# Health Benefits 2003 Newsletter

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+-----------------------------------------------------------------------+
| ### Information!                                                      |
+-----------------------------------------------------------------------+

-   FEHB and 2002 Open Season;

-   Federal Long Term Care;

-   Flexible Spending Account;

-   Temporary Continuation of Coverage;

-   PlanSmartChoice;

-   How to Enroll or Make changes during Open Season; and

-   Plans dropping out of the FEHB for 2003

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-   ***FEHB and 2002 Open Season***

![](media/image2.wmf)

*The Federal Employees Health Benefits (FEHB) Open Season will be held
from November 11 - December 9, 2002.*

**Alert!**

**This year, several plans will not be participating in the FEHB Program
after December 31, 2002. In addition, some plans have been dropped.
Employees affected MUST enroll in a different plan to continue FEHB
coverage in 2003. (See pages 4 to 7)**

During open season, any eligible employee who is not currently enrolled
may enroll. Eligible enrollees may change from one plan or option to
another, from self only to self and family or make a combination of
these changes. In addition, open season allows employees to change their
premium conversion election. An eligible employee who enrolls in FEHB
may elect to participate or to waive participation in premium
conversion. Also, an eligible enrollee may elect to begin participation
if they have previously waived premium conversion.

Enrollees who wish to continue their current enrollments and premium
conversion elections do not need to take any action during this open
season.

There are three basic types of plans available under the FEHB Program:

![](media/image3.wmf)1. **[Managed Fee-for-Service Plans]{.underline}.**
These plans reimburse you or your health care provider for covered
services after you receive the service. If you enroll in one of these
plans, you may choose your own physicians, hospitals, and other health
care providers. These plans are considered "managed" because they all
contain features such as pre-certification of hospital admissions and
utilization review of ongoing care. In addition, most of the
fee-for-service plans have preferred provider arrangements in many parts
of the country. By using preferred providers, you can reduce your
out-of-pocket expenses and, in some cases, receive enhanced benefits.

2\. **[Health Maintenance Organization Plans (HMOs)]{.underline}.**
These plans provide a comprehensive array of medical services,
emphasizing prevention and early detection of disease, through
contracted physicians, hospitals, and other providers in particular
locations. Each HMO is open to employees within the plan\'s enrollment
area. You cannot enroll in an HMO if you are located outside its
enrollment area. Refer to the plan\'s brochure if you have any questions
about the enrollment area. **If you are enrolled in an HMO, be sure to
review the brochure carefully to see if there are any changes in the
plan\'s service area, which may require action on your part.**

3\. **[Plans Offering a Point of Service (POS)]{.underline}**

**[Product]{.underline}.** Some FEHB plans combine their features. A
number of fee-for-service and HMO plans offer two forms of health care
delivery, known as "in network\" and \"out of network.\" In an HMO that
offers a POS product, the POS product acts like a fee-for-service plan.
The HMO enrollees may use non-affiliated (out of network) providers if
they wish, but the services will cost them more\--in terms of
deductibles and coinsurance\-\--than if they used plan providers.

#### All 2003 FEHB Guides, health plan brochures, and the news release announcing the 2003 premium rates are available on the OPM's web site at [***http://www.opm.gov/insure/health***](http://www.opm.gov/insure/health) or you may contact TASC Human Resource Services at x64459.

#### Long Term Care

The Federal Long Term Care Insurance Program (FLTCIP) is an important
new benefit for over 20 million members of the Federal Family, including
Federal and Postal employees and annuitants, members and retired members
of the uniformed services and their qualified relatives.

The Office of Personnel Management (OPM) contracted with John Hancock
and MetLife to provide the insurance. They formed a company called Long
Term Care Partners to administer this Program. **Open Season for the
FLTCIP runs through December 31, 2002.** The only way to apply is to
submit an application directly to Long Term Care Partners. You can
obtain an application at [www.ltcfeds.com](http://www.ltcfeds.com/) or
by calling 1-800-LTC-FEDS; TDD for the hearing impaired: 1-800-843-3557.
Certified LTC Specialist's are available 8:00 am - 12:00 am EST, 7 days
a week to answer your questions.

-   Flexible Spending Account

A new benefit -- Flexible Spending Accounts (FSA) will be offered to
federal employees beginning in July 2003. Employees will be able to set
up a health care FSA to use for out-of-pocket costs including
co-payments, deductibles and health care expenses not covered by
insurance, such as dental services and eye-care. Employees also will be
able to set up an account for dependent-care expenses for children and
aging parents. It also allows employees to establish a personal savings
account with pre-tax dollars.

-   ***What is Temporary Continuation of Coverage?***

Temporary Continuation of Coverage (TCC) is a feature that allows
certain people to temporarily continue their FEHB coverage after regular
coverage ends. Who is eligible for TCC? Separated employees, former
spouses and children who have reached age 22. TCC enrollees must pay the
total plan premium (without a Government contribution) plus a 2% charge
for administrative expenses. You have 60 days from the qualifying event
to elect TCC.

##### **PlanSmartChoice**

PlanSmartChoice is a suite of web-based decision tools that helps FEHB
participants choose a medical plan for the upcoming year. It offers four
tools that help you in your decision-making process:

-   Selection Tool: A three step exercise that helps you determine what
    is important to you when choosing a plan. Based on this exercise, it
    determines which of the plans available to you best fit your stated
    needs.

-   Comparison Module: This tool provides you with the ability to
    compare detailed plan benefits across the plan available to you.

-   Performance Module: This tool lets you examine enrollee National
    Committee for Quality Assurance (NCQA) satisfaction data across the
    plans available to you.

-   Medical Cost Calculator: This tool allows you to estimate your 2003
    out of pocket costs for each plan available to you based on your
    estimated usage of medical service.

To access the PlanSmartChoice website, log onto
[www.employeeexpess.gov](http://www.employeeexpess.gov/).

Please note that information you provide by enrolling in the Federal
Employees Health Benefits Program may also be used for computer matching
with Federal, State, or local agencies\' files to determine whether you
qualify for benefits, payments, or eligibility in the Federal Employees
Health Benefits Program, Medicare, or other Government benefits
programs.

***[How to Enroll or Make an Enrollment Change During Open
Season]{.underline}*.**

###### It's Fast -- It's Simple and It's Easy!

![](media/image4.wmf)

**OST, TASC, BTS and TSA employees who wish to enroll in FEHB must use**
**Employee Express (EE)** to make Health Benefits open season elections
through the Internet at

[www.employeeexpress.gov](). You will need your social security number
and PIN, or you may use a touch-tone phone: 1-800-827-6289 and from
work: 1-478-757-3084. Hearing-impaired persons can dial TDD
1-888-880-0412. New and transferring employees will automatically
receive a PIN within a month of their EOD. Employees will need their
Social Security Number, Date of Birth, and Organization. New
enrollments, changes to current enrollments, and changes to premium
conversion elections made during open season will become effective on
January 12, 2003. If you change plans, any covered expenses incurred
January 1-11, 2003, will count toward the 2002 deductible of the plan
you are changing from.

   

## ![](media/image5.wmf)

## 

## 

## 

## 

## 

## FEHB PROGRAM OPEN SEASON: SIGNIFICANT PLAN CHANGES FOR 2003

####### 

####### Plans dropping out of FEHB for 2003

Employees in these plans who do not change health plans during open
season will not have health benefits for 2003.

+-------------------+----------------------------+---------------------+
| ####### State     | ####### Plan               | ####### Code        |
+-------------------+----------------------------+---------------------+
| CA                | Western Health Advantage   | 5Z                  |
+-------------------+----------------------------+---------------------+
| CO                | Rocky Mountain HMO         | XJ                  |
+-------------------+----------------------------+---------------------+
| CT                | Health Net of Connecticut  | DP                  |
+-------------------+----------------------------+---------------------+
| IA                | SecureCare of Iowa         | 3Q                  |
+-------------------+----------------------------+---------------------+
| IN                | Welborn HMO                | H3                  |
+-------------------+----------------------------+---------------------+
| NY                | Univera Healthcare         | QE                  |
+-------------------+----------------------------+---------------------+
|                   | Univera Healthcare         | SH                  |
+-------------------+----------------------------+---------------------+
|                   | Health Net of New York     | PD                  |
+-------------------+----------------------------+---------------------+
| PA                | KeystoneBlue               | EF                  |
+-------------------+----------------------------+---------------------+
| TX                | HMO Blue Texas             | YX                  |
+-------------------+----------------------------+---------------------+
| VA                | HealthKeepers              | X8                  |
+-------------------+----------------------------+---------------------+
| WI                | Unity Health Plans         | W4                  |
+-------------------+----------------------------+---------------------+

####### Plans reducing their service areas by terminating an 

####### Enrollment Code

Enrollees in these enrollment codes who do not change health plans
during open season will not have health benefits for 2003.

+-------------------+----------------------------+---------------------+
| ####### State     | ####### Plan               | ####### Code        |
+-------------------+----------------------------+---------------------+
| IN                | Aetna Health               | 7L                  |
+-------------------+----------------------------+---------------------+
| KY                | Aetna Health               | 7L                  |
+-------------------+----------------------------+---------------------+
| NV                | Aetna Health               | 8L                  |
+-------------------+----------------------------+---------------------+
| NY                | Aetna Health               | TG                  |
+-------------------+----------------------------+---------------------+
| PA                | Health Net of PA           | 27                  |
+-------------------+----------------------------+---------------------+

#######  

####### 

####### Plans reducing their service areas without terminating an

####### Enrollment Code

Enrollees in the area being dropped who do not change health plans
during open season will have to travel to their plan\'s remaining
service area to obtain medical care in order to receive full benefits
from the plan in 2003.

+---------+---------------------+-------------------------------------+
| ######  | ####### Plan        | ####### Code - Counties Dropped     |
| # State |                     |                                     |
+---------+---------------------+-------------------------------------+
| AZ      | Health Net of       | A7-Coconino                         |
|         | Arizona             |                                     |
+---------+---------------------+-------------------------------------+
| CA      | Aetna Health        | 2X-San Diego                        |
+---------+---------------------+-------------------------------------+
|         | Health Net          | LB-Amador, Colusa, Glenn, Lassen,   |
|         |                     | Mariposa, Mendocino, Plumas,        |
|         |                     | Sierra, Tehama                      |
+---------+---------------------+-------------------------------------+
|         | PacifiCare          | CY-Imperial County, City of Blythe  |
|         |                     | (Riverside County)                  |
+---------+---------------------+-------------------------------------+
| FL      | Av-Med              | EM-[Gainesville area]{.underline}:  |
|         |                     | Alachua, Bradford, Citrus,          |
|         |                     | Columbia, Dixie, Gilchrist,         |
|         |                     | Hamilton, Levy, Marion, Putnam,     |
|         |                     | Suwannee, Union; [Jacksonville      |
|         |                     | area]{.underline}: Baker, Clay,     |
|         |                     | Duval, Nassau, St. Johns; [Orlando  |
|         |                     | area]{.underline}: Orange, Osceola, |
|         |                     | Seminole; [Tampa area]{.underline}: |
|         |                     | Lee, Sarasota                       |
+---------+---------------------+-------------------------------------+
| MO      | BlueChoice          | 9G-Adair, Linn, Putnam, Schuyler,   |
|         |                     | Sullivan, Butler, Carter, Ripley,   |
|         |                     | Wayne                               |
+---------+---------------------+-------------------------------------+
| IL      | PersonalCare HMO    | GE-Edgar, Macon, Montgomery, Morgan |
+---------+---------------------+-------------------------------------+
| IN      | Advantage Health    | 6Y-Adams, Allen, DeKalb, Gibson,    |
|         | Plan                | Huntington, Kosciusko, LaGrange,    |
|         |                     | Noble, Porter, Posey, Vanderburgh,  |
|         |                     | Warrick, Wells, Whitley             |
+---------+---------------------+-------------------------------------+
| KY      | Aetna Health        | RD-Entire State                     |
+---------+---------------------+-------------------------------------+
| MI      | The Wellness Plan   | K3-St. Clair, Shiawassee            |
+---------+---------------------+-------------------------------------+
|         | OmniCare            | KA-Monroe                           |
+---------+---------------------+-------------------------------------+
| NV      | Health Plan of      | NM-Lyon, Mineral, Washoe            |
|         | Nevada              |                                     |
+---------+---------------------+-------------------------------------+
| OH      | Advantage Health    | 6Y-Defiance                         |
|         | Plan                |                                     |
+---------+---------------------+-------------------------------------+
|         | Aetna Health        | 7D-Allen, Crawford, Erie, Hancock,  |
|         |                     | Hardin, Henry, Lucas, Ottawa,       |
|         |                     | Putnam, Sandusky, Seneca, and       |
|         |                     | portions of Auglaize, Fulton,       |
|         |                     | Huron, Wood                         |
+---------+---------------------+-------------------------------------+
| OK      | PacifiCare          | 2N-Logan                            |
+---------+---------------------+-------------------------------------+
| TX      | HMO Blue Texas      | YM-Aransas, Atascosa, Bastrop, Bee, |
|         |                     | Bell, Bexar, Blanco, Bosque,        |
|         |                     | Brazos, Brooks, Burleson, Burnet,   |
|         |                     | Caldwell, Cameron, Comal, Fayette,  |
|         |                     | Freestone, Gonzales, Guadalupe,     |
|         |                     | Hays, Hidalgo, Hill, Jim Wells,     |
|         |                     | Karnes, Kendall, Kenedy, Kleberg,   |
|         |                     | Lee, Leon, Madison, McLennan,       |
|         |                     | Medina, Milam, Navarro, Nueces,     |
|         |                     | Refugio, Robertson, San Patricio,   |
|         |                     | Starr, Travis, Willacy, Williamson, |
|         |                     | Wilson                              |
+---------+---------------------+-------------------------------------+

####### Plans Splitting a Service Area

***Enrollees in this plan under the 2002 enrollment code shown below
should check their plan brochure to determine which 2003 code they
should be under.***

  --------------- ------------------- -------------- ---------------------
  **State**       **Plan**            **Code 2002**  **Code 2003**

  NY              Univera Healthcare  Q8             KQ, Q8
  --------------- ------------------- -------------- ---------------------

####### 

Note: Univera Healthcare will split its service area into two enrollment
codes. Univera Healthcare-Southern Region (Allegany, Cattaraugus and
Chautauqua counties) will get a new enrollment code KQ, and Univera
Healthcare-Northern Region (Erie, Genesee, Niagara, Orleans and Wyoming
counties) will retain the current enrollment code Q8. Current Federal
members enrolled in code Q8 who live or work in the counties designated,
as the Southern Region must enroll in KQ or a new plan during Open
Season.

  --------------- ------------------- -------------- ---------------------
  **State**       **Plan**            **Code 2002**  **Code 2003**

  FL              Av-Med              EM             EM, ML
  --------------- ------------------- -------------- ---------------------

####### 

Note: Av-Med Health Plan will split their FEHB contract into two
separate contracts which will result into two enrollment codes. Av-Med
Health Plan -- South Region will get a new enrollment code ML, and
Av-Med Health Plan -- North Region (Tampa) will retain the current
enrollment code EM. Any current Federal members under the enrollment
code EM who reside in the counties assigned to the South Region must
change plans during open season. Federal subscribers will not be
automatically transferred to the South Region enrollment code ML. Av-Med
members in the South Region that wish to remain with Av-Med for contract
year 2003 must make a positive election into Av-Med Health Plan -- South
Region, enrollment code ML during open season.

**Plan Name Changes**

  ------------- --------------------------- ---------- ----------------------
  **State**     **Plan Name (Old)**         **Code**   **Plan Name (New)**

  OH            Health Maintenance Plan     R5         Blue HMO

  NY            Univera Healthcare -- WNY   Q8         Univera Healthcare

  Nationwide    Aetna U.S. Healthcare, Inc             Aetna Health Inc.
  ------------- --------------------------- ---------- ----------------------

####### 

### **Plans dropping a Point of Service (POS) Product**

+-----------------+----------------------------+-----------------------+
| ####### State   | ####### Plan               | ####### Code          |
+-----------------+----------------------------+-----------------------+
| NV              | Health Plan of Nevada      | NM                    |
+-----------------+----------------------------+-----------------------+

#### Plans adding an Option

  ------------ ------------------------- ---------- -----------------------
  **State**    **Plan**                  **Code**   **Option Added**

  IL           Humana                    75         Standard Option

  NY           HIP of New York           51         Standard Option

  TN           HealthSpring              6K         Standard Option

  TX           Humana                    UR         Standard Option

  OH           Health Plan of the Upper  U4         Standard Option
               Ohio Valley                          

  Nationwide   APWU                      47         Consumer-driven Option
  ------------ ------------------------- ---------- -----------------------

Plans dropping an Option

  ------------ ------------------------- ---------- -----------------------
  **State**    **Plan**                  **Code**   **Option Added**

  MN, WI       Health Partners Classic   53         Standard Option
  ------------ ------------------------- ---------- -----------------------

####### 

####### Service Area Expansions without New Enrollment Codes

+-------+---------------------+----------------------------------------+
| ###   | ####### Plan        | ####### Code - Counties Added          |
| ####  |                     |                                        |
| State |                     |                                        |
+-------+---------------------+----------------------------------------+
| ##### | Union Health        | ####### 76-Kane, Kendall, Will         |
| ## IL | Service             |                                        |
+-------+---------------------+----------------------------------------+
|       | Health Alliance     | FX-DeKalb, Adams, Brown, Pike,         |
|       |                     | LaSalle, Grundy, Kendall (Note: The    |
|       |                     | counties of Hancock and Schuyler will  |
|       |                     | be moved from the Macomb service area  |
|       |                     | to the Quincy service area)            |
+-------+---------------------+----------------------------------------+
|       | BlueChoice          | ####### 9G-St. Clair, Madison          |
+-------+---------------------+----------------------------------------+
| ##### | ####### Phy         | ####### DQ-Elkhart                     |
| ## IN | sicians Health Plan |                                        |
+-------+---------------------+----------------------------------------+
| ##### | ####### Fallon Co   | ####### JV                             |
| ## MA | mmunity Health Plan | -Amesbury, Erving, Groveland, Merrimac |
|       |                     | , New Salem, Salisbury, Newbury, Newbu |
|       |                     | ryport, West Newbury, Warwick, Wendell |
+-------+---------------------+----------------------------------------+
|       | #                   | #                                      |
|       | ###### ConnectiCare | ###### TE-Franklin, Hampden, Hampshire |
+-------+---------------------+----------------------------------------+
| ##### | ####### Coventry He | ####### HA-Andrew, Carro               |
| ## MO | alth Care of Kansas | ll, Gentry, Grundy, Livingston, Pettis |
+-------+---------------------+----------------------------------------+
| ##### | ####### Avera       | #######                                |
| ## MN |                     |  AV-Expands in the state of Minnesota  |
|       |                     | to include counties of: Rock, Nobles,  |
|       |                     | Jackson, Cottonwood, Murray, Pipestone |
+-------+---------------------+----------------------------------------+
| ##### | ###                 | ####### 6V-Richmond, Nassau, Suffolk   |
| ## NY | #### GHI HMO Select |                                        |
+-------+---------------------+----------------------------------------+
|       | ###                 | ####### MX-Sullivan                    |
|       | #### MVP Healthcare |                                        |
+-------+---------------------+----------------------------------------+
| ##### | ####### Blue        | ####### R5-Remainder of the foll       |
| ## OH | HMO (formerly Healt | owing counties: Ashtabula, Darke, High |
|       | h Maintenance Plan) | land, Logan, Madison, Sandusky, Van We |
|       |                     | rt. They will add the following counti |
|       |                     | es: Adams, Auglaize, Belmont, Crawford |
|       |                     | , Guernsey, Hardin, Hocking, Knox, Mar |
|       |                     | ion, Mercer, Morrow, Muskingum, Perry, |
|       |                     |  Pike, Richland, Ross, Scioto, Wyandot |
+-------+---------------------+----------------------------------------+
| ##### | ####### UMPC        | ####### 8W-Erie, Cr                    |
| ## PA |                     | awford, Warren, McKean, Mercer, Venang |
|       |                     | o, Forest, Elk, Cameron, Lawrence, But |
|       |                     | ler, Armstrong, Jefferson, Clearfield, |
|       |                     |  Beaver, Allegheny, Indiana, Cambria,  |
|       |                     | Blair, Washington, Westmoreland, Green |
|       |                     | e, Fayette, Somerset, Bedford, Clarion |
+-------+---------------------+----------------------------------------+
|       | ###                 | ####### 26-Cr                          |
|       | #### Health America | awford, Erie, Forrest, Venango, Warren |
+-------+---------------------+----------------------------------------+
| ##### | #######             | ####### 9K-Expandin                    |
| ## UT |  Altius Health Plan | g into the remainder of Sanpete County |
+-------+---------------------+----------------------------------------+
| ##### | ####### MD-IPA      | ####### JP-Culpeper,                   |
| ## VA |                     |  Greene, Madison, Wise, City of Norton |
+-------+---------------------+----------------------------------------+
| ##### | ######              | ####### VT-King County                 |
| ## WA | # Kitsap Physicians |                                        |
+-------+---------------------+----------------------------------------+
| ##### | #####               | ####### WD-Green, Juneau, Vernon       |
| ## WI | ## Dean Health Plan |                                        |
+-------+---------------------+----------------------------------------+

If you need further information or assistance, visit TASC Human Resource
Services in room 2227, or contact Benefits Staff on (202) 366-4459.