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Consumer-Driven Care

The jury is still out on whether high-deductible health plans are in general a good option for federal employees. But with the open season for benefits elections quickly approaching, it could be helpful to understand and determine whether such a plan is right for you.

High-deductible health plans and the savings accounts that accompany them provide greater flexibility and discretion over how enrollees use their health care benefits. These plans feature lower monthly premiums than traditional ones, but in exchange, have higher annual deductibles.

The Office of Personnel Management started offering high-deductible plans in the Federal Employees Health Benefits Program in 2005. During the open season for 2008 benefits, which runs from Nov. 12 to Dec. 10, there will be 32 high-deductible plans offered, compared to 29 during the last open season.

High-deductible plans also feature health savings accounts or health reimbursement arrangements. The savings accounts allow enrollees to set aside tax-free dollars for their health needs, and the money invested rolls over from year to year regardless of whether participants switch plans or leave the federal government.

If you are enrolled in Medicare, you are not eligible for a health savings account. Under Internal Revenue Service standards, the maximum amount a federal employee can deposit into a health savings account in 2008 is $2,900 for singles and $5,800 for families. The capped amounts include the deposits that carriers may automatically insert into your account.

Aetna currently has the most popular high-deductible plan in FEHBP, having enrolled more than 60 percent of all federal high-deductible plan participants. The Aetna plan provides 100 percent in-network preventative care for medical, dental and vision and has lowered its premiums by 17 percent for 2008.

"Our HSA is a great plan that is priced very competitively," said Tom Bernatavitz, vice president of the federal government sector for Aetna. "It's a personal frustration to me that more individuals don't take the opportunity to enroll in a plan that could really benefit them their entire lives."

Aetna's high-deductible plan biweekly rates for non-postal employees will be $30.92 for singles and $67.72 for families in 2008. The plan automatically inserts an annual amount of $750 for singles and $1,500 for families into participants' savings accounts.

Deductibles in 2008 will be $1,500 for singles and $3,000 for families. The most that enrollees would have to pay in a year (catastrophic maximum), including the deductible, is $4,000 for singles and $8,000 for families.

Enrollees in Aetna's high-deductible plan can also expect to receive additional dental and vision benefits. For dental, cleanings and X-rays are covered at 100 percent in-network, and for vision, routine eye exams are completely covered, with enrollees receiving an eyewear reimbursement of $100 every 24 months. The plan also offers a massage therapy discount.

Currently, 96 percent of enrollees in Aetna's high-deductible plan have rolled-over balances in their savings accounts, Bernatavitz said. The current average balance is $1,300 for singles and $1,750 for families, he said.

Meanwhile, Blue Cross Blue Shield will launch its first high-deductible plan next year as a pilot project in four locations -- Ohio, Minnesota, Tennessee and Kansas City. The plan, called the consumer basic option, is a sub-option of Blue Cross' basic plan and holds the same premium and benefits as the basic option.

"We're doing the pilot in a limited area primarily because of the complexity of the [high-deductible] product," said Jena Estes, executive director of program integrity for the Blue Cross Blue Shield federal employee plan. "Before we launch a broad offering of the product, we want to at least test it, learn from it and evaluate the needs of the members as to whether it works for them."

The plan's biweekly rates for nonpostal employees for 2008 will be $39.13 for singles and $91.66 for families. Blue Cross automatically inserts an annual amount of $900 for singles and $1,800 for families into participants' accounts.

Deductibles for the Blue Cross plan will be $2,900 for singles and $5,800 for families. The annual deductible and the catastrophic maximum are set at the same dollar amount.

Still, some employee groups strongly oppose high-deductible plans, arguing that they could result in higher premiums and reduced benefits for employees enrolled in more comprehensive, traditional offerings. According to a 2005 Government Accountability Office report, most participants in high-deductible plans are younger, healthier and better educated than those in comprehensive plans.

As part of the pilot, Blue Cross plans to examine whether a high-deductible plan could affect the cost and benefits of more traditional plans, Estes said. "It's not really for every consumer," she said. "It serves as a financial tool, and some can potentially save on their health care long term."

The following Web sites may be able to help you to better determine whether a high-deductible plan is right for you:

Office of Personnel Management

Aetna HSA Calculator

GEHA HSA Calculator

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Brittany Ballenstedt writes Nextgov's Wired Workplace blog, which delves into the issues facing employees who work in the federal information technology sector. Before joining Nextgov, Brittany covered federal pay and benefits issues as a staff correspondent for Government Executive and served as an associate editor for National Journal's Technology Daily. She holds a bachelor's degree in journalism from Mansfield University and originally hails from Pennsylvania. She currently lives near Travis Air Force Base, Calif., where her husband is stationed.

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