By C. Todd Lopez
FORT MEADE, Md. (Nov. 16, 2011) -- Even if a federal employee is happy with current health insurance, officials say it's probably a good idea to do at least a little research during "open season," which began Monday and runs through Dec. 12.
The Federal Employee Health Benefits Plan open season refers to the time each year when employees are allowed to change options for health care coverage, including dental and vision insurance.
"A federal employee has many choices between health plans," said Anne Healy, a representative from the BlueCross BlueShield Federal Employee Program.
In Maryland, Healy said, employees can choose from as many as 25 plans, including preferred provider plans, health management organizations, and high deductible health plans.
"There's all different types of options," she said. "If an employee is enrolled in one plan, say an HMO (health maintenance organization), and they decide they want to change to a PPO (preferred provider organization), the only time they can do that is during the open season."
New federal employees pick a health care plan when they are hired. And existing employees can change their coverage options during "life-changing events" such as getting married or having a baby. But otherwise, employees must wait until "open season" to make changes to their health coverage.
But even if an employee doesn't make changes to health insurance coverage during open season, providers can make changes of their own. And employees should be aware of those changes, because they can reflect on their paycheck come January.
"A couple years ago we had one health carrier that raised its premiums tremendously," said Peggy Schultz, the director of the Army Benefits Center. "We had a lot of unhappy people after open season because by then it's too late to do anything about it. And it was a significant increase."
Schultz said that federal employees, during open season, should investigate changes being made to their current health, dental and vision plans to ensure that when the new year rolls around, there will be no surprises in their paycheck.
"People should go out there to investigate with the tools available," she said.
Schultz said some of those tools are available on the "Smart Choice" website that is available at https://www.plansmartchoice.com.
Additionally, there is information available on the "Army Benefits Center-Civilian" website at https://www.abc.army.mil.
Schultz said that during open season, Army civilians can look at and modify their health coverage options on the "Employee Benefits Information System" at https://www.ebis.army.mil.
Somewhere between 90 and 95 percent of Army civilians use the EBIS site to make changes to their health insurance plans, Schultz said. "They have embraced the automation." Others, she said, can call the toll-free number available on the site to work with an operator.
Mark Ruddick, a representative of the Kaiser Permanente health care organization, said during open season, federal employees should reassess their health care needs and then look at all the options available to them.
"What's important for them -- that's part of my dialogue when I meet with a potential member -- it is not necessarily to sell a plan to them, but to really find what they are looking for.
"Buying health insurance is a very personal issue," Ruddick said. "So what's important to you might not be important to me. So it's having a conversation with somebody, as they look at all this information. Is it choice of physician, is it the cost of the plan, it is having them on an integrated network?"
According to the Office of Personnel Management website, most Federal Employee Health Benefit plans will see benefit and rate changes beginning in January 2012. Some plans are dropping out, for instance, and some plans are changing their coverage area.
"It is wise to review your coverage during this period to decide what coverage and premium best suits your needs for the upcoming year," the website reads.
Information from OPM can be found at http://www.opm.gov/insure/openseason. Included there is information about health, dental and vision plans, as well as information about flexible spending accounts.
A flexible spending account allows an employee to set aside untaxed money to use for authorized medical expenses. Employees who use flexible spending accounts must enroll each year to continue participating.
The OPM website also offers several video seminars online regarding the 2012 open season.