Changes to Be Expected in Certain FEHB Plans in 2019

OPM announced that there are some changes to be expected on FEHB, which will significantly affect some Federal Employee Health Benefits plans and enrollees. The changes are a significant consideration for the federal employees, especially those that are affected by the changes since they will have to re-enroll in different programs or they could opt to take the risks of ending up in other insurance plans, which might or might not suit their needs.

FEHB to reduce service areas without eliminating enrollment codes

The plans have been modified in a manner that guides the enrollees and shows them that their respective service areas are being eliminated. If you fall under the category of these enrollees, you have to elect a new health plan for 2019. Failure to do so will lead you to emergency services, where you will have to travel to areas where your services remain to get full benefits.

Termination option and enrollment codes

Employees in the category may opt to select a new health plan during the open season, or they can decide to remain with their current program and be switched to another plan option automatically.

In a case of new coverage, the new plan’s coverage will be effective from the first day of the pay period which commences on or after January 1, 2019. The enrollees will remain covered and will be able to get 2018 benefits of their old plan until the coverage under their new policy becomes effective.

FAQ

OPM has gathered a list of the frequently asked questions regarding the expected changes as follows.

How do you know if your enrollment is affected?

The affected will receive a letter notifying them that their plans are no longer effective in the FEHP Program, dropping an option or that it is not offering services in your area anymore.

What do you do next?

The next thing to do is to wait for the Open Season or the period set by OPM so that you can change your enrolment to a different plan.

What will happen if you do not change your plan after your current plan reduces its service in your area and eliminates your enrollment code?

As a federal employee, Tribal employee or annuitant and you fail to change plan; then you will automatically be enrolled into the lowest-cost plan option available as per OPM’s determination.

What happens when your plan reduces its service area but keeps your enrolment code?

In this case, you will only use the coverage for emergency care services in your area. You will have to travel to get full coverage benefits for your care.

What will happen when your plan eliminated your option, but you do not change to a remaining option?

If you fail to change the plan, you will be enrolled in the plan’s remaining option automatically or in the lowest cost plan as determined by OPM.

What will happen to your health savings account if your High Deductible Health Plan is terminating coverage in your service area or leaving FEHB Program?

You will have no choice but to enroll in another HDHP plan if you wish to keep contributing to your HSA. If not, you can withdraw money from HAS for qualified medical needs.

How do you change your enrollment to another plan?

As a Federal Employee, you can use online self-service systems such as MyPay, EBISS or Employee Express or contact your HR office for further guidance.

What will happen to your coverage in a case where you have a supplemental dental plan provided through your old FEHB plan?

Any other supplemental dental or vision coverage will be terminated in the process, but FEDVIP provides dental and vision insurance for qualifying Federal workers and retiree.

What happens to your coverage if you have other supplemental coverage through your old FEHB?

Any supplemental coverage you may have through the plan will be terminated too, but you can contact your plan for further information.