Open Season, where federal employees and retirees can make changes to their health, dental, and vision insurance benefits for 2016, and employees can enroll in Flexible Spending Accounts (FSAs) will be held November 9 – December 14, 2015. As an overall general reminder, employees should contact their agency’s Human Resources Office with health plan and enrollment questions, while annuitants should contact OPM. Questions regarding dental and vision plans can be directed to BENEFEDS at 1-877-888-3337 or at www.benefeds.com. Any questions about a specific insurance plan can be directed to the specific insurance carrier.
In an earlier memo to you following the Office of Personnel Management’s (OPM) announcement on premium increases for Federal Employees Health Benefits Program (FEHBP) health plans for calendar year 2016, NTEU informed you that on average, premiums are set to increase 6.4%—6% for the government and 7.4% for enrollees. The 2016 health plan premiums are listed on OPM’s website.
Specific plan brochures are expected to be made available on OPM’s web site the first week of November prior to the official start of Open Season. All enrollees are advised to make full use of Open Season to review plan choices, and to carefully study medical and prescription drug benefits, premiums, deductibles, coinsurance, and copays. The main OPM FEHBP Open Season site (which is not yet updated for the coming 2016 Open Season) will be https://www.opm.gov/healthcare-insurance/open-season/.
New Self Plus One Enrollment Option
The main change for the 2016 FEHBP plan year, is that there now will be three enrollment type options, with Self Plus One being added to each plan option, as a result of a change in law in 2013. The Self Plus One option will be open to any enrollees with one dependent family member; however, please note that these enrollees are NOT required to enroll in this option. Rather, enrollees who cover a total of two people under FEHBP can decide whether they prefer to remain enrolled under Self and Family or whether they want to move to the new Self Plus One Option. Just to be clear, enrollees with only one dependent family member who are enrolled in Self And Family for plan year 2015, will not be automatically rolled over to the new Self Plus One plan option. These enrollees will remain enrolled in Self And Family unless they take action during the upcoming Open Season to enroll in Self Plus One.
While NTEU encourages all FEHBP enrollees to comparison shop between plans during this upcoming Open Season, they specifically recommend that those enrolling two individuals under FEHBP, visit OPM’s new Self Plus One dedicated site at www.opm.gov/selfplusone. We have also attached the new Self Plus One flyers that agencies will begin to share with you in the coming days. Please note that for a small number of plans (5% of plans), premiums paid by enrollees for Self Plus One may be greater than premiums under the Self And Family option. Again, enrollees can choose between these two options, and are not forced to enroll in Self Plus One just because they are covering two people. While the Self Plus One option will have lower premiums than Self And Family for the majority of plans, some plans will have higher premiums for Self Plus One than Self and Family.
FEHBP Audit
Given everyone’s heighted state of alert following the recent data breaches, we also wanted to remind you that OPM is conducting a small audit of FEHBP enrollee dependent family members. OPM’s stated purpose of the audit is to verify the eligibility of currently-enrolled family members. Approximately 1,000 FEHBP employees or annuitants enrolled under the Self and Family option will receive a mailed letter from HMS Employer Solutions, the contractor that has been selected to actively conduct the audit on behalf of OPM. A cover letter from OPM will also be included in this mailing. Those selected for the audit will be asked to provide legal documentation demonstrating the family relationship of currently-enrolled family members, such as a marriage or birth certificate. OPM has indicated to us that while they cannot require current employees to respond (note: they do have this authority for retirees as they are directly responsible for annuitant FEHBP enrollment), they plan to refer non-responses to the employee’s agency, highlighting a potential need for the agency to dis-enroll family members. Attached is a flyer from OPM that provides further information regarding this audit. Complete information regarding which family members, including spouses and children (natural, adopted, foster, step, and adult-incapable of support) are eligible for enrollment under FEHBP can be found on OPM’s website. FEHBP family member eligibility is set in statute.
Carrier Requests for Social Security Numbers
Additionally, OPM has informed NTEU that as part of the continued implementation of the Affordable Care Act, individuals with employer-sponsored health insurance, including FEHBP, will be receiving tax forms in 2016 verifying health insurance coverage, which will be needed for tax-filing purposes. Employers, including the U.S. Government, are also now required to report employee health coverage information to the IRS, and therefore any FEHBP carriers that are currently missing enrollee or dependent family member Social Security numbers, will be contacting enrollees and asking for this information. For further information, OPM has posted a new set of Qs & As.
You can download a flyer on the new Self Plus One Enrollment Type at this link. You can download a frequently asked questions (FAQ) document on Self Plus One at this link. Finally, you can download an FEHB FAQ at this link.
NTEU will keep you updated on any further information for the upcoming Open Season.
Diane Lynne
President, NTEU 280
202 566 2786