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FEHB Open Season for 2023 Plans– Higher Costs on the Horizon

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The 2022 FEHB Open Season will run from November 14, 2022 through December 12, 2022. Open Season starts every year on the Monday of the second full work week in November and ends on the Monday of the second full work week in December.

OPM sent a FEHB Program Carrier Letter [2] to all FEHB providers on February 17, 2022. This letter outlines the policy goals and initiatives for the 2023 FEHB Program. A follow-up letter provided technical guidance and instructions.




OPM GOALS

As excerpted from their guidance letter, “OPM’s focus for the upcoming plan year is advancing health equity and ensuring the federal government, as the largest employer in the country, offers competitive, comprehensive health insurance benefits to its employees, annuitants, their families, and other eligible persons and groups.”

They further state, “Our health equity initiatives for the 2023 plan year relate to maternal health, gender affirming care and services, and obesity.” They also address assisted reproductive technology, preventive health services, coverage for necessary medical food, with emphasis on the Coronavirus Disease 2019 (COVID-19) pandemic.” Mental health and substance abuse disorders were also mentioned.

PREMIUM IMPACT

The average increase for our FEHB plans in 2022 was a reasonable 2.4% while Medicare premiums skyrocketed 14% [3]! The carriers will be challenged this year by inflation and to provide expanded coverage requested by the administration.

COST NEUTRALITY

According to OPM’s cost neutrality clause, “When proposing an increase in benefits, Carriers must propose corresponding benefit reductions to offset any potential increase in premium, with limited exceptions directed by OPM.”

They provide an example in the clause, “If a Carrier were to propose decreasing a cost sharing in one benefit and this increase in benefits would have an additional cost impact, the Carrier would have to have also proposed benefit decreases in other areas with an equal or greater reduction in cost than the benefit increase in the same plan option”

We could end up paying substantially more next year when you factor in inflation and expanded coverage requirements for 2023 that must be offset by reducing benefits elsewhere. Time will tell.

EVALUATE YOUR CURRENT FEHB PLAN

It’s a good time to review your current plan’s coverage and ask yourself if they met your needs and expectations this year. Ask these questions:

• Did I have coverage issues?
• What additional coverage will I need next year?
• Was I able to get the medications / prescriptions needed?
• Did I have to pay high prescription copayments?
• Where my deductibles, copayments and coinsurance excessive this year?
• Are the labs, doctor’s offices, hospitals, and outpatient facilities available in my immediate area and covered by my current FEHB plan?
• Did I have to travel out of my area to see a provider or have procedures performed?
• Was customer service helpful and easily accessible?
• Did I encounter unanticipated expenses that I thought were covered in my current plan.
• Are you signing up for Medicare this or next year? if so, you may want to consider moving to a lower cost FEHB plan [4].
• Explore Medicare signup options [5]

Answering these and others will help you prepare for the upcoming open season. If you had problems this year, look for plans that will better suit your needs in 2023.

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Last 5 posts by Dennis Damp