Monday, December 8 is the final day that federal employees and retirees can make changes to their benefit plans. The annual open season began on November 10 and will not return until next November. During open season, feds can elect to enroll in, change options or plans, reduce, or cancel enrollment in the Federal Employees Health Benefits (FEHB) program, Flexible Spending Account (FSA), and Federal Employees Dental and Vision Insurance Program (FEDVIP).
Representative Danny Davis (D-IL), who chairs the House Subcommittee on the Federal Workforce, the Postal Service and the District of Columbia, says he has received numerous complaints about significant premium and co-pay increases on one of the most popular FEHB plan, Blue Cross and Blue Shield’s Standard Option. In addition to a 13 percent hike in premiums, there are increases in prescription co-pays and a new $7,500 co-pay for surgery performed by an out-of-network physician that has confused many enrollees.
Nancy Kichak, Associate Director for Strategic Human Resources Policy at the Office of Personnel Management (OPM), told the subcommittee last week that the out-of-network surgery co-pay is intended to save enrollees money. Previously, there was no limit on the amount that non-network surgeons’ could charge. She cited one case in which a federal employee who had back surgery and was responsible for paying the doctor $55,000. With the new co-pay, that amount can be no more than $7,500 but that was not clearly explained in the plan brochure.
Davis asked Kichak if OPM would consider extending open season to allow employees and retirees more time to study the changes. Kichak said that she would not recommend an extension as that could jeopardize the start of coverage for participants.
Blue Cross and Blue Shield officials are aware of the controversy and said they were open to considering changes for the next renegotiation of the FEHB plan for 2010.
For links to premiums, plan guides, and plan comparison tools…
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