Health Insurance Plan Deadline Extended

Posted December 5, 2008 at 6:21pm

All federal employees — including Capitol Hill staffers — will now have until the end of January instead of Monday to switch health insurance plans.

The Office of Personnel Management has asked insurance agencies to allow “belated enrollment” after Members questioned whether workers were aware of substantial changes to a popular health insurance plan, Blue Cross Blue Shield Standard Option.

Now, OPM and Blue Cross are renegotiating one of those changes and allowing employees extra time to make their decision.

Other insurance agencies will also be able to renegotiate their coverage of out-of-network surgery — the change in the Blue Cross plan that upset Members and caught employees by surprise.

In a press release, Democratic Members of the the Oversight and Government Reform Subcommittee on the Federal Workforce, Postal Service and the District of Columbia applauded the decision.

“I am very pleased to see that OPM has heeded our advice and extended the open enrollment period,” Rep. Elijah Cummings (D-Md.) said. “Federal employees and retirees need this extra time to re-evaluate their health plans, and I appreciate that they will be given it.”

The changes to Blue Cross’ Standard Option plan came to light last week after a group of doctors and patients railed against an increase in the cost for some surgeries performed by out-of-network surgeons.

Starting Jan. 1 — barring any changes during negotiations — federal employees under the Standard Option will have to pay the entirety of nonemergency surgical procedures, up to a $7,500 co-pay, if they go to an out-of-network physician. After $7,500, the insurance company picks up 100 percent of the tab.

Before, employees paid for 25 percent of the plan’s allowance for the surgery, plus the difference between the allowance and the doctor’s bill.

The plan’s premiums will also go up by 13 percent, and a visit to the emergency room could cost $350.

In a hearing last week, Members chastised OPM officials for not sufficiently alerting employees to the changes, other than to describe it in a 137-page brochure that employees are unlikely to read.

Nancy Kichak, OPM’s associate director for strategic human resources policy, defended the changes and OPM’s outreach to employees. The $7,500 co-pay, she said, was meant to help employees who are stuck with bills in the tens of thousands of dollars for some out-of-network surgeries.

With the new plan, they won’t pay more than $7,500, while employees with bills of less than $7,500 will pay for their out-of-network surgeries in full.

At the hearing, Kichak was lukewarm on Members’ ideas to reverse the change or extend “open season.” But pressure from subcommittee Chairman Danny Davis (D-Ill.) and others seemed to change the agency’s mind.

If employees decide to change their health insurance plan after Monday but before Jan. 31, they have to go to their personnel office, fill out an enrollment request form and fill in “belated open season enrollment/change,” according to the subcommittee press release.