Fedweek

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OPM has sent to agencies its annual instructions on preparing to conduct the November 12-December 10 benefits open season, including information they are to make available to employees describing the implications of a plan leaving the program, restricting its coverage area or ending an option.

For the 2019 plan year four FEHB plans are dropping out: Healthnet of Arizona, Inc. (Cochise, Gila, Maricopa, Pima, Pinal, and Santa Cruz counties), UnitedHealthcare of California (Central and Southern California), UnitedHealthcare Plan of the River Valley, Inc. (Eastern and Central Iowa and West Central Illinois) and Physicians Plus Insurance Corporation (South Central Wisconsin). In addition, eight plans are reducing service areas without eliminating enrollment codes and nine are eliminating options.

Affected enrollees should receive a letter directly from the carrier, said OPM, which also included the affected plans in its guidance and told agencies to distribute that list. “It is your responsibility to monitor employees who are covered by these terminating plans and follow up with those who have not submitted an enrollment change before the end of open season,” it told agencies.

For plans dropping out, enrollees who do not elect a different plan will be automatically enrolled in a new offering from Blue Cross and Blue Shield, FEP Blue Focus, which will be the lowest-cost nationwide plan available. The same will happen if a plan is reducing its service area and eliminating an enrollment code.

If a plan reduces its service area but keeps an enrollment code, affected enrollees would have to travel to the remaining service area for all services but emergency care, which will remain covered.

Those enrolled in an option that is being eliminated and who do not elect new coverage will be automatically enrolled into one of the plan’s options that remain—unless the only remaining option is a high-deductible option, in which case those who do not elect new coverage will be automatically enrolled in FEP Blue Focus.

That plan is the only new national offering—an HMO covering parts of Colorado also is being added—while seven regional plans will offer new options—three of them high-deductible options—and 16 plans will expand their service areas.

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