Choose from two powerful options backed by the NALC Health Benefit Plan. Whether you want predictable copays and a lower deductible on services through the High Option Plan, or a higher deductible with a Personal Care Account (PCA) through the CDHP plan, this page helps you make the right choice.
Your health plan choice matters. Here’s a quick summary of the benefits and differences you’ll see with NALC HBP as your main plan.
|
Feature |
High Option Plan |
Consumer Driven Health Plan (CDHP) |
|---|---|---|
|
Plan Fundamentals |
A traditional fee-for-service plan with predictable costs for many services. |
A consumer-driven plan with a higher deductible, paired with a Personal Care Account (PCA). |
|
Your Premiums |
Generally higher. |
Generally lower. |
|
Meeting Your Deductible |
Lower annual deductible, which applies to some services before cost-sharing begins. |
Higher deductible, but your PCA helps with eligible costs first. |
|
Personal Care Account (PCA) |
Yes. Annual contribution for eligible medical, mental health, and prescription costs. |
|
|
Who Might Prefer This Plan |
Those who want predictable costs, receive medical care regularly, or anticipate major health needs. |
Those who are generally healthy and prefer lower premiums while managing a health fund. |
|
Your Enrollment |
NALC HBP High Option (Code) |
NALC HBP CDHP (Code) |
|---|---|---|
|
Self Only |
$238.29 (77A) |
$128.11 (77D) |
|
Self Plus One |
$576.50 (77C) |
$290.08 (77F) |
|
Self and Family |
$516.58 (77B) |
$314.00 (77E) |
|
Enrollment Type |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Self Only |
$300 |
In-Network =$2,000 Out-of-Network = $4,000 |
|
Self Plus One / Family |
$600 |
In-Network = $4,000 Out-of-Network = $8,000 |
|
Feature |
NALC HBP High Option |
NALC CDHP |
|---|---|---|
|
Personal Care Account (PCA) |
N/A |
Self Only = $1,200 Self Plus One / Family = $2,400 |
|
How PCA Works |
N/A |
Use your PCA to cover everyday health needs—from prescriptions to checkups and counseling sessions—and everything you spend from it goes toward your deductible. |
|
Rollover of Unused PCA Funds |
N/A |
Unused PCA funds roll over to the next year. |
|
Maximum PCA Rollover
(Rollover only applies if the member stays in the CDHP plan.) |
N/A |
Self Only: $5,000 Â Self Plus One / Family: $10,000 |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Self Only |
In- Network = $3,500 Out-of-Network = $5,000 |
In-Network = $6,600 Out-of-Network = $12,000 |
|
Self Plus One / Self and Family |
In-Network = $7,000 Out-of-Network = $10,000 |
In-Network = $12,000 Out-of-Network = $24,000 |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Preventive Care In-Network |
The Plan covers preventive care at 100%. |
The Plan covers preventive care at 100%. |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Primary Care & Specialty Visits (In-Network) |
$25 copay per visit. |
After your PCA and deductible — you pay 20% of the Plan allowance. |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Inpatient Hospital Admissions (In-Network) |
$350 copayment per admission. No copayment is due when services are related to the routine delivery of a newborn. |
After your PCA and deductible - you pay 20% of the Plan allowance. |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Complete Maternity Obstetrical Care (In-Network) |
You pay nothing. |
After your PCA and deductible — you pay 20% of the Plan allowance. |
|
Treatment for postpartum depression or depression during pregnancy (In-Network) |
You pay nothing up to four visit limit. |
Not Included. |
|
Certified Doula (Per pregnancy) |
Nothing up to the $500 Plan maximum. All charges after we pay $500. |
Not included. |
|
Feature |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Outpatient Professional Service Visits for Mental Health and Substance Use Treatment (In-Network) |
$25 copay per visit. |
After your PCA and deductible — you pay 20% of the Plan allowance. |
|
Tier |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Generic Drugs (Network retail) |
20% of the Plan Allowance (10% for asthma, diabetes & hypertension) |
$10 ($5 for asthma, diabetes & hypertension) |
|
Formulary Brand Drugs (Network retail) |
30% of the Plan Allowance |
$40 |
|
Non-Formulary Brand Drugs (Network retail) |
50% of the Plan Allowance |
$60 |
Prescription Out-of-Pocket Maximum
|
Tier |
NALC HBP High Option |
NALC HBP CDHP |
|---|---|---|
|
Self Only |
$3,100 |
$6,600 (includes medical services) |
|
Self Plus One / Self and Family |
$5,000 |
$12,000 (includes medical services) |
* For Postal retirees with Medicare: If you’re in the SilverScript PDP or MAPD, all qualifying out-of-pocket amounts for Medicare-covered care also count toward your PSHB maximum. Once the $2,000 prescription cap is reached (for PDP), your covered medications are paid in full for the remainder of the year.

If you’re a Postal annuitant with Medicare, here’s how the plans coordinate.
High Option: Often pays remaining costs after Medicare, meaning
little or no out-of-pocket.
CDHP: Medicare pays first, then PCA applies, then deductible.
Both plans: include SilverScript® Prescription Drug Plan (EGWP)
for Part D.
Compare how both plans support your Medicare benefits — and decide what fits your life and budget best.
Managing your health plan should be convenient. Access your NALC HBP benefits and important health information whenever and wherever you need it with these helpful digital tools.
|
Digital Tool |
NALC High Option |
NALC CDHP |
Key Features & Access |
|---|---|---|---|
|
NALC HBP Member Access Portal & Mobile App |
Manage claims, ID cards, and partner programs — all in the NALC HBP App.
*CDHP Members can only manage ID Cards |
||
|
myCigna® Portal & App |
Find doctors, check claims, and estimate costs in myCigna
*HO Members cannot check claims through MyCigna |
||
|
CVS Caremark® Portal & App (myCVS™ On the Go) |
Manage your prescriptions—refills, history, and local pharmacies—all in one place. |
||
|
NALC HBP Telehealth (powered by Amwell®) |
Get care from home with NALC HBP Telehealth — When and where you need it Urgent care ($10), dermatology ($10), nutrition and women’s health (free). |
||
|
MDLive (via myCigna.com) |
Get care from home with MDLive — When and where you need it Urgent care, primary care, dermatology and behavioral care. 10% of the Plan allowance after deductible. |
||
|
Cost Estimation Tools |
Estimate costs for physicians, hospitals, and procedures. |
||
|
Online Provider Directories |
Locate medical, mental health, and pharmacy network providers. |
Your health journey is important to us! Both NALC HBP plans offer a fantastic range of programs and rewards to help you live your healthiest life.
|
High Option |
CDHP |
|
|---|---|---|
|
Hinge Health® (For Back & Joint Pain) |
||
|
Hello Heart® (For Cardiac Care) |
||
|
Diabetes Care Management (Transform Care) |
||
|
Maven (Women's & Family Health) |
||
|
Weight Loss Program (Real Appeal®) |
||
|
Weight Loss Program (Cigna) |
||
|
CVS Rx Weight Management Program (For Weight Loss Medications) |
||
|
Mental Health Resources (Optum® Network & Tools) |
||
|
Mental Health Resources (Cigna® Network & Tools) |
||
|
Smoking Cessation Program |
||
|
24-Hour Health Information Line |
||
|
Wellness Rewards Program (Earn $$ for healthy actions) |
||
|
Dental Discounts (CignaPlus Savings®) |
||
|
Vaccine Administration Network |
||
|
MinuteClinic® Access |
We’re proud to support our postal family — and the feeling is mutual.
Whether it’s Open Season or you’ve had a Qualifying Life Event (QLE), enrolling in the NALC Health Benefit Plan is easy.
Here’s what to do:
During Open Season
Follow the PSHB enrollment steps by visiting https://health-benefits.opm.gov/pshb/, or you can call 844-451-1261.
After a QLE
Contact your employing office if you are actively working, or OPM if you are retired to report the change and update your benefits
No matter when you enroll, choosing the NALC Health Benefit Plan is a positive step toward better health coverage and peace of mind.
Have a question about the NALC Health Benefit Plans? Need a little help to understand something? We're always happy to assist!
