Agency will use FEHBP experience to run some health plans under Obamacare

Kamil Macniak/Shutterstock.com

The Office of Personnel Management will draw on its experience running the Federal Employees Health Benefits Program in its new role administering multiple state health plans on the 2010 Affordable Care Act’s insurance exchange network.

Private health insurers that participate in the multi-state plan program on the exchanges will contract with OPM, the agency responsible for administering FEHBP. Providers must offer at least two multi-state plans on each of the exchanges in the 50 states and the District of Columbia. The law allows companies to phase in their coverage in all states and D.C. over four years, though they must offer coverage in at least 31 states in the first year of participation.

The initial open enrollment for plans offered through the exchanges starts Oct. 1, 2013, for coverage beginning in January 2014.

The Affordable Care Act directs OPM to negotiate premiums and benefits with insurance providers who participate in the multi-state plans on the exchanges, similar to the agency’s administration of FEHBP, which provides health care benefits to 8.2 million federal employees, retirees and their dependents. The health reform law created the multi-state plan program to foster competition among health insurance plans in the individual and small group markets in cost and quality, aiming for a level playing field for insurance issuers that participate in the exchanges.

OPM pledged in proposed rules published this week to negotiate the best deals for consumers who purchase their health insurance through the multi-state plans on the exchanges. FEHBP enrollees will be separate from the beneficiary population of multi-state plans, according to the draft rules.

The agency has a good track record administering FEHBP, although average premium hike rates of more than 7 percent a few years ago as a result of benefit changes and rising health care costs irked beneficiaries. Many FEHBP enrollees are generally pleased with their health care coverage, but some federal workers have complained that the cumulative increase in premium rates, co-payments and prescription drug expenses that they’ve experienced during the past few years is much more than the reported average, and it adds insult to injury on top of the ongoing pay freeze.

OPM in September announced that premiums will increase an average of 3.4 percent in 2013; changes in the enrollee share of premiums vary from plan to plan.

The public can comment on the proposed rules through Jan. 4, 2013.

(Image via Kamil Macniak/Shutterstock.com)

Stay up-to-date with federal news alerts and analysis — Sign up for GovExec's email newsletters.
FROM OUR SPONSORS
JOIN THE DISCUSSION
Close [ x ] More from GovExec
 
 

Thank you for subscribing to newsletters from GovExec.com.
We think these reports might interest you:

  • Sponsored by Brocade

    Best of 2016 Federal Forum eBook

    Earlier this summer, Federal and tech industry leaders convened to talk security, machine learning, network modernization, DevOps, and much more at the 2016 Federal Forum. This eBook includes a useful summary highlighting the best content shared at the 2016 Federal Forum to help agencies modernize their network infrastructure.

    Download
  • Sponsored by CDW-G

    GBC Flash Poll Series: Merger & Acquisitions

    Download this GBC Flash Poll to learn more about federal perspectives on the impact of industry consolidation.

    Download
  • Sponsored by One Identity

    One Nation Under Guard: Securing User Identities Across State and Local Government

    In 2016, the government can expect even more sophisticated threats on the horizon, making it all the more imperative that agencies enforce proper identity and access management (IAM) practices. In order to better measure the current state of IAM at the state and local level, Government Business Council (GBC) conducted an in-depth research study of state and local employees.

    Download
  • Sponsored by Aquilent

    The Next Federal Evolution of Cloud

    This GBC report explains the evolution of cloud computing in federal government, and provides an outlook for the future of the cloud in government IT.

    Download
  • Sponsored by Aquilent

    A DevOps Roadmap for the Federal Government

    This GBC Report discusses how DevOps is steadily gaining traction among some of government's leading IT developers and agencies.

    Download
  • Sponsored by LTC Partners, administrators of the Federal Long Term Care Insurance Program

    Approaching the Brink of Federal Retirement

    Approximately 10,000 baby boomers are reaching retirement age per day, and a growing number of federal employees are preparing themselves for the next chapter of their lives. Learn how to tackle the challenges that today's workforce faces in laying the groundwork for a smooth and secure retirement.

    Download
  • Sponsored by Hewlett Packard Enterprise

    Cyber Defense 101: Arming the Next Generation of Government Employees

    Read this issue brief to learn about the sector's most potent challenges in the new cyber landscape and how government organizations are building a robust, threat-aware infrastructure

    Download
  • Sponsored by Aquilent

    GBC Issue Brief: Cultivating Digital Services in the Federal Landscape

    Read this GBC issue brief to learn more about the current state of digital services in the government, and how key players are pushing enhancements towards a user-centric approach.

    Download
  • Sponsored by CDW-G

    Joint Enterprise Licensing Agreements

    Read this eBook to learn how defense agencies can achieve savings and efficiencies with an Enterprise Software Agreement.

    Download
  • Sponsored by Cloudera

    Government Forum Content Library

    Get all the essential resources needed for effective technology strategies in the federal landscape.

    Download

When you download a report, your information may be shared with the underwriters of that document.