Open Season Report

PEN SEASON

REPORT

2022 OPEN SEASON: NOVEMBER 7 – DECEMBER 12

FEHB PLAN CHANGES

The 2022 Federal Benefits Open Season will run from Monday, November 7, through Monday, December 12.

During Open Season, federal employees may enroll or change their current enrollments in several federal insurance benefit programs: the Federal Employees Health Benefits (FEHB) program, the Federal Employee Dental and Vision Insurance Program (FEDVIP) and the Federal Flexible Spending Account Program (FSAFEDS).

Federal retirees and survivors may make changes to their current enrollment in FEHB and FEDVIP. Open Season is the only time of the year when enrollees in FEDVIP can cancel their enrollment.

In early October, the Office of Personnel Management (OPM) will release information regarding the 2022 premiums and benefit changes for the numerous insurance plans participating in these federal programs. This occurs well ahead of the start date of Open Season in order to give everyone enough time to study the options and decide whether to make a change.

NARFE will publish selected premium rates and information in the November and December issues of NARFE Magazine. The information will also be posted on NARFE’s website at www. narfe.org.

THIS YEAR’S FOCUS

Generally, OPM encourages carriers to consider a broad range of value- and evidence-based plan designs. In its annual call for carriers earlier this year, OPM announced its focus on advancing health equity and ensuring the federal government, as the largest employer in the country, offers competitive, comprehensive health insurance benefits to its employees, annuitants, their families, and other eligible persons and groups. For the 2023 plan year, OPM requested particular emphasis on certain areas of concern: • Maternal Health: America has one of the highest rates of maternal mortality among high-income countries despite significantly higher spending on maternity care.

Additionally, 50,000 women in the U.S. each year experience pregnancy complications or severe maternal morbidity, which includes unexpected and life-threatening outcomes of labor and delivery that result in significant short- or long-term consequences to their health. Racial disparities persist even when controlling for education, income, maternal age, hypertension, and receipt of prenatal care.

OPM is urgeing FEHB carriers to consider expanding coverage and services in support of prenatal and postpartum care including, but not limited to, childbirth education classes,

group prenatal care, home visiting programs or home health care during pregnancy and postpartum, and care management for highrisk pregnancies. OPM also encourages FEHB carriers to increase communication efforts to

FEHB members who are either pregnant or of childbearing age. • Gender Affirming Care and Services:

In the 2023 plan year, OPM is focused on furthering ways FEHB carriers can improve access to gender affirming care for transgender and gender diverse individuals.

This focus is in accordance with Executive

Order 14035, which directs OPM to “promote equitable healthcare coverage and services for enrolled LGBTQ+ employees” and their covered family members through the FEHB

Program. For the 2023 plan year, individuals diagnosed with and/or undergoing evaluation for gender dysphoria must be provided the option to use a Care Coordinator to assist and support them as they seek gender affirming care and services. This aligns with the practice of care coordination offered for other complex diagnoses or conditions (e.g., obesity, diabetes, advanced cardiovascular disease, kidney disease). OPM also is instructing

FEHB carriers to review their formularies to ensure that transgender and genderdiverse individuals have equitable access to medications including medically necessary hormonal therapies. Clinical criteria should be evidence-based, transparent, easy to access and not impose unnecessary barriers to medically necessary care. • Obesity: Obesity serves as a major risk factor for developing conditions such as heart disease, stroke, type 2 diabetes, renal disease, non-alcoholic steatohepatitis, and certain types of cancer. Obesity disproportionally affects some ethnic and/or racial groups.

Estimates have shown that the annual medical cost for people who have obesity are on average 42% -75% higher than those of normal weight, with costs increasing significantly with the severity of obesity.

Does MHBP have plans that work for retirees? We do.

MHBP has plans for every stage of your life.

We offer plans with highly competitive rates that are full of great features. And we understand how a health plan’s programs can help you live a healthy lifestyle.

As we approach Open Enrollment, be sure to check out all your options.

© 2021 Aetna, Inc. Plans offered by First Health Life & Health Insurance Company. Plans contain exclusions and limitations. This is a brief description of the features of the plans. Before making a final decision, please read the Plan's Federal brochure. All Benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. © 2021 Aetna, Inc. 19.22.320.1-OCT (8/21) HERE’S HOW TO LEARN MORE

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OPEN SEASON REPORT

Timely management of obesity can be cost effective, lower health risks, and prevent disease progression. OPM is instructing FEHB carriers that they are not allowed to exclude anti-obesity medications from coverage based on a benefit exclusion or a carve out. Further, FEHB carriers must have adequate coverage of FDA-approved anti-obesity medications on the formulary to meet patient needs and must include their exception process within their proposal.

COMMON FEHB OPEN SEASON QUESTIONS Will my current health plan continue to participate in the FEHB program?

Don’t assume that your urrent plan will remain in the program or have the same coverage this year. The FEHB program adds new plans and drops others each year, and plans can change from year to year. For instance, you may find that your premium stays the same, but certain medical procedures are not covered the way they have been in the past. The best way to stay on top of upcoming changes is to read the information available from your health plan and from OPM. To ensure you do not miss any critical communication, make sure your current address is on file with both OPM and your FEHB plan.

My health plan will continue to participate in the FEHB program next year. What should I do if I want to stay with my present enrollment?

If you are satisfied with your present health insurance coverage, don’t do anything—your plan will automatically continue unless you make a change or your plan option is terminated. But do confirm that all aspects of your plan are remaining the same before making this commitment.

My health plan will not be participating next year. What happens if I do not change to another plan before Open Season ends?

If your current plan will not be participating in the FEHB program in the upcoming year, you may elect a new plan during Open Season. In the event of a plan termination, if you don’t proactively make an election during Open Season, by regulation, the employing agency (if employed) or OPM (if retired) will enroll the employee/annuitant in the lowest cost nationwide plan.

How do I get a plan brochure for Open Season? I didn’t get the one I expected in the mail.

Health insurance carriers are no longer required to send plan brochures through the mail. You can view the brochures online at OPM’s website (www.opm.gov/healthcareinsurance/healthcare/plan-information/plans/) or call your carrier using the contact information on your health plan ID card.

What changes are permitted during Open Season?

During Open Season, you may enroll, cancel an enrollment, change plans or options, and waive or begin participation in premium conversion. If you waived participation in premium conversion, you can change from Self and Family enrollment to a Self Only enrollment or cancel your enrollment at any time.

I am a federal annuitant. Can I change my enrollment to Self Plus One during Open Season or was enrollment in Self Plus One required in the five years leading up to my retirement?

No, you do not have to be enrolled in Self Plus One for the five years before you retire to change during Open Season.

If I make a change during Open Season, when will it be effective?

Open Season changes for annuitants are effective January 1. Changes for most current employees are effective the first day of the first full pay period in January. If you need medical services before the effective date of your Open Season enrollment, you should contact your old plan.

— NARFE FEDERAL BENEFITS INSTITUTE

TOGETHER, WE CAN SUPPORT THE HEALTH OF FEDERAL EMPLOYEES

We’re proud to stand with The National Active and Retired Federal Employees Association (NARFE) in supporting federal employees. Through our quality coverage, nationwide network and helpful tools and resources, we’re dedicated to empowering active and retired federal employees to stay healthy.