The Office of Personnel Management has announced a number of important changes that will impact some plans and enrollees in the Federal Employee Health Benefits Program (FEHB) next year.
Some plans are leaving the FEHB in 2020. Employees in these terminating plans must enroll in a new plan during Open Season or they will be enrolled in the GEHA Indemnity Benefit Plan – Elevate option (the lowest-cost nationwide plan option for 2020 as determined by OPM).
Other plans are adding new options or reducing service areas. The document at the end of this article includes details on the changes and affected plans as announced by the Office of Personnel Management.
OPM has advised federal employees with additional questions about their benefits to contact their local HR representatives.
Information for Impacted Enrollees
Here is what OPM says affected federal employees and retirees need to know about these changes.
Plans Leaving FEHB
These plans are listed in table 1 in the included document. Employees in these plans must enroll in a new health plan during Open Season. If they do not enroll in a new plan, they will be enrolled in the GEHA Indemnity Benefit Plan – Elevate option (the lowest-cost nationwide plan option for 2020 as determined by OPM).
New Coverage: Coverage under an enrollee’s new health plan will be effective the first day of the first pay period beginning on or after January 1, 2020; for most employees this will be Sunday, January 5, 2020. Enrollees will remain covered and receive the 2019 benefits of the old plan until coverage under the new plan becomes effective.
FEHB Plans Reducing Service Areas without Terminating Enrollment Codes
These plans are listed in table 2 in the document at the end of the article. The plans have been instructed to notify enrollees that their respective service areas are being terminated.
If you are impacted by one of the plans that falls under this category, you should elect a new health plan for 2020. Employees who do not choose a new health plan will only have emergency services where they live and will have to travel to their plan’s remaining service area to receive full benefits.
FEHB Plans Terminating Option and Enrollment Codes
Employees in the plan dropping an option (Table 3 in the included document) may choose a new health plan during Open Season or remain with their current plan and be switched automatically into the plan’s option specified in Table 3.
New Coverage: Coverage under an enrollee’s new health plan or option will be effective the first day of the first pay period beginning on or after January 1, 2020; for most employees this will be Sunday, January 5, 2020. Enrollees will remain covered and receive the 2019 benefits of the old option until coverage under the new option becomes effective.
Frequently Asked Questions
OPM has also provided these frequently asked questions about the changes to the selected FEHB plans.
How will I know if my enrollment is affected?
You will receive a letter from your plan stating that it is no longer participating in the FEHB Program, is dropping an option, or is no longer providing services in your area. You can contact your Human Resources (HR) office with additional questions.
What do I do now that I know my enrollment is affected?
You may need to change your enrollment to another plan during Open Season or during the time period set by OPM. Follow the instructions in the letter you received from your plan.
My plan is reducing its service area AND eliminating my enrollment code. What happens if I don’t change to another plan?
If you are a Federal employee, annuitant, or Tribal employee and you do not change plans, you will be automatically enrolled into the lowest-cost nationwide plan option available as determined by OPM.
My plan is reducing its service area where I live/work but keeping my enrollment code. What happens if I don’t change to another plan?
You will only have coverage in your area for emergency care services in the new plan year. You must travel to the plan’s remaining service area to receive full coverage for your care.
My plan is eliminating my option. What happens if I don’t change to a remaining option or to another plan?
You will be automatically enrolled into one of the plan’s remaining options. If no options remain, or the remaining option is a High Deductible Health Plan (HDHP), you will be automatically enrolled into the lowest cost nationwide plan option as indicated by OPM. Please refer to the letter you received from your plan for more information.
If my High Deductible Health Plan (HDHP) is terminating coverage in my service area or is leaving the FEHB Program, what happens to my Health Savings Account (HSA) or my Health Reimbursement Arrangement (HRA)?
If you wish to continue contributing to your HSA, you must enroll in another HDHP. If you do not enroll in another HDHP, you can withdraw money from your HSA for qualified medical expenses. You should check Internal Revenue Service (IRS) guidance on use of HSA dollars for non-qualified medical expenses. You should work directly with your fiduciary to make decisions regarding your HSA.
Unless you use your HRA credits, they will be forfeited once your plan terminates.
How do I change my enrollment to another plan?
If you are a Federal employee, you may be able to use your agency’s online self-service system such as Employee Express, MyPay, Employee Personal Page, EBIS, etc. If you need additional help, contact your HR office.
If you are a Tribal employee, contact your Tribal Employer.
If you are a Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS) retiree, call Open Season Express at 1.800.332.9798 or access Open Season Online at https://retireeFEHB.opm.gov. Outside of Open Season contact the Retirement Office through email at [email protected] or by phone at 1-888-767-6738.
I have other supplemental coverage through my old FEHB plan. What happens to that coverage?
Since your plan is terminating coverage, any supplemental coverage that you have through your plan may also terminate. Please contact your plan for more information about your supplemental coverage.
How can I compare the different health plans available to me?
There are several resources available to help you compare plans: