Sixty-five health plans to drop federal enrollees

Sixty-five health plans to drop federal enrollees

letters@govexec.com

More than 50,000 federal employees, retirees and others enrolled in the Federal Employees' Health Benefits Program will have to switch health plans this fall because 65 plans have decided to stop covering federal employees next year.

In 1998, 350 health plans offered insurance under FEHBP. In 1999, only 285 plans will participate in the program. The Office of Personnel Management, which runs FEHBP, attributes the decline to shakeouts and consolidations in the health-care industry. OPM Director Janice Lachance said the decline had nothing to do with the Clinton Administration's mandate that FEHBP health plans comply with the President's Patients' Bill of Rights.

"I would like to make one point absolutely clear, because the question is bound to be asked," Lachance said in a statement. "Expanded benefits and increased patient protections did not account for attrition among plans. Not one of the departing plans cited these as factors. Moreover, the overwhelming majority of plans, covering in excess of 95 percent of the individuals in the FEHB program, implemented the patient protections contained in the Patients' Bill of Rights at no added cost. The overall effect of the Patients' Bill of Rights was negligible."

Enrollees whose plans are dropping out of the program must choose a new health insurance provider during the FEHBP open season, which runs from Nov. 9 to Dec. 14 this year.

One fee-for-service plan, the Beneficial Association of Capitol Employees, is dropping out of the FEHBP. It covers about 1,200 employees. Other major plans and the number of enrollees affected are listed below.

Plans Dropping Out of FEHBP in 1999
Plan No. of
enrollees
States
Blue Choice Healthcare 420 GA
Care Choice 1,813 MI
CIGNA MidAtlantic 4,503 MD,VA, DC
CIGNA of Ohio 2,380 OH
Community Blue 3,176 NY
Companion Healthcare 826 SC
Exclusive Healthcare 611 KS, MO
Harris Methodist Health Plan 2,138 TX
Health Advantage 1,338 AR
Health Options 1,557 FL
Healthplan Southeast 514 FL
Healthsource Ohio 333 OH
Healthsource Tennessee 1,063 TN
HMO Maine 317 ME
HMSA's Community Health Program 731 HI
IHC SelectMed 628 UT
Matthew Thornton 1,282 MA, NH
Maxicare 1,386 IL, IN, IA
Maxicare Northern California 703 CA
Maxicare North Carolina 1,338 NC, SC
Maxicare WI 238 WI
M.D. Health Plan 1,036 CT
Medfirst Health Plans 232 LA
Medica Primary 3,570 MN
NYLCare Health Plans 844 CT, NY
NYLCare Health Plans 2,070 NJ
NYLCare Health Plans of the Midwest 367 IL
Ochsner 625 LA
Oxford Health Plan 274 CT
Oxford Health Plan 3,343 NY
Principal Health Care of Illinois 1,199 IL, IN
Principal Health Care of NE 1,479 NE, IA
Prudential 328 IN
QualChoice 688 OH
QualMed Oregon Health Plan 815 OR, WA
United Healthcare 540 AR
United Healthcare 458 LA
United Healthcare 641 TN
United Healthcare 572 TX
United Healthcare of CA 280 CA
United Healthcare of Illinois 9,060 IL
United Healthcare Mid-Atlantic 2,119 VA