Health Insurance Plans Leaving the FEHB

By on October 19, 2015 in Pay & Benefits with 17 Comments

Image of doctor holding a broken piggy bank

A number of current participants in the FEHB may be changing plans this year to enter the self plus one option that will be available during the upcoming open season. Other participants may be planning on just staying in their current plan.

Before making your final plans, it would be a good idea to check and see if your current plan is still in the federal employee health insurance program. There are changes to the options that are available and some plans are leaving the program. When you search the database of health plans for federal employees and the 2016 rates, you will not find these plans included.

There are a number of other changes, such as changes to enrollment codes for existing plans. You can peruse the document at the end of this article for a complete listing of these changes. This article outlines some of the changes likely to be of greatest impact and interest to readers.

Here are plans that are leaving the FEHB for 2016. Note that if you do not enroll in another FEHB plan during the open season you will not have health benefits under the FEHB for 2016.

State Plan Name 2015 Enrollment Code General Location
Florida Coventry Health Plan of Florida

5E1, 5E2, 5E4,

5E5, J41, J42

South Florida
Indiana Physicians Health Plan of Northern Indiana DQ1, DQ2, DQ4, DQ5 Northeast Indiana
Louisiana Coventry Health Care of Louisiana BJ1, BJ2, BJ4, BJ5 New Orleans
Massachusetts Fallon Community Health Plan JG1, JG2 Central and portions of Eastern Massachusetts
Ohio The Health Plan of the Upper Ohio Valley U41, U42 Northeast and Eastern Ohio
Virginia Piedmont Community Health Plan 2C1, 2C2 Lynchburg Area
West Virginia The Health Plan of the Upper Ohio Valley U41, U42 55 Counties in West Virginia

The following plan has reduced its service area and terminated its enrollment code. Participants in these terminating enrollment codes must make a positive election into another FEHB plan during Open Season or they will not have health benefits coverage for 2016.

State FEHB Plan 2015 Enrollment Code Area Dropped
Nevada Aetna Open Access HF1, HF2 State of Nevada

FEHB Plans Reducing Service Areas Without Terminating Enrollment Codes

Participants in the areas being reduced who do not change FEHB plans during Open Season will only have emergency health services where they live and they will have to travel to their FEHB plan’s remaining service area to obtain medical care in order to receive full benefits from the FEHB plan in 2016.

State FEHB Plan 2015 Enrollment Code Area Dropped
Idaho Select Health SF1, SF2, SF4, SF5 Idaho County

FEHB Plans Terminating Option And Enrollment Codes

Your payroll office should automatically move participants in the FEHB plan’s terminating option into their plan’s surviving option and enrollment code unless you have selected another FEHB plan during Open Season.

State FEHB Plan Terminating Options at the end of 2015 Terminating Enrollment Code (end of 2015 Deemed 2016 Enrollment Codes
Kansas Coventry Healthcare of Kansas HDHP* 9H1, 9H2 HA4, HA5
Missouri Coventry Healthcare of Kansas HDHP* 9H1, 9H2 HA4, HA5

*Participants who want to continue enrollment in 2016 in an HDHP and receive or make additional contributions to the Health Savings Account (HSA) must change to another HDHP in the FEHB Program during Open Season. They need to contact their current 2015 HDHP HSA Fiduciary and the Internal Revenue Service (IRS) for any guidance and questions about their HSA, including tax considerations and penalties. If enrollees are interested in consolidating their HSA accounts, they also need to contact their upcoming 2016 HDHP HSA Fiduciary.

2016 FEHB Significant Plan Changes

© 2016 Ralph R. Smith. All rights reserved. This article may not be reproduced without express written consent from Ralph R. Smith.


About the Author

Ralph Smith has several decades of experience working with federal human resources issues. He has written extensively on a full range of human resources topics in books and newsletters and is a co-founder of two companies and several newsletters on federal human resources.