Starting in 2027 all FEHB carriers would have to cover three primary care visits and three behavioral health visits each year without charging a copayment. Image: Minerva Studio/Shutterstock.com
By: FEDweek StaffPresident Biden’s fiscal 2025 budget proposal seeks several relatively minor changes to the FEHB health insurance and the FEDVIP vision-dental insurance programs while leaving federal retirement programs untouched.
In the FEHB, starting in 2027 all carriers would have to cover three primary care visits and three behavioral health visits each year without charging a copayment, coinsurance, or deductible-related fee. “For High Deductible Health Plans, these services would be considered pre-deductible for meeting Health Savings Account requirements. This proposal would increase FEHB premiums by approximately 0.9 percent,” a budget document says.
In addition, the budget would limit cost-sharing for insulin in the FEHB to $35 a month, the same level now applying in the Medicare program, effective in 2025. “This proposal would increase FEHB premiums by approximately 0.1 percent,” it says.
The budget also outlines several administrative steps ahead as OPM prepares to carve out postal employees and retirees into a parallel Postal Service Health Benefits program effective in calendar year 2025.
In the FEDVIP program, the budget repeats past proposals to expand children’s eligibility to the age 26 cutoff used in the FEHB, compared to the current age 22 cutoff; and allow FEDVIP carrier contracts as short as one year with potential annual extensions—compared with the current seven-year term—in a bid to increase competition.
The only mention of retirement is in the context of the long-running controversy over the time spent in processing applications before retirees begin receiving their full benefits. “The Budget invests in the Office of Personnel Management to reduce processing times for Federal retirement and improve customer satisfaction, including hiring additional employees to process cases and $3 million to continue to develop a digital file system and online retirement application,” a fact sheet says.
A budget document says that average processing time for new retirement cases “dropped from 89 days in October 2022 to 69 days in November 2023. The new retirement case inventory in November 2023 (15,826) is the lowest it has been since December 2017.”
However, the November figures predate the annual spike in retirement applications around the turn of the year. Through February, the figure stood at nearly 20,000—OPM’s “steady state” goal is 13,000—although the average processing time was down to 47 days. That measures only the time at OPM; applications typically don’t reach OPM from employing agencies for several weeks or longer after retiring employees submit them.
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