Let the Open Season Panic Begin!

Really there’s no need to be alarmed. But some health plan changes are in the works.

It isn’t even September yet, but there is a lot going on already in preparation for the 2013 Federal Employees Health Benefits Program open season at the end of the year. With the implementation of the 2010 Affordable Care Act under way, some employees and retirees are worried about its impact on their benefits. Here is an email I received this week:

As I understand, our insurance will change in January and the benefits won't be as they were before. I know, nobody knows exactly what will happen … but what about surgeries which could wait a few months (like hip/knee and similar). Would it be better to have it before 2014?

In general, for federal employees, there’s no need to panic. FEHBP will continue as you know it. Unless you are a member of Congress or congressional staff member, you will continue to be covered by an FEHBP health plan next year. (Under the ACA, those on Capitol Hill must obtain insurance through new health exchanges that are in the process of being set up.)

The 2013 FEHBP Open Season will begin Monday, Nov. 11 and end on Monday, Dec. 9. As usual, you will be able to select a new federal health benefits plan, a supplemental dental and/or vision plan, and allocate allotments to your flexible spending account during this period. Your agency will advise you of important dates and information as it becomes available.

What’s New?

There have been some changes to FEHBP of late:

  • With the recent Supreme Court decision in the Defense of Marriage Act case, same-sex couples who are legally married are now eligible for the program, and for Federal Employees Group Life Insurance. They can enroll during a 60-day open enrollment period that runs through Aug. 26.
  • Legally married same-sex couples also can participate in self and family enrollments during the annual FEHBP open season, as can any other married couples.
  • In the future, the word “spouse” in any Office of Personnel Management documentation pertaining to federal benefits will cover both same and opposite-sex spouses. If there is a need to differentiate between same and opposite-sex spouses, their marriages or children, OPM will do so explicitly.
  • Legal same-sex marriages will be treated in the same manner as opposite-sex marriages, regardless of an employee’s or annuitant’s state of residency. (For additional information on coverage of same-sex spouses, see OPM’s recent Benefits Administration Letter.)
  • There will be three new dental plans and one new vision plan available through the Federal Employees Dental and Vision Insurance Program.
  • The maximum annual election for a Health Care Flexible Spending Account and a Limited Expense Health Care Flexible Spending Account (for those enrolled in a high deductible health plan) will be $2,500 for the 2014 benefit period. The dependent care FSA limit remains at $5,000.
  • OPM has developed a chart to assist employees when reviewing their insurance needs during open season.

FEHBP’s Future

The way I see it, the only reason for concern about Congress removing itself from FEHBP is that many federal employees have felt at least some sense of security in knowing that Congress was covered under the same health insurance as they were. That, some employees assumed, made it less likely that lawmakers would make changes that would negatively impact FEHBP.

On that front, there is some good news. Members of Congress still seem interested in making sure FEHBP is efficient and effective. For example, a House Oversight and Government Reform subcommittee held a hearing back in April on the following question: “The Federal Employees Health Benefits Program: Is it a Good Value for Federal Employees?”

At the hearing, subcommittee chairman Blake Farenthold, R-Texas, noted that FEHBP premiums have risen 5.78 percent in past five years. “While this is a pretty small increase compared to what we are seeing in some private sector rates, where rates have risen much more,” he said, “it is our duty to see how we can continue to save taxpayers’ hard-earned dollars and provide the best coverage for our federal workforce.”

Del. Eleanor Holmes Norton, D-D.C., said evidence showed that FEHBP has generally performed as well or better than private employers’ insurance, particularly at holding down rate increases.

If you’re interested in delving into these issues in more detail, you can read the full text of the hearing, or watch a video of it.