The number of federal employees who are eligible for the Federal Employees Health Benefits Program, but not enrolled, is somewhere between 100,000 and 200,000 people, FEHBP experts agree. “I’m sure it’s a considerable number of people,” says David Ermer, a managing partner at Washington-based Ermer Law Group who represents the Association of Federal Health Organizations, a trade association of FEHBP plans. So what are uninsured feds’ options now that everyone is required to have health insurance under the 2010 Affordable Care Act?
The answer is: It depends.
Federal employees who have opted out of FEHBP coverage do so for different reasons. For some, FEHBP might be too expensive so they choose not to be insured at all, while other feds are on their spouse’s health care plan. Then there are part-time employees and seasonal workers, most of whom are not currently eligible to enroll in FEHBP. Federal workers who don’t participate in FEHBP because of cost concerns eventually will have to choose between enrolling in the federal plan and in the insurance exchange network created by Obamacare. If they don’t want FEHBP, then “they are going to have to look at signing up for the exchanges for 2014, or face the penalty,” says Ermer. The Obama administration has delayed compliance with the law’s individual mandate until March 31, 2014, so uninsured, FEHBP-eligible feds still have some time to peruse their options, though, according to Ermer, there’s really no contest. “Feds are sharp people and they know how to do math,” says Ermer. “I just don’t see how the exchange coverage is going to be a better deal than FEHB.”
If they choose to enroll in FEHBP, uninsured federal employees have to do so during open season, which ends this year on Dec. 9. If they miss that cutoff, they would be forced onto the exchanges in 2014, or pay a penalty. It’s not clear yet whether the administration will delay compliance with the individual mandate past March 31.
Federal workers who participate in their spouse’s health care plan don’t have to do anything, unless they are forced off that plan for some reason, either because of cost or a change in their marital status. Still, it’s probably worth taking a look at what FEHBP has to offer. The program will have 256 health plans in 2014.
Some federal part-time employees, including firefighters and those who provide emergency response services, became eligible to enroll in FEHBP last year, but the vast majority of seasonal workers are not. That could change under Obamacare. The administration has delayed the employer health care mandate until 2015, which means the government will make FEHBP available to many more part-time employees at some point. The Affordable Care Act requires employers with more than 50 employees to extend coverage to all employees who work 30 hours per week for an extended period of time. Ermer says he expected the Office of Personnel Management to be “leading the charge to open up FEHB for those folks in 2014, but that hasn’t happened yet.” It could in 2015, he says. In addition, the Affordable Care Act requires large employers, including the federal government, to auto-enroll new employees into their health plans by 2015. “I don’t know exactly how that will work in terms of FEHB,” Ermer says. The administration “will have to come up with that mechanism too.”
The Postal Service, which awarded a contract to UnitedHealthcare this past spring, will roll out its new health insurance plan for non-career employees on Jan. 1, 2014, to comply with the law. The agency plan could offer health benefits to 35,000 non-career postal employees who are currently left out of FEHBP.
It’s too hard to predict how extra FEHBP enrollees due to Obamacare might affect premium rates, Ermer says. But, he adds, “I can’t imagine it’s a bad thing to add new enrollees.”