PMS season hits government

Legend has it that each year during the health insurance open season scores of federal civil servants lose control at the office. They get depressed or cranky. People try to avoid them. Some must be restrained, then sedated and sent home accompanied, sometimes, by a sympathetic coworker. It is unofficially known as Plans Make Sick, or PMS.

PMS does not differentiate between people because of their age, race, sex, color, creed or grade level. It strikes young and old, active and retired, alike. You may have it and not know it!

Between now and Dec. 12, government workers, retirees and survivor annuitants must pick their 2012 health plan. Most people do nothing, and (unless their plan is leaving the program) they remain in the same plan year after year.

The “problem” for feds and postal workers is one lots of private sector workers would welcome. Government workers typically have about 20 plans and options to chose from. The government will pay about 70 percent of the total premium for white collar workers and retirees. The U.S.Postal Service, under its union contract, pays an even greater share of employee (but not retiree) premiums.

Picking a health plan is similar to — but a lot more important than — buying a car. You decide what you are willing to pay and the options you want. In the case of health insurance you want one with good catastrophic coverage in the event you are hit with a serious illness of accident. It is also good to have a plan whose network of preferred providers includes your doctor.

Between now and the end of open season we’ll have a series of columns on the “best buys” as rated by Consumers Checkbook. Its health insurance expert Walton Francis will provide the ratings. He was our guest last week on our Your Turn radio show and he will be on again this Wednesday. Many agencies have subscribed to the online version of Checkbook. That means you don’t have to pay for it yourself, and you can do your shopping at work.

Meantime, here’s a quick checklist to help you pick your best buy:

  • HMOs typically have lower costs than traditional fee-for-service plans. Checkbook says that in the Washington area, for example, HMOs like Kaiser Mid-Atlantic Standard option, CareFirst BlueChoice High option, and Aetna Open Access Basic option will save the typical family more than $1,500 compared to the most popular plan, Blue Cross Standard option.
  • When it comes to good service — that is, the claims disputes — Checkbook rates Blue Cross and SAMBA plans at the top. It says that APWU and Mail Handlers have dispute rates that are twice as high.
  • The NALC plan got top marks for quality service.
  • Although its prescription benefit is weak, Checkbook says, the GEHA Standard option with its lowe premiums is highly recommended for retirees with Medicare.
  • Because the government pays the lion’s share of it insurance premiums many agencies want their employees to be educated consumers. That’s why many have subscribed to the online version of Checkbook. To see if you can get free access through your agency, visit:>


By Jack Moore

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