U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

OPM Goals

Goal 3

Objective 3

Federal employees, annuitants and their families can choose from among quality and fiscally responsible carriers to address their specific insurance needs.

We strive to provide Federal employees, annuitants and their families with flexible insurance benefits based on quality, flexibility and informed choice. The insurance programs, which include Health Benefits, Life Insurance, Long Term Care Insurance and Flexible Spending Accounts, provide a range of options from which customers can assemble a benefits package that meets most of their specific insurance needs. To continue and enhance flexibility in the insurance programs, OPM must explore new offerings. To strengthen the quality of care and services, we must hold participating carriers accountable for the delivery of services and financial performance, and take steps to prevent the occurrence of fraud. We must provide program customers and other eligible persons with the information they need to choose the coverage that best protects them and their families. In addition, we must ensure beneficiaries receive care and benefit payments that are timely and accurate. Finally, we must work with the insurance industry to contain the spiraling cost of health care.

We are pursuing a number of strategies to achieve these outcomes which will create an environment in which all insurance program customers can choose from among quality and fiscally responsible carriers to address their specific insurance needs.

Strategies

• Base carrier profit on performance and quality of services.
• Build database to track and report on health plan performance.
• Strengthen strategies to address fraud and abuse in the FEHBP.
• Maintain the performance of the life insurance program.
• Promote enrollment in the long-term care insurance program.
• Explore new insurance benefit offerings such as flexible spending accounts, medical savings accounts and direct contracting for selected benefits.

Performance Indicators/Measures

We will know that we are succeeding in these things when most enrollees of the health benefits program are in quality health plans and are satisfied with the services and care they receive, when life insurance claims are paid in a timely manner, and the take up rates for the Federal Long Term Care Insurance Program and Flexible Spending Accounts attain expected levels. Examples of indicators and measurements are:

• Satisfaction with health plan performance reflects industry trends positively (Consumer Assessment of Health Plans Survey);
• The percentage of enrollees covered by a quality plan increases;
• Erroneous payments are reduced;
• Accuracy of fraud reporting improves;
• Life Insurance payment processing times decreases;
• Life Insurance payment accuracy is maintained;
• Expected LTC take up rates are achieved; and
• Agencies are satisfied with insurance program informational materials and training.

Goal 1    Objective 1    Objective 2    Objective 3    Objective 4

Goal 2    Objective 1    Objective 2

Goal 3    Objective 1    Objective 2    Objective 3