Make informed choices during open enrollment


The open season for health benefits, dental and vision insurance, and flexible spending accounts will run from Nov. 8 through Dec. 13. Not only will it give employees and retirees who are already enrolled the opportunity to change their health care coverage, but it will also give eligible employees who aren’t enrolled the opportunity to elect coverage.

In this column, I’ll focus on the Federal Employees Health Benefits Program.

Premiums will rise an average of 7.2 percent for employees’ share. That isn’t good news, but at least it’s better than the expected 8.9 percent to 10.5 percent for large-employer health programs in the private sector. Still, that’s small consolation for retirees, who didn’t receive a cost-of-living increase this year and won’t be getting one next year, either.

To put the increases in dollar terms, enrollees with self-only coverage on average will pay $5.53 more each biweekly pay period, while those with family coverage will pay $11.45 more. Since retirees pay on a monthly basis, they can double those numbers to estimate what their increase will be.

Among the changes that can help offset the pain of increased premiums are these. As a result of the recently passed Affordable Care Act, preventive care and screening will be available in all plans with no out-of-pocket costs. Further, enrollees will be able to add their adult children younger than 26 to their family health plan coverage. Also, all FEHBP plans will now be in compliance with the Public Health Services’ clinical substance guide on tobacco cessation. That means that if you need help to stop smoking, you won’t be charged any co-payments for the following: seven Food and Drug Administration-approved medications, four counseling session per quit attempt, and two quit attempts per year.

Of interest to seniors is the news that two plans, Government Employees Health Association (GEHA) and Mail Handlers, will be offering a pilot program designed to coordinate their benefits with Medicare. Those plans will contribute toward the cost of the Medicare Part B premiums of their Medicare-eligible enrollees who participate in the pilot. In exchange, the participants agree to accept the same co-payments or co-insurance for FEHBP benefits as non-Medicare enrollees. Medicare currently offsets some of those costs. The expectation is that overall costs for those who participate will go down.

Because the premiums charged by individual plans will vary widely in 2011, it’s important for you to carefully assess your current plan’s costs and benefits and then compare them with other plans that offer similar benefits and health care quality. You can do that with the help of the Office of Personnel Management’s Guide to Federal Benefits, which also includes consumer satisfaction surveys. Copies of the guide and each participating health care plan brochure are available at OPM’s website,

While at OPM’s website, you can also access the federal benefits FastFacts site, compare dental and vision plans, use the flexible spending calculator and, if you are an employee, get agency contact information.


About Author

Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to

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