High Option ID Card Information

Important Information About Your Benefits

Welcome to NALC Health Benefit Plan High Option! To learn more about your coverage under this Plan, refer to Section 4 of the Plan Brochure, Your Costs for Covered Services. You may also access additional resources from this link: https://www.nalchbp.org/high-option-plan/plans-and-benefits.

Below is information concerning your Plan’s deductible and out-of-pocket maximum:

High Option Deductible and Out-of-Pocket Maximums

Annual Deductible:  $300/person ~ $600/family
Annual PPO Out-of-Pocket Maximum:  $3,500/person ~ $5,000 family
Annual PPO and Non-PPO Combined Out-of-Pocket Maximum:  $7,000/person or family
Prescription Out-of-Pocket Maximum:  $3,100/person ~ $4,000/family

You may also visit this link for a listing of in-network providers and facilities: https://www.nalchbp.org/high-option-plan/providers.

Important Notice: When you get emergency care, use an out-of-network air ambulance provider, or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. “ Surprise billing” is an unexpected balance bill as defined by a new federal law called the No Surprises Act. This can happen when you cannot control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Please review this disclosure for more information about your rights under this new law: Disclosure Notice Regarding Patient Protections Against Surprise Billing.

If you have any questions about your benefits, please contact us at 888-636-6252 (NALC).