Posted on Friday, 21st July 2023 by

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The 2023 FEHB Open Season will run from November 13 through December 11, 2023. 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 to all FEHB providers on March 1, 2023. This letter outlines the policy goals and initiatives for the 2024 FEHB Program. A follow-up letter provides technical guidance and instructions.

OPM GOALS

As excerpted from their guidance letter, “OPM’s focus for the upcoming plan year are on the following critical Program priorities: Fertility Benefits, FEHB and Medicare Coordination, and Pharmacy Benefit Design.”

They further state, “OPM is continuing to emphasize the importance of Gender Affirming Care and Services, Maternal Health, Prevention and Treatment of Obesity, and Mental Health and Substance Use Disorders.”

PREMIUM IMPACT

The average increase for our FEHB plans in 2023 was 7.2% while Medicare premiums actually decreased approximately 3% after the previous year’s 14% increase!  In March, Medicare Trustees forecasted monthly Part B premiums would increase to $174.80 in 2024 from $164.90 this year, a 6% increase.

The carriers will again be challenged this year by inflation and to provide expanded coverage requested by the administration. Over the last decade the average annual FEHB increase was 4% according to OPM.

The additional costs for gender affirming care, obesity treatments, and other coverage will require higher premiums across the board, especially when OPM is waiving the “cost neutrality clause,” as noted below.

This expanded coverage was sanctioned by executive orders, not by the Congress. The government pays the majority of our premiums, this new coverage increases spending and our country’s deficit. Congress authorizes and controls spending, a President can approve or veto their bills, they don’t have cart blanch authority to do whatever they desire.

It seems all Presidents, in recent memory, used executive orders to usurp the legislative branch and implement changes that Congress wouldn’t pass.

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”

OPM will issue waivers to the cost neutrality requirement for proposals of coverage outlined in their program carrier letter. We could end up paying substantially more next year when you factor in inflation and expanded coverage.

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.
  • Explore Medicare signup options

Answering these questions 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 2024

Conclusion

The new 2024 premium rates will be announced in October; we don’t know how much they will go up overall. However, it seems inevitable that increases are coming our way.

A recent news cast talked about how Medicare subscribers are using health care services more since COVID is behind us. Many senior citizens weren’t able to get the care they needed and are now scheduling the many services they missed these past two years.

Hopefully, premiums won’t increase as much as I and others anticipate, only time will tell. I’ll send out a newsletter to announce the new rates when they are released.

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Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change.

The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

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