Some Benefit Changes Sought

One change mandated by law enacted last year for all health plans requires carriers to offer parity in benefits for medical and surgical benefits and mental health or substance use benefits, including out-of-network benefits. OPM also said it expects carriers to: review their catastrophic limitations for all benefits as well as balance billing for the services of out-of network providers to ensure FEHB enrollees receive appropriate coverage for medically necessary services; continue health care cost and quality transparency initiatives; and broaden the use of health information technology. OPM also urged carriers to continue to work to control the costs of prescription drugs—a major driver of premium increase in the program—by strengthening features that encourage members to use generic drugs such as through reduced copays or coinsurance.