GovernmentExecutive.com

The Office of Personnel Management is calling on federal health insurance carriers to begin offering enhanced hearing benefits to adults.

In its annual "call letter," sent on March 11, OPM encouraged insurance carriers under the Federal Employee Health Benefits Program to boost insurance coverage for adults who have hearing problems or need hearing aids.

FEHBP rolled out dental and vision benefits to federal employees in 2006. Last year, many carriers also opted to provide enhanced hearing benefits to children up to age 22, all with little or no increase in premiums, OPM wrote.

Sending out the call letter kicks off the season of negotiations over 2009 benefits and rates in FEHBP. OPM said it plans to complete the negotiations by Aug. 15, allowing for federal employees to select new health care options during the annual open season that occurs in the fall.

The letter also asked insurance carriers to submit ideas on how to coordinate FEHBP coverage with Medicare for federal retirees. The proposal calls for carriers to offer a suboption for Medicare-eligible annuitants with the same premium as the high, standard and basic options of most plans.

For most federal retirees 65 and older, Medicare serves as the primary payer for insurance claims, and FEHBP is the secondary payer. FEHBP plans often waive deductibles, co-payments and co-insurance for retirees who pay premiums for Medicare Part B.

The call letter suggests that insurers considering creating "premium pass-through" accounts that would enable a portion of a retiree's FEHBP premium to be credited toward Medicare premiums. "The uniform contribution amount should provide an adequate incentive for eligible members, but need not represent the full amount of Medicare premiums," the letter said.

Margaret Baptiste, president of the National Active and Retired Federal Employees Association, expressed concern about the suboption proposal, noting that creating a plan specifically for Medicare-eligible federal annuitants could open the door for separate retiree plans with substantially higher premiums than those under FEHBP.

"In the 48-year history of the program, there has never been a separate FEHBP plan based on retirement status or age," Baptiste said.

She also expressed concern that the cost of the "pass-through" accounts could result in benefit cuts or higher deductibles, co-payments and co-insurance for federal retirees and their survivors.

OPM's letter also called on carriers to provide proposals to expand the availability of high deductible health plans and the health savings accounts that accompany them. "These consumer-driven options continue to increase in popularity, and we will work with you on flexible approaches to make them more available to the federal population," the letter said.

FEHBP started offering high deductible plans in 2005, and the number of carriers offering the them went up from 29 in 2007 to 32 this year.

Baptiste criticized OPM's call for expanded high deductible plans, noting that the option has attracted only a small portion of federal workers and retirees. NARFE has long opposed such plans, arguing that they could result in higher premiums and reduced benefits for employees and retirees enrolled in traditional health plans.

COMMENTS

• Here is a copy of my 09/17/07 e-mail to OPM: Dear Ms. Springer, I learned from Government Executive that you had a news conference last week that indicated that OPM might approve some new Federal hearing benefits for children up to age 22. This is great progress, however a baby step toward improved benefits. The benefit does me no good because I am over age 22 and I am the one with the hearing loss and the need for hearing healthcare. Research has shown that one in every ten (31.5 million) Americans has hearing loss. That includes a lot of Federal employees. One state-commissioned study published in 2000 shows that the average cost for requiring hearing aid coverage by all insurers, non-profit health plans and health maintenance organizations every three years at $16. This is based on a $1400 contribution per hearing aid (beneficiaries wanting more expensive hearing aids would pay the difference), excluding the cost of batteries and maintenance that is estimated at about $300 per year. My hearing aids back then cost me about $2500 each, and was all out of pocket expense. A contribution from Federal health insurance would help defray my costs when I need new hearing aids. Please consider hearing healthcare that will benefit Federal employees as well as their families. I believe that if more employers provided this type of coverage, overall cost of hearing aids would come down and be more affordable. I hope that OPM can be a catalyst for this change. Thank you, Paula Sutton Paula Sutton Posted June 8, 2008 12:35 AM
• Health insurance is an issue for all of us and I feel that Domestic Partners should be covered. Male/Female should not be an issue. If it is, this is discrimination. If that the case the only the employee should have coverage and not thier spouse. Marie Mohr Posted May 29, 2008 4:31 PM
• In the past several years Federal Employees have watched our health care premiums rise and our covered benefits shrink. Our deductibles have risen substantially as well as copays. I was told by a network hospital that our coverage is now considered to be "supplemental" as only 85% of all eligible costs will be reimbursed. For the lucky, an occasional visit to the doctor will not impact greatly. But for those with chronic illnesses the impact of partial coverage is devestating. Each and every out patient treatment requires a 15% out of pocket expense. This doesn't include all co-pays for prescription drugs. I am being hit up with a $9,500 bill that a relentless hospital claims I owe.Our insurance is slowly but surely being chiseled out from under us. OPM, where are you? Christine Zongilla Posted March 28, 2008 11:55 AM