OPM offers ‘limited’ second chance for FEHB change

Beginning on Monday, Feb. 1 and running through Feb. 29 members of the Federal Employees Health Benefits (FEHB) Program are getting the chance to adjust their p...

Federal employees rethinking their health plans are days away from a second chance for a new choice.

Beginning on Monday, Feb. 1, and running through Feb. 29, members of the Federal Employees Health Benefits (FEHB) Program are getting the chance to adjust their plans during a limited enrollment period.

“A record number of FEHB enrollees made enrollment changes during the recent Open Season, but we know there are still some enrollees in self-and-family who can benefit from changing their enrollment to self-plus-one,” said John O’Brien, OPM’s director of health care and insurance. “The limited enrollment period will allow those individuals a second opportunity to make the change.”

Employees who are wondering whether they can — or should — take advantage of the limited enrollment period are advised to ask themselves one question, said federal benefits expert Walton Francis.

“They don’t need to think hard about it,” Francis said. “In the plan that [they’re] already in, is the self-plus-one premium lower than the family premium? If you’re not in that category, forget you ever heard of it.”

Self-plus-one covers an enrollee and one eligible family member. In September, OPM estimated that about 33 percent of the active federal employees with self or family coverage would shift to self-plus-one, while about 80 percent of the retirees would partake in the new insurance choice.

Francis said roughly nine out of 10 plans would have a lower premium under the self-plus-one option, though there are exceptions.

He said for the D.C. area, the plans where the family premium would be lower are: Foreign Service Benefit Plan, MHBP Standard Option and Kaiser High Option.

But for the most part, people will be saving between $100 and $200 per year if they make the switch to self-plus-one.

“In one case the saving is so dramatic,” Francis said. “If you are in the plan called MD-IPA (MD-Individual Practice Association), if you’re in the family option, you could cut your premium in half by going to self-plus-one.”

Francis said it’s important to remember that this limited enrollment period truly is limited. It’s a one-time event in which an employee can change from family to self-plus-one. There’s no switching of health plan providers, only a “switching down” within a plan.

OPM is urging employees to make changes via the electronic enrollment system. Any problems or questions should be addressed with the local human resources office.

The agency provided the following list of guidelines for the limited enrollment period:

  • Only for active employees enrolled in self-and-family (must be paying for premiums pre-tax).
  • Decreases in enrollment to self-plus-one are the only allowable enrollment changes.
  • No changes in plans, no option changes, no increases or other decreases in enrollment are allowed.
  • All enrollment changes will be prospective to the first day of the first pay period following the one in which the change is requested.

For annuitants:

  • The limited enrollment period does not apply to annuitants because they are allowed to decrease enrollment at any time. This means that if you have a self-and-family enrollment and you decide you would like to change to a self-plus-one enrollment, you may do so throughout the year.
  • If you have a self-only enrollment, however, you must experience a qualifying life event in order to change to self-plus-one outside of Open Season.

The 2015 Open Season was the busiest on record. The Office of Personnel Management reported that nearly 710,000 transactions were processed during Open Season, which ended Dec. 14. Tht was roughly 275,000 more transactions than last year and more than double the number recorded in 2012, the first year for which OPM has data on Open Season transactions.

OPM officials pointed to the new self-plus-one option as the catalyst for the record-breaking enrollment.

“This year, with the new self-plus-one enrollment type available, it was more important than ever that enrollees review the plans available to them and to make an informed decision … and they did,” O’Brien said.

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