Fedweek

OPM has sent to agencies its first round of instructions and materials to be provided to employees in preparation for the annual federal benefits open season, which this year will run November 11-December 9.

During open season, active employees may newly enroll in the Federal Employees Health Benefits program and those already enrolled may change plans, may change options within plans for those with more than one, or may change among self-only self plus one and family coverage. Retirees generally may not newly enroll but may make the other types of changes if they are already enrolled.

Rates and some specifics of FEHB plans for the 2020 plan year typically are announced in September, with full details released just ahead of the open season. OPM earlier announced that a new “indemnity benefit plan” with two new options, sponsored by the Government Employees Health Association, will join the program. In such a plan, not available in the FEHB since the late 1980s, an enrollee may choose any health care provider but may have to pay a portion of the charge and, if it exceeds “usual and customary” rates, the difference.

The “call letter” OPM sent to FEHB carriers early in the year—kicking off the annual negotiations that end with the premiums announcement—once again emphasized controlling prescription drug costs and encouraging participation in wellness programs. It also invited plans to propose new incentives for enrollees to use lower-cost care options and opened the door for carriers to propose new benefits that are not offset by cost reductions in the same plan option, an exception to its long-standing policy that additional benefits must be “cost neutral.”

Separately, as part of the budget proposal, the administration proposed varying the government’s contribution toward premiums depending on a plan’s quality ratings. However, that would require a change in law and Congress has not actively considered that idea.

The open season also applies to the Federal Dental and Vision Insurance Program, with similar choices available except that in FEDVIP, retirees may newly enroll. That program experiences few changes in coverage terms year to year.

The open season also is the opportunity for active employees (but not retirees) to enroll for a health care account, a dependent care account or both under the flexible spending account program for the next calendar year. Unlike FEHB and FEDVIP, where enrollments continue unless changed, a new enrollment in the FSA program is required each year for those wishing to continue in the program.