It’s Time to Start Thinking About Health Insurance Open Season

Among the signs that fall is upon us is that health insurance open season looms in the not-too-distant future. The 2020 open season will run from Nov. 11 to Dec. 9, 2019. It makes sense to do some homework before the start of open season because, as usual, you’ll have a lot of options.

The 279 health plans available in the Federal Employees Health Benefits Program include:

• 18 fee for service plans open to all 
• 4 fee for service plans with availability limited to certain groups 
• 257 HMO plans
• 19 high deductible health plans
• 28 consumer driven health plans 

Plan brochures and plan comparison tools will be available in early November, before the start of open season. The 2020 rates for all FEHBP plans are available now. 

There’s a new indemnity benefit plan called GEHA Elevate that will fill a spot that has been open for 30 years in FEHBP. Indemnity plans allow you to visit almost any doctor or hospital you like. The insurance company then pays a set portion of your total charges. 

The lines between preferred provider organization plans and health maintenance organization plan continue to blur.  Today, you may find that a traditional fee for service plan such as Blue Cross/Blue Shield Basic Option requires the use of network providers (similar to an HMO) for the plan to provide coverage. 

Plans such as Aetna Direct, which is classified as an HMO, work well for retirees nationwide who are enrolled in Medicare Parts A & B. It does not require a referral to see a specialist and coverage is available outside of the network providers. 

Laurie Bodenheimer, acting director of health care and insurance at OPM, said this week that only 5% to 6% of federal enrollees change plans during open season, adding that she wished the percentage was higher. She admitted that switching can be a daunting task, and people enrolled in plans currently accepted by their doctors may be reluctant to change. Others are put off by the confusing jargon in the health insurance world.

Two health plans will no longer participate in FEHBP in 2020: MVP Health Care, which covers 3,200 employees and more than 4,000 retirees in New York; and Highmark Choice Co. (also known as Keystone Health Plan West), which  covers 718 employees and 323 retirees in Pennsylvania. Enrollees in these plans will have to select a new plan during open season. Otherwise, they will be automatically enrolled in the lowest-cost nationwide plan option, which for 2020 is GEHA Elevate. 

Blue Cross/Blue Shield’s standard option remains the most popular FEHBP plan with retirees, with more than 930,000 retiree enrollments as of March 2018. But it’s also one of the most expensive. Blue Cross/Blue Shield’s basic option was most popular among current employees, with 807,000 enrollments.

Some plans will significantly increase premiums in most areas in 2020. They include:

• Rural Carrier Benefit Plan
• Aetna HealthFund Value Plan
• Aetna HealthFund High Deductible Health Plan
• Aetna HealthFund Consumer Driven Health Plan (in some areas)
• Aetna Open Access High Option Plan
• Health Net of California High and Standard Option Plans (in some areas)
• Humana Health Plan Basic, Standard and High Option Plans
• Humana CoverageFirst Value and Consumer Driven Health Plans 
• Humana Medical Plan High and Standard Option Plans
• Humana Employers Health Plan of Georgia Basic, Standard, and High Option Plans
• District of Columbia M.D. IPA
• Hawaii Aetna HealthFund Value Plan

Some plans will be reducing premiums in 2020:

• APWU High Option
• GEHA High Option
• MHBP Standard and Value Options
• SAMBA High and Standard Options
• Aetna HealthFund Consumer Driven Plan (in some areas)
• United Healthcare Insurance Company High Deductible Health Plan
• Health Net of California Basic Plan
• Aetna Open Access Basic and High Option Plans (in some areas)

As open season nears, we’ll look in more depth at how you can assess your options.