First open season since health reform is around the corner

This year's open season for changing Federal Employees Health Benefits Program elections marks the first since President Obama signed a major health reform law, provisions of which will affect government workers. From Nov. 8 to Dec. 13, FEHBP participants can alter their health, dental, vision and flexible spending account benefits; switch plans; or cancel their enrollment without penalty.

Click here for our guide to Open Season 2010

New next year will be requirements for insurance providers to cover preventive services and screenings without requiring co-insurance; to offer smoking cessation programs that will include four counseling sessions per quit attempt (with two quit attempts annually); to eliminate annual and lifetime dollar limits on medication and treatment; and to extend coverage to adult dependent children up to age 26. Five plans have increased benefits for hearing devices and 16 have expanded coverage for bone marrow and stem cell donor testing. And for the first time, the Mail Handlers Benefit Plan and GEHA will pick up part of enrollees' Medicare Part B premiums. There are no major changes to dental and vision programs.

The total average premium increase for FEHBP plans will be 7.3 percent, or $27.10 per pay period, the Office of Personnel Management announced on Oct. 1. Of that amount, the government will increase its contribution to employees' health care costs by $18.86 per pay period, or 7.3 percent. That leaves federal workers with an average increase of $8.24 in their premiums, or 7.2 percent.

The average nonpostal employee will see premiums rise by $5.53 per pay period for individual coverage, and by $11.45 for family coverage. For postal workers, premiums will cost an extra $6.10 per pay period for individual coverage and $12.73 more per pay period for family plans.

Premiums for dental insurance will rise 3.8 percent and will average $15.33 per pay period for an individual, $30.06 for self plus one and $43.85 for family plans. Vision insurance will go up 3 percent, costing individuals an average of $4.78 per pay period, self plus one enrollees $9.55 and family users $14.11. Dental premiums increased 4.2 percent and vision 2.4 percent in 2010.

OPM last year introduced the Managing My Own Health website, a set of tools to help streamline medical visits and compare how various states and insurance plans handle diagnosis and treatment of specific conditions. In 2011, OPM will roll out a health claims database tool that will track and evaluate the quality and cost of FEHBP services and will help the agency find ways to reduce health costs.

A few questions to consider when exploring plan options:

  • What are the premium rates for 2011?
  • Has your plan changed, or left FEHBP in the past year?
  • Do new benefits apply to you?
  • Do you expect your family's needs to change during the next year?
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