FEHB: Here’s what’s new for Open Season 2024

Before Open Season begins on Nov. 13, it’s important to review what’s new in the Federal Employees Health Benefit Program. As in previous years, there are significant premium, benefit, and plan availability changes that will affect both active and retired federal employees. We’ll walk you through important updates impacting your budget and plan choice in 2024.

The Plans

With Humana exiting the FEHB market, there are far fewer plans available in 2024 than 2023―only 156 compared to 271. Besides Humana, additional HMO plans are no longer participating next year, including UnitedHealthcare Choice Plus Advanced in Florida and Georgia, United HDHP in Iowa and Kentucky, Indiana University Health Plan, AultCare in Ohio, and Aetna Open Access in Kansas and Missouri. Remember: If your plan is no longer available next year, you must choose a new one or you will be auto-enrolled in the least expensive national PPO plan, GEHA Elevate.

Besides plans leaving, service area changes could impact your choice of available plans. Kaiser Permanente in Colorado is both adding and removing counties for High, Standard, and Prosper plans; Blue Shield of California High Open Access is dropping counties; and Capital Health Plan in Florida, Health Alliance in Michigan, and HealthPartners in South Dakota are all adding counties.

There aren’t many new plan options for 2024. Compass Rose has changed their offerings with both a high and standard option. They have also expanded their enrollment criteria by granting Veterans Affairs Department employees and retirees with eligibility. Sentara High has a new plan available in Northern Virginia.

The Benefits

Every federal employee and annuitant should check Section 2, “What’s New for 2024,” of their current plan’s official FEHB brochure, plus any other plan they’re considering. This is where the plan will inform you of important benefit changes. While some plans will have very few and may only mention premium, other plans may have very different benefits in 2024 that could affect your decision.

For example, United Choice Plus Advanced is increasing the catastrophic out-of-pocket maximum from $3,000 to $6,000 for self-only enrollees and from $6,000 to $12,000 for self-plus-one and self-&-family enrollees.

Plans are offering some new benefits next year. MHBP plans have enhanced maternity programs as a wellness benefit, SAMBA plans are offering doula coverage, BCBS plans have both marital and family counseling and medically necessary genetic testing.

Improved Fertility Coverage

This is by far the biggest FEHB benefit change. OPM mandated that all FEHB plans in 2024 must provide coverage of artificial insemination procedures and IVF-related fertility drugs. Families that need these services will still face high out-of-pocket costs, however, as the cost share is sometimes as much as a 50% coinsurance. Also, some plans, like Aetna Advantage, don’t count out-of-pocket costs for fertility services toward the out-of-pocket maximum.

The fertility coverage available to you is somewhat determined by where you live. FEHB plans based in Hawaii, HMSA & Kaiser, have covered IVF for many years because of laws passed in that state. And, historically, IVF coverage has been more widely available in HMO plans.

Next year you can find IVF coverage in the following HMO plans:

• Presbyterian High, Standard, and Wellness in NM
• UPMC HDHP and Standard in PA
• Calvo’s Selectcare in Guam
• Triple S Salud in Puerto Rico
• SelectHealth HDHP and High in UT
• Baylor Scott & White Basic and Standard in TX
• Health Alliance HMO in IA/IN/IL
• Priority Health High, Standard, and Value in MI

Two restricted enrollment PPO plans offer improved IVF coverage in 2024: Rural Carrier and Foreign Service.

And, importantly, one national PPO plan with open enrollment has gone above and beyond the OPM mandate. BCBS Standard now has a $25,000 annual maximum for assisted reproductive technologies . Artificial insemination procedures and fertility drugs do not count toward the $25,000 annual maximum. Do keep in mind though that BCBS Standard has the highest premium of any national PPO plan.

Higher Premiums

Overall, the average enrollee share of premium is rising 7.7% in 2024. This is slightly below last year, which was an 8.7% increase. When combined, however, this two-year span is one of the highest periods of increased premiums FEHB enrollees have faced in recent history.

Federal annuitants enrolled in Medicare Part B and paying the standard premium will see those premiums rise from $164.90/month to $174.70/month, a 5.9% increase.

Higher Contribution Limits for Tax Preferred Savings Accounts

With higher premiums and the potential for higher out-of-pocket healthcare costs in 2024, it’s essential that active federal employees maximize the opportunity to save by using tax-preferred savings accounts.

Health Savings Accounts are available from High-Deductible Health Plans. HDHPs contribute a portion of the premium into the HSA as a monthly premium pass through. The total amount contributed to the HSA varies by plan, but ranges from $900 to $1,200 for self-only enrollees and $1,800 to $2,400 for self-plus-one and self-&-family enrollees. In 2024, the HSA contribution limit from the FEHB plan and employee is increasing to $4,150 for self-only enrollees and $8,300 for self-plus-one and self-&-family enrollees.

Only about 20% of all federal employees use a Flexible Spending Accounts (FSA), which is a great way to save about a third of the cost on a qualified healthcare expense. FSA contribution limits for 2024 have not been released by the IRS, but the limit is expected to rise to $3,200.

Improved Prescription Drug Coverage for Annuitants

There are 17 FEHB plans that will offer a new Part D prescription drug plan in 2024. Plan members that have Medicare Part A or Medicare Parts A & B will be auto-enrolled in the Part D plan, except for BCBS plans which will only auto-enroll members that have both A & B.

• BCBS Basic, Standard, FEP Blue Focus
• NALC High
• MHBP Standard, Value, Consumer Option
• APWU High
• Rural Carrier High
• Foreign Service High
• SAMBA Standard, High
• HealthPartners Standard, High
• Aetna Direct Consumer Option
• Aetna Open Access Basic High – DC, MD, VA

Impacted members will receive communication of the new Part D coverage from their insurance plan and will have the opportunity to opt-out if they wish. However, almost everyone should keep the new Part D coverage. Why? Because the Part D prescription drug coverage is as good or better than what’s available in the FEHB plan, at no extra premium. Additionally, BCBS Standard, Rural Carrier High, Foreign Service, and the MHBP and Aetna plans have all added a $2,000 prescription drug out-of-pocket max, which could have a major impact on annuitants that face moderate to high prescription drug expenses.

High income annuitants will be subject to an Income Related Monthly Adjustment Amount (IRMAA) for Part D coverage. However, the Part D IRMAA is much lower than for Part B. For the first tier of IRMAA, individuals with yearly income above $103,000 but less than $129,000 and couples with income above $206,000 and below $258,000, you’ll pay an extra $12.90/month for Part D compared to an extra $69.90/month for Part B. The enhanced Part D benefits will outweigh Part D IRMAA for most.

The Final Word

Your FEHB plan will change for 2024. Most will see increased premiums next year, and some 2023 FEHB plans won’t be available in the new year. There could be an important benefit that you use that has a new pre-authorization requirement, or there could be a newly available benefit next year. Make sure you review Section 2 of the official plan brochure to see how your plan is changing.

Federal employees and annuitants will both face higher healthcare costs in 2024. Active employees have access to tax-preferred savings accounts while working, but many don’t take advantage of this easy way to save on qualified healthcare expenses.

Annuitants will face both higher FEHB plan premiums and a higher Medicare Part B premium. However, new Part D prescription drug coverage available from certain FEHB plans will be an important way for annuitants that face moderate to high prescription drug costs to save money.

Kevin Moss is a senior editor with Consumers’ Checkbook. Checkbook’s 2024 Guide to Health Plans for Federal Employees will be available on the first day of Open Season, November 13th. Check here to see if your agency provides free access. The Guide is also available for purchase and Government Executive readers can save 20% by entering promo code GOVEXEC at checkout.