FEHBP open season nears as Congress considers major health care reform

As Congress crafts a health care reform package, this year's open season for the Federal Employees Health Benefits Program takes on even greater importance. From Nov. 9 to Dec. 14, government workers can make changes to their health, dental, vision and flexible spending account benefits, switch plans or cancel their enrollment without penalty. Employees enrolled in the Long Term Care Insurance Program will be able to modify their plans until Feb. 15, 2010. Click here for our guide to Open Season 2009.

New this year is "Managing My Own Health," a set of tools on the Office of Personnel Management's Web site to help streamline medical visits and compare how various states and insurance plans handle diagnosis and treatment of specific conditions. Also new is out-of-network coverage for mental health and substance abuse services on par with physical health benefits, as well as several plans that cover childhood obesity and diabetes treatment.

Insurance premiums for FEHBP plans on average will increase 8.8 percent, or $9.21 per pay period, compared with 2009 rates, according to figures OPM released on Sept. 29. This is a sizable increase: Premiums jumped an average of 7 percent in 2009 and 2.1 percent in 2008. In 2010, the typical employee will see premiums increase $5.98 per pay period for individual coverage, and $12.87 per pay period for family coverage. The cost of dental coverage will increase 4.2 percent, and vision insurance prices will rise 2.4 percent. For some federal employees enrolled in the long-term care program, premium hikes will range from 5 percent to 25 percent.

In the lead up to this year's open season, ending or modifying FEHBP has been a topic of Senate debate, and key players have discussed proposals for reducing prescription drug costs for feds. In addition, a provision in the health care reform bill crafted by the Senate Finance Committee would levy a 40 percent tax, beginning in 2013, on the overall value of health insurance plans that cost more than $8,000 for individuals and $21,000 for families. By some calculations, FEHBP plans already are above the threshold designated for the excise tax, should it be enacted.

According to OPM, a few questions to consider when exploring a change in your plan include:

  • Do you expect medical needs for you and your family to extend beyond routine care?
  • Have your benefits changed in the past year?
  • What are the premium rates for 2010?
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