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OPM Seeks Health Plan Auto-Enrollment for Certain Feds

The proposed rule would prevent a gap in coverage for employees enrolled in plans dropped from FEHBP.

A proposed rule would ensure that certain federal employees don’t experience a gap in health care coverage if they fail to choose a new plan within a specific time frame.

The Office of Personnel Management on Wednesday published a draft regulation that would require agencies to automatically enroll employees and annuitants into the cheapest available nationwide plan within the Federal Employees Health Benefits Program based on self-only cost available if their current plan is dropped from FEHBP or discontinued because of a disaster.

The current policy ends such employees’ FEHBP enrollment if they don’t pick a new plan within a certain time frame, typically within the annual Open Season, which runs from early November to early December, or within 60 days of a disaster. Since carriers who decide to leave FEHBP tend to do so at the end of the contract year, under the current policy if feds don’t choose a new plan during Open Season, then they would have to wait until the next Open Season – a year – to re-enroll.

Retirees whose plans leave FEHBP now are enrolled in the Blue Cross and Blue Shield Service Benefit Plan that is most on par with their cancelled plan. Under the proposed rule, they too would be automatically enrolled in the cheapest available nationwide FEHBP plan.

“Under the proposed regulation, a plan will not be considered the lowest-cost nationwide plan option if it is a High Deductible Health Plan or if it requires a membership fee or an association fee,” the draft rule stated.

More than 25,000 federal employees and retirees have been forced to find new health insurance for 2015, as their carriers dropped plans from FEHBP.

David Ermer, a managing partner at Washington-based Ermer Law Group who represents the Association of Federal Health Organizations, a trade group of FEHBP plans, said he thinks OPM’s proposed change is fair. “It’s a reasonable protection for them to make,” he said.  Ermer said the most important part of the proposal is that it would extend auto-enrollment to all FEHBP participants affected by a plan termination, not just retirees.

The proposed rule would not affect feds who voluntarily enroll or switch their plans during the annual Open Season, or within 60 days of a “qualifying life event.” Qualifying life events include marriage, divorce or a return to civil service from military duty.

The public can weigh in on the proposed change through March 9. 

(Image via  / Shutterstock.com)

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