WHAT CARRIERS QUALIFY TO PARTICIPATE IN FEHB

The Office of Personnel Management (OPM) has a strict set of standards that allow carriers to participate in the Federal Employees Health Benefits (FEHB) Program.  The Office of Personnel Management is invested in making the best health care decisions available to ensure the health and safety of the Federal workforce, their families and retirees.  As such the FEHB Program only contracts with health benefits carriers that offer a comprehensive line of medical services to include doctor’s office visits, emergency care, hospitalization, prescription drug coverage and the treatment of substance abuse and mental illness.

The Office of Personnel Management is strictly prohibited from contracting with companies offering limited services such as dental, vision, prescription drug plans, supplemental insurance and disability insurance.   OPM also does not consider partnering with fee-for-service carriers.

The Office of Personnel Management is vigilant in its efforts to see where there seems to be a gap in services or states deemed to be classified as a medically underserved by the Department of Health and Human Services (HHS).  Some of those states include South Carolina, South Dakota, North Dakota, Alabama, Illinois, Louisiana, Arizona, Idaho, New Mexico, Wyoming, Oklahoma, Mississippi, Missouri and Montana.

OPM further invites applicants to submit applications who are qualified by HHS, Centers for Medicare and Medicaid Services (CMS) as Federally qualified or are an approved Competitive Medical Plan (CMP).

P. S.  Always Remember to Share What You Know.

Dianna Tafazoli