Federal employees and pensioners were in for a surprise last month when the Office of Personnel Management released details about the upcoming Federal Employee Health Benefits (FEHB) open season. Health insurance premiums are set to rise by an average of 13.5% next year, the largest increase in recent memory. OPM also announced expansions to infertility treatment and maternity benefits.
Let's see how these changes will affect us next year.
Increase in insurance premiums
Although the average percentage of participants' premiums is rising, not all plans reflect that trend. Of the 144 FEHB plans available in 2024 and 2025, self-only premiums decreased in 28 plans, remained the same in 5 plans, increased below average 13.5% in 69 plans, and increased above average in 42 plans. Masu.
Some changes are noticeable. The largest decline in enrollee share of premiums will come from Presbyterian Health Insurance Standard (PS), available in New Mexico, which will be reduced by 23% in 2025 to about $732 next year for self-only enrollees. You can save.
CareFirst BlueChoice Blue Value Plus (B6), available in the DC area, will have the same premium next year. The largest increase comes from the Health Alliance HMO Standard (K8), available in multiple states, which will increase by 66% in 2025, increasing costs by $2,222 next year for self-only enrollees.
This average increase of 13.5% is the largest in the past 20 years. Just three years ago, the average enrollment rate increased by only 3.8%. It's unclear whether 2025 will be an outlier or a trend, but federal employees and pensioners should be prepared for significant premium increases in the future.
How to combat rising insurance premiums
First, choosing a plan is important. Only about 5% of federal employees and pensioners switch coverage each year, and many stay in the same plan for years. However, not all insurance premiums are increasing at the same rate. If you haven't considered more affordable options lately, this open season is a great time to do some research and see if there's a less expensive plan that offers similar provider access and benefits to your current plan. This is an opportunity.
If you are an active federal employee, consider using a Flexible Spending Account (FSA). Medical expenses include not only health insurance premiums, but also out-of-pocket expenses such as medical expenses, dental expenses, and vision test expenses. With an FSA, you can save about 30% on these costs through pre-tax contributions. FSAFEDS, which administers the Federal Financial Services Agency program, faced fraud problems earlier this year and suspended new registrations, but new fraud prevention and security measures were introduced and registrations resumed in August. Currently, only about 20% of federal employees have an FSA, meaning many are missing out on guaranteed savings on health care costs. The FSA Open Season is linked to the FEHB Open Season and runs from November 11th to December 9th.
fertility benefits
Starting this year, all FEHB plans provide access to all artificial insemination methods and ovulation-inducing drugs associated with in vitro fertilization (IVF) (up to three cycles per year). Additionally, BCBS Standard, a National Preferred Provider Organization (PPO) plan, offered a $25,000 annual stipend to cover the cost of IVF; It did not count towards the dollar limit.
Next year, federal employees seeking IVF coverage will be able to choose from an additional nationwide plan, GEHA High. In addition to these options, some local plans plan to expand benefits to include IVF coverage in 2025. In the D.C. area, these include CareFirst Plan, Sentara Health (N. Virginia), and MDIPA. In Colorado, Kaiser is planning. In New York, an independent health plan. And in California, Western Health, and Sharp.
Despite expanded coverage of IVF, families who use these services still face significant out-of-pocket costs. The cost of a single IVF cycle ranges from $15,000 to $30,000, and coinsurance (the portion that plan members must pay) varies between 15% and 50% of the total cost of the procedure, depending on the plan. I will. This means families could be facing thousands of dollars in out-of-pocket costs. Those planning to take advantage of IVF benefits should consider using an FSA, which allows contributions of up to $3,200 in 2024, to offset these costs.
maternal health
Plan year 2025 will expand maternal health benefits. All FEHB plans cover mental health treatment for postpartum depression, 80% of plans cover certified nurse midwives, 67% cover births in birth centers, and 72% cover nurses. Masu. home visits, 47% cover doulas; For more information on maternity benefits, please see section 5(a) of the official FEHB scheme brochure.
Please keep sending us your questions about FEHB. I plan to include the answers below in future columns.
Question: I am a retired federal employee (non-postal retiree) with American Postal Workers Union (APWU) health insurance under the FEHB. I know I don't qualify for the new Postal Service health plan, but do you know if the APWU health plan will still be available under the FEHB in 2025?
Postal union plans offered by APWU, the National Association of Letter Carriers (NALC), and the Mail Handler Benefit Plan (MHBP) are available to nonpostal employees and pensioners who become associate members upon enrollment by paying an annual fee. Masu.
APWU offers two plans, Consumer Directed Health Plan (CDHP) and High, and associate members pay an annual membership fee of $35.
NALC offers two plans, CDHP and High, and associate members pay an annual membership fee of $36.
MHBP offers three plans: Consumer Option, Standard Option, and Value Plan, and associate members pay an annual membership fee of $52.
Kevin Moss is a senior editor at Consumers' Checkbook. See more of his free advice and see if the Health Planning Guide for Federal Employees is available for free from your agency. You can also purchase the guide and save 20% using promo code FEDNEWS.
Copyright © 2024 Federal News Network. Unauthorized reproduction is prohibited. This website is not directed to users within the European Economic Area.
