OPM seeks enhanced hearing benefits in federal health plan

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.