Postal Worker Magazine Article

Recently I received the feedback from a reader of the Postal Worker Magazine and this blog. The readers comments are paraphrased below to protect the their identity and personal health information.

I found your March/April Postal Worker Magazine article to be unbalanced. Your article should have featured resources for your members that have dependents who will age out of FEHB coverage. Specifically information about COBRA and how the insulin dependent diabetics could have continued to have identical health coverage.

Thank you to everyone who reaches out to the APWU Health Plan Directors Blog. Input of any kind is always appreciated as that is how we stay so well connected to the membership, by allowing direct communication with the highest level of our management.

As far as the comments above, I stand by my article in the APWU Postal Worker magazine. The cost of injectable drugs has increased 15% per year from 2008-2016 making insulin and other lifesaving drugs unaffordable for the insured and uninsured alike.

I understand your point but unfortunately members of a FEHB insurance plan DO NOT have the ability to participate in COBRA benefits. The APWU Health Plan only insures Postal, Federal active employees and Retirees. Our members are not allowed to invoke COBRA benefits. However I appreciate your point and the opportunity to educate everyone on what the options are if one loses FEHB coverage due to aging out of the plan.

If you lose Federal Employee Health Benefit coverage because you no longer qualify as a family member you may be eligible for TCC (Temporary Continuation of Coverage.) Full details about TCC are available on the OPM website https://www.opm.gov/healthcare-insurance/healthcare/temporary-continuation-of-coverage/#url=Pamphlet.

The employing office is not obligated to inform you of your child’s eligibility for TCC and conversion rights when he/she is no longer eligible for coverage. You must contact your Human Resources Office within 60 days of your child’s 26th birthday to inform them that your child is turning age 26 and that you are interested in enrolling them in TCC or a conversion plan.

According to OPM.gov children and former spouses can continue TCC for up to 36 months after the date of the qualifying event when the child was covered under regular FEHB enrollment. Also, OPM enrollees are responsible for the full costs of the TCC plan, this is the enrollee share, the government share and a 2% administration charge which makes these plans very expensive which is not helpful to working Americans. The guide that lists premiums is located on the OPM website http://www.opm.gov/insure/health/planinfo/guides/index.asp.

Information on enrolling in the Temporary Continuation of Coverage (TCC) is available directly from OPM at Get the RI 79-27, which describes TCC, from your employing or retirement office or from www.opm.gov/healthcare-insurance/healthcare/planinformation/ guides. It explains what you have to do to enroll.

Another option is a person losing FEHB coverage may elect to enroll in and ACA marketplace plan. More information about the marketplace is available at www.healthcare.gov , information about our conversion plan is at www.apwuhp.com  , or on page 12 of our federal brochure https://www.apwuhp.com/our-plans/compare-plan-options/.

 

APWU Health Plan Celebrates Women’s History Month

March is Women’s History Month and is an ideal time to celebrate the brave, bold and fearless women who have influenced history. The important role women have played in shaping this country our world cannot be overlooked. It is important that we honor the impressive contributions women have made to the APWU Health Plan, the union movement, our country and the world we share.

Today we are proud to provide a token of our appreciation to the women of the APWU Health Plan for all they do on behalf of our membership and to celebrate women’s history month. Team members received a Women’s History Month special edition newsletter and a gift in our cafeteria. Monitors throughout the APWU Health Plan have been displaying a special Women’s History Month Message. This celebration was well received and a great success.

If you would like to learn more about Women’s History Month visit https://womenshistorymonth.gov/.Displayflowers

High Option Members: How to fill a 90 day prescription at CVS or Walgreens

APWU High Option members should check their inbox for instructions on how to take advantage of the new 90-day prescription drug benefit available at in-network Smart90 retail pharmacies. If you did not receive the email please check your spam folder. You can update your email address contact with us  by calling 1-800-222-APWU.

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Attention High Option Members: New Smart90 Program

High Option members may now obtain (non-specialty) maintenance drugs at an in-network Smart90 retail pharmacy (CVS or Walgreens). If you are already using mail order and would like to start filling your prescriptions at CVS or Walgreens, you will need a new 90-day prescription. You cannot transfer your existing mail order prescription to the retail pharmacy.

For more information on Smart90, call Express Scripts at 800-841-2734.

Save the Date!

We are thrilled and excited for the APWU Health Plan hosting 2019’s seminar in the Great Pacific Northwest.

Watch your mailbox for our 34th Annual Open Season Seminar Save the Date postcard. If you would like to be added to our mailing list for future mailing please contact John’s Executive Assistant Kimberly at (kbeauvais@apwuhp.com). For additional information visit us at www.apwuhp.com/events.

2019 hpr save the date

Happy Holidays from APWU Health Plan!

As the year draws to a close, I want to take the opportunity to express our gratitude for your membership in the APWU Health Plan. We strive to provide quality, affordable healthcare for all of our members. You, the Health Plan Member, are the reason for everything we do. So on behalf of the over 225 employees at the APWU Health Plan we wish you a blessed holiday season filled with family and friends.

hide-obara-233-unsplashPlease be aware that in conjunction with the Federal Holiday closures, the APWU Health Plan offices will be closed on December 24 and 25, 2018.

APWU Health Plan Dental

Dear Health Plan Representatives,

The APWU Health Plan is offering a new dental insurance plan! In response to feedback from our membership, we are now offering two affordable plan options. Full details about the plan are available on our website at www.apwuhp.com. Just click the link in the blue box.

Copies of this dental brochure are on the way. Our union printer will mail them directly to your local office. Please inform your Local, State and Retiree chapter leadership that they should expect these brochures soon. This is another resource to support their union-owned Health Plan.

To ensure that our members have an opportunity to enroll in this comprehensive plan the Open Season deadline for the APWU Health Plan Dental has been extended to December 20, 2018. This deadline extension is exclusively for the APWU Health Plan Dental and does not apply to other medical or dental plans.

In friendship and solidarity,
John L. Marcotte

APWU Health Plan Incentives for APWU Local, State and Retiree Chapter Organizations

Dear Health Plan Representatives,

The delegates assembled at the 2018 National Convention took action on a resolution from Michigan, Washington, Alaska, Oregon, Idaho, and Montana Postal Worker Unions, NEB # 5. The delegates approved the NEB’s recommendation that considering concerns with the execution and accountability of NEB #5 as written recommended a substitute. In lieu of NEB #5, the delegates directed Secretary-Treasurer Liz Powell and Health Plan Director John L. Marcotte to meet and arrive at a recommendation in the spirit of this resolution within 90 days for presentation to the NEB.

Several in person and phone discussions were made by Sister Powell and myself to arrive at a recommendation that satisfies the NEB committee concerns with the resolution as written within the directed 90 days. This was reported to the HPR’s at our seminar in San Antonio.

I am pleased to inform you the National Executive Board has approved the below recommendation for cash payments and incentives to Local, State and Retiree Chapter organizations.

Please inform your Local, State and Retiree chapter leadership of this wonderful support of their Health Plan efforts by the National Executive Board.

In friendship and solidarity,

John L. Marcotte

California Wildfires: APWU Health Plan Disaster Relief Initiative

Aware of the increasing magnitude of these tragic wildfires, the APWU Health Plan is taking a proactive approach to provide support and help ease the burden of our Health Plan members.

The APWU Health Plan has altered the benefits for any Health Plan member that has been or are currently being impacted by the wildfires in the affected zip code areas of Butte, Los Angeles, and Ventura counties in California. The affected area and time frame will be extended as conditions warrant. The following accommodations will be provided to members in the High Option and Consumer Driven Option who reside in the affected zip codes no matter where services are rendered from 11/9/18 through 12/9/18:

  • All member claims will be paid as in-network regardless of the provider’s network status.
  • The Health Plan will waive precertification requirements for all in-patient admissions (medical). Beacon Health Options will use maximum flexibility in approving requests for inpatient mental health services.
  • Telephonic counseling will be available for all affected membership; members should call Beacon Health Options at 888-700-7965 to speak to a
  • Extensive provisions have been made with your pharmacy administrator so that members can obtain their prescriptions for both retail and mail order. For assistance with prescriptions, High Option members should call Express Scripts at 800-841-2734 and Consumer Driven Option members should contact Optum RX at 800-718-1299. The following exceptions will be made:
    • 30 day supply or refills can be obtained at a network retail pharmacy
    • Refills can be obtained before the refill date for members that have lost their prescription
    • Paper claims submitted by affected members will be identified and processed at the normal retail copay
  • Mail orders of narcotics and temperature-sensitive medications for impacted areas will be held; members should contact their pharmacy administrator to discuss alternative delivery options to ensure safe and accurate delivery
  • Mail orders can be shipped to a temporary alternate address by calling your pharmacy administrator
  • If a member is unable to receive their order by mail it can be transferred to a retail pharmacy for dispensing by calling your pharmacy administrator
  • Orders that have already been shipped can be reprocessed. Up to a seven-day supply obtained through a retail pharmacy at no cost to the member; members should visit a retail pharmacy to obtain the order or refill

Hurricane Michael: APWU Health Plan Disaster Relief Initiative

In response to Hurricane Michael, the APWU Health Plan is taking a compassionate proactive approach to provide support and help ease the burden of our Health Plan members.

The APWU Health Plan has altered the benefits for any Health Plan member that resides in the affected areas of Florida, Alabama, Georgia, North Carolina, South Carolina, and Virginia. The affected area and time frame will be extended as conditions warrant. The following accommodations will be provided to members in the High Option and Consumer Driven Option from October 10, 2018 through November 09, 2018:

  • All member claims will be paid as in-network regardless of the provider’s network status.
  • The Health Plan will waive precertification requirements for all in-patient admissions (medical).Beacon Health Options will use maximum flexibility in approving requests for inpatient mental health services.
  • Telephonic counseling will be available for all affected membership; members should call Beacon Health Options at 888-700-7965 to speak to a representative.
  • Extensive provisions have been made with your pharmacy administrator so that members can obtain their prescriptions for both retail and mail order. For assistance with prescriptions, High Option members should call Express Scripts at 800-841-2734 and Consumer Driven Option members should contact Optum RX at 800-718-1299. The following exceptions will be made:
  • 30 day supply or refills can be obtained at a network retail pharmacy
  • Refills can be obtained before the refill date for members that have lost their prescription
  • Paper claims submitted by affected members will be identified and processed at the normal retail copay
  • Mail orders of narcotics and temperature-sensitive medications for impacted areas will be held; members should contact their pharmacy administrator to discuss alternative delivery options to ensure safe and accurate delivery
  • Mail orders can be shipped to a temporary alternate address by calling your pharmacy administrator
  • If a member is unable to receive their order by mail it can be transferred to a retail pharmacy for dispensing by calling your pharmacy administrator
  • Orders that have already been shipped can be reprocessed. Up to a seven-day supply obtained through a retail pharmacy at no cost to the member; members should visit a retail pharmacy to obtain the order or refill