It could have been worse.
That's one of the messages civil service and postal employees and
retirees could take from yesterday's announcement that premiums will be
going up by an average of 10.6 percent next year in the Federal Employees
Health Benefits Program. [Related story, Federal Page, A25.]
"The good news is that the bad news isn't worse," quipped Charles L.
Fallis, president of the National Association of Retired Federal
Employees.
Kay Coles James, director of the Office of Personnel Management,
announced the premium rates for the 2004 enrollment period, which begins
Nov. 10. She began her remarks by pointing out that the average increase
is less than what many public and private-sector employees are facing next
year.
As most federal employees and retirees know, the average increase does
not apply to all FEHBP plans. As in the past, the average masks higher
rates in some plans, changes in co-payments and deductibles in others, and
even benefit reductions in a few.
To get a sense of what the 2004 average increase means for employees
and retirees, here's a snapshot of three popular, nationwide
fee-for-service health plans. The biweekly rates are what employees will
pay.
• Blue Cross and Blue Shield. Employees will pay $112.88 biweekly, a
7.3 percent premium increase, for standard family coverage. The biweekly
premium for basic family coverage will be $88.99, an 8.2 percent
increase.
Steve Gammarino, senior vice president for the Blue Cross
federal plan, said basic coverage will eliminate co-payments for pediatric
preventive care visits and introduce an "affinity drug program" that will
allow Blue Cross enrollees to get an average 20 percent discount on
certain prescription drugs not covered by the plan. Those include drugs
for sexual dysfunction and weight loss.
• Mail Handlers. Family coverage in the high-option plan will cost
employees $180.61 biweekly, a 55 percent increase. High-option self-only
coverage will be $95.59 biweekly, a 48.7 percent increase.
The Mail Handlers standard family plan will cost $69.81 biweekly, and
the standard self-only plan will cost $32.16 biweekly. The premiums for
both standard options are up 14.5 percent over the previous year.
Krista Lannert, vice president for FEHBP at First Health, which
administers Mail Handlers, said the sizable increase in the high-option
plans was partly caused by the departure of about 50,000 enrollees who
switched to free Tricare for Life military insurance after a federal rule
change made that possible.
Lannert said Mail Handlers has made changes for 2004 that enrollees
should find attractive. Among them, no pharmacy deductible for retirees,
no deductible for generic drugs and a lower co-pay for children's medical
services.
• Government Employees Hospital Association. The biweekly premiums for
standard family and individual coverage will go up 10 percent. The 2004
rates will be $68.75 for a family and $30.25 for the self-only plan.
GEHA's high-option family coverage will be $153.05, up 13.8 percent, and
individual coverage will rise a similar percentage, to $76.24
biweekly.
Karen Schuler, a GEHA spokeswoman, said that the plan will cover
all medically necessary sonograms during pregnancy and that mental health
services will be subject to the same deductibles as regular medical
expenses.
These examples, of course, only scratch the surface of FEHBP, which
will offer 205 health care options next year, up from 188 this year.
Washington area employees and retirees will have a choice of 17 plans,
up from 11 last year.
Frank Titus, an OPM assistant director, cautioned that employees
and retirees should pay special attention to health plan brochures listing
benefit changes.
"While the average [premium increase] is great, there are plans that
are above average and plans that are below average," he said.
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