Civil Service 

Retirement 

System 

Federal Employees’ 

Group Life 

Insurance Program 

Federal Employees 

Health Benefits 

Program 

Federal Employees 

Retirement 

System 

Long Term 

Care Insurance 

Program 

United States 

Office of 

Personnel Management 

The Federal Government’s Human Resources Agency

Retirement and Insurance Service 

Benefits Administration Letter 

Number: 01-211 Date: April 19 , 2001 

Subject: Federal Employees Health Benefits (FEHB) Program: Opportunity for 

Certain Enrollees of PacifiCare Health Plans, Enrollment Code CY, to 

Change Enrollment 

Effective May 1, 2001, PacifiCare Health Plans, enrollment code CY, in the State of California, 

will no longer contract with Matrix IPA and St. Agnes Hospital. 

We are authorizing an opportunity for certain PacifiCare of California enrollees in code CY, to 

change their enrollment to another participating plan. Only enrollees who live or work in the 

following counties are eligible to change: Fresno, Kings, Madera, and Mariposa. 

The opportunity to change enrollment will begin immediately and continue through May 11, 2001. 

The effective date of all enrollment changes will be the first day of the pay period following the one 

in which an enrollee makes the change, but no later than May 20, 2001. Enrollees who do not 

change plans must contact PacifiCare Health Plans to request a change in Primary Care 

Physicians. 

Please note that the Plan will send notices to affected enrollees. We have attached a copy of that 

notice for your information. 

Thank you for your cooperation in this matter. 

Attachment 

 

 Abby L. Block 

 Assistant Director 

 for Insurance Programs 
2

URGENT NOTICE 

TO ALL FEDERAL ENROLLEES OF 

PACIFICARE OF CALIFORNIA HEALTH PLAN 

THAT LIVE IN FRESNO, KINGS, MADERA, AND MARIPOSA COUNTIES

PacifiCare of California is sending this important notice to you at the request of the United States Office of 

Personnel Management (OPM). 

Effective May 1, 2001, PacifiCare of California will no longer contract with Matrix IPA and St. Agnes 

hospital. Because of this change, we are providing you with the following options: 

• You may continue your enrollment with PacifiCare but you may have 

to select a new primary care physician (PCP) because of the provider 

network change. 

• You can select another health plan. 

For members who wish to continue their enrollment with PacifiCare

You and eligible family members may need to select a new primary care doctor that practices in one of 

the provider networks. To select a new primary care doctor, call PacifiCare Customer Service at 1-

800-624-8822. If you do not select a new primary care doctor, we will select one for you. If you do 

not want the doctor we select, contact our Customer Service Department at the above number to 

change the selection. Your new primary care doctor will be responsible for providing or arranging 

your care. 

For members who wish to change their enrollment from PacifiCare to a new 

health plan 

If you are an employee, contact your personnel office and follow their instructions. Your personnel 

office will provide you with a 2001 Guide to Federal Employees Health Benefits Plans. You may also 

visit the OPM website at www.opm.gov/insure to view the Guide or plan brochures. 

If you are a retiree (annuitant) under the Civil Service Retirement System (CSRS) or Federal 

Employees Retirement System (FERS), you should call toll free 1-888-767-6738 to make your 

enrollment change as soon as possible but no later than May 11, 2001. If you have impaired hearing, 

call 1-800-878-5707. Please have your CSRS or FERS annuity claim number and your social 

security number available when you call the toll-free number. If you are a retiree (annuitant) of 

another Federal retirement system, you should contact that system to select a new health plan. 

Employees and Retirees who change their enrollment from PacifiCare to a new health plan are also entitled to 

transitional care under the Patient’s Bill of Rights as follows: 

If you (or a family member) have a chronic or disabling condition, or are in the second or third trimester of 

pregnancy, you have a right to continue seeing your specialist for up to 90 days from this notice or through the end 

of post-partum care. The plan that gets the new member must pay for the transitional care. Contact your new plan 

so it can help coordinate your care. 

We apologize for the inconvenience and thank you for your cooperation in this matter.