OPM has finalized rules to address what it calls an “asymmetry” in FEHB policies by allowing all plans to offer three options or to offer two options plus a high deductible health plan. That currently is the rule for HMO plans but not for fee for service plans.
“This will give enrollees additional options when considering which health plan is best suited for them, for example, using a variety of variables such as premium, co-pay, and deductible costs, provider networks, and referral and pre-authorization policies,” OPM said in a Federal Register notice. “Since all health plans must compete annually for enrollees, the availability of additional options could create an incentive for plans to keep premiums as low as possible to attract enrollees.”
More on the Federal Employee Health Benefits (FEHB) program at ask.FEDweek.com
“OPM considers a competitive environment as one in which all carriers conduct business under the same set of rules, meaning no carrier has the advantage of offering products that another carrier cannot. While plan benefits vary, OPM wants all carriers to be able to offer the same number and types of plan options,” it said.
Carriers would not be required to offer a new option, but if they do, OPM said it will “ensure that any new options are distinct and meet enrollee interests and that enrollees have access to adequate information to understand the available plan options.”