The Rural Carrier
Benefit Plan
The Rural Carrier Benefit Plan is sponsored by the National Rural Letter Carriers’ Association (NRLCA). For nearly 60 years, the Rural Carrier Benefit Plan has proudly served the specific needs of NRLCA members and their families
View the Summary of Benefits and Coverage chart.
Enrollment Codes
- Self Only: 381
- Self Plus One: 383
- Self and Family: 382
Please do not rely on this chart alone. Not all benefits are shown— only those most commonly compared. All benefits and details about specific definitions, limitations, and exclusions are fully described in the Official Plan Brochure.
Premiums for Tribal employees are shown under the Monthly Premium Rate column. The amount shown under employee pay is the maximum you will pay. Your Tribal employer may choose to contribute a higher portion of your premium. Please contact your Tribal Benefits Officer for exact rates.
| Type of Enrollment | Enrollment Code | Biweekly (active) Your Share | Monthly (annuitants) Your Share |
|---|---|---|---|
| High Option Self Only | 381 | $130.98 | $283.79 |
| High Option Self Plus One | 383 | $253.14 | $548.47 |
| High Option Self & Family | 382 | $243.23 | $527.00 |
| High Option Benefit | In-Network – You Pay | Out-of-Network – You Pay |
|---|---|---|
| Diagnostic and treatment services provided in the office | 15% of cost* | 30% of our allowance and any difference between our allowance and the billed amount* |
| Office visit by primary care provider
(including telemedicine) |
$20 copayment | 30% of our allowance and any difference between our allowance and the billed amount* |
| Office visit by specialist
(including telemedicine) |
$35 copayment | 30% of our allowance and any difference between our allowance and the billed amount* |
| Surgery | 15% of our allowance (no deductible) | 30% of our allowance and any difference between our allowance and the billed amount |
| Telehealth through DialCare® or Teladoc Health® f | Nothing | No benefit |
| High Option Benefit | In-Network – You Pay | Out-of-Network – You Pay |
|---|---|---|
| Inpatient (24 hours or more) | $200 copayment per admission (waived for maternity stay) | $400 copayment per admission; 30% of room and board and other charges |
| Outpatient | 15% of our allowance* | 30% of our allowance* and any difference between our allowance and the billed amount |
| High Option Benefit | In-Network – You Pay | Out-of-Network – You Pay |
|---|---|---|
| Accidental injury | Nothing for emergency room visit and first physician office visit | Nothing except the difference between the Plan allowance and the billed amount (No deductible) |
| Medical emergency | Emergency room $200 copayment | Emergency room $200 copayment and any difference between the Plan allowance and the billed amount |
| Medical emergency | Services in a primary care provider’s office $20 copayment Services in a specialist provider’s office $35 copayment | 15% of the Plan allowance and any difference between our allowance and the billed amount |
RCBP knows how important pharmacy benefits are to you—with your plan, you have:
Non-specialty Pharmacy |
|||
|---|---|---|---|
| Pharmacy | Tier I (Generic) | Tier II (Brand Name on primary drug list) | Tier III (Brand Name not on primary drug list) |
| Network Retail Pharmacy (up to a 34-day supply) | 30% of cost*; maximum $7.50 per prescription | 30% of cost*; maximum $200 per prescription | 30% of cost*; maximum $200 per prescription |
| Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) | 30% of cost (No deductible); maximum $7.50 per prescription | 30% of cost (No deductible); maximum $200 per prescription | 30% of cost (No deductible); maximum $200 per prescription |
| Out-of-Network Retail Pharmacy (up to a 34-day supply) | 30% of cost* | 30% of cost* | 30% of cost* |
| Out-of-Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) | 30% of cost (No deductible) | 30% of cost (No deductible) | 30% of cost (No deductible) |
| CVS Retail Pharmacy or CVS Caremark mail service (up to 90-day supply) | $10 (No deductible) | $50 (No deductible) | $80 (No deductible) |
| CVS Retail Pharmacy or CVS Caremark mail service, Medicare Part B primary (up to 90-day supply) | $10 (No deductible) | $40 (No deductible) | $70 (No deductible) |
Specialty PharmacySpecialty drugs are used to treat chronic complex conditions and require special handling and close monitoring and must be obtained from CVS Specialty Pharmacy. Note: Preauthorization is required. Call CVS Specialty Pharmacy at 1-866-814-5506 (TTY:711). |
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| Pharmacy | Tier IV ( Specialty generic drugs) | Tier V (Specialty preferred brand drugs) | Tier IV (Specialty non-preferred brand drugs) |
| CVS Caremark Specialty Pharmacy 30-day supply (includes when Medicare Part B coverage) | $70 (No deductible) | $90 (No deductible) | $120 (No deductible) |
| CVS Caremark Specialty Pharmacy, 90-day supply (includes when Medicare Part B coverage) | $100 (No deductible) | $125 (No deductible) | $250 (No deductible) |
| High Option Benefit | You Pay |
|---|---|
| Dental care | Any difference between our scheduled allowance and the billed amount. See section 5(g). Dental Benefits of the Official Plan Brochure for more covered benefits and our fee schedule |
| High Option Benefit | In-Network – You Pay | Out-of-Network – You Pay |
|---|---|---|
| Inpatient (24 hours or more) | Your cost-sharing responsibilities are no greater than for other illnesses or conditions. | Your cost-sharing responsibilities are no greater than for other illnesses or conditions. |
| Outpatient | Your cost-sharing responsibilities are no greater than for other illnesses or conditions. | Your cost-sharing responsibilities are no greater than for other illnesses or conditions. |
| High Option | In-Network | Out-of-Network |
|---|---|---|
| A deductible is a fixed amount of covered expenses you must incur for certain covered services and supplies before we start paying benefits for them. | Self Only $350; Self Plus one or Self and Family coverage $700 | Self Only $800; Self Plus one or Self and Family coverage $1600 |
| High Option Benefit | In-Network – You Pay | Out-of-Network – You Pay |
|---|---|---|
| Protection against catastrophic costs (out-of-pocket maximum) Note: Benefit maximums apply and some costs do not count toward this protection |
Nothing after $5,000 per person for Self Only enrollment or $10,000 for Self Plus one or Self and Family enrollment per calendar year | $7,000 per person for Self Only enrollment or $14,000 for Self Plus one or Self and Family enrollment per calendar year |
This is a summary of RCBP High Option benefits when you use a doctor that’s part of our network. Out-of-network benefits are also available, so you are free to use any doctor, though it may cost you more.
*Calendar year deductible applies.
