For the next four weeks, federal employees and retirees willselect their health insurance coverage for 2007. Many will escapethe sticker shock of past years, as federal officials say 63 percentof enrollees in the federal employee health insurance program willsee no increase in their premiums next year.
But policy analyst Walton Francis, who tracks premium and benefitchanges in the Federal Employees Health Benefits Program, cautionsagainst falling into open-season complacency.
Without the jolt of the usual large premium increase, 'the dangeris that people won't pay attention,' he said. 'They are going toyawn and go about their business, and that's a mistake.
'There is a 'change' page in every plan brochure, and peopleought to be looking at that page,' Francis said.
He added, 'There are lots of decisions to be made by eachindividual subscriber, and there is often a better deal availableright now.'
Francis is the chief researcher and writer of the annual'Checkbook's Guide to Health Plans for Federal Employees,' sponsoredby the nonprofit group that publishes Washington Consumers'Checkbook magazine. The guide rates the more than 250 FEHBP plans,taking into account premiums, catastrophic limits and estimated out-of-pocket costs for most medical expenses. The guide also figures intax savings that employees gain by paying their premiums throughpretax payroll deductions.
The 2007 guide, Francis said, shows that:
Some plans are good buys and can save hundreds or thousands ofdollars.
A federal family of four, for example, should check out BlueCross basic, the American Postal Workers Union consumer-driven plan,the Government Employees Hospital Association standard option, andthe Aetna and Mail Handlers high-deductible health plans.
The guide also give high marks to some health maintenanceorganizations, such as the Kaiser Foundation Health Plan's mid-Atlantic standard and high options, the Aetna Open Access basicoption and M.D.-IPA.
A retired federal couple enrolled in Medicare parts A and Bshould take a look at the annual costs and savings under GEHAstandard, Mail Handlers high-deductible, Blue Cross basic and theAPWU consumer option, according to the guide.
The retired couple also might reduce medical costs by enrollingin an HMO, such as Kaiser's standard option, Aetna basic and theAetna Health Fund consumer-driven option.
Some benefits are changing, and sometimes for the better.
The Mail Handlers standard and high options have dropped theirprescription-drug deductible -- a change that helps enrolleesregardless of how much or how little they use prescriptionmedicines. (Co-payments continue at Mail Handlers, such as a $10 co-pay for generic medications from in-network retail pharmacies.)
Enrollees hold down their medical costs when they stay in-network.
Double-check to make sure your doctor and dentist acceptreimbursement from federal plans. Dental and vision benefits, inparticular, are based on preferred providers.
Attention to premiums is especially important when decidingwhether to enroll in the dental and vision program, which starts forthe first time Dec. 31.
Regular health insurance typically covers annual checkups andteeth cleaning, and almost all health insurance plans providecoverage for accidental dental or vision injuries.
The stand-alone dental plans can cost several hundred dollars ayear in premiums, and Francis suggests that they may make the mostsense for people who anticipate moderately high dental expenses,want some protection against unexpected bills and like thepredictability of paying a regular premium.
The vision plans also should be seen as a way to prepay routinecosts for eye exams, glasses, contact lens and related services.They are not true insurance plans, Francis said.
Employees who are uncertain about whether to enroll for dental-vision coverage have the option of setting up a flexible spendingaccount. FSAs help limit out-of-pocket costs by providing what theConsumers' Checkbook guide estimates as one-third savings on health-care expenses because payments are made in pretax dollars.
Stephen Barr's e-mail address is barrs@washpost.com.
