November 29, 2010 — Hosts Bob Leins and Tammy Flanagan discuss federal employee health options with SAMBA Federal Employee Benefit Association Executive Director Walt Wilson and Deputy Executive Director Pam Cummings.
Standard vs. high option plans Both SAMBA standard and high option plans have a $20 copay for doctor or specialist visits, Wilson said.
However, the high option generally has a lower calendar-year deductible, lower drug co-pay and lower catastrophic limit, Wilson said.
“Primarily the big differences are in the drug structure,” he said.
If you are covered under Medicare, Wilson recommended enrolling in the standard plan.
Dental and vision SAMBA has a nationwide dental and vision plan. You can enroll anytime, not just during open season, Wilson said.
Enrollees can sign up for self, self plus one or family, he said.
Under the Affordable Care Act, dependent adult children up to age 26 can be covered under health coverage, but not dental and vision. However, SAMBA is offering dental and vision coverage up to age 26, Wilson said.
Employee benevolent fund This fund provides a $17,500 death benefit and is in addition to life insurance or survivor benefits, at a cost of $1 per paycheck.
“It takes a period of time four to six weeks or longer to get those benefits paid,” Wilson said. “There’s a need to sustain the family during this period.”
Click here to check if your agency offers the fund.
Smoking cessation program Over-the-counter and prescription medication to help stop smoking are covered at 100 percent, Cummings said.
According to the SAMBA website, the smoking cessation benefit also includes counseling sessions.