Fedweek

OPM cites outdated enrollment experience for enrollees, unnecessary and costly administrative burden on agencies and carriers

OPM is investigating creating a central enrollment program service for the FEHB to provide a “one-stop-shop” that would become the “authoritative source for program-wide FEHB enrollment data, and provide real-time enrollment and premium transaction information to all employing agencies and participating FEHB health insurance carriers.”

In a notice to industry requesting information, OPM said it envisions a portal where enrollees can “compare and learn about FEHB plan options, including benefits, cost-sharing, and total out-of-pocket expenses; select a plan that fits the unique needs of their family; and complete the enrollment process, all with customer service assistance.”

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OPM said that such a system would benefit enrollees, carriers and agencies “by ensuring consistent and timely processes, providing robust support for enrollment decisions, and assuring that only eligible persons enroll and are able to continue that enrollment into retirement.”

“While overall program administration is centralized at OPM, the enrollment process, enrollment reconciliation, and most customer service functions are decentralized across the federal government and beyond,” it said. “This has resulted in processes that do not deliver a modern enrollment experience for enrollees, and adds unnecessary and costly administrative burden on agencies and carriers. The current enrollment process relies on multiple independent systems performing redundant functions, as well as paper and manual processes.”

It said that the responses to its request will be used to determine the extent to which industry solutions can deliver some or all of those capabilities. It asked for information to be submitted by March 11 but indicated no timetable for next steps.