Benefits Administration Letter

This letter transmits significant events affecting certain plans during the upcoming FEHB Open Season. Some of these events will require action on the part of agencies and enrollees. Also note the plans that are dropping out of the Program at the end of 2006. Since employees in these plans must enroll in new plans during Open Season if they are to continue insurance coverage in 2007, we ask you to distribute this list widely within your agencies.

These end-of-year changes such as plan terminations are already available on the web site on the plan changes page. Visit http://www.opm.gov/insure/07/planinfo and you will find a link directly to the health plan changes for 2007.

We encourage you and your employees to visit the web site at www.opm.gov/insure for the most up-to-date information. We will update these pages on a regular basis throughout the Open Season.

TERMINATIONS

Table 1:  Plans Leaving the FEHB Program for 2007

What Must Employees Do?

• Employees in terminating plans (Table 1) must choose a new health plan during Open Season.
• New Coverage.  Coverage under an enrollee’s new health plan will be effective the first day of the pay period beginning on or after January 1, 2007; for most employees this will be January 7, 2007.  Enrollees will remain covered and receive the 2007 benefits of the old plan or option until coverage under the new plan becomes effective.

What Must You Do?

• You must notify employees in the terminating plans or enrollment codes to select new plans.  Advise your employees if they do not choose new health plans, they will not have coverage in 2007.
• We strongly recommend you distribute copies of this list to each employee, along with your agency’s notice about Open Season.
• We also recommend you follow-up with employees in these plans and remind them to select new plans.
• Belated changes.  Some employees still might not receive instructions to change plans during Open Season.  We encourage you to be liberal in accepting belated Open Season changes from employees enrolled in terminating plans/enrollment codes.

What Will Health Plans Do?

• Plan Notification:  The plans in Table 1 have been instructed to notify enrollees of the need to select new health plans for 2007.  However, because some plans’ enrollments and address lists may not be up-to-date, we encourage you to accept belated changes.

SERVICE AREA REDUCTIONS

Table 2:  Plans Reducing Their Service Areas without Terminating an Enrollment Code

What Must Employees Do?

• Enrollees in the service areas being terminated must elect new health plans for 2007.  Enrollees who do not choose new health plans will have to travel to their plan’s remaining service area to receive full benefits.

OTHER CHANGES

Table 3:  New Plans Entering the Program for 2007

Table 4:  Existing Plans offering a High Deductible Health Plan (HDHP) without new enrollment codes

Table 5:  Existing Plans offering an HDHP with new enrollment codes

Table 6:  Service Area Expansions with New Enrollment Codes

What Must Employees Do?

• Enrollees in these plans must make an enrollment change to enroll in the new code for their service area or elect another health plan during the open season.

What Must You Do?

• We strongly recommend you distribute a copy of these lists to each employee, along with your agency’s notice to employees about Open Season.
• If you do not distribute the lists, remind employees to check their new health plan brochures carefully to see if there have been any changes to their plans’ service areas that will affect them.

Table 7:  Plans Adding a New Option

What Must You Do?

• You must include these new plans and expanded service areas when you count the number of eligible employees and place your orders for brochures.

Table 8:  Service Area Expansions without New Enrollment Codes

Table 9:  Plan Name Changes

Table 10:  Service Area Movement

Table 11: Closed Plans Available to New Agencies, Employees, or Retirees

We look forward to working with you to ensure Federal employees have a successful open season. 

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