Big changes cause OPM to extend FEHB open season Published Dec. 11, 2008 By Tinker Public Affairs TINKER AIR FORCE BASE, Okla., -- The U.S. Office of Personnel Management announced it has taken steps to provide additional protections for federal employees participating in the Federal Employees Health Benefits Program who have non-emergency surgeries performed by out-of-network surgeons. The agency has also asked FEHB carriers to re-evaluate their benefits for non-emergency surgeries and has instructed Federal agencies to accept belated Open Season enrollments from employees who wish to change their coverage. "A lot of employees decide to keep the same coverage they have the previous year and they don't check the changes in coverage. This year, there was such a big change that OPM had to notify people and give them additional time to make changes," said Peggy Wimer, 72nd Force Support Squadron retirement program manager. "You may make belated Open Season enrollment changes to your FEHB Program, Federal Employees Dental and Vision Insurance Program and the Federal Flexible Spending Account Program if FEHB benefit changes affect your enrollment decisions in these programs. You will have an extended enrollment opportunity through January 2009 to make any enrollment changes in these programs," read an OPM letter to employees. The action is the result of concerns over a change in coverage in the Blue Cross Blue Shield reimbursement that would have established a $7,500 co-pay for out-of-network surgeries. The agency had negotiated this change to address situations where enrollees could be billed tens-of-thousands of dollars for non-emergency surgeries performed by out-of-network providers, a practice known as balanced billing. According to OPM, if employees make a belated Open Season change to their enrollment in these programs, the effective dates of the belated change will vary among the programs. Depending on the timing of their change and pay periods, it may take one or more pay periods for the Federal Benefits deductions/allotments to be adjusted to match the employees new election. "You need to know if you make a belated Open Season change and you have claims for services incurred in 2009 under your former plan, you and/or your provider may be responsible for reimbursing the former plan for any benefits paid," said the statement. Carriers have been asked to propose changes no later than Monday, December 8. OPM will not allow changes to premiums in 2009 or to other types of benefits in 2009. Belated FEHB changes will take effect the first day of the pay period that starts on or after January 1, 2009. Belated FEDVIP changes will take effect January 1, 2009. Belated FSAFEDS changes will take effect on January 1, 2009, or the day after the change is received, whichever is later. "At civilian personnel, we can't counsel employees on what coverage is best for them. Everyone should have an opportunity to get online during open season and decide for themselves what is best," Ms. Wimer said.