A MESSAGE FROM THE CEO

I am pleased to provide you with our annual Summer Health Newsletter. So much has

happened here in Washington (Health Care Reform, Mental Health Parity and OPM instruc-

tions to Federal Employees Health Benefits (FEHB) Plans on required changes), we hardly

know where to start. I hope you will find this letter filled with information that will help you

understand where the FSBP stands now, and where we are going.

The Affordable Care Act passed in March. On page 10 is a synopsis of the bill and what it

means for the FEHB Program. This is just the beginning – there will be changes and amend-

ments throughout the coming years, and we will have to make required adjustments. I invite

you to check our Web site from time to time for updates on issues that affect the Plan.

We continuously strive to bring the membership new benefits and services, and this year is

no exception. We are excited to be on the cutting edge of Health Information Technology

(HIT). You will learn of the enhanced My Online Services (MOS) Web site from Coventry

and additional online pharmacy services from Medco. The 2011 FOREiGn SERviCE BEnEFiT

PlAn (FSBP) will offer new benefits geared to maintaining and improving the health of our

members, along with providing a comprehensive benefit design at very competitive rates.

2009 was a particularly challenging year for the FSBP, and – more importantly – for our

members. But I believe we have made improvements in our service level, which admittedly

was affected with the change in our PPO Network and last summer’s implementation of the

new claims processing system.

I again want to thank all of our members for your patience as we worked through the

challenges the past year brought us. The PROTECTivE ASSOCiATiOn is known for its

understanding of the unique needs of our membership and our ability to respond to those

needs. I sincerely hope you believe, as we do, that we are back to providing the service

you have come to expect from us. We appreciate the opportunity to serve you and welcome

your feedback and ideas on how we can improve even further.

To Your Health,

Paula S. Jakub, RHU

Executive Vice President

Founded in1929

AFSPA was founded in 1929 “to promotein all lawful and legitimate ways, the advance-ment of the welfare of its members including thewelfare of their dependents and their designatedbeneficiaries.” There are no initiation fees ordues.

BOARD OF DIRECTORSThomas M. Tracy, Chairman

Richard J. Shinnick, Vice ChairmanSarah R. Horsey, Secretary/TreasurerKathleen T. Austin-Ferguson, Director

Joan M. Clark, DirectorFrank J. Coulter, DirectorJan A. Mohr, Director

Phyllis E. Oakley, DirectorJohn P. Shumate, DirectorJames D. Whitten, Director

Chief Executive OfficerPaula S. Jakub, RHUExecutive Vice President

Deputy Executive OfficerKenneth A. Messner

Members of the Board of Directorsare Career Foreign Service or otherExecutive Branch personnel, on activeduty or retired. They serve the Asso-ciation without compensation.

American Foreign ServiceProtective Association, Inc.

1716 N Street, NWWashington, DC 20036-2902

Phone: (202) 833-4910Fax: (202) 833-4918

E-mail: AFSPA@AFSPA.orgWeb site: www.AFSPA.org

Summer2010

Summer Health Newsletter of the

FOREIGN SERVICE BENEFIT PLAN

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 1

2

AvOiDinG HEAlTH CARE GAPS

By Floyd Shewmake, MD, Senior Medical Director

Coventry Health Care, Inc.

Most of us enter adulthood with the belief that chronic illness

is something that happens to other people. As young adults it

is unusual to require medical care and those rare visits are

usually just for minor acute problems. However, life has a way

of catching up with us and by middle age it is not uncommon

to have developed one or more chronic diseases. For the

majority of us these problems do not cause major lifestyle

changes, but it is important to realize that they do require

ongoing treatment and monitoring.

Such chronic illness as high blood pressure and high choles-

terol usually are controlled easily with diet and medications

combined with periodic physician visits to monitor treatment.

However, it is too easy for many of us to fall into a treatment

gap and forget to fill prescriptions or fail to adhere to our diet.

Once we let ourselves veer from the prescribed program, we

risk developing complications from our chronic disease.

Diabetes is a particularly good example of a chronic disease,

which when well controlled is much less likely to cause long-

term problems than when carelessly controlled. Several

medical studies have demonstrated a reduction in the devel-

opment of heart, kidney, and eye complications when diabetic

patients carefully follow the prescribed treatment plan. For

diabetics, treatment always includes watching the diet and

having a regular exercise program. Most diabetics will also

need some type of medication and all need to control their

weight to avoid long-term problems. It’s also important to

remember that regular check ups with your physician are

necessary to monitor the progress and adjust treatments when

necessary.

To assist in avoiding gaps in the treatment of chronic diseases

the FOREiGn SERviCE BEnEFiT PlAn (FSBP) provides members

with programs to help them keep chronic diseases under the

best control. These programs involve periodic informative

mailings which help members better understand their disease,

since a good understanding is key to maintaining control. In

some cases specially trained nurses may call to assist with

answering questions and to remind members of needed follow

up visits with their physicians. These nurses are also available

for members to call when questions arise. Such advice is not

meant to take the place of your treating physician’s program

for you, but to enhance it by improving your understanding

of the disease and the reasons for the treatments that were

recommended.

Through the use of these chronic disease programs, the FSBP

wants to help you avoid falling into a health care gap and get

the most out of your benefits. Currently we have programs for

the following diseases: diabetes, coronary artery disease,

chronic obstructive pulmonary disease, congestive heart

failure, asthma and chronic kidney disease. Each of these

conditions has a unique program, which has been designed

with the assistance of experts in the treatment of these medical

problems. Participation is, of course, voluntary and members

with these conditions will be contacted as they are identified

to determine if they are interested in the program. In addition,

the Plan offers the same programs to members in foreign

countries through an exclusive arrangement with Coventry

Health Care, the Plan’s underwriter. As a physician I encour-

age members with chronic diseases to get involved with these

programs. The best outcomes result from coordinated efforts

from you the members, your physicians and your health plan.

Stay on track with your treatment program and avoid falling

into a health care gap.

COvEnTRy HEAlTH CARE REPlACES

HEAlTHwAyS FOR DiSEASE MAnAGEMEnT

SERviCES

The FOREiGn SERviCE BEnEFiT PlAn (FSBP) is pleased to

announce that Coventry Health Care (Coventry), the Plan’s

underwriter, has received URAC accreditation for its Disease

Management Program (DM). Consequently we have asked

Planning for Change Seminar

The Senior Living Foundation of the American Foreign

Service is sponsoring a “Planning For Change” seminar

on Thursday, September 16, 2010 from 1:00 to 5:30 p.m.

at the Courtyard Marriott, 1600 Rhode Island Ave, NW,

Washington, DC. Speakers will address a variety of

topics relevant to seniors, including Medicare and the

FEHB, senior living facilities, wills and more. If you will be

in the Washington, DC area at that time you are invited to

attend. Check our Web site www.SLFoundation.org for

more information or to RSVP online. You may also RSVP

by e-mail at info@SLFoundation.org or by phone at

202-887-8170.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 2

3

Coventry to administer your disease management program

starting on July 1, 2010. Healthways, the previous provider

of DM services, will no longer provide services for disease

management.

Stateside members with asthma, congestive heart failure

(CHF), chronic obstructive pulmonary disease (COPD),

coronary artery disease (CAD), diabetes and now chronic

kidney disease (CKD) will receive extra assistance from

Coventry's Disease Management Program. Coventry will

continue our exclusive Overseas Disease Management

Program just as they have been doing for the last few years.

Disease management programs help members manage their

health and improve their quality of life. The change of disease

management providers means members will have:

• Specialized case manager nurses at Coventry for support

for chronic conditions.

• More streamlined experience with one case manager for

our members with complex conditions, regardless of the

number of conditions you have.

• New educational materials with a new look and feel – and

more useful information.

The FSBP and Coventry are dedicated to helping members

live and feel well. If you have one of the conditions shown

above or need further assistance, please contact Coventry at

1-800-579-5755 (in the U.S.) or e-mail the Plan from outside

the U.S. through our secure Web site at

www.AFSPA.org/FSBP and click on the “Ask AFSPA” tab.

THE iMPORTAnCE OF STAyinG On TRACk

wiTH yOuR MEDiCATiOnS

There is much evidence that taking medication as prescribed

can improve your health and lower your healthcare costs. Still,

only about half of all patients follow doctors’ orders regarding

medications.1

If you take medication over a long period of time, sometimes

the medication works so well that you might think you don’t

need it anymore. Perhaps you believe it is not working or you

do not wish to deal with an inconvenient side effect. You might

even be tempted to cut corners to save money.

ASk AFSPA vERSuS AFSPACOnnECT

ASk AFSPA is a secure electronic system that allows you to contact and communicate securely with the FOREiGn

SERviCE BEnEFiT PlAn (FSBP) so that you can include your Private Health Information (PHI). Also, you may contact usthis way regarding our other programs that you might have.This method protects the confidentiality of any informationyou send to us, including your claims.

Submitting Scanned Claims to FSBP

To submit scanned claims securely to us, visit the Plan’s Website: www.AFSPA.org/FSBP.

• Click on the “Ask AFSPA” tab and select “FSBP”.

• Next scroll down and click “Submit Scanned Claim” and follow the instructions.

• Once you submit a claim, we send you an e-mail confirmation notifying you that your file was successfullytransmitted.

Secure Communication with AFSPA

To communicate with us securely, visit our Web site:www.AFSPA.org/FSBP.

• Click on the “Ask AFSPA” tab and choose the programabout which you wish to communicate (e.g., FSBP).

• Choose the nature of your secure message: General, Enrollment or Open Season.

Sending claims and messages to us using these methods assures the confidentiality of your information.

AFSPAconnect, on the other hand, is where you sign in toview secure messages sent by the Plan.

We use this method when our messages to you contain PHI.

You also can verify the address we have on file for you andany information regarding your enrollment in the other plans offered by the AMERiCAn FOREiGn SERviCE PROTECTivE

ASSOCiATiOn.

Both programs are compliant with all requirements of HIPAAand are designed to protect your privacy and personal healthinformation.

new Capabilities to AFSPAconnect Coming This Fall

AFSPA will add two new capabilities to AFSPAconnect thisfall — tracking claims submitted electronically and SingleSign-on.

• ClaimsTracker will allow members logged into AFSPAconnect to submit claims electronically and trackthe status of their claims. They will be able to view a listof submitted claims and see whether the claim is beingprocessed at AFSPA or has been sent to Coventry forprocessing.

• Single Sign-on will allow members logged into AFSPA connect to access their information on Coventry’s My Online Services Web site and Medco’s Personalized Pharmacy Web site by clicking a button. This will give members the convenience of accessing a wide range of claims, medical and pharmacy information while only needing to remember a single password.

1 Wertheimer AI, Santella TM. Medication compliance research: still so far to

go. J App res 3(3), 2003.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 3

4

Medications that are used to treat a chronic condition—such

as diabetes, acid reflux, or high cholesterol—usually maintain

health either by preventing those conditions from worsening

or at least keeping their symptoms under control. If your

medication is working as intended, then it is tempting to think

you do not need it or can safely skip a few doses.

You should change the way you take your medication—or stop

it altogether—only with the approval of your doctor. Otherwise,

there could be serious complications from the illness or you

could end up with unpleasant or even dangerous withdrawal

symptoms.

For example, someone with diabetes may feel fine and decide

to stop taking the medication that controls blood sugar.

Yet without that medication, blood sugar could increase

dramatically and result in a greater risk of heart disease, kidney

disease, nerve damage, or blindness. Likewise, someone with

a sinus infection may feel better after a few days of antibiotics,

but a small number of bacteria may still exist and could multiply

and spread if you do not finish the course of antibiotics.

Advice

• Talk to your doctor or pharmacist. If your medication

is causing unpleasant side effects, ask if there is anything

that your doctor or pharmacist can suggest to lessen the

problem. Also, with the FOREiGn SERviCE BEnEFiT

PlAn (FSBP) you can speak to a Medco Specialist

Pharmacist by calling Medco (the Plan’s Pharmacy

Benefit Manager) Member Services at 1-800-818-6717

within the United States or 1-800-497-4641 (available in

over 140 countries) from outside the United States.

Specialist Pharmacists are specially trained in a particular

disease state and can answer your questions and suggest

ways to help you keep track of your medications for your

specific condition.

• know how long you are supposed to take the

medication. For example, should you take all the pills in

a bottle even if you’re starting to feel better?

• is paying for prescriptions a problem? If so, find

out whether there is a lower-cost alternative, such as a

generic drug. Compare medications and see how

much you might save by visiting Medco’s My Rx

Choices® prescription savings program at

www.medco.com/choices.

• Create routines and backup plans. Connect taking your

medication with daily events, such as meals or bedtime.

Keep some medication in a drawer at work or in a purse or

coat pocket, as a backup supply in case you forget to take

your normal dose.

• keep a schedule. Write down the medications you take,

the frequency and any special directions. You can record

this information the old-fashioned way—on a notepad or

kitchen whiteboard—or you can make use of modern

methods such as recurring pop-up alerts on a cell phone

or your computer.

Remember, it is important to take your medications as

prescribed. By following your doctor’s recommendations and

staying informed about your treatment and condition, you will

have a better chance of avoiding unnecessary hospital care and

higher medical costs.

If you have any questions or difficulty taking your medications,

talk to your doctor. You also can call Medco Member Services

toll-free at 1-800-818-6717 within the United States or

1-800-497-4641 (available in over 140 countries) from outside

the United States and ask to speak to a pharmacist. If you are

outside the United States and the toll-free number does not

work for you, you can call Medco collect at 412-829-5932 or

412-829-5933.

Reference:

U.S. Food and Drug Administration. Are You Taking

Medication as Prescribed? June 2009 article:

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm164616.htm.

Accessed March 29, 2010.

The FSBP makes it easy for members to comply with

medication regimens by providing the following on-line

services through:

• Online refill through the Medco Pharmacy (mail order) –

check the status of your order;

• E-mail notification of the status of your order;

• Extended Pay Program – spread your cost over three

months, particularly important when a member takes

multiple drugs and/or, for overseas, fills for greater than

a 90-day supply;

• Widget Refill Reminder – download to your desktop to

remind you to refill your mail order prescriptions.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 4

5

COvEnTRy AnnOunCES iMPORTAnT ClAiMS

PROCESSinG CHAnGES

The FOREiGn SERviCE BEnEFiT PlAn (FSBP) and Coventry

Health Care (Coventry), the Plan’s underwriter, would like to

inform you of a change to claims processing as required by

provider coding changes under the Health Insurance Portabil-

ity and Accountability Act (HIPAA). Over the years, when a

provider submitted an incorrect code on a claim, Coventry

would manually change the code. This process is no longer

allowed. Coventry continues to make improvements to

provide more timely and accurate claims processing for FSBP

members. A new provider education initiative (for both

Preferred and non-Preferred Providers) has been put in place

to encourage providers to use the correct coding for claims.

what this means to you

Starting on January 1, 2011, Coventry will no longer change

invalid codes on claims submitted to the Plan electronically.

These claims will be denied and providers will have to resubmit

them. EOBs will reflect the denial and you may receive

another bill from your provider. In this situation, you may ask

your provider to resubmit the claim with the required correct

code. They can contact Coventry for more information.

what Coventry is doing

Coventry has been educating providers about this situation by

regularly including notifications with Explanations of Benefits

(EOBs). In addition, Coventry is running quarterly reports to

identify providers who routinely submit claims with invalid

codes. They are reaching out to those providers and working

with them to ensure the proper submission of claim codes.

Coventry Health Care and the FOREiGn SERviCE BEnEFiT PlAn

are committed to providing excellent service to FSBP

members. If you have questions or need further assistance,

call Member Services at 202-833-4910.

OFFiCE OF MEDiCAl SERviCES (MED) OF THE

DEPARTMEnT OF STATE AnnOunCES RulES

On inPATiEnT HOSPiTAl DEDuCTiBlES AnD

COPAyS

MED would like to remind employees of information that

affects those covered under the Department of State Medical

Program. Excerpting from a recent cable State sent to all posts:

“1. …The Department will NOT reimburse insurance

deductibles (copays) related to hospitalizations….

2. The Federal Health Benefits Program provides primary

health insurance for USG employees serving in the

United States or overseas. If you are assigned over-

seas, it is important to check the extent of your health

insurance plan's coverage for outpatient services, since

the Department's Medical Program (see Para 3 below)

does NOT pay outpatient bills for employees, eligible

family members, or TDY employees abroad unless the

bills relate to an associated hospitalization within a

12-month period. The Department's Medical Program

does not pay for medical care in the United States during

periods such as home leave, R&R, etc. Since more and

more procedures are now performed in the outpatient

setting, it is important that subscribers understand

exactly how insurance companies determine reimburse-

ment levels.

COMING THIS FALL!

AFSPA is pleased to announce that we will be offering two

new programs for our members on September 1, 2010.

The latest long Term Care plan, underwritten by Pruden-

tial Insurance Company of America, will offer comprehen-

sive coverage to members and eligible family members

ages 18-84. This “Next Generation” Plan has several

options that provide benefits for the way we use long term

care.

Our new Disability plan, underwritten by Lloyd’s of

London, is meant to fill a particular gap in coverage for a

condition that does not necessarily result in a permanent

disability, but rather a long period of absence from work.

Coverage is available to principal members of AFSPA who

are active duty, direct hire employees. The application

process will be done online via our Web site and premiums

will be paid on a monthly basis via direct debit from your

designated financial institution.

For more details on these programs, visit our Web site

www.AFSPA.org.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 5

6

3. The Department's Medical Program serves as the

secondary payer for an eligible patient who is hospital-

ized abroad. That is to say, the Medical Program pays

the co-payments remaining after the insurance company

has paid its share. Employees MUST carry primary

health insurance in order for the Medical Program to

serve in this secondary-payer capacity. Employees

who do not carry health insurance will be financially

responsible for all health care service costs….”

Relative to the cable, the FOREiGn SERviCE BEnEFiT PlAn

(FSBP) reminds our members that you have no Inpatient co-

pay (deductible) when you are hospitalized overseas. In ad-

dition, our excellent benefits provide the high PPO coinsurance

no matter what covered healthcare providers you choose.

And, of course, we generally do not subject overseas claims

to reasonable and customary (Plan allowance) reductions.

PPO AnD THE FOREiGn SERviCE BEnEFiT PlAn

The FOREiGn SERviCE BEnEFiT PlAn (FSBP) and Coventry

Health Care (Coventry), the Plan’s underwriter, are proud of

the size and depth of the Coventry National Network.

Currently, our Preferred Provider (PPO) network includes more

than 4,900 hospitals and 450,000 physicians and allied health

care professionals participating throughout the United States

and Puerto Rico. Coventry believes in local contracting and

the value of provider relationships. This strategy is supported

by more than 30 provider relations offices throughout the

country.

However, there often are reasons why a provider chooses not

to participate with Coventry or Coventry may elect not to

contract with a provider. Before a physician can be listed as a

participating provider, they must pass Coventry’s credentialing

requirements. While most physicians provide excellent care

to their patients, Coventry occasionally rejects a provider's

application because the practitioner did not pass credentialing

(for various reasons).

From time to time, a provider group may reach a critical

number of patients in their practice and may not be able to

provide appropriate care to additional patients. Physicians,

like other professionals, move, retire, reduce their availability

or just prefer to treat a smaller patient population. Occasion-

ally providers may elect to close their practice to new patients,

only to reopen once existing patients leave. In addition, a

provider group may choose to participate with select products,

such as Medicare or PPO. This decision can exclude the

practice automatically from participation in other types of

health benefit products.

Some physicians run what are known as cash-practices and

generally do not contract with health insurers. The specialties

that most commonly engage in this type of practice are plastic

surgeons and dermatologists. These practices tend to focus

on cosmetic services that are not covered by a commercial

health benefit plan. Additionally, select specialties, such as

emergency medicine, radiologists, anesthesiologists and

pathologists (ERAP), also known as hospital-based

physicians, can be especially challenging to bring into the PPO

network. The FSBP is pleased to have offered a solution

for many years to this problem. We pay benefits for ERAP

services at the PPO coinsurance rate subject to Plan

allowance when treated at a PPO facility. This offers the

patient some financial relief if the provider is non-PPO.

Finally, providers may forego participation in Coventry’s

network for financial reasons. Coventry is committed to

QuAliTy AnD THE FOREiGn SERviCE BEnEFiT

PlAn (FSBP)

Congratulations to Coventry and Medco

The American Medical Association rated Coventry Health

Care (Coventy), the Plan’s underwriter, the highest of

seven commercial insurers for accuracy. Coventry’s

accuracy rating was 88%, as reported in a recent

Washington Post article entitled Commercial Insurers

Inaccurate on 20% of Claims. In fact, the Coventry office

processing FSBP claims has an accuracy rating of 97%,

higher than the company average.

In addition, Medco Health Solutions (Medco) has

received the “Gold Seal of Approval” from the Joint

Commission on Accreditation of Health Care Organizations

(JCAHO) for Full Standards Compliance in Home Care –

Pharmacy Dispensing Services. Earning the Gold Seal of

Approval places Medco among the leading organizations

in this category to receive accreditation with no additional

recommendations for further improvement.

The FSBP salutes both of our partners in achieving these

accolades.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 6

7

securing market competitive rates for their clients and that

means some providers’ rate expectations cannot be met.

While never an easy decision, Coventry makes these

determinations because their clients trust them with keeping

their healthcare affordable; and that is a responsibility both

Coventry and the FSBP take very seriously.

MEDiCARE AnD THE FOREiGn SERviCE BEnEFiT PlAn

What do I do when I turn 65? Am I required to take Medicare?

Do I have to give up the FOREiGn SERviCE BEnEFiT PlAn

(FSBP)? These are some of the questions members ask.

When you turn 65, you become eligible for coverage with

Medicare. You are covered automatically by Medicare A

(inpatient hospitalization) and don’t pay a premium if you

retired after 1983, while Medicare B (medical services) is

optional and you do pay a premium if you are retired.

Medicare is always primary and if you choose Medicare

coverage, Medicare becomes your primary coverage and the

FOREiGn SERviCE BEnEFiT PlAn (FSBP) becomes secondary.

Most people will pay the standard Medicare Part B premium

amount ($96.40 for 2010). However, if your modified adjusted

gross income as reported on your IRS tax return from 2 years

prior to retirement is above a certain amount, you may pay

more – quite a bit more in some cases. Because figures and

regulations change, we suggest you contact Medicare for com-

plete details. You can visit www.medicare.gov or call

1-800-MEDICARE (1-800-633-4227).

How the FSBP works with your Medicare coverage –

Inpatient hospitalization

Medicare A usually pays 100% of their allowed amount for

each inpatient benefit period (a benefit period begins the day

you are admitted as an inpatient). There is a $1,100

deductible and no coinsurance for days 1-60 for each benefit

period. As secondary, the FSBP will coordinate benefits

(COB) with Medicare and pay 100% of the Medicare Part A

deductible.

Medical services (physician office visits, surgery, labs and

other diagnostic services)

If you choose Medicare B, then Medicare will pay 80% of what

they allow. The FSBP will coordinate benefits with Medicare

and pay the Part B yearly deductible of $155 and the 20%

coinsurance after Medicare’s allowed charge. When the

FSBP is secondary, we waive our coinsurance and any

amount that would normally apply to your deductible.

For a complete description of how the FSBP coordinates

benefits with Medicare, please refer to Section 9 of the FSBP

Brochure entitled Coordinating benefits with other coverage.

Under present regulation if you go to a doctor who has “opted

out” of the Medicare Program entirely, that is, does not file with

Medicare and does not accept what his/her charges should

be, then you are liable for the full amount. The doctor may ask

you to sign a ‘private contract’ but often does not. Either way,

the FSBP (as other FEHB plans) is required to pay only 20%

of the provider’s charge. The doctor will require you to pay the

full balance.

It is your decision to choose to be covered under Medicare B

and is a personal one that you must make. The FSBP has

many members who choose Medicare coverage.

FOREiGn SERviCE BEnEFiT PlAn

MEMBER iDEnTiFiCATiOn (iD) CARDS

All members of the FOREiGn SERviCE BEnEFiT PlAn (FSBP)

receive a member identification card when they join the

Plan. Below is some important information regarding the

ID card:

1. The Group ID is 8200001798; and your individual

member ID begins with ‘79’.

2. The suffix indicates subscriber (01) or dependents

(for example, 02, 03, 04…).

3. Text on the back of the ID card contains important

information about our current precertification,

preauthorization and concurrent review require-

ments in the United States.

4. Please make sure you give a copy of your current

ID card to all of your healthcare providers, including

your network pharmacy in the United States.

5. CARRy yOuR iD CARD wiTH yOu AT All TiMES

– OvERSEAS AnD in THE uniTED STATES.

If you did not receive your ID card, please contact

us through our secure e-mail process at

www.AFSPA.org/FSBP and click on the

“Ask AFSPA” tab to request one.

As always, we are here to assist.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 7

8

POTEnTiAl TAx TRAPS On MEDiCARE B

PREMiuMS

By Jennifer Lee, Bean Kinney & Korman P.C.

Arlington, VA

Medicare Part B is designed to cover doctors’ services, outpa-

tient care, home health care and some preventive services.

The U.S. government pays a portion of the premiums for

beneficiaries of Medicare Part B. Prior to 2007, the income of

a Medicare beneficiary was not a criterion for determining the

Part B premium for that individual. The government paid 75%

of the beneficiaries’ premiums while the beneficiaries paid the

remaining 25%. The Medicare Modernization Act of 2003 (the

“Act”) changed how Part B premiums are calculated for

beneficiaries with higher incomes. As a result, the government

portion of the Part B premium is reduced for beneficiaries with

incomes above a certain amount.

Under the Act, the Social Security Administration (“SSA”)

calculates the beneficiary’s modified adjusted gross income

(“MAGI”) based on the most recent tax information provided

by the Internal Revenue Service (“IRS”). Generally, this

means that the premiums for any given year are calculated

using income figures from two years prior to the year at issue.

For example, to calculate a beneficiary’s 2010 monthly

premium, the SSA will use information from the beneficiary’s

tax return filed in 2009, reflecting income for tax year 2008.

MAGI is calculated as the combination of a beneficiary’s

taxable adjusted gross income and tax-exempt interest income

earned from that year.

Individuals with MAGI above $85,000 or married couples filing

jointly with MAGI above $170,000 will have to pay an Income-

Related Monthly Adjustment Amount (“IRMAA”). The total Part

B premium paid for these individuals will be equal to the basic

Part B premium plus the IRMAA.

Since a beneficiary’s Part B premium is recalculated on an

annual basis, it is important to keep in mind that any income

earned in a given year can affect the calculation of future Part

B premiums. For example, if a beneficiary cashes out his or

her annual leave upon retirement or cashes out an IRA in

2010, this will cause a spike in taxable income for this year. If

the spike causes the beneficiary’s income to rise above the

MAGI threshold for the basic Part B premium, the beneficiary

will have to pay an increased Part B premium in 2012. To

avoid this potential result, beneficiaries should consider timing

of income-generating transactions, including distributions from

retirement accounts or sale of property.

Beneficiaries who are subject to the increased Part B premium

normally receive a letter from the SSA explaining how the

determination was made. Beneficiaries should review the

information used by the SSA in its determination to ensure that

the information is accurate.

A beneficiary may request a new determination from the SSA

if one of the following five situations apply:

(i) beneficiary experienced a qualifying life changing event,

(ii) beneficiary wishes to request that the SSA use informa-

tion from an amended tax return,

(iii) erroneous information was provided to the SSA by the

IRS,

(iv) the SSA used three year old tax information and two

year old information is available, or

(v) beneficiary has a change in living arrangements.

If none of the above situations apply, but the beneficiary

disagrees with the SSA’s determination, the beneficiary may

appeal the IRMAA, in which case the beneficiary should

submit a “Request for Reconsideration” form (Form SSA-561-

U2) within a specified time of receiving the SSA’s initial

determination notice. If the beneficiary disagrees with the

SSA’s Reconsideration decision, he or she can request a

hearing before a Medicare Administrative Law Judge within a

specified time of receiving the Reconsideration decision by

submitting a “Request for Hearing by Administrative Law

Judge” form (Form HA-501-US), along with an “Authorization

for SSA to Disclose Tax Information for Your Appeal of Your

Medicare Part B Income-Related Monthly Adjustment

Premium Amount” form (Form SSA-54).

Additional information on the initial determination and appeals

process can be found in the SSA’s Program Operations

Manual System, which is available online at

https://secure.ssa.gov/apps10/poms.nsf/subchapterlist!ope

view&restricttocategory=06011.

nOTE: Bean Kinney and Korman is one of the law firms that

participate in AFsPA’s legal services Program. Attorneys

who participate have agreed to provide AFsPA members legal

services at preferred rates. Please go to our web site

www.AFSPA.org and click on the “AFsPA services” tab and

then “legal services” for more information.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 8

9

MEDCO PATiEnT / PRESCRiBER SuPPORT

SySTEMS AnD EnHAnCED PROCESSES

Medco Expatriate Team Operational Overview

Medco provides unique support for FOREiGn SERviCE BEnEFiT

PlAn (FSBP) members overseas (expatriates – defined as

covered members living outside the United States). The

establishment of the Medco Expatriate Processing Team in

Tampa, Florida has brought about enhancements to support

communications with patients and prescribers utilizing new

and unique routing and communications strategies.

Medco supports the dispensing of medications to expatriates

while establishing unique electronic connectivity with Regional

Medical Officers (RMOs) and patients with validated secure

e-mail addresses. Medco identifies prescriptions ordered by

RMOs and patients’ current prescription addresses and flags

them for EXPAT handling.

Expatriate Processing Specialist teams have been organized

in all Medco pharmacies for both clinical and administrative

services to provide consistently the highest level of processing

service standards as well as the best clinical outcomes

possible.

A collaborative practice model has been established between

the Department of State Regional Medical Officers (RMOs)

and Medco pharmacies that encompasses such processes as:

• Deployment of a new secure e-mail product;

• Creation of a new facility for e-mail address storage,

authentication and validation processes;

• Fax handling capabilities that launch secure e-mails when

faxes are received from Regional Medical Officers

confirming receipt;

• Electronic prescribing (ePrescribing) licenses were

originally provided to the Department of State at no

charge to jump start the utilization of electronic Point of

Care technologies which were not available to any

Federal Medical Provider; and

• ePrescribing capabilities to improve quality and reduce

processing times.

Some bottom line impacts of enhancements are:

• The combination of deploying ePrescribing with the ability

to communicate directly with prescribers via secure e-mail

has established a practice relationship that in many ways

is more effective than with many non-ePrescribing

stateside prescribers.

• The synergism between technologies has greatly

improved prescriber satisfaction with Medco by removing

most geographical and time barriers. International phone

and fax barriers no longer are problematic.

In addition, patients are affected positively by secure e-mail

communications and allowed more timely updates about their

prescriptions when issues arise. Patients also can participate

in the resolution of issues blocking the dispensing of their

medications where appropriate.

Medco’s collaboration with patient and prescriber has reduced

average turnaround times for internationally shipped

prescriptions. These changes have improved Expatriate

Member satisfaction.

The FOREiGn SERviCE BEnEFiT PlAn Takes

Special Care of our Overseas Members

Earthquakes and volcanoes – you might think they are

unusual occurrences, but for FSBP members these are not

out of the ordinary.

As soon as the earthquake hit Haiti, we notified the Federal

government that we stood ready to expedite care and

claims for victims of this horrible event. Once we identified

members affected, we flagged them so that any precertifi-

cation requirements were waived and claims were

processed immediately upon receipt. In addition, our Case

Management Nurses set up benefits under our Flexible

Benefits Option for services not ordinarily covered by the

Plan but were essential to the care of the patient.

During the volcanic event in Iceland, Medco immediately

worked with DOD and the State Department to ship

prescriptions abroad through any alternative route

available.

The FSBP is pleased to provide special assistance to

Federal employees posted abroad.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 9

10

HEAlTH CARE REFORM, MEnTAl HEAlTH

PARiTy AnD wHAT 2011 will BRinG TO

THE FEDERAl EMPlOyEES HEAlTH

BEnEFiTS PROGRAM

Health Care Reform

Congress passed the Patient Protection and Affordable Care

Act, H.R. 3590 (PPACA) on Sunday, March 21, 2010 by a

219-212 margin. The President signed the bill into law

(Pub. L. No. 111-148) on March 23, 2010.

Congress also passed a package of amendments to the

PPACA (H.R. 4872), which received final approval on March

30, 2010. We refer to this package (original bill plus amend-

ments) as the Affordable Care Act (ACA).

At press time, OPM (the Office of Personnel Management –

administrator of the Federal Employees Health Benefits

(FEHB) Program) is sorting through the pages of regulations

published (and yet to be published) to implement the Afford-

able Care Act (ACA). The Plans in the Program look to OPM

for guidance on how to implement the law within the regula-

tions governing the FEHB Program. Some items we do know

and can share with you are:

• Expansion of dependent coverage effective

January 1, 2011:

o Children are covered in a Self and Family enrollment up

to age 26.

o There are no residency, financial dependency require-

ment or marriage restrictions. Note: There may be

financial dependency requirements for foster children

when there is no legally established foster child relation-

ship, e.g., a member’s grandchild.

o Coordination of benefits with other group policies is the

same as for other members.

o TCC (Temporary Continuation of Coverage) applies at

age 26.

o The change does not apply to FEDVIP (Federal

Employees Dental and Vision Insurance Plan).

• FSAFEDS – the Flexible Savings Account (FSA)

program for Federal employees

o 2011 – FSA’s can reimburse over-the-counter (OTC)

drugs only if supported by a prescription (excluding

insulin). Other OTC items that are not medicines or

drugs, such as bandages and contact lens solution,

remain reimbursable without a prescription.

o 2013 – FSA’s will be capped at a maximum contribution

of $2,500 (instead of the current level of $5,000).

o Contribution cap will be adjusted annually thereafter for

inflation.

• Health Exchanges

o By 2014 – Exchanges will be operational in states and

administered by a government agency or non-profit

organization.

o Full-Time Federal employees who do not have an FEHB

plan will be auto-enrolled in the FEHB Program, subject

to opt out. Note: This could occur before 2014.

o If an employee opts out and does not obtain other

minimal essential coverage then a penalty applies.

• Free Choice vouchers

o 2014 - FEHBP enrollees whose family income is less

than 400% of the Federal Poverty Level ($43,320 for an

individual and $88,200 for a family of four in 2010) and

whose FEHB Program enrollee contribution ranges from

8.0% to 9.8% of family income will receive a free choice

voucher equal to the Government contribution.

o The enrollee may use the voucher to purchase health

exchange coverage.

How does the law pay for the above?

o New fees on branded pharmaceutical manufacturers,

medical device manufacturers and indoor tanning parlors

that will be passed on to consumers.

o Application of Medicare taxes to unearned income for

individual taxpayers with $200,000 of adjusted gross

income and joint taxpayers with $250,000.

• Health insurer Fee to be phased in starting 2014

o There will be a Health Insurance Provider Fee on

premiums charged by health insurers.

o Some plans will be exempt, for example: Medicare,

Medicaid, etc.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 10

11

o It is estimated that this will add at least 3% to most FeHB

premiums.

• Plan Excise Tax to begin 2018

o 40% tax on premiums exceeding $10,200/$27,500 for

Self/Self and Family coverage will be imposed on the

Plans, not the individual.

o The tax is imposed on the balance exceeding above

amounts.

o The amount above includes employer, employee, FSA,

HSA and HRA contributions.

o The FOREiGn SERviCE BEnEFiT PlAn (FSBP) is not

expected to reach the threshold for this tax until about

2022.

o The enrollee’s 2012 W-2 will show the entire premium for

2011, but the premium is not included in taxable income.

• Medicare and Medicaid

o Congress anticipates $455 billion savings from cuts to

both programs.

o Providers and healthcare facilities are expected to

cost-shift expenses to commercial and FEHB plans

(Federal employees have some relief due to legislation).

o Beginning right away, 16 million additional low-income

Americans will join more than 60 million who currently

receive Medicaid in one form or another.

o The pace of the increase in Medicaid enrollment will

quicken in 2014 when Medicaid becomes available to all

non-Medicare eligible individuals under age 65 with

incomes up to 133 percent of the Federal Poverty Line

(FPL) – $14,400 for an individual in 2010.

Yet to be addressed is Health Care Delivery. The U.S. faces

a shortage of primary care physicians (~ 40,000 in the next

decade), Oncologists (~ 3,000 to 4,000 already today), Nephrol-

ogists and – perhaps the most scary – Nurses (~ 300,000 in

the future according to one study). These figures do not

account for the demand created by health care reform. So, we

have a ways to go before we have reached our goal of afford-

able healthcare for every American. The Affordable Care Act is

a good start toward that goal.

Mental Health Parity

Compliance with the Paul Wellstone and Pete Domenici

Mental Health Parity and Addiction Act of 2008 (Public L. No.

110-343) poses challenges for many plans in the FEHB

Program.

Under regulations published by the Department of Health and

Human Services, health plans cannot have separate deductible

and out-of-pocket maximum requirements that are applicable

only with respect to mental health or substance use disorders.

This means plans must accrue member expenses toward the

same deductibles and out-of-pocket maximums for both

medical and surgical benefits and mental health and substance

use disorder benefits. In addition, if a health plan has a lower

copayment for Primary Care Physician visits, the Plan must use

the same copayment level for outpatient visits to providers of

mental health or substance use disorder services.

The regulations also prohibit discrimination in the application of

non-quantitative treatment limitations, such as medical

management standards, prescription drug formulary design,

determinations of usual, reasonable and customary amounts,

step therapy and requiring benefits be subjected to a condition

such as completing a course of treatment. Plans, however, may

apply preauthorization and concurrent review to the extent that

clinically appropriate standards of care permit this.

Fortunately, we can be brief here. the FSBP is pleased to

have been in the forefront of mental health parity for many

years and is fully compliant with the law.

what To Expect in Benefit Changes for the

FOREiGn SERviCE BEnEFiT PlAn (FSBP) in 2011

OPM has approved our proposal for several substantial en-

hancements to our benefits for 2011. A few changes are:

• Include Facility and Anesthesia charges related to a

routine colonoscopy exam for PPO providers and

providers outside the 50 United States;

• Improve the Home health care benefit;

• Increase chiropractic, acupuncture and massage

therapy benefits;

• Enhance the Smoking cessation benefit;

• Increase the Nutritional counseling benefit and

Diabetic education and Weight management benefits;

and

• Improve the current Diabetic Wellness Incentive and

add a similar benefit for coronary artery disease

(CAD).

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 11

12

RadiaTion ExPosuRE and unnECEssaRymEdiCal TEsTs

Our 2009 Summer Health Newsletter provided an article

explaining the impact medical imaging has had on diagnosis

and treatment of disease. Because of the danger of radiation

exposure from tests and other sources, we are excerpting an

article from USAtoday.com dated 12/21/2009:

“The average American is exposed each year to …

‘background radiation,’ produced by the sun, cosmic

rays and even radon in the home. Some diagnostic

imaging tests exposed patients to additional radiation.”

Below is a table indicating the equivalent amount of back-

ground radiation for certain medical tests as stated in the

article:

We chose to bold the last four tests to draw your attention to

them. The FoREign sERviCE BEnEFiT Plan (FsBP) pays for

medically necessary diagnostic high-end radiology tests. An

increasing number of these tests ordered by the providers do

not meet the definition of “medically necessary”; therefore, the

Plan cannot pay for them. Because we do not want our

members facing several hundred dollars in medical costs, as

well as the safety concerns noted in this article and the chart,

the Plan has instituted preauthorization procedures for

MRI, CT and PET scans. If your provider orders one of

these tests, please make sure your provider calls the Plan at

1-800-593-2354 to preauthorize the test.

a BETTER Way To sHoP: inTRoduCing THEmEdCo HEalTH sToRE™ – a nEW Way TosavE TimE and monEy – and Could EvEnsavE youR liFE

The healthcare market has shifted considerably, with over-the-

counter (OTC) drugs becoming an integral part of consumer

drug regimens and many consumers mixing both prescription

and OTC drugs. In fact, 68% of older adults using prescription

medications are also using OTC medications, dietary supple-

ments, or both.1

In order to provide the convenience of a single online shopping

experience for both prescription and OTC products, medco

(the Plan’s Pharmacy Benefit Manager) enhanced the

consumer health products Web site for FoREign sERviCE

BEnEFiT Plan (FsBP) members. The medco Health store

features a broad array of consumer health products (i.e.,

nonprescription items), which members are able to purchase

online and receive through the mail, saving both time and

money.

But there’s more to it. There can be potential drug interactions

between OTC products and the prescription medications you

take. For example, the combination of warfarin (coumadin)

and simple aspirin increases the risk of severe bleeding.

Because Medco has your entire prescription history, both retail

and mail order, it is in a unique position to warn you of any

potential drug interactions. You may see a screen that looks

like the one shown on the following page.

At check out from the Medco Health Store, you will be asked

to authorize the sharing of your prescription information with

the Medco Health Store. This will enable Medco and the

Medco Health Store to perform a drug utilization review that

Test Equivalent amount of

background radiation

Chest X-ray 10 days

Dental X-ray 20 days

PET scan, brain 3 ½ months

CT, routine head 6 ½ months

PET scan, heart 3 ½ years

CT, suspected aneurysm 6 ½ years

26483_AFSPA:12-pgs 8/25/10 11:33 AM Page 12

13

will alert you to harmful interactions such as described above.

If you choose not to share the information, then you proceed

right to check out.

The Medco Health Store offers over 25,000 nonprescription

products including antacids, vitamins, moisturizers, cosmetics,

natural products and more. It is available to you upon signing

in to medco.com. After registering at medco.com, click on any

of the links to access the Medco Health Store, where you will

find the products members need and use every day.

You benefit in a number of ways when you utilize the

Medco Health Store Web site, including:

n Convenient 24/7 online access and ordering from the

comfort of home;

n A wide range of over 25,000 products;

n A tailored member retail experience, with products and

information aligned with known health conditions;

n Products organized by therapeutic category (e.g.

diabetes) or traditional retail categories to simplify finding

what’s needed; and

n Online drug interaction screening that brings a new level

of safety to consumers taking both OTC and prescription

drugs.

Improving member well-being and lowering overall

healthcare costs

Like Medco’s advanced pharmacy model that is helping to

identify and close gaps in care with Specialist Pharmacists,

the Medco Health Store aims to improve both member

well-being and lower overall healthcare costs. To learn more,

log in to medco.com.

SOURCES

1 “Among Older Adults, Prescription And Over-the-Counter Medications Are

Commonly Used Together”. 24 December 2008. Accessed online

04/29/09.

http://www.medicalnewstoday.com/articles/133661.php

26483_AFSPA:12-pgs 8/26/10 11:28 AM Page 13

14

SAvinGS On viSiOn CARE FOR FOREiGn SERviCE

BEnEFiT PlAn MEMBERS

vision Care and Glasses

No matter what our age, eye exams are important to health.

As we age, our eyes are also at greater risk for sight-threaten-

ing conditions such as cataracts and macular degeneration.

Annual comprehensive eye exams can help detect these

conditions and many others before damage is irreversible.

Now, the FOREiGn SERviCE BEnEFiT PlAn (FSBP) and

Coventry, the Plan’s underwriter, are pleased to bring you the

opportunity to save on vision care through EyeMed Vision

Care.

FSBP members have new options to save on eyewear through

a materials discount program offered by EyeMed Vision Care.

This program is available to all members and eligible depend-

ents and cannot be combined with any other discounts.

For our members who reside overseas, plan to take advantage

of these discounts when you are in the U.S.

For more information on this program, visit

www.AFSPA.org/FSBP and select My Online services. Once

you have logged into My Online services, select “Wellness

Tools”, “Discount Programs” and then “EyeMed Vision Care

Discount Program”. This will take you to the EyeMed Web site

where you can view providers who participate in the discount

program. The network offers the choice of leading optical

retailers, including LensCrafters, Pearle Vision, Sears Optical,

Target Optical, JCPenney Optical, as well as thousands of

private practitioners all near where you work and shop.

FSBP members now have access to savings on

lASik eye surgery through QualSight lASik!

If you have considered corrective eye surgery, take advantage

of the QualSight LASIK network. The FOREiGn SERviCE BEnEFiT

PlAn (FSBP) and Coventry are pleased to bring you this

benefit. QualSight LASIK provides FSBP members savings of

40 to 50 percent off the national average price for traditional

LASIK eye surgery. QualSight’s credentialed network of the

nation’s most experienced LASIK surgeons features 800

locations nationwide and over 2.5 million LASIK procedures

performed. Flexible financing options are available with

payments as low as $50 per month*.

How it works:

1. To obtain the preferred pricing call 1-877-213-3937.

FSBP members residing overseas can contact

QualSight through the QualSight Web site at

www.qualsight.com/-coventry to schedule the procedure

during a stateside stay.

2. A QualSight Care Manager explains the program and

answers any questions.

3. Select your preferred provider and set up the appoint-

ment right over the phone!

To learn more, visit www.AFSPA.org/FSBP and select

My Online services. Once you have logged into My Online

services, select “Wellness Tools”, “Discount Programs” and

then “QualSight Lasik Discount Program”. This will take you

to the QualSight Web site, where you can review details of the

program and find out how to take advantage of the discounts.

This is a value added service available to FSBP members

through Coventry. The QualSight program is not an insured

benefit. The preferred pricing program is available to members

to provide access to QualSight preferred pricing for LASIK

surgery.

*Subject to GE CareCredit approval

Foreign Claim Processing Tips

To help speed up the processing of your claims, we offer

the following suggestions:

1. Submit scanned claims electronically through our

secure Web site referenced on page 3 of this

Newsletter.

2. Include your name and/or Member ID number as

found on your ID Card on the copy of the bill.

3. If you submit a handwritten note, make sure to

print your name on the note.

4. While we do not need a translation, it is helpful to

submit the reason for the visit, especially when

related to maternity or routine preventive services.

5. If in doubt, go to the FOREiGn SERviCE BEnEFiT PlAn

(FSBP) Web site at:

www.afspa.org/site/insurance/fsbp/fileclaimOI.html

to obtain further helpful information.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 14

FAMily-FOCuSED wEllnESS FROM

kiDSHEAlTH®

Keeping kids healthy and happy can be challenging and

that is why the FOREiGn SERviCE BEnEFiT PlAn (FSBP) and

Coventry Health Care (Coventry), the Plan’s underwriter,

have teamed with Nemours, one of the nation’s largest

nonprofit pediatric health systems, to bring you kidsHealth®,

an online resource that educates families and helps them

make informed decisions about their children’s health.

Using KidsHealth is a fun and engaging way to encourage

preventive behaviors and motivate kids and teens to become

more involved in their health. KidsHealth has a comprehen-

sive library of health information for families featuring

thousands of medically reviewed articles, animations, features

and age-appropriate content. The KidsHealth Web site is

organized for three distinct audiences: parents, kids and

teens. For parents, KidsHealth offers hot topics and news, recipes, a

Q&A section and other information aimed at helping parents

understand the health issues that may affect their children.

The Condition Center provides information, tools and practical

advice to help both newly diagnosed individuals and families

deal with ongoing disease management issues. In addition to

health information, KidsHealth contains articles on positive

parenting and advice to help parents handle tough topics, from

birth through the teen years.

For children, KidsHealth provides engaging content, such as

peer stories and articles on staying healthy, in a fun format for

kids. Games, quizzes and other interactive features keep kids

interested and aid in understanding. Teens can choose from

a wide array of emotional and developmental content on

issues important in their lives, finding answers, advice and

straight talk, presented in a style and tone that speak to them.

To see what is available on KidsHealth, go to

www.AFSPA.org/FSBP and log in to My Online services, click

“Wellness Resources” and then “KidsHealth” or visit

fsbp.coventryhealthcare.com/wellness-resources/index.htm

and click “KidsHealth”.

15

Have you recently moved?

Are you moving soon?

Please don’t forget to contact us and give us your

new address.

The FOREiGn SERviCE BEnEFiT PlAn would like to stay

in touch!

use our secure e-mail process through our web

site at www.AFSPA.org/FSBP to notify us of any

address changes. Just click on the “Change of

Address” tab at the top of the page.

26483_AFSPA:12-pgs 8/23/10 12:26 PM Page 15

THE Protective aSSociation oFFErs oUr MEMBErs MAnY sErvicEs

THAT inclUDE...

Health insurance

Dental insurance

Term life insurance

Accidental Death and Dismemberment insurance

long Term care insurance

Total Disability insurance

Travel insurance

legal services

Foreign Service BeneFit Plan

1716 n street, nW

Washington, Dc 20036-2902

For more information please contact us at:

Telephone: (202) 833-4910 Fax: (202) 833-4918

E-Mail ProTEcTivE AssociATion: AFsPA@AFsPA.org

E-Mail ForEign sErvicE BEnEFiT PlAn: Health@AFsPA.org

Web site ProTEcTivE AssociATion: www.AFsPA.org

Web site ForEign sErvicE BEnEFiT PlAn: www.AFsPA.org/FsBP

PRSRT STD

U.S. POSTAGE

PAID

PERMIT#5165

RIVERDALE, MD

26483_AFSPA:12-pgs 8/26/10 1:29 PM Page 16