U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

This is a general description of the plan changes. This page is not an official statement of benefits. For that, go to the Benefits descriptions in the Plan Brochure. Also, we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.

• Your share of the non-Postal premium for High Option will increase by 13.8% for Self Only and increase by 13.8% for Self and Family. There is no increase or decrease in your share of the non-Postal premium for Standard Option for either Self Only or for Self and Family.

  Benefit changes under High Option:

• We now charge a copay for allergy injections whether you receive them from a doctor or nurse. Your injections will be subject to a $15 copay for each visit to a primary care physician (PCP), and a $20 copay for each visit to a Specialist. (Section 5(a))

• We now cover autologous tandem transplants for ovarian cancers, as well as for testicular cancers. There will be a $20 copay per specialist office visit and nothing for the surgery. (Section 5(b))

• We now cover residential crisis services received on an outpatient basis, at a facility licensed to provide such services, subject to a specialist copay of $20. (Section 5(e))

  Benefit changes under Standard Option:

• We now charge a copay for allergy injections whether you receive them from a doctor or nurse. Your injections will be subject to a $20 copay for each visit to a primary care physician (PCP), and a $25 copay for each visit to a Specialist. (Section 5(a))

• We now cover autologous tandem transplants for ovarian cancers, as well as for testicular cancers. There will be a $25 copay per specialist office visit and nothing for the surgery. (Section 5(b))

• We now cover residential crisis services received on an outpatient basis, at a facility licensed to provide such services, subject to a specialist copay of $25. (Section 5(e))

  Benefit changes under both High and Standard Options:

• We now cover artificial insemination at 6 cycles per lifetime. (Section 5(a))

• We have reduced a portion of our Service Area for the Maryland area only for 2004. If you live or work in the county of Worcester, you must select another FEHB plan during the Open Season. If you do not select another FEHB plan during the Open Season, you will be covered only for emergency care received outside our Service Area. (See page 11)

• We have increased our Service Area in the State of Virginia to include the Central and Richmond, Virginia areas and various surrounding cities and counties. (See page 11 for a detailed description of the Service Area)