FEHB 2011 Open Season

[XL-entLady]

"...Open season -- the time when federal employees can change their FEHBP enrollments -- runs from the beginning of the second full work week of November to the end of the second full work week of December. OPM proposed switching it to run from Nov. 1 to Nov. 30.

"This will simplify the annual announcement of the time period for open season and allow agencies and employees to better plan for the enrollment opportunity since they will know well in advance when it will occur each year," the agency said in the notice.

In addition, OPM suggested changes to the kinds of plans health care companies can offer through FEHBP. Right now, insurers can offer two regular options and one high-deductible plan, in which enrollees pay most of their costs out of pocket in exchange for low premiums. OPM proposed allowing companies to choose between offering two plans and a high-deductible option, or three regular plans."

http://www.govexec.com/story_page.cfm?articleid=45075&dcn=todaysnews

OPM notice is found at:

http://edocket.access.gpo.gov/2010/pdf/2010-8957.pdf

 

[Viva_La_Migra]

Ihope this is an effort to phase out the high deductible plans. Those things are huge moneymakers for Insurance companies and encourage the "users" to not go to the doctor unless its something critical.

Why would you want that? What's wrong with people choosing for themselves what plan is best for them?

 

[Viva_La_Migra]

Well, I don't know VLM...I hate to sound "anti-freedom" but does anyone really know what their health is going to be in the next 12 months??

I thought I was healthy as a buck back when I was in my early 20s. However, an unexpected shoulder injury would have cost me $15,000. A 5,000-10,000 deductible would have runed me at that time...none of my credit cards even had that limit.

No one can predict if they are going to get into a serious car accident...or find a cancerous tumor during a routine visit. But this happens to milions of people. That's why "comprehensive insurance" is always a good idea. Most people that have hi-deductible plans do because they can't afford a better plan...or they are too cheap and want to roll the dice, and many of those end up costing US more in the end....aka ER visits and our high premium hikes.

The other unintended consequence of hi-deductible plans that hurts our society as a whole...people put off routine visits or checkups becasue those hi deduction plans are entirely out of pocket for stuff like that. Big reason why cancer, MS, diabetes, heart disease gets found late with a lot of folks in those plans.

So, in my opinion, high deductible plans don't count as insurance.
They encourage people to not go to the doctor at all, or put them in a position to go bankrupt if they have 2 bad years in a row. This happens to almost a million Americans a year with insurance.

When they compare US insured to other countries, they should leave those here on those plans out of the "insured " count. That would give us 70-80 million uninsured to "under-insured"...or roughly 25% of our country. 100% of people in Canada, France, Japan have coverage plans similar or better than yours/mine. And I remember how yours is better than anything on the FEHB.:blink:

I agree that it would be better if everyone purchased a comprehensive insurance plan that would cover them in the event of a catastrophic illness or injury. That said, I don't believe the government should force anyone to purchase it if they don't want to or can't afford to. Freedom means you can choose to have or not have insurance. With freedom comes the responsibility to take care of yourself, or face the consequences. Too many people want to be cared for from the cradle to the grave, and don't want to take responsibility for themselves.

 

[SWAVET]

I disagree as appears you misunderstand regarding to HDHP that you can save a lot of $ on your health insurance (& from IRS) as the health plans contribution up to 85.96% ($1,800 - $2,500) for family and 95.35% ($500 - $1,200) for single depend on the plan you choose or the plan that is available for you. Beside the plans contribution – you may contribute up to $5,150 for family and $2,500 for single to the accounts before tax or tax free, beside the TSP that you are not pay tax. The combine of the plans contribution and your contribution can not exceed the amounts of $6,150 for family and $3,050 for single in 2010. The $ in the account is for you to use for anything related to medical expense and keep even after you change to different health plan such as HMO. By the time of retirement and need the $ for what ever reason for none medical purpose - just withdraw and pay tax as your income for that amounts without penalty.

The $ in the accounts you can invest in JP Morgan Mutual Fund when your account has exceed $2K. As this is HIGH DEDUCTIBLE – You must be able to save up for the first two years to cover the deductible as for in-network the deductible the amounts are $2,500 to $6,000 for family and $1,150 to $3,000 for single and expect more for out of network (Use the balance in HSA to cover this).

For those that know OR expecting something such as pregnant or major surgery - by the end of the year change to what ever plans you like, then switch back to HDHP later year to save extra $ from deductible on your HSA.

As I paid $38.71 per month for family plan (Aetna) in 2010 after plan contribution of $125 to my HSA. This is my second year with HDHP and my current balance is $8.3K as I agree that one can predict if they are going to get into a serious health issued that what is your HSA balance come into to play as I withdrew $4K so far for this year to cover for Doctor, Medicine (cost the same as your regular PPO) included one at emergency room for my family and after you max out your family (or individual) deductible for the year then the insurance come into to play. If you have PPO with 5-10% deductible for major expense then this plan is far better as it will cost approx. $4.8K for BlueCross BlueShield PPO each year even if you are healthy or paid only $464.52 for entire year. Why not take advance of this of tax free contribute to to cap HSA. The hard part is the first two year out of pocket cost, but if you keep track of your family health record to see how much you spend then you can do it. By the way my kids have asthma that need medicinces (I used my HSA to pay for medicines instead out of pocket as it used to be), then if I can do it as I save $1,302 (28% in federal tax) for my contribution extra $4,650 into my HSA - I'm not see someone want to ignore the benefit if you and/or your family are healthy enroll into this. You can switch back and forth as any other plans when the open season. Don't be mistake as you pay less HDHP cover less as the gov't pay the same amounts for you and your family as any other plan. The HDHP will cover the same thing as any other plans if an unexpected shoulder injury cost $15,000 as mentioned, then you pay more up front for deductible in netwok cap at $1.5K (single) or $3K (family) and the rest will be paid by the insurance (Aetna as example).

Here is the website for additional info: http://www.opm.gov/insure/health/hsa/hd ... tion.asp#1

Well, I don't know VLM...I hate to sound "anti-freedom" but does anyone really know what their health is going to be in the next 12 months??

I thought I was healthy as a buck back when I was in my early 20s. However, an unexpected shoulder injury would have cost me $15,000. A 5,000-10,000 deductible would have runed me at that time...none of my credit cards even had that limit.

No one can predict if they are going to get into a serious car accident...or find a cancerous tumor during a routine visit. But this happens to milions of people. That's why "comprehensive insurance" is always a good idea. Most people that have hi-deductible plans do because they can't afford a better plan...or they are too cheap and want to roll the dice, and many of those end up costing US more in the end....aka ER visits and our high premium hikes.

The other unintended consequence of hi-deductible plans that hurts our society as a whole...people put off routine visits or checkups becasue those hi deduction plans are entirely out of pocket for stuff like that. Big reason why cancer, MS, diabetes, heart disease gets found late with a lot of folks in those plans.

So, in my opinion, high deductible plans don't count as insurance.
They encourage people to not go to the doctor at all, or put them in a position to go bankrupt if they have 2 bad years in a row. This happens to almost a million Americans a year with insurance.

When they compare US insured to other countries, they should leave those here on those plans out of the "insured " count. That would give us 70-80 million uninsured to "under-insured"...or roughly 25% of our country. 100% of people in Canada, France, Japan have coverage plans similar or better than yours/mine. And I remember how yours is better than anything on the FEHB.:blink:

 

[omusser]

responding to fireWeatherMet's "Well I don't know, VLM " ...

You don't understand how FEHB hi deductible health plans work, as you obviously have never read the Aetna or GEHA HDHP brochures. For example you said:

I thought I was healthy as a buck back when I was in my early 20s. However, an unexpected shoulder injury would have cost me $15,000. A 5,000-10,000 deductible would have runed me at that time...none of my credit cards even had that limit.

With Aetna HDHP, your cost for this injury, assuming that 15K is the 'negotiated' rate for Aetna ( meaning original doctor bill about 25K ):
You would pay the first 1500 ( with self coverage ) and then Aetna would have paid 90%: total bill 1500 + 1350 = 2850. Your tax savings if you had put the annual 3000 in HSA: (deducted pre-tax, no SS, no medicare, no tax, so about 38% saving) $1100. So net cost: 1750. would than have 'runed' you ? I have had two bad years like this since I started HDHP four years ago, and I still have a nice balance in my HSA account.
(my tax savings have more than paid for all of my bills ).

The other unintended consequence of hi-deductible plans that hurts our society as a whole...people put off routine visits or checkups becasue those hi deduction plans are entirely out of pocket for stuff like that.

This is completely wrong. All FEHB HDHPs have 100% free preventative care, even before the new health care bill which requires all plans to have this. So I get complete physical exam and all associated tests for free with $0 out of pocket expense. Women get that plus ob/gyn exam.

They encourage people to not go to the doctor at all, or put them in a position to go bankrupt if they have 2 bad years in a row. This happens to almost a million Americans a year with insurance.

Wrong again. My Aetna HDHP has a catastrophic maximum of $4000/yr.
And if you contribute to your HSA and therefore use HSA funds to pay for your costs, that 4K only cost you 2480 after tax savings. So you could have a multi million health catastrophe, and really only have to pay about 2500 out of pocket! And for most HDHP regulars, they have considerably more than that saved in their HSA.

Would this bankrupt anyone? As I said above I have had two bad years, but still have paid all of my out of pocket costs with tax savings.

So I suggest that you read the HDHP brochures, to make an intelligent decision on which fehb plans are best.

 

[nnuut]

Good Points omusser, and welcome to the Message Board!
Best of luck
Norman

 

[jimijr]

I thought that if one did not use up the HSA by the end of the year, it reverted back to the govt. You are saying it rolls over?

 

[SWAVET]

I thought that if one did not use up the HSA by the end of the year, it reverted back to the govt. You are saying it rolls over?

Yes, it rolls over just like your regular checking account with ATM card and like you retiree (Congratulations), you can withdrawal any amount in the account to use for personal purpose other than medical then paid tax as regular income, but you are not allow while you are still in service. I expect to have at least $100K by the next 20 yrs with current balance $9.3K (so far small cap and int'l are great).

 

[SWAVET]

(Almost) Free Health Insurance

http://www.govexec.com/story_page.cfm?filepath=/dailyfed/1010/100810rp.htm

 

[burrocrat]

ok it's open season, someone check my logic before i push the button here?

i normally carry GEHA standard self+family, was $83, going up to $90. i hardly ever go to the clinic or doctor, if you can get on your feet you're ok, never have met my measly $700 deductible. if something big happens i'm going broke anyway no matter what if any insurance i carry. i am in a 'medically underserved' location so anywhere we go is in-network.

looking at the HDHP plan, costs $100 self+family only an additional $10. a little bit more for some services and big deductible but again it will break me if i hit it no matter what.

are you saying that of $100 biweekly premium ($2600/yr), $1500 of that goes into an account i can use for copays, prescriptions, visits etc.? net cost for insurance only $1100 then and a $1500 cushion to cover routine expenses? and carries over year to year? and i can withdraw funds and only be liable for taxes i would have paid anyway? and i can contribute extra funds tax free if i foresee a need?

what happens to the money if i switch to say BCBS regular plan in the future? still there for med expenses? can switch back and continue adding to balance?

if i understand this correctly, what's not to love about HDHP plans?

why does this insurance thing seem like dancing with the devil? at least we got choices.

 

[Buster]

I'm with BCBS basic..No yearly deductable, co-pays are $25/$35, meds are $10/$35...extended hospital stays max out at $750.00...saved $2000/yr in monthly premiums...Over BCBS Standard.

Thing is, EVERYBODY accepts BCBS, EVERYWHERE there is a perferred provider.

 

[dannyboy]

I'm with BCBS basic..No yearly deductable, co-pays are $25/$35, meds are $10/$35...extended hospital stays max out at $750.00...saved $2000/yr in monthly premiums...Over BCBS Standard.

Thing is, EVERYBODY accepts BCBS, EVERYWHERE there is a perferred provider.

I've always been BCBS and it's easy to find participating physicians and everythng is comperble close?, for me.

DB

 

[nasa1974]

I have been with BCBS for years and really haven't had any problems. But I am looking at switching to GEHA. It appears their coverage is pretty close to BCBS. My primary doctors are covered and their premiums are half of BCBS.

 

[James48843]

Don't forget to enroll in a flexible spending account-

https://www.fsafeds.com/fsafeds/index.asp

that covers the copays and deductables.

 

[Steel_Magnolia]

Spouse and I use Aetna HDHP. We buy two Self-Only coverages because that's less expensive than one Family. And we can do that because we're both Fed retirees. I do the spreadsheets every year, and every year it looks like we can save about $200 a month over BCBS because of their HSA feature: Aetna puts almost all of the premium I pay them back into my HSA. Sweet!

All of July's bills aren't in yet (gr-r-r-r) but I probably reached my catastrophic maximum this year.

You know, I think that the insurance alone makes it worth it to be a Fed. If we hadn't had our Aetna HDHP, last July would have ruined us for sure!

Maggie

 

[Steel_Magnolia]

Serious question: Has anyone ever reached their catastrophic limit when insured by Aetna HDHP? If so, was Aetna prompt in taking over all additional bills?

Squale, my teddy bear friend, are you there and did this ever apply to you? Anyone else?

TIA,
Maggie

 

[burrocrat]

ok, i'm still a bit unsure and open season choices need made soon. can anybody who has used the HDHP plans with HSA explain in plain english how it works?

a big portion of your premium (pretax) goes into a savings account which funds you can use to pay billed expenses like co-pays, whatever portion of invoices insurance doesn't pay, etc.? right?

so how do you access the money? debit card and pay at point of sale? issued a 'checkbook' and write a note off your HSA balance? pay with personal funds and provide documentation to get reimbursed?

and what happens if the dr. takes one look and me and says 'you are a train wreck waiting to happen, plus you're freakin crazy as a loon' and then straps me to a gurney and i don't get out for a few weeks until i figure out how to negotiate the system?

i think i'm going to give it a shot. there is something appealing about most of my premiums to the corporate robbers passing through right back to me for my use. let's just say i'm in moral agreement with the philosphy there.

 

[Steel_Magnolia]

BC, I use the Aetna HDHP. Yeah, me. With all my health problems. It works well, with $65 of my currently +/- $75 premium going into a HSA that I can access with a Visa card.

I have to pay a $1,500 co-pay, which I reach within the 3rd week of January because of my meds. I can use the money in my HSA to help with that co-pay. And if I have a year with absolutely choking health bills, like last July, well there is a catastrophic limit of $4,000. And every penny after the $4K is paid by Aetna.

So the deductible would choke a horse. But between the low price of the monthly insurance cost and the fact that I get most of that monthly cost back for my medical bills, it makes sense for me.

But that's just me. Everybody is different and your mileage may definitely vary!

Maggie

 

[burrocrat]

but how do you actually physically pay for it? card, check, cash up front and then reimbursed? digital ones and zeros just magically fly around and the system makes sure the pot is right?

it's your money, but how do you get it? more importantly, how do you go about actually spending it?

maybe i'm just being stupid here, but it's important to me to understand how the logistics work before i commit.

 

[Steel_Magnolia]

My insurance premium is deducted from my pay as usual. The premium goes to Aetna. Aetna puts $65 of that premium into a Debit card that is handled through, if I remember correctly, Chase National Bank. And I then use those funds in the debit card to pay for prescriptions, etc.

I'd be happy to answer any questions I can. Ask away.