OPM to manage part of Affordable Care Act program

A key element of the Obama administration’s health care overhaul will roll out Oct. 1 when the Health Insurance Marketplace begins accepting enrollments.

But the launch of state insurance exchanges will have little impact on most federal employees, the Office of Personnel Management says.

A fact sheet provided to agency chief human capital officers by acting OPM Director Elaine Kaplan reiterated that all plans under the Federal Employees Health Benefits Program (FEHBP) meet the Affordable Care Act’s “minimum essential coverage” standards and that federal employees’ benefits will not be affected once the exchanges open.

It’s a different story for OPM, itself, however. The federal human-resources agency has been tasked with managing a program that assures at least two “multi-state plans” are offered on each state’s exchange.

“OPM was given the responsibility for creating and administering the [Multi-State Plan Program] because of its history with overseeing the Federal Employees Health Benefits Program for over 50 years,” the agency fact sheet stated.

The multi-state plans aim to boost competition within the state exchanges and to give consumers more choices. At least one of the insurance carriers must be a nonprofit. The plans will be offered in at least 31 states starting in 2014, expanding to all 50 states and the District of Columbia by 2017.

A May 30 White House memo stated that OPM was currently reviewing more than 200 proposed multi-state health plan options.

While most feds won’t be affected by many of the Affordable Care Act’s key provisions, the law did mandate several new requirements for insurance plans in the FEHBP, many of which have already gone into effect.

These include:

  • Allowing adult children up to age 26 to stay on their parent’s insurance plan
  • Requiring FEHBP plans to fully cover several preventive health services, such as cancer screenings and childhood immunizations
  • Requiring all federal health plans to eliminate annual spending limits on certain categories of essential benefits

However, a more major change involves the insurance benefits of lawmakers and their official staffs. They will no longer be eligible for FEHBP coverage and will instead have to buy insurance on the exchanges.


OPM provision defines how Congress, staff receive health benefits in 2014

OPM asking feds’ opinions of their health, wellness benefits

OPM in talks to add 6 new carriers to FEHBP



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