracted “customer support center” that is to handle “enrollment changes made by telephone or mail, verifying documentation proving eligibility of family members and enrollees, answering Postal enrollee questions concerning the PSHBP, and reconciling enrollment and premium discrepancies. It will also include a call center to offer year-round, multi-lingual customer service staff to answer inquiries and provide enrollment assistance by phone, email, and live chat in the U.S. and internationally.”

OPM is expected to soon issue rules governing the program, which was ordered by a Postal Service reform law enacted last year and is to generally parallel the FEHB. OPM is to contract with insurers to offer plans, which would need to meet certain coverage requirements; generally, any insurer with a plan having at least 1,500 USPS employees or retirees enrolled as of the start of this year would be required to offer plans in the PSHB program.

One major difference, will be that Medicare-eligible USPS future annuitants and their Medicare-eligible covered family members generally will be required to enroll in Medicare Part B (physicians and related services); there would exceptions for those already retired at the start of 2025, current employees age 64 or older as of that point, and those VA or Indian Health Service coverage. Also, the postal population will form its own premium pool, with a currently unknown impact on rates for them and for the rest of the current FEHB population.

OPM added: “If successfully implemented, the PSHBP will see robust participation by health plans offering innovative, affordable, high-quality benefits, accurate and efficient enrollment and payment processing that generates savings by reducing premium payments for ineligible persons and other enrollment discrepancies, and superior enrollee satisfaction with the health benefits selection process and their chosen health plan.”

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2023 Federal Employees Handbook