Compare Benefit Options
The Service Benefit Plan offers two types of coverage: Standard Option and Basic Option. Standard Option gives you the freedom to receive covered services from both Preferred and Non-preferred providers. Basic Option members must receive care performed by Preferred providers, except in certain situations like emergency care. Standard Option also has a calendar year deductible, while Basic Option does not. Most care under Basic Option is subject to a copayment amount.
Outlined below is a summary of the Service Benefit Plan benefits. Refer to the Service Benefit Plan brochure (RI 71-005) for comprehensive benefit information for both options. All benefits are subject to the definitions, limitations and exclusions set forth in the 2013 Benefit Plan brochure.
If you are a tribal employee, please note that rates may vary for you. Contact your Human Resources representative for additional information or to inquire about enrolling.
|2013 Standard Option||2013 Basic Option|
|Category 1||Category 2||Category 1||Category 2|
Non-Postal rates apply to most non-Postal employees. If you are in a special enrollment category, refer to the Guide to Federal Benefits for that category or contact the agency that maintains your health benefits enrollment. Career non-law enforcement employees may also refer to the Guide to Federal Benefits for United States Postal Service Employees, RI 70-2, to determine their rates. Different rates apply and a special Guide is published for Postal Service Inspectors and Office of Inspector General (OIG) employees (see RI 70-21N). For additional assistance, Postal Service employees can call the Human Resources Shared Service Center at 1.877.477.3273 and select option 5. Postal rates do not apply to non-career postal employees, postal retirees or associate members of any postal employee organization who are non-career postal employees. Refer to the applicable Guide to Federal Benefits.
The following chart offers a comparison of Standard and Basic Option benefits when you use Preferred providers.
|Benefit||2013 Standard Option
|2013 Basic Option
|Inpatient services, including surgery, medical care and outpatient surgery|
|Home and office visits, and outpatient second surgical opinions and consultations|
|HOSPITAL / FACILITY CARE|
|Hospital Inpatient: Precertification required|
|Outpatient Facility Care|
|ACCIDENTAL INJURY / EMERGENCY CARE|
|Accidental Injury Care: Physician and facility care|
|Medical Emergency Care: Facility care|
|Medical Emergency Care: Physician care|
|Mail Service Pharmacy|
Up to a 34-day supply. 90-day supply for 3 copayments.
|Preventive Screenings and related office visit charge, routine physical exams.|
|Routine Dental Care|
|CHIROPRACTIC CARE AND OSTEOPATHIC MANIPULATIVE TREATMENT|
Page last updated: December 31, 2012