Take time to review health care options


It’s time once again to make a decision about your health benefits coverage. Open season for the Federal Employees Health Benefits Program is Nov. 14 through Dec. 12.

Those of you who are already enrolled will have the opportunity to change your health care provider, and those of you who are eligible but not yet enrolled will be able to do so.

Having an annual opportunity to change plans to meet your health and financial needs is one of the real pluses of FEHBP. And if you aren’t enrolled, being able to sign up for coverage isn’t an opportunity to be taken lightly. Even if you are covered by someone else’s nonfederal plan, you need to remember that if you aren’t enrolled in FEHBP for the five consecutive years before you retire, you won’t be able to carry that coverage into retirement. Moreover, you won’t be able to enroll as a retiree. As for those of you who are covered by the military Tricare system, that time can be used to meet the five-year requirement, but only if you are enrolled in FEHBP when you retire.

The average premium will increase 3.8 percent for employees outside the U.S. Postal Service and for all annuitants. That’s a lot better than last year, when the average premium went up 7.3 percent.

To put the 2012 increase in dollar terms, if you are an employee with self-only coverage, you’ll pay on average $2.32 more each biweekly pay period. If you have self and family coverage, you’ll pay on average $6.18 more. Retirees, who make 12 monthly premium payments instead of biweekly ones, can estimate their premium increases to be about double those dollar figures.

Among the changes that have helped offset increased premiums, according to the Office of Personnel Management, are these:

• Avoidance of significant benefit changes.

• Added incentives for tobacco cessation.

• Increased emphasis on preventive medicine, which means that preventive care and screening will continue to be available in all plans with no out-of-pocket cost to you.

Detailed information on all plans is available on OPM’s website.

When comparing plan benefits and costs, look for any incentives being offered to help you either assess your health risk or better manage an illness or a chronic condition. Some plans are even offering gift cards or debit cards to help you do that.

Although I’ve emphasized what you can do during the annual open season, some changes can be made outside of open season. For example, newly eligible employees may enroll within 60 days of their becoming eligible for the program, and plan members who move outside of the area covered by their plans may enroll in different plans covering their new locations. Also, OPM may announce special open seasons affecting members of specific plans only. As a rule, that only happens when a plan unexpectedly leaves the program between open seasons.

During open season three weeks away, plan to spend time studying your options. Even if you end up staying where you are, you’ll still be better informed about what your costs and benefits will be in 2012.


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1 Comment

  1. This would be a good time to remind employees that due to health care law changes they are alowed to have their children up to age 26 covered on their policy.

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