Insurance Providers Drop Out of Federal Employee Health Program
Alyssa Rosenberg | Government Executive
October 12, 2009
Some federal employees will have to choose new health plans during open season this year because their insurance providers are leaving the Federal Employee Health Benefits Program, or reducing the number of areas they cover.
“Some employees still might not receive instructions to change plans during open season,” Kathleen M. McGettigan, deputy associate director of the Center for Retirement and Insurance Services at the Office of Personnel Management, wrote in a Sept. 29 letter to agency benefits administrators. “We encourage you to be liberal in accepting belated open season changes from employees enrolled in terminating plans or plans with service-area reductions and terminating enrollment codes.”
Fourteen plans are leaving FEHBP altogether: PacifiCare of Arizona, PacifiCare of Colorado, ConnectiCare’s plans in Connecticut and Massachusetts, United Healthcare of Florida, JMH Health Plan, PersonalCare Insurance of Illinois, Group Health Plan of Illinois and Missouri, PacifiCare of Oklahoma, United Health Care of Ohio, Paramount Health Care in Ohio, Keystone Health Plan Central and Keystone Health Plan East.
Eighteen plans are lowering coverage in certain areas: In California, Blue Shield of California Access+HMO will no longer cover employees in Northern California, though it will continue coverage in Tulare County. In Colorado, Humana CoverageFirst is dropping Colorado Springs and Denver. Coventry Health Care will no longer cover federal employees in Delaware. Florida’s Humana CoverageFirst is dropping patients in Daytona, Pensacola and Fort Walton. In Indiana, Aetna Open Access is pulling out of Southeastern Indiana, and Humana CoverageFirst is leaving Eastern Indiana. UnitedHealthcare of Midwest Inc. plans to stop covering patients in Kansas City in Kansas and Missouri. In Kentucky, Aetna Open Access and Humana CoverageFirst both are pulling out of the northern part of the state, and in Ohio, Aetna Open Access is ending coverage for federal employees who live near Columbus and Greater Cincinnati, while Humana CoverageFirst is leaving Cincinnati and Dayton. Aetna Open Access also is leaving the Las Vegas and Reno areas. Coventry Health Care is stopping coverage in Southern New Jersey. In Oklahoma, Aetna Open Access will no longer cover workers in Oklahoma City and Tulsa. The plan also will leave Nashville, Tenn., and Houston. FirstCare is pulling out of Central Texas.
Some health plans are shrinking their coverage areas, but not closing the codes under which employees can enroll. Federal employees who don’t switch out of those plans will retain their coverage, but will have to travel to areas where their providers still are offering coverage to receive treatment. The plans that are both reducing coverage and eliminating the FEHBP codes for those areas no longer will continue to provide coverage to federal employees, and those employees will have to switch to new plans.
Four companies are eliminating their high-deductible health plans: Group Health Plan in Illinois and Missouri, CDPDP Universal Benefits in New York, Paramount Health Care in Ohio, and Coventry Health Care is moving its high-deductible health plan out of Delaware and New Jersey.
OPM has provided agencies with a full list of changes to FEHBP health plans. Health care providers that are lowering coverage or dropping areas entirely are responsible for informing enrollees of those changes, McGettigan said, but agencies should follow up with employees anyway, in case insurers miss workers due to changes in contact information.