Join us for Federal News Network’s 2024 Open Season Exchange on Nov. 12. During this exclusive event, Federal News Network reporters and editors will sit down with agency and industry experts to share details about what to consider when making your 2025 FEHB selections during Open Season.

Our 2023 Open Season Exchange event featured speakers from the Office of Personnel Management, Defense Health Agency and Consumers’ Checkbook.

Register today to save the date on your calendar and receive updates!

The post Federal News Network’s Open Season Exchange 2024 first appeared on Federal News Network.

Ahead of a new year of health care, federal employees and annuitants have less than a week left to take advantage of Open Season — and possibly make changes to their enrollments.

Enrollees have until 11:59 p.m. on Dec. 11 to make their final selections. If they don’t act, their current plan in the Federal Employees Health Benefits (FEHB) program will automatically roll over into 2024.

Not every enrollee should necessarily make a change to their health, vision and dental plan options. At the very least, it’s wise to learn how your plan will change in 2024, said Kevin Moss, editor of the Consumers’ Checkbook’s Guide to Health Plans for Federal Employees.

“You can’t assume that the plan you had this year will be the exact same plan next year,” Moss told Federal News Network. “You might find new pre-authorization requirements, cost share changes, new benefits or benefits that are no longer available. Also, the in-network status of providers can change any year, as can the coverage status of prescription drugs.”

Information about the coming changes to any plan can be found in section two of a carrier’s official plan brochure as well as on the plan’s website.

The Office of Personnel Management, which runs FEHB and the Federal Employee Dental and Vision Insurance Program (FEDVIP), also offers plenty of tools and information on its website to help enrollees understand their options.

“We really are encouraging our folks to be proactive,” OPM Director Kiran Ahuja said during Federal News Network’s Open Season Exchange. “There’s just lots of information that we want folks to take advantage of so we can increase the participation of going through the review. If your plan is great, that’s good. But we want to see more activity on our website to make sure that folks are taking advantage of those materials.”

“All federal employees should have an FSA”

With another sizeable premium increase of 7.7% on average starting in January, taking advantage of Open Season may be especially important this year.

One option that many federal health experts have recommended to FEHB participants is starting a flexible spending account (FSA). These accounts let enrollees set aside pre-tax dollars to go toward covering eligible health care, prescription, dental, vision and child and adult day care expenses.

FSAs are an option for all federal employees, but only 20% actually use them.

“Most federal employees will be paying more for healthcare next year and should be looking for ways to save,” Moss said. “The FSA is one of those ways. All federal employees should have a flexible spending account.”

It’s important to note that participation in an FSA doesn’t continue automatically. Those who had an FSA for 2023 will need to opt into FSAFEDS again.

And there are certain limitations on these accounts that may require a bit of budgeting. Feds can roll over $640 of unused funds into the next plan year. For 2024, there is a maximum contribution limit of $3,200.

Enrollees can sign up for an FSA on the FSAFEDS website.

The argument for a high deductible health plan

Aside from starting or continuing an FSA, feds can also consider enrolling in a high deductible health plan (HDHP) to hedge against rising premium rates.

“This tax preferred plan type generally has the lowest estimated yearly costs in the Guide to Health Plans,” Moss said. “It also lets you save for current and future health care expenses.”

HDHPs give feds access to a health savings account (HSA), which lets enrollees set aside funds that can be used to cover qualified medical expenses not covered by a health plan.

An HDHP “gives you greater flexibility and discretion over how you use your health care dollars,” OPM said on its website.

This type of plan isn’t right for everyone, though. OPM said in general, HDHPs are beneficial for those with low medical expenses. But each HDHP is somewhat unique. OPM recommends reviewing individual plan brochures before making a final decision.

Be aware of Medicare Part D changes

There are also significant changes coming to FEHB next year that will impact federal annuitants with Medicare.

In 2024, those who are enrolled in any of the 17 FEHB plans that offer Prescription Drug Plans (PDPs) and who are enrolled in Medicare Part A or Medicare Parts A and B will be auto-enrolled into the PDP option. Enrollees will have the choice to un-enroll, if desired.

But in most cases, a PDP will be the best option for annuitants on Medicare, Moss said, since the carriers must provide as good or better coverage than what an annuitant’s current plan offers.

Moss reviewed the specifics of these changes — and some instances where it may not make sense — in a recent interview on Fed Life.

Just a few days left in Open Season

There are a number of changes to coverage for the 2024 plan year, including expanded coverage for infertility treatments, maternal health care, dependent care and more.

“Our team works very hard to find the right balance between providing the comprehensive coverage that our federal employees and their families have learned to expect and appreciate, coupled with the affordability of those plans,” OPM’s Ahuja said. “That is something we constantly strive for in the balance that we see.”

Additionally, the number of plans and options out there may overwhelm some enrollees, but there are a few ways to narrow it down.

For one, enrollees can use OPM’s plan comparison tool to weigh up to four different plan options at once.

Additionally, on the very last page of FEHB plan brochures, participants will find premium tables detailing the per-paycheck costs for self, self-plus-one and family health plans.

These tables also break down the share of costs between the enrollees’ share and the government’s share of the premiums. That can help feds consider the costs and benefits of different options.

Regardless, anyone looking to take part in Open Season has to act soon. The open enrollment period ends Dec. 11.

The post What feds should know before Open Season ends this year first appeared on Federal News Network.

If you want a reliable source of accurate information, turn to an encyclopedia. For information on the upcoming year’s Federal Employee Health Benefits Plan options, we found a human encyclopedia: Kevin Moss, editor of the Consumers’ Checkbook Guide to Health Plans for Federal Employees 2024.

During Federal News Network’s 2024 Open Season Exchange, Moss detailed what working and retired federal employees can expect as this year’s open season gets underway.

First off, Moss said, don’t pay attention to threats of a lapse in appropriations or the concerns about possible government shutdowns. Open season and health insurance itself will continue irrespective of what happens on the political front.

The FEHB process “will all happen as it normally does,” he said. “Make sure you go through your agency and follow your agency’s instructions in terms of signing up for your health plan. And worst case scenario, even if there is an interruption, you would just keep your same health plan next year. That’s how FEHB works.”

Moss detailed how premiums will change next year. On average, they’ll rise 7.7%, a solid jump, but at least lower than last year’s average rise of 8.7%.

How come?

“When the Office of Personnel Management was talking about these premium increases, they were referencing higher prescription drug usage and higher outpatient care as reasons why these premiums went up,” Moss said. He said private industry health care insurance will also go up next year by around 7%.

Disappearing FEHB plans in 2024

Federal employees and annuitants will have fewer plans to choose from for next year, Moss said. Last year, the FEHB program had 271 plans. That dropped to 156 this year. The main reason is that Humana, which offered plans via health maintenance organizations in Florida, Texas and across the Midwest, dropped out of the program. Ditto for the Indiana University Health Plan.

Kaiser Permanente still offers HMOs in Atlanta, Denver, Hawaii, several cities in California and the Pacific Northwest, and the Washington, D.C., area. Moss cautioned: “Kaiser is very specific — that both the human providers and the facilities themselves are all Kaiser-branded. It’s very different than many other, even local HMO plans.”

Some providers offered new plans for 2024, Moss said. Compass Rose added a standard plan, for example. Sentara Health expanded out of the Newport News, Virginia, area to the Northern Virginia area, where tens of thousands of federal employees live.

Although only a small percentage of feds switch plans year to year, Moss said it’s wise to look at your options.

“Even if you’re not motivated to switch your health plan, you still have homework to do every open season,” he said. If nothing else, you’ll want to be sure your current plan is still available and also discover whether any new options have come into your area.

Moss pointed out that prices of specific plans vary, and not all are on the rise.

“In fact, for some plans, the premiums actually went down,” Moss said. “There’s a plan in Texas where the premium went down 50%. It’s Baylor Scott & White. That’s going to save a self-only enrollee about $1,300 next year.”

Some plans shot up as much as 20%, while others will price about level with this year, Moss said. He advised feds to make price only one of their considerations when choosing plans and to also consider specific coverage needs. For more pricing detail, he noted, simply consult the last page of each FEHB plan brochure.

“That’s the premium table,” Moss said. “It shows you what you’ll pay.” The table details prices for self-enrollees, self-plus-one and families. It states prices on a per-pay-period basis.

People with a spouse or partner, but without dependent children, often ask whether they should choose self or self-plus-one.

“If you have two federal employees that are married, you are entitled to have your own plan as a self-only enrollment,” Moss said. “And oftentimes, that’s a way to save some money.”

Anticipating differing medical needs constitutes one reason for self-only by rather than self-plus-one.

Moss added, “But keep in mind that if you if you do make that [self-only] decision, there’ll be an individual deductible each person then will have to face versus both people together in a plan.”

FEHB deductible considerations

A household member thinking he or she might need minimal health care should consider a plan with a high-deductible limit but a relatively lower premium, Moss said. Some high-deductible plans put a portion of a member’s premium into a health savings account (HCA), which has the effect of lowering the plan holder’s out-of-pocket expenses.

The additions typically range from $900 to $1,200, divided over 12 months, Moss said, so you’ll have more at the end of the year than at the beginning.

“And if you’re able to put in a little additional money on your own, this is a really important way for federal employees to save money for health care expenses now and in the future,” he said.

He pointed out that when you turn 65, “you can use those funds in an HSA for nonqualified health care expenses.”

Moss added: “You have to pay normal taxes if you do decide to do that. But basically, it turns into an IRA at that point. You can use it any way that you want.” That includes dental, vision and hearing loss care. Moss said that retirees can use the resulting funds to offset the costs of Medicare Part B premiums.

Plus, HSAs are generally managed by financial services companies, giving the HSA owner choices of investments. “It grows tax free. So any investment returns you receive, you keep tax free,” Moss said. Only on withdrawals after age 65 would you have to pay taxes.

Feds can save a solid amount of money in this manner. “We know many federal employees that have $25,000, $30,000 or $40,000 in their health savings account because they’ve been doing it for a long time,” Moss said.

Attention annuitants

Moss discussed a few items of particular interest to federal retirees. Among the top considerations: Medicare Part D, which covers prescription drug costs. Until now, annuitants didn’t have to think about Part D, Moss said, because drug coverage under most FEHB plans “were as good or better than what you could get from a Medicare Part D plan.”

But a provision in the 2022 Inflation Reduction Act reformed Medicare Part D. For example, it instituted a cap of $35 per month out-of-pocket limit for insulin this year. Starting in 2024, the law ends cost sharing by individuals for catastrophic drug coverage for Part D enrollees with prescription drug expenses of more than $8,000. Then, Moss said, in 2025 comes an out-of-pocket limit of $2,000 for drugs under any Part D plan.

“If you have moderate to high prescription drug costs, this $2,000 cap is going to be really, really important for you,” Moss said. OPM, he added, anticipated these changes “and challenged the plans to offer more Part D coverage to federal annuitants. And the plans have responded.”

Moss said that next year, 17 prescription drug plans will become available under FEHB plans.

“In order for them to be approved by OPM,” Moss said, “they had to offer as good or better prescription drug coverage. We’ve looked at it, and it’s true. It’s as good or better.” He said some plans — including plans from Aetna, Blue Cross Blue Shield and MHBP Federal — went ahead and offered the $2,000 out-of-pocket drug cost limit a year early.

High-income annuitants, as defined by the Centers for Medicare and Medicaid Services, can opt out of Part D, Moss said. That means individuals with $103,000 in adjusted gross income and $206,000 for couples. They would have to pay something called the income-related monthly adjustment, or IRMA. But the adjustment is only $13 a month, he said.

“What’s probably true is that the value of those increased prescription drug benefits are going to be worth more than that Part D IRMA,” Moss said.

He added that annuitants in Medicare Part A or parts A and B who have one these plans, will receive automatic enrollment in the Part D coverage. This includes three Blue Cross Blue Shield plans that cover two-thirds of federal employees and annuitants.

Worth the homework

Above all, Moss urged, take the time to examine the options rather than simply roll over to the same plan.

“Even if you don’t think you want to switch your health plan, don’t assume that your health plan is exactly the same,” Moss said. “We already know the premiums are probably different. Some benefits probably have changed too.” He said the best place check is simply section two of your plan brochure. Brochures are available both at OPM’s website and at that of Consumers’ Checkbook.

As an example of how a plan can change, United Choice Plus Advanced will double its catastrophic limit to $6,000 for self-only members and to $12,000 for self-plus-one, Moss said. “That’s a really big change,” he said. “You have a lot more risk in that plan in 2024 than in 2023.”

Blue Cross Blue Shield plans will add marital and family counseling as part of their mental health services, Moss said.

Also in 2024, plans will expand certain drugs for in-vitro fertilization, although those undergoing fertility treatments will continue to have significant out-of-pocket expenses. A few plans will go further. Moss cited Blue Cross Standard, which will cover up to $25,000 for assisted reproductive technologies including IVF and artificial insemination. Moss called that a huge improvement.

Fertility coverage “is new territory because this is a big expansion of benefits that previously weren’t available,” he said.

Above all, take the time to check out the options. “Far too few will change their health plan in any given year,” Moss said. On average, about 5% do.

“Unless you have an adverse experience, most federal employees will just keep the plan they have,” he said. “The danger in doing that, especially on the annuitants’ side, is there’s a lot of innovation that’s happening, ways for you to save money. If you’re not looking at it, you’re missing out on better benefits. It’s quite possible that you’re overpaying versus some less expensive options that could provide just as good or, in some cases, maybe even better coverage for a lower price.”

Whatever you choose, you won’t find a so-called junk plans in the FEHB program, Moss said.

“OPM has structured this system for you never to have a situation where you would find yourself having something not being covered and have an insurmountable amount of medical debt. That’s really not going to happen in the FEHB program.”

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: Kevin Moss of Consumers’ Checkbook on what you need to know about FEHB plans in 2024 first appeared on Federal News Network.

Caring for your teeth can affect your general well-being.

“There is a pretty important connection actually to your dental health, your gum health, and then to your overall health,” said Haley Landherr, director of business operations and chief of staff at UnitedHealthcare Dental.

Landherr added, dental hygiene “is how your body helps to protect itself against illness. It plays a significant role in your overall well-being.”

Studies have linked gum disease to cardiovascular disease, osteoporosis and diabetes, she said during Federal News Network’s 2024 Open Season Exchange.

“And there’s research that shows that people with gum disease have a harder time controlling their blood sugar levels,” she said, “and that regular periodontal care can help to improve diabetes care management.”

As you change so do your dental needs

UnitedHealthcare’s Federal Employees Dental and Vision Insurance Program plan includes benefits aimed at a total health approach to dental care.

“If you’re managing one or more of these conditions like diabetes, rheumatoid arthritis, COPD, asthma or if you happen to be pregnant, you’re eligible for enhanced coverage that will help you get additional cleanings or different periodontal maintenance,” Landherr said.

She experienced this need personally before giving birth to twins earlier this year. Her dentist emphasized the importance of extra tooth cleanings and flossing, preferably with a water jet device.

“What is so nice about this enhanced coverage is that it gives you some peace of mind,” Landherr said. “Members can focus on other parts of their pregnancy journey and not have to worry about unexpected out-of-pocket costs when it comes to dental care.”

Given that infants soon reach the stage of needing dental care too, Landherr pointed out that people’s dental care requirements change during different stages of life.

“Your oral health is really important through all the stages of your life,” she said and cited the American Dental Association recommendation that dental care start during infancy.

“Make sure you’re cleaning your baby’s gums with a wet washcloth or maybe a child-sized toothbrush,” Landherr said. When teeth appear, use a soft bristle brush with a tiny smear of toothpaste.

“As you get older, it’s important to keep your hygiene up and maintaining your oral health hygiene throughout your life,” she said. ADA recommendations for adults include brushing not only your teeth but also your tongue.

Virtual dental triage? Yep, it’s a thing

People who visit a dentist regularly for cavity and tartar checks might be surprised to find that virtual visits have become part of dental care. Landherr said that UnitedHealthcare Dental plans cover virtual visits.

Acknowledging that a virtual dental visit might be hard to visualize, she described it as the start of a triage situation.

“Dealing with an unexpected dental problem where you have some pain in your mouth, you might try and get in to see a dentist,” she said. “It’s hard to see the dentist; they don’t have availability. Your dental problems probably don’t happen at the most convenient times.”

If the patient can have a video visit and get advice ahead of an in-person visit, it might mitigate the condition and avoid an emergency room visit until the person can be seen by the dentist in the office, Landherr said.

Another benefit of the UnitedHealthcare plan stems from its online presence, she said. The website has enhancements for providers so they can prepare more timely and individualized treatment plans for patients and share information about treatment costs.

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: UnitedHealthcare Dental’s Haley Landherr on picking a dental plan that adapts with you first appeared on Federal News Network.

Stigma around mental health and seeking treatment has faded, but it hasn’t disappeared. Yet the need for mental health services for people of all ages has grown since the onset of the COVID-19 pandemic, especially among young people.

“All of that really leads to needing support, how to navigate the health care system and access behavioral health support,” said Dr. Rhonda Randall, executive vice president and chief medical officer at UnitedHealthcare.

She called the need a crisis.

“We know that the pandemic exacerbated what we were seeing prior to that,” she said during Federal News Network’s 2024 Open Season Exchange. “The reports are consistent and clear — especially for women, for adolescents, for seniors, for multiracial adults and for people with disabilities — that there are high rates of poor mental health.”

Knowing when to seek mental health support

Randall said a range of life events can be the catalysts for declines in mental health and that knowledge of them can help people realize if they could benefit from treatment.

“It can include things as common as grief,” she said, “or going through a change in life where you need some support to something more serious — substance abuse and substance use disorders, for example.” But understanding how to navigate one’s way to support is crucial, Randall said.

Federal employees and retirees who enroll in  Federal Employees Health Benefits plans offered by UnitedHealthcare receive specific ways to navigate to mental health care providers appropriate for their individual needs.

“You call that customer service number on the back of your card,” Randall said, “and we’re going to help you get to the right door to get the support that you need. Just as you would if you had a physical illness.”

Randall said a person’s primary care physician is another place to start. “Because when you have that long standing relationship, they’re going to help you navigate this, and often they can get you in quickly.”

For adolescents having trouble academically or with relationships, a pediatrician can service as the gateway to mental health services.

“Pediatricians are now routinely screening youth with just a couple of simple questions around how they’re feeling emotionally,” Randall said.

For crisis situations, she recommended calling 988 or another hotline, or “look into virtual care options, which can often get you in immediately — within minutes — and assist you very quickly.”

Expanded mental health services through telehealth

Randall pointed out that the number of licensed mental health providers per capita varies widely from region to region. In New England, for example, numerous universities turn out mental health graduates in large numbers. The choices are fewer in some Southeastern states, she said.

“One of the things that’s really helped us equal that out is tele-behavioral health and telemedicine because that can be practiced across state lines,” Randall said. “Telehealth is also a really good way to get your care in the privacy of your home. We found that members, patients and healthcare professionals really like this modality of care.”

She also noted the importance of general well-being, one component of which is staying out in front of your mental health and avoiding crises.

“Our goal in all this is to avoid being in a crisis,” Randall said.

People can temper mental health issues by taking care of their total health. “Physical activity, the way we eat and how we take care of our broader physical health very much has a big impact on prioritizing our mental health,” she said. Attending to chronic conditions such as diabetes can support one’s mental health too.

Randall said UnitedHealthcare has made growth in its network of mental health providers a priority. It’s Optum Behavioral Health unit now encompasses about 375,000 providers, of which about 150,000 are available virtually. She said an equally important priority has been enhancing access to the appropriate provider for each plan member.

Plus, UnitedHealthcare has what Randall called an expanding breadth of solutions. These include digital self-help tools and coaching services for people with mild levels of anxiety. Plus, UnitedHealthcare’s Family Engagement Center can help with situations involving children and young adults, which can affect the entire family.

Mental health care can be tough to navigate. But “our care advocates can help guide you to the right care at the right time across that broad range of our network,” Randall said. “You’ll get a personal experience to help eliminate that complexity.”

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: UnitedHealthcare’s Dr. Rhonda Randall on getting mental health care when you need it first appeared on Federal News Network.

While federal employees and annuitants are thinking about their health care options during Open Season, on the other side of the table, the Office of Personnel Management busily fields questions about the Federal Employees Health Benefits Program.

With more than 150 options in the program, one of the most frequent questions from FEHB participants is which specific plans are available to them, said Amber Rhodes, a supervisory analyst at OPM.

“There are about four nationwide plans. Everyone has about 17 plans that they are eligible for,” Rhodes said during Federal News Network’s 2024 Open Season Exchange. “Then based on where you live or work, there are the regional plans that one may be eligible for.”

Using OPM’s plan comparison tool

That high number of options may appear overwhelming, but Rhodes said she encourages FEHB participants to use OPM’s plan comparison tool to see exactly what they’re eligible for.

“Our plan comparison tool allows you to compare up to four plans at a time and you can look across the ones that you choose,” she said. “It’ll show you co-pays, rates and brochures. There’s contact information, benefit information, pharmacy information. I think it’s very helpful for everyone.”

Additionally, the tool on OPM’s website lets participants look at plans based on geographic region.

“You put in your ZIP code, and it will show what’s available to you based on where you live or work,” Rhodes said. “If there is any uncertainty, the front of every brochure has the locality which they cover.”

Reviewing FEHB plan brochures

Aside from the comparison tool, FEHB carriers’ plan brochures are a useful place for participants to look if they need more information to make their decisions for health care benefits. The brochures are the official statement of benefits from the different carriers in the program.

“You definitely want to take a look at that brochure,” Rhodes said. “In every brochure, there is a page to tell you what has changed from the previous year to the current year. So that’s a good place to look as well.”

Specifically, Section 2 of each FEHB plan brochure shows what’s new for that plan option for the coming year. For 2024, there are additions to infertility treatment coverage, Medicare coordination, gender affirming care and treatment, mental health and telehealth options, obesity treatment, maternal health care coverage and treatment for substance abuse disorders.

And on the last page of each brochure, participants can find premium tables detailing the rates for self, self plus one, and family plans for each carrier.

As the name implies, Open Season means that everyone in FEHB has the ability to change plans — not just current federal employees.

“Some people think when you retire that you’re stuck with the plan that you were with when you retired,” Rhodes said. “But Open Season is an opportunity for everyone, including annuitants. They may also change. We encourage them to use those same tools to look up what’s best for them.”
And although Open Season is the biggest time of the year for FEHB enrollees to consider their options, OPM’s health and insurance teams spend the entire year planning and developing what will be available the following year. Rhodes said her office will soon be looking ahead to 2025.

“Once Open Season ends this year, we’ll go out and do our debrief and our internal review, and we’ll take that information based on the feedback, based on our own findings,” Rhodes said. “We look at all of our statistics and begin preparing for next year. Right after one Open Season ends, we’re in full swing for next year.”

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: OPM’s Amber Rhodes on tools to help make the right plan choice first appeared on Federal News Network.

Just like going to the doctor for a physical exam each year, federal employees and annuitants in the Federal Employees Health Benefits Program would be wise to schedule an annual checkup on their health insurance options too.

There are many different reasons feds might want to consider a change to their plan options for 2024. Maybe they’re looking to expand their families or their overall health has changed. Or maybe they’re simply looking for a way to save a bit of money.

Whatever the reason — and whether or not someone makes a change in the end — everyone should take a look during Open Season at what will be changing next year, advised Kiran Ahuja, director of the Office of Personnel Management.

“Listen, I was one of these federal employees [who said], ‘I’m pretty good. I’m just going to let my plan roll over,’ ” Ahuja said during Federal News Network’s 2024 Open Season Exchange. “But we really are encouraging our folks to be proactive. There’s just lots of information that we want folks to take advantage of so we can increase the participation of going through the review. If your plan is great, that’s good. But we want to see more activity on our website to make sure that folks are taking advantage of those materials.”

The changes in health care needs aren’t just on the side of the individual enrollee though. OPM also announced major changes to the offerings available in FEHB and several new requirements of FEHB carriers this year. It’s all the more reason to read the information available on OPM’s website and in FEHB plan brochures, Ahuja said.

“Plans change. There are adjustments every year. There are certain things that we’re asking plans to cover. It’s just worth going back and saying, ‘Does this plan work for me?’ ” she said. “Maybe there is a significant life event or an addition to the family or other circumstances. Even if not, I just really want to encourage our federal employees to go through the exercise of taking a look at their current plan and actually see what’s now available because there are shifts every year.”

She encouraged employees and federal retirees to evaluate FEHB’s 2024 plans and coverage options using OPM’s plan comparison tool. Enrollees have until Dec. 11 to make health, dental and vision plan selections for the coming year.

FEHB changes coming in 2024

Some of those shifts for 2024 are quite significant and cover changes to fertility benefits, Medicare coordination, pharmacy benefit design, gender affirming care and services, maternal health, prevention and treatment of obesity, mental health and substance use disorders, telehealth, and antibiotic stewardship, OPM said in its Open Season guidance for 2024.

7.7%

Average premium increase for FEHB enrollees in 2024

SOURCE: Office of Personnel Management

Specifically, when it comes to infertility treatments, OPM for 2024 requires all FEHB carriers to cover at least two forms of artificial insemination and the drugs associated with those procedures, as well as at least three cycles of drugs related to in-vitro fertilization (IVF) annually.

In the area of maternal health, OPM said it’s looking to address inequities and calling on carriers to make improvements, for example, by providing information and raising awareness of potentially life-threatening warning signs during and after pregnancy. Many carriers will also offer coverage for support services, such as doulas.

Additionally, about 400,000 service members will get access to dependent care flexible spending accounts in 2024. A DCFSA lets an enrollee make pre-tax contributions for certain dependent care services, such as preschool, summer day camp, before- or after-school programs and child or adult daycare.

Many FEHB carriers will also begin offering expanded coverage for anti-obesity medications, low- or no-cost telehealth options for mental health and substance use disorder services, and expanded gender-affirming care for transgender and gender-diverse individuals.

Recent OPM survey data on federal benefits showed that many early-career individuals are attracted to government work because of these expanding options.

“We know that federal employees under the age of 40 do very much appreciate the benefits and also the leave that we provide as part of the federal government,” Ahuja said. “These types of benefits make a difference for federal employees and make a difference around the retention that we want in the federal government.”

Hedging against rising FEHB premium rates

Along with increasing coverage in several health care areas, federal employees and annuitants will see insurance premium rates rising alongside that.

For 2024, FEHB enrollees will pay an average of 7.7% more toward their health care premiums.

Next year’s premium increase comes after an 8.7% jump for 2023. Given a few consecutive years of rising premium rates, some enrollees might be getting anxious.

“Our team works very hard to find the right balance between providing the comprehensive coverage that our federal employees and their families have learned to expect and appreciate, coupled with the affordability of those plans,” Ahuja said. “That is something we constantly strive for in the balance that we see. Our barometer is, where is the industry trend? This time around, in 2024, we do fall slightly below that trend with similarly situated or sized employers.”

By comparison, CalPERS, which purchases health insurance for California state government employees, announced even higher premium rate increases for 2024, at an average of 10.77%. CalPERS is the nation’s second-largest public insurance purchaser, only after the federal government.

Additionally, it’s important to remember that not every FEHB carrier has increased its premium rates for the coming year. It’s all the more reason that OPM is encouraging enrollees to take a look at their options during Open Season and evaluate the balance between premium rates and the coverage they will need.

Aside from switching plans, there are ways that FEHB enrollees can find cost savings too. Setting up a flexible spending account through OPM’s FSAFEDS program can help offset some of those growing costs. An FSA lets an enrollee set aside pre-tax dollars to go toward certain out-of-pocket health care expenses.

Despite the opportunities available through FSAFEDS, just 20% of federal employees are currently enrolled in the program.

“I keep on getting shocked by the numbers,” Ahuja said. “You can take advantage of the FSAFEDS for some of those out-of-pocket expenses.”

Participants can also carry over up to $500 into another health care FSA in the subsequent year.

Dental and vision changes

Similar to FEHB, Ahuja said she recommends taking a look at dental and vision options, too. Compared with a 7.7% average increase in FEHB premiums for 2024, the vision and dental premiums are rising much less. Premiums will grow for dental plans by 1.4% on average, while vision plans will go up by 1.1%.

“We know that the premium increases for the dental and vision plans tend to be a lot more modest than the health plans,” Ahuja said. “So that’s something for folks to think about as they determine whether it’s a good deal for their family to take advantage of those particular plans.”

FEHB enrollees can compare 2024 plans by using OPM’s plan comparison tool.

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: OPM’s Kiran Ahuja on new FEHB coverage available next year first appeared on Federal News Network.

Many federal employees and retirees right now might be caught up figuring out what health, vision and dental plans are right for them for 2024.

While they’re at it, it’s common for many feds to start thinking about their broader insurance needs too, said Shane Canfield, CEO of WAEPA.

That’s exactly this reason that Open Season is the busiest time of year for the long-time federal life insurance provider.

“You’re opening the door to health insurance where you’re thinking about deductibles and co-pays and networks — that’s a huge financial decision,” Canfield said during Federal News Network’s 2024 Open Season Exchange. “But why not look at your entire financial plan? Life insurance is always a part of that.”

Unlike gradually rising premiums in other types of insurance, WAEPA’s rates have not gone up in 80 years. There are many variations of life insurance, but WAEPA is somewhat unique in its offerings since it’s available solely to current and former federal civilian employees. That helps keep the rates down, while also making the insurance plans more stable and predictable, Canfield said.

“That in turn allows us to do something we’ve done for 27 of the last 28 years — we return a piece of the premium to individuals in the plan. It’s one of our differentiators,” he said.

What feds should consider for life insurance

Similar to how federal employees and retirees might look at their individual situations to determine what coverage they’ll need in their health insurance plans the coming year, life insurance can be individualized as well.

When determining exactly how much life insurance someone might need, Canfield said one way to think about it is to combine two separate buckets. One bucket is the cost of any debts an individual has — such as from credit cards and mortgages — and the other bucket is the cost of lost income over the rest of an individual’s career.

Still, a person’s needs for life insurance are susceptible to change over time.

Canfield used himself as example: “I’m an empty nester. My insurance needs are very different as my bills are paid down and my mortgage is paid off. I don’t have the same needs for life insurance than I did when I had a couple of kids at home and a big mortgage.”

Recent changes to WAEPA’s offerings

To adapt to changes over time and as a hedge against rising inflation, WAEPA now offers an automatic benefit increase.

“Over a 10-year period of time, if you sign up for it — and there’s no cost to sign up for it — the death benefit will increase in increments of $25,000 every year automatically with no underwriting,” Canfield said.

Although Open Season is WAEPA’s busiest time of year, there is still a lot of business that happens all year long.

“If there’s a need for life insurance, if you do an evaluation in the middle of the spring or the summer and you recognize you need more, you do not need to wait for a waiver,” Canfield said. “You can apply whenever you want to change the amount you have.”

And in 2022, WAEPA overhauled its online application system for most applicants to make it more efficient, he said. Rather than taking two or three weeks for individuals to see if they qualify for coverage, most will now be able to get an answer in 15 minutes.

“COVID ushered in a change — people want things faster, quicker, easier,” Canfield said. “We spent an awful lot of time making sure that we got this right.”

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: WAEPA’s Shane Canfield on taking broader look at insurance landscape first appeared on Federal News Network.

For participants in the Federal Employees Health Benefits (FEHB) program, Open Season kicks off Monday and will run until 11:59 p.m. on Dec. 11.

“We really advise that people do take this time during Open Season and look to see if there are some better plan values out there,” Kevin Moss, federal health benefits expert at Consumers’ Checkbook, said in an interview. “If you’ve been in the same plan for five, 10, 15 years, there probably are new plans you’ve never looked at before.”

If they do take a look at FEHB carriers’ plan brochures over the next month, employees and annuitants may see some significant changes. Federal News Network laid out several of these changes last week.

Some things, though, are staying the same. For one, all national plans that were available to FEHB enrollees last year are still available for the upcoming plan year.

Participants will also be paying 7.7% more on average toward their insurance premiums. That’s largely due to increases in cost and utilization of prescription drugs, emergency care and outpatient care, the Office of Personnel Management said.

One way to help offset the rising costs is by setting up a Flexible Spending Account through FSAFEDS. With an FSA, enrollees can set aside pre-tax dollars to cover certain health care costs during the upcoming plan year. Currently, just 20% of FEHB participants are enrolled in FSAFEDS.

“Setting aside the annual amount they are projected to spend in out-of-pocket health, dependent care, dental and vision expenses in an FSA saves federal employees money,” OPM said.

If they re-enroll for the 2024 plan year, participants can also carry over up to $610 of unused funds in their FSA.

Where to look inside FEHB plan brochures

All FEHB carriers publish comprehensive plan brochures for enrollees to review plan details for the following year.

Specifically in section two of those brochures, enrollees can see exactly what will be changing in the upcoming year. There may be new benefits allowed, for instance, that have never been there before.

“You may find out that there’s some additional pre-authorization requirements for a procedure. Or maybe those are taken away and there’s easier access to a service,” Moss said. “You may also find that a catastrophic out-of-pocket maximum has increased in your plan.”

Additionally, on the very last page of the plan brochure, participants will find premium tables detailing the per-paycheck costs for self, self-plus-one and family health plans.

These tables also break down the share of costs between the enrollees’ share and the government’s share of the premiums.

It’s also important to consider the type of plan. For enrollees looking to get health care coverage for two people, a self-plus-one plan option will be less expensive than the family plan option about 75% of the time. But there are still about 40 family plan options in FEHB that come at a lower cost than the self-plus-one plan options.

“This can add up to some serious money,” Moss said.

OPM’s plan comparison tool lets FEHB participants weigh the costs and benefits of multiple plan options at a time.

The post Open Season has arrived. Here’s what feds should look out for first appeared on Federal News Network.

roseIt’s easy to point to growing health insurance premiums as the driving force behind changing health plan options ahead of 2024.

But it’s certainly not the only factor that federal employees and annuitants should consider during Open Season, said Joni Huber, vice president and chief operating officer of Compass Rose Benefits Group.

“I always encourage people to look at more than the premium,” Huber said during Federal News Network’s 2023 Open Season Exchange. “There may be coverages that you are needing that your current plan does not provide.”

For 2024, not only are Compass Rose’s premiums lower than they were for 2023, but the provider is making significant changes to both its eligibility and offerings. That makes it all the more prudent that FEHB participants take a second look, Huber said.

VA employees now eligible

Compass Rose is a lesser-known carrier in the Federal Employee Health Benefits marketplace, but the health insurance provider has offered care options to federal employees since 1948, and it’s unique in more ways than one.

As a closed health plan provider, Compass Rose is currently available only to those in the departments of Defense, Homeland Security and State, and the Intelligence Community.

But starting in 2024, the carrier’s FEHB plan options will open up to another significant portion of federal employees and annuitants: those in the Department of Veterans Affairs.

“It really just fits in very nicely with our mission overall — to provide those protecting our country and serving our country with the best customer service, the best health plan that we can,” Huber said.

New standard option for younger feds

Aside from expanded eligibility, Compass Rose is adding another plan option to its docket this year as well. A new standard plan option will be available along with the current high and Medicare Advantage plan options.

The new standard option may be particularly appealing to young federal employees who often look for more basic coverage and a lower premium, Huber said.

“We had the high option that was covering families and the Medicare Advantage for retirees,” she said. “But for someone who’s just starting out in the government with their work, we wanted to make sure we had coverage available for them.”

Compass Rose’s new standard plan option offers 100% coverage for preventive care, a $100 vision allowance — and the added perk of massage therapy. The standard option provides coverage for up to four massage therapy sessions per year, while the high option covers up to 12 sessions per year.

In addition to massage therapy, Huber said Compass Rose generally aims to offer coverage to help feds improve and maintain overall wellness — including coverage for acupuncture and chiropractic care — that aren’t necessarily available from every FEHB carrier.

“We’re excited to offer some of the alternative cares to members who may use them,” she said.

And of course, Compass Rose’s standard plan option also covers the basic services that people look for in a health plan, Huber added.

Regardless of what type of coverage it is, the bottom line is that FEHB participants should think about what they’ll need over the next year and consider those needs during Open Season, Huber said.

“People not looking at their health plan and not seeing what other options are out there, they’re really doing a disservice to themselves. Just like their needs may change from year to year, so does the plan.”

To discover more insights and advice shared during the 2024 Open Season Exchange, visit the event page.

The post Open Season Exchange 2023: Compass Rose’s Joni Huber on why you should consider more than a plan’s premium first appeared on Federal News Network.

A second year in a row of a big premium increase for the Federal Employees Health Benefits (FEHB) program is just one reason federal health experts are encouraging employees and annuitants to take advantage of Open Season.

Open Season, which runs this year from Nov. 13 to Dec. 11, is the window of time when FEHB enrollees can make changes to their health care options for the following calendar year. But each year, just about 5% of enrollees end up making changes.

For 2024, the upcoming 7.7% average premium increase is certainly grounds for enrollees, at the very least, to take a look at what other options are out there. Because that 7.7% increase is an average, that of course means not every plan will increase the same amount — and some won’t increase at all.

“Not all plans actually raise their premiums,” Kevin Moss, federal health expert at Consumers’ Checkbook, said in an interview with Federal News Network. “Last year, in fact, for 31 plans, the premiums decreased. For eight plans, the premiums were the same. 68 plans were below the average and then 47 were above the average.”

By letting Open Season fly by, enrollees could be missing out on thousands of dollars in cost savings, the Office of Personnel Management said.

OPM’s plan comparison tool lets FEHB enrollees compare different options and take a look at which ones are available in their geographic region.

Aside from rising premiums costs, here are five other reasons FEHB participants should take a look at their enrollments during this year’s Open Season.

Number of FEHB plan options dropping significantly

Compared with the available options for 2023, FEHB participants will see significantly fewer health plans in 2024.

For next year, participants can select from 158 total plans across 68 carriers, far fewer than the 271 plan options available in 2023.

The decrease is largely due to health carrier Humana exiting FEHB. The carrier offered a broad array of choices, but was not attracting a lot of enrollees, according to OPM.

That change is also not unique to FEHB — Humana is exiting the market entirely. But the health carrier will still be a provider in the Federal Employees Dental and Vision Insurance Program (FEDVIP).

Enrollees who were in a Humana plan, or any other plan leaving the FEHB program, will receive a notification informing them of the change. They’ll have to make a new selection during Open Season.

Anyone who doesn’t make a selection will be automatically enrolled in the lowest cost nationwide plan.

Reforms ahead for Medicare Part D

Changes to Medicare Part D are yet another reason that federal annuitants in particular should take a look during this year’s Open Season.

Medicare Part D reforms included in the 2022 Inflation Reduction Act (IRA), such as caps on insulin costs and out-of-pocket costs, offer a chance for feds to find cost savings in their health enrollments when choosing a plan that includes Part D.

“Federal employees really haven’t had to worry much about Part D in the past because prescription drug coverage in the FEHB plans has been as good as what you could get in a Medicare Part D plan,” Moss said. “It didn’t require you to go out to Medicare Part D and pay an extra premium in order to receive it.”

For 2024, federal annuitants can access Medicare Part D through one of two ways: a Medicare Advantage Plan or a Prescription Drug Plan (PDP).

The PDP is a new type of plan available this year in FEHB. In 2024, 17 FEHB plans will offer a PDP. The majority of PDPs will auto-enroll participants if they are in a plan that offers it and if they have Medicare Part A, or Medicare Parts A and B.

Medicare Advantage Plans have been around in FEHB for the last several years, but there are more options available next year. 28 FEHB plans will offer a Medicare Advantage Prescription Drug Plan (MA-PD) in 2024.

Dependent care options for military members

In one specific subset of insurance coverage, about 400,000 individuals are newly eligible to start a Dependent Care Flexible Spending Account (DCFSA).

Specifically, active-duty service members and members of the Active Guard Reserve will be able to enroll in the program starting in 2024.

DCFSA allows for pre-tax contributions for some dependent care services including preschool, summer day camp, before or after school programs and child or adult daycare.

The program expansion stems from an executive order that President Biden signed in June, which aimed to increase the hiring of military and veteran spouses in agencies by offering, for example, broader federal insurance coverage.

New infertility treatment coverage for 2024

Also beginning in 2024, FEHB enrollees who are looking at family planning options will see some coverage of infertility treatments.

All FEHB carriers will, at a minimum, begin coverage of two forms of artificial insemination and associated drugs, as well as three cycles of drugs related to in-vitro fertilization (IVF).

That coverage is significant. Just one cycle of IVF can cost up to $30,000, and 35% of that cost comes from the necessary prescription drugs.

The changes come, in part, after some lawmakers, including Rep. Gerry Connolly (D-Va.), called for infertility treatment options for federal employees.

“By implementing these improvements, OPM has helped the federal government on its worthy mission to become the employer of choice for millions of talented Americans looking to serve their country and start a family,” Connolly said in a statement.

Still, OPM’s new requirement leaves some gaps in coverage for ART procedures, most notably IVF procedures, as well as the cost of donor sperm, donor eggs and cryopreservation.

Federal health experts recommend that enrollees create and use a flexible spending account (FSA) through OPM’s FSAFEDS program to help offset some of the costs.

Eligibility for FEDVIP is expanding

Finally, federal employees and annuitants will see some big changes to the government’s dental and vision program, too.

Earlier this year, tens of thousands of temporary, part-time, seasonal and U.S. Postal Service employees became able to get dental and vision coverage through the program.

OPM set a 60-day special enrollment window for the newly eligible FEDVIP participants earlier this year, but that window has since ended. Those who missed the special window will be able to enroll during Open Season to get coverage for 2024.

Despite the significant expansion, OPM said it does not anticipate any major changes to costs for FEDVIP. In 2024, premiums will rise for FEDVIP dental plans by 1.4% on average. Vision plans will go up by 1.1% on average.

The post 6 reasons feds should take a look during Open Season this year first appeared on Federal News Network.

The open season deadline is looming, but federal health insurance experts said it’s not too late to make changes — even if you haven’t done anything yet.

“You can do what you need to do in less than an hour. The simplest and most important thing to do is think about the medical situation of you and your family,” said Walton Francis, a health policy analyst and author of the annual Consumers’ Checkbook guide to health plans for federal employees and retirees.

The “Checkbook” guide is one of many tools available to help participants figure out what will match their needs best. Along with that online resource, the Office of Personnel Management’s website offers overall FEHB information, as well as a plan comparison tool, a list of frequently asked questions about the program, along with much more. These resources let FEHB enrollees take a closer look at cost savings and compare coverages for 2023.

OPM has said it’s especially important this year to be active during open season this year, as FEHB participants will pay an average of 8.7% more toward their premiums in 2023. It’s the highest year-to-year increase in over a decade.

“This is a big premium increase that’s going to impact almost all federal employees and retirees. However, it’s not uniform. In fact, they’re actually 56 plans next year where the premiums going down, nine plans where the premium’s staying the same. And then 119 plans where the premium is going up, but below that 8.7% average. And then 78 plans where it’s above that average,” Kevin Moss, director of marketing for the Consumers’ Checkbook, told the Federal Drive with Tom Temin.

Each year, only a small minority of FEHB enrollees make changes during open season. During last year’s open season, for example, 2.5% of enrollees changed their health coverage and just 0.6% switched insurance carriers.

Even if participants want to stay within the same insurance carrier, there are still a few items they can check off on their open season to-do list. Many health insurance carriers, including GEHA, Blue Cross and Blue Shield, UnitedHealthcare and plenty of others in FEHB offer multiple types of plans. Regardless of a participant’s final decision, it’s always worth taking a look.

“Even if you don’t think that you want to switch your health plan this year, your premium has changed. And I think most people don’t want to be surprised in 2023. So you have to check to see how your premium is changing,” Moss said.

And those who don’t want to make changes at all, despite the savings it could offer, should still take a look as well, as their coverages might be changing next year. The FEHB plan brochures on OPM’s website lay out all the notable benefit changes for 2023.

“There’s a page in every brochure, in section two, that details how the plan changes for next year. Turn to it and just run your eye down that list to make sure there’s no bad news on that list of changes,” Francis said. “You could search the brochure of any health plan, including the one you’re in. You can download it from the Checkbook website, the OPM website or the plan’s website. And you can look up diabetes, maternity or whatever else may be important to your family’s health.”

There are some specific situations, too, that may require an extra look at what’s on the table, before open season comes to a close. For instance, two-person families should consider a self-plus-one option from one of the many carriers in FEHB, according to Moss. For 2023, there are 86 plans where the “self and family” option is the least expensive.

Retired FEHB enrollees have specific considerations during open season as well. A shift in FEHB over the last couple of years has yielded more options for Medicare Advantage plans, which cover most or all of the premium costs of Medicare Part B for enrollees. One area that federal retirees should focus on particularly is to see how Medicare Advantage plans will handle the cost of prescription drugs. Regardless, these plans can lead to thousands of dollars in cost savings for retirees.

“Even [if the plan doesn’t cover prescription drug costs], the benefit will be better than what you get in an FEHB plan,” Francis said.

Current federal employees should consider whether a high-deductible plan with a health savings account (HSA) is right for them. HSAs are tax-free investments that roll over, year after year, and can be put toward health costs, even years down the road. Francis said there are some cases of enrollees who have HSAs with tens of thousands of dollars, after contributing to the accounts over a long period of time.

“If you have more flexibility and can save even more, then the health savings account is a great additional choice,” Francis said.

But if an HSA isn’t the right choice for an individual, there’s also the Federal Flexible Spending Account Program, nicknamed FSAFEDS, that offers flexible spending accounts to active federal employees. Those accounts have to be renewed each year, meaning enrollees must opt into FSAFEDS each year to receive the benefit.

“A flexible spending account gives you a tax preference, which saves about a third of what you spend, for example, on co-pays for doctors’ visits in most plans,” Francis said.

Despite the cost savings that it can yield, fewer than a fourth of federal employees take advantage of the program. In 2022, less than 20% of eligible federal employees used FSAFEDS.

The last day of open season, when FEHB enrollees can make changes to their health enrollments for 2023, is Monday, Dec. 12.

The post Tools, resources and more for FEHB enrollees during the final days of Open Season first appeared on Federal News Network.

In this exclusive ebook, we share details on what’s changing and what’s new, along with tips from experts and links to OPM resources.

The post Open Season 2023 FEHB Guide first appeared on Federal News Network.

Federal employees and retirees have from Nov. 8 through Dec. 13 to check in with your current plan, explore others and maybe make a few changes.

This exclusive e-book jumpstarts your research and plants the seeds of your knowledge base that tools from the Office of Personnel Management and from the private sector can help germinate and grow.

The post Expert Edition: Open Season 2022 first appeared on Federal News Network.

Account balances of $30,000 to $40,000 are not unusual. At least one fed has $100,000 in their health savings account, which is offered by a growing number of FEHBP plans. The open season when people can pick their 2021 health plan ends Dec. 14. So there is still time to figure if this is the time to consider an HSA, a flexible spending account or a high deductible or consumer driven health plan.

Health savings accounts and health reimbursement accounts (HRAs) provide “significant tax advantages,” according to Walton Francis, editor of Consumer’s Checkbook Guide to Health Plans for Federal Employees. And they can permit policyholders who build up large financial accounts.

HSAs have the most advantages, he says, because “you can add to your HSA account by advance planning, just as if it were a flexible spending account. Second, while you can only establish an FSA account in advance you can add to your HSA account any time during the year — if you have unanticipated late year expenses of an extra $1,000. In most HDHPs you can have $1,000 transferred from your account to your pay, to your HSA, lowering your taxable income by $1,000, pay the bill through the HSA, and obtain what amounts to a one-third discount on your unplanned  expenses.”

Or, Francis says, you could transfer the extra $1,000 even if you don’t have any unexpected expenses, saving one third in taxes, and build up your account for future years.

He said that since you have the HSA account for life, “regardless of Open Season plan changes or retirement — and it can accumulate tax-free earnings — it can become a very substantial lifelong protection against health care expense.”

Nearly Useless Factoid

By Amelia Brust

From 1934 to 1986, paddlers and anglers in Minnesota’s remote Boundary Waters Canoe Area Wilderness could get drinks from Dorothy “the root beer lady” Molter. She made the beverage from the waters of Knife Lake. Her isolated and rugged lifestyle made her a celebrity, and she even won a fight with the U.S. Forest Service to stay on the land after the Wilderness Act of 1964 required her to close her fishing camp and sell root beer “for donations.”

Source: Atlas Obscura

The post Health plan perk: No taxes, ever — a Roth IRA on steroids! first appeared on Federal News Network.