Following are excerpts from a recent OPM report that describe participation rates in major federal employee benefits programs.
Flexible Spending Account Programs
Flexible Spending Accounts Programs (FSAFEDS) is one of three separate benefits programs offered by OPM to its employees and most Federal employees of an Executive branch agency or an agency that has adopted the Federal Flexible Benefits Plan ("FedFlex"). FSAFEDS began in 2003 and offers (1) a health care flexible spending account, (2) a limited expense health care flexible spending account, and (3) a dependent care flexible spending account. Eligible employees can enroll in FSAFEDS each year during the Federal Benefits Open Season or within 60 days of new Federal employment or a recognized life event (marriage, child birth or adoption). Programs details can be found at: www.opm.gov/insure and www.fsafeds.com. FSAFEDS currently has about 289,000 participants representing 279,700 health care accounts and 41,000 dependent care accounts. The difference between participants and total accounts is attributed to some participants having both account types. Current enrollment represents approximately 16% of the eligible Federal population (1.8m employees). The average annual election for health care accounts is $1,900 and $3,700 for dependent care accounts. OPM reviews the program each year and enrollment has increased each year.
Federal Child Care Subsidy Program
The Federal Child Care Subsidy Program (FCCSP) helps lower income Federal employees pay for child care. The program was established in 2001 by Public Law 107-67, Sec. 630, which allows agencies to use appropriated and revolving funds for this purpose. Agencies choose whether or not they wish to participate, based on considerations such as budget, mission priorities, and the demographics and needs of their employee population. Agencies have broad latitude in determining key elements of their program, including income ceiling and total amount disbursed. Each implementing agency administers its own program, often through a contract with a third-party administrator. As of FY 08, twenty agencies offered child care subsidies in whole or in part.
OPM issued regulations for the program in 2003 — 5 CFR Part 792. OPM also provides guidance and support to Federal agencies. Resources include the Guide for Implementing Child Care Legislation , quarterly meetings with agency subsidy coordinators, and assistance to agencies who are contemplating implementation of a program as well as supporting agencies with existing programs, as needed.
Federal Employees Dental and Vision Insurance Program
The Federal Employees Dental and Vision Insurance Program (FEDVIP) provides comprehensive dental and vision insurance to eligible Federal employees and eligible Federal retirees. There are seven dental plan and three vision plans from which to choose. FEDVIP offers nationwide, international, and regional plans. Enrollees pay the entire premium; there is no government contribution. Currently, there are approximately 815,000 enrollees in the dental program and 570,000 enrollees in the vision program.
Federal Employees Health Benefits Program
The Federal Employee Health Benefits Program (FEHB) is one of three separate benefit programs offered by OPM to its employees and to most Federal employees. Eligible employees can enroll in a health plan through FEHB during open season. The types of programs offered include,
Managed Fee–for–Service Plans – These plans reimburse you or your health care provider for covered services.
Health Maintenance Organization Plans (HMO‘s) – These plans provide a comprehensive array of medical services, emphasizing prevention and early detection of disease, through contracted–physicians, hospitals, and other providers in particular locations.
Plans Offering a Point of Service (POS) Product – Some FEHB plans combine their features. A number of fee–for–service and HMO plans offer two forms of health care delivery, known as ”in network“ and “out of network.”
High Deductible Health Plan (HDHP) – A health plan product that, when combined with a Health Savings Account (HSA) or a Health Reimbursement Account (HRA), provides insurance coverage and a tax–advantaged way to help save for future medical expenses.
The Federal employees and retirees can choose from approximately 269 health-plan options in the FEHB Program. At least a dozen health plan choices are available to each employee, which allows for a broad choice so that employees can select the plan that best meets their own individual health care needs. While specific benefits vary among FEHB plans, none can impose a waiting period or require a medical exam to enroll in their plan. www.opm.gov/insure/health/index.asp.
As of March 2009, 74% (1,477,584) of Federal employees are enrolled in FEHB. FEHB Program covers approximately 8 million Federal employees, retirees and their dependents. The plans in the FEHB Program have comprehensive coverage that includes benefits for covered maternity, family planning, and infertility services as well as benefits for preventative care services such as mammograms, Pap tests, and bone density tests. OPM requests that plans in the FEHB Program follow the guidelines on preventive care for children recommended by the American Academy of Pediatrics and the guidelines for adults recommended by the United States Preventive Services Task Force. Eligible employees or dependents who lose FEHB coverage may be eligible for a conversion policy (a non-FEHB individual policy) or Temporary Continuation of Coverage (TCC) or Spouse Equity coverage. TCC allows certain people to temporarily continue their FEHB coverage after regular coverage ends. Also, under the Civil Service Retirement Spouse Equity Act of 1984, certain former spouses of Federal employees, former employees, and annuitants may qualify to enroll in a health benefits plan under the FEHB Program. If an enrollee or covered dependent disagrees with the plan’s decision on their claim, the FEHB Program provides for an appeal process. Section 8 of all the FEHB plan brochures provides directions for the individual’s disputed claims process to OPM.
Federal Employees Group Life Insurance
The Federal Employees’ Group Life Insurance (FEGLI) Program is a life insurance program for Federal and Postal employees and annuitants. The Office of Personnel Management (OPM) administers the Program and sets the premiums.
FEGLI is group term life insurance. It consists of Basic insurance and three types of optional insurance. In most cases, new Federal employees are automatically covered by Basic life insurance. Their payroll office deducts premiums from their salary unless the employees waive the coverage. In addition to the Basic insurance, there are three forms of Optional insurance employees can elect: Option-A Standard, which provides $10,000 of insurance, Option B-Additional, which provides for coverage from 1 to 5 times salary, and Option C-Family, which provides for coverage for a spouse and eligible dependent children from 1 to 5 multiples. Each Option C multiple equals $5000 for a spouse and $2500 for each child. The program also offers the opportunity to retain coverage into retirement for enrollees who meet certain criteria. Program details can be found at: http://www.opm.gov/insure/life/. For FY 08 more than 4 million employees and annuitants are covered under FEGLI with a participation rate of 89% (1,668,461) The FEGLI program operates at a high level of efficiency but future planned improvements including reducing further the already low level of improper payments.
Long Term Care Insurance Program
Newly hired and newly eligible Federal employees and their spouses and newly married spouses of eligible Federal employees can apply for long term care insurance coverage under the Federal Long Term Care Insurance Program (FLTCIP) with abbreviated underwriting (few questions about health). Long term care helps people with daily activities when they are unable to perform them without assistance due to aging or an ongoing illness or disability. Long term care insurance can provide assistance with the expenses associated with a variety of services, including but not limited to: nursing home care, assisted living facility care, adult day care and at-home care. Current employees, annuitants, and their qualified relatives can apply for coverage any time with full underwriting (more questions about health). The FLTCIP is medically underwritten and coverage is not guaranteed. Currently, there are 224,500 enrollees. Program details can be found at: http://www.ltcfeds.com.
