Feeling Confused About PSHB Open Season? Let’s Break Down What You Need to Do Before 2025

Key Takeaways:

• The Postal Service Health Benefits (PSHB) program will officially launch on January 1, 2025, replacing the current FEHB program for USPS employees and retirees.
• Open Season for enrolling or making changes to your PSHB plan will run from November 11, 2024, to December 9, 2024. This is your key window to review options and ensure you’re covered.

Why the PSHB Open Season Matters

Feeling overwhelmed by all the chatter about the Postal Service Health Benefits (PSHB) program? Don’t worry—you’re not alone. With the transition away from the FEHB (Federal Employees Health Benefits) program, it’s crucial to understand what’s happening and what you need to do before the PSHB Open Season wraps up on December 9, 2024.

Here’s a simple breakdown of the key steps you need to take to make sure you’re on the right path before the new PSHB plan launches on January 1, 2025. We’ll also touch on some changes in costs and Medicare requirements, so you’re fully prepared.

What’s Happening: The Postal Service Reform Act

First, let’s start with the big picture: why is this all happening? The Postal Service Reform Act of 2022 laid the foundation for significant changes in how USPS employees and retirees receive health benefits. One of the biggest changes? The shift from the FEHB to the PSHB program, which is tailor-made for postal workers and their unique needs.

If you’re currently enrolled in the FEHB program, you’ll be automatically transferred to a PSHB plan starting January 1, 2025. However, you’ll still have the opportunity to review and update your coverage during the 2024 Open Season, running from November 11 to December 9, 2024.

What Should You Do During Open Season?

Step 1: Review Your PSHB and FEDVIP Plans

Even if you’re happy with your current health coverage under FEHB, it’s essential to check out the new PSHB plan options. The Open Season period is your chance to compare PSHB plans to ensure you have the best coverage for your needs starting in 2025.

Alongside your PSHB plan, you’ll also need to review your dental and vision coverage under the Federal Employees Dental and Vision Insurance Program (FEDVIP). Thankfully, FEDVIP coverage will remain unaffected by the transition to PSHB, so if you’re already covered for routine dental exams, cleanings, or prescription eyewear, that won’t change. However, dental premiums will rise by an average of 2.97% in 2025, while vision premiums will see a modest 0.87% increase.

Step 2: Use the OPM Plan Comparison Tool

Not sure which plan is best for you? The OPM plan comparison tool is available during Open Season to help you weigh your options. Whether it’s the cost of premiums or coverage specifics for certain prescriptions, this tool is your go-to resource for making an informed decision.

Step 3: Pay Attention to Medicare Part B Enrollment

For retirees, one of the most significant factors to consider is Medicare Part B enrollment. If you’re retiring before January 1, 2025, you’re in the clear—you won’t need to enroll in Medicare Part B to keep your PSHB coverage. However, if you retire after January 1, 2025, you’ll need to enroll in Medicare Part B once you become eligible (usually at age 65) to maintain your PSHB plan. Keep in mind that this requirement extends to your family members as well.

For those already eligible but not yet enrolled in Part B, a Special Enrollment Period (SEP) ran from April to September 2024, offering USPS retirees a penalty-free opportunity to enroll. If you didn’t take advantage of it, be sure to review your Medicare options ASAP.

Costs to Keep in Mind

Let’s talk numbers. Transitioning to PSHB means you’ll need to familiarize yourself with new premium rates and how they compare to what you’re used to paying under FEHB. Here’s a general breakdown of the average biweekly premiums for 2025:

• Self Only: $397.35
• Self Plus One: $858.89
• Self and Family: $934.65

Keep in mind that the government covers 72% of the total premium, so your contribution as an employee or retiree will be around 28% of the total cost. This means your biweekly contribution will look something like this:

• Self Only: $111.26
• Self Plus One: $240.49
• Self and Family: $261.70

On an annual basis (over 26 pay periods), this translates to:

• Self Only: $2,892.76 per year
• Self Plus One: $6,252.74 per year
• Self and Family: $6,804.20 per year

These numbers might feel a bit overwhelming, but the good news is that most retirees who also enroll in Medicare Part B can enjoy reduced out-of-pocket healthcare costs. Some PSHB plans offer perks like Part B premium reimbursements, waived deductibles, and overall lower expenses for medical services.

If you’re nearing retirement, be sure to crunch the numbers and see how enrolling in Medicare Part B could save you money down the line.

What About Prescription Coverage?

Here’s some great news—if you’re Medicare-eligible, you won’t need to sign up for a separate Part D plan. That’s because all PSHB plans for Medicare enrollees will include Medicare Part D prescription drug coverage. This means your prescription drugs will be covered as part of your PSHB plan, streamlining your healthcare expenses and making it easier to manage your medications.

That said, it’s still a good idea to review your plan’s formulary (the list of covered medications) to ensure your prescriptions are included. Not every drug may be covered, so make sure you understand how your specific medications fit into the plan you choose.

What if You Miss Open Season?

The PSHB Open Season is your best opportunity to review and adjust your plan before the January 1, 2025, transition date. But what happens if you miss it? If you don’t make any changes during Open Season, you’ll automatically be moved to a plan similar to what you had under FEHB. However, your options for making changes after the deadline will be limited, so don’t wait until the last minute!

It’s essential to act during Open Season if you have changes in your healthcare needs or want to explore other coverage options. This is particularly true if you’re anticipating retirement soon or have dependents who will also be affected by the shift to PSHB.

Wrapping It All Up

In short, the transition to PSHB may feel like a lot to take in, but with the right preparation, you can make sure you’re covered without any surprises. Remember the key dates: November 11, 2024 – December 9, 2024 is your time to review your options and choose the best plan for you and your family. After that, the new Postal Service Health Benefits (PSHB) program officially kicks off on January 1, 2025.

If you’re approaching retirement, pay extra attention to how Medicare Part B fits into your plan, and don’t forget to check out any extra perks your PSHB plan might offer. Take advantage of the resources available, like the OPM comparison tool, and don’t hesitate to make any necessary changes before the Open Season window closes.

Plan for Your PSHB Transition in 2024

Now that you know what’s coming, it’s time to act. Mark your calendar for the PSHB Open Season dates, review your options, and make the necessary adjustments so you’re ready for January 1, 2025. With a bit of planning, you’ll be ready to take on this new chapter in your postal career or retirement with confidence.