NALC Health Benefit Plan, NALC High Option: 2027 PSHB premiums and benefits
Federal Benefits Open Season for plan year 2027 runs November 9 to December 14, 2026.
* Three PSHB options end after 2026: GEHA High, MHBP Consumer, and UnitedHealthcare Postal East. If you are in one, choose a plan by December 14. See what ends| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code 77A | $116.06 gov $318.23 | $251.46 | $251.46 | $-5.08 biweekly (-4.2%) | $3,018 |
| Self Plus One code 77C | $290.00 gov $689.34 | $628.33 | $628.33 | $-3.31 biweekly (-1.1%) | $7,540 |
| Self and Family code 77B | $270.37 gov $748.55 | $585.80 | $585.80 | +$2.95 biweekly (+1.1%) | $7,030 |
Traditional, PPO network. Offered nationwide. Postal employees must be dues-paying members of an NALC local branch (dues vary by branch). Retirees, survivor annuitants, and TCC enrollees who are not members become associate members at $36 a year. Source. The government share is the lesser of 72% of the PSHB program-wide average premium or 75% of this plan's premium (OPM). Employee figures are OPM's rate for active postal employees; USPS non-career employees and some union contracts differ.
Educational information only; StandWatch is not acting for OPM or the Postal Service, and the brochure and the HR Shared Service Center are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $350 out of network $350 | $700 out of network $700 | $700 out of network $700 |
| Out-of-pocket maximum | $3,500 out of network $5,000 | $7,000 out of network $10,000 | $7,000 out of network $10,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Primary care visit | $25 Copayment | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Specialist visit | $25 Copayment | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Urgent care | $25 Copayment | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Emergency room | 15% Coinsurance After deductible | 15% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Labs and X-rays | 15% Coinsurance After deductible | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| CT, MRI, PET | 15% Coinsurance After deductible | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Hospital stay, per admission | $350 Copayment Per admission | $450 Copayment Per admission, plus the difference between Plan allowance and billed amount |
| Hospital room | Member Pays Nothing Included in admission | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Surgeon, inpatient | 15% Coinsurance No deductible | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Outpatient surgery | 15% Coinsurance After deductible | 35% Coinsurance After deductible, plus the difference between Plan allowance and billed amount |
| Mental health, office | $25 Copayment | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Mental health, inpatient | $350 Copayment Per admission. No deductible. | $450 Copayment Per admission |
| Physical therapy | 15% Coinsurance 75 combined visits | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Chiropractic | $25 Copayment 24 visit limit | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Acupuncture | $25 Copayment No deductible and all charges after 25 visit limit. | 35% Coinsurance After deductible, and any difference between Plan allowance and billed amount, all charges after 25 visit limit |
| Maternity care | Member Pays Nothing | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Maternity hospital stay | Member Pays Nothing | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Infertility diagnosis and treatment | 15% Coinsurance After deductible | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Covered Nothing up to the Plan limit and all charges after we pay $2,500 (no deductible) | Covered Nothing up to the Plan limit and all charges after we pay $2,500 (no deductible) |
| Durable medical equipment | 15% Coinsurance After deductible | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount |
| Home health | 15% Coinsurance After deductible, 50 visit limit | 35% Coinsurance After deductible, and any difference between Plan allowance and the billed amount, 50 visit limit. |
| Adult dental exams | Not Covered | Not Covered |
| Children's dental exams | Not Covered | Not Covered |
| Routine eye exam | Not Covered | Not Covered |
| Eyeglasses | Covered One pair, following accidental ocular injury or intraocular surgery | Covered One pair, following accidental ocular injury or intraocular surgery |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Generic - 20% Coinsurance | Generic - 50% Coinsurance |
| Tier 2 | Preferred Brand - 30% Coinsurance | Preferred Brand - 50% Coinsurance |
| Tier 3 | Non-Preferred Drugs - 50% Coinsurance | Non-Preferred Drugs - 50% Coinsurance |
| Tier 4 | Preferred Specialty Tier - $200 Copayment | Preferred Specialty Tier - 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $3,100 | Not listed |
| Prescription out-of-pocket maximum, family | $5,000 | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (Medicare Advantage option) | $900 up to $900 per enrollee | Not listed |
| Part B premium reimbursement (prescription drug plan) | $600 Up to $600 per enrollee | Not listed |
| Part D drug plan: most you pay in a year | $2,400 | Not listed |
| Deductible with Parts A and B | Deductible waived We pay Medicare deductible | Deductible waived We pay Medicare deductible |
| Out-of-pocket maximum with Parts A and B | Not applicable | Not applicable |
| Primary care with Parts A and B | Member Pays Nothing | Member Pays Nothing |
| Specialist with Parts A and B | Member Pays Nothing | Member Pays Nothing |
| Hospital stay with Parts A and B | Member Pays Nothing | Member Pays Nothing |
| Part B reimbursement with Parts A and B | $600 Maximum | $600 Maximum |
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
NALC Health Benefit Plan plan site · Summary of Benefits and Coverage · Brochure RI 71-024 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · High Option - (888) 636-NALC (6252) & CDHP - (855)-511-1893
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the U.S. Postal Service, the Office of Personnel Management, or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM PSHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM PSHB premium charts for the change from 2026.
