Office of Personnel Management

Retirement and Insurance Group

1920 1954 1959 1986 

 

Benefits Administration Letter

Number: 96-403 Date: September 19, 1996 

SUBJECT: 1996 FEHB Open Season: Ordering and Distribution

_________________________________________________________________

OVERVIEW

_____________________________________________

 Open Season Open season material is prepared by OPM for

 Material use by employees and other FEHB enrollees during open

season and throughout the year.

The following material will be used during the 1996 open

season:

 1. FEHB Guides. These booklets are prepared for

various groups of enrollees. They contain a

comparison chart giving general information about the

plans and their premium rates and the FEHB

Customer Satisfaction Survey results. This year they

will also include information on which plans are

accredited by the National Committee on Quality

Assurance (NCQA).

 2. Plan brochures. These brochures are the statements

of benefits, exclusions, and limitations.

 3. Material for the visually impaired.

 4. SF 2809 (Health Benefits Registration Form) and SF

2809-A (Federal Employees Health Benefits Program

Information for Federal Civilian Employees and U.S.

Postal Service Employees).

_____________________________________________

 Shipping and Printing contractors will continue to use

 Packaging color-coded shipping labels to distinguish between FEHB
Benefits Administration Letter 96-403

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Guides (goldenrod) and plan brochures (pink). FEHB

Guides and plan brochures will be packaged in groups of 25

and boxed at up to 250 Guides per container.

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FEHB GUIDES

_____________________________________________

 Names and 1. 1997 FEHB Guide for Federal

 Numbers civilian employees (RI 70-1). This guide will be

used by most employees. The rates shown are the

enrollee's share of the biweekly and monthly

premiums. [The corresponding guide for Postal

employees is RI 70-2.] 

2. 1997 FEHB Guide for Certain temporary

employees (Those eligible to enroll in FEHB

under 5 U.S.C. 8906a) (RI 70-8). This guide shows

the full biweekly and monthly premium rates (without

a Government contribution) for all plans. 

 3. 1997 FEHB Guide for Individuals eligible to enroll for: 

Temporary continuation of coverage and Coverage

under the spouse equity law or similar statutes

providing coverage to former spouses (RI 70-5). This

guide shows the monthly premium rates for enrolled former

spouses (total premium) and for persons eligible for TCC

(total premium plus 2% administrative add-on). 

_____________________________________________

 How Do Agencies OPM will arrange to have supplies of the FEHB

 Get the Guides? Guides shipped to each agency's designated distribution

point(s).

In addition, the FEHB Guides will be 

available on OPM Mainstreet. 

_____________________________________________

 How Many Do The quantity is based on information on the

 Agencies Get? number of eligible employees provided

 by headquarters Insurance Officers to OPM. 
Benefits Administration Letter 96-403

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For RI 70-1 and RI 70-8 the quantity is equal to 60% of the

reported number of eligible employees.

 _____________________________________________

 What Do Agencies RI 70-1 and RI 70-8 will not be printed in 

 Do with Them? sufficient quantities to distribute a personal copy to each

employee. Before open season begins, agencies must notify

employees of the availability of RI 70-1 and RI 70-8. 

Employees should be given their agency contact to obtain a

copy of RI 70-1 or 

RI 70-8 if they are considering making a 

change during open season.

RI 70-7 will no longer be printed. Instead, we asked that the

employee population that previously received the RI 70-7 be

included in the RI 70-1 quantities.

Please note: The RI 70-5 (for individuals covered under

TCC) and the RI 70-8 (for temporary employees) will

not be printed on different color paper this year.

Agencies should hold a quantity of RI 70-1 

and RI 70-8 in reserve for use during 

calendar year 1997. 

Throughout the year, 

agencies must 

give the appropriate FEHB Guide 

to new employees and others who become 

eligible to participate in the FEHB Program.

RI 70-5 will be printed in the same quantities as in the past. 

Agencies are responsible for distributing RI 70-5 to former

spouses and TCC enrollees whose enrollments they

maintain. (Those agencies for which the USDA's National

Finance Center maintains these accounts do not have this

responsibility.)

_____________________________________________
Benefits Administration Letter 96-403

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 How Do Agencies Additional (limited) quantities will be

 Order More? available upon written request only from agency

headquarters Insurance Officers after January 1, 1997. [We

cannot fill orders for agency field offices. They must request

additional stock from the agency headquarters Insurance

Officer.] 

The address is OPM/RIS, Forms Analysis and Design,

Room 4H28, Attn: RI-[insert number of the guide being

ordered], Washington, DC, 20415, or FAX 202-606-0910.

Be sure to include an agency contact, telephone number, and

the shipping address.

_________________________________________________________________

PLAN BROCHURES

_____________________________________________

 How Do Agencies Fee-for-service plans will ship a supply of

 Get Managed Fee- their brochures to each agency's designated

 for-Service Plan distribution point(s).

 Brochures?

_____________________________________________

 How Do Agencies If the plan is a managed fee-for-service plan

 Get Brochures with a point of service product, the plan 

 for Plans with a will ship a supply of their brochures to each

 Point of Service agency's designated distribution point(s).

 Product? If the plan is a health maintenance 

organization (HMO) with a point of service 

product, you must order plan brochures 

directly from 

the plans, as described below. 

 _____________________________________________

 
Benefits Administration Letter 96-403

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 How Do Agencies Agencies must order HMO brochures directly 

 Get Health from the plans. OPM will send agencies

 Maintenance a list of plan contacts to use for this

 Organization Plan purpose.

 Brochures?

The personnel official designated for each agency

installation must determine the number of employees

working at or serviced by the installation who are eligible to

enroll in each HMO; i.e., the number of employees located

in the plan's enrollment area. The installation should then

contact each plan and provide the plan with:

 1. a conservative estimate of the number of eligible

employees (be sure to include former spouses and

TCC enrollees in this estimate) and

 2. the address to which the plan should ship the

brochures.

After receiving this information, the plan will ship a supply

of brochures directly to the installation.

_____________________________________________

 How Many Do Managed fee-for-service plans are given a 

 Agencies Get? distribution list that shows the quantity they are to ship to

each distribution point (generally 15% of the agency's

eligible FEHB population). Each agency orders HMO 

brochures directly from the plan and should be sent a

quantity equal to 15% of the number of eligible employees. 

This amount is computed by the plans at the time of

shipment.

_____________________________________________

 What Should Each employee currently enrolled will receive

 Agencies Do a brochure from his/her plan, along with a

 with Them? notice of the plan's 1997 rates.

Agencies must keep a supply of brochures on hand for

reference and for distribution to employees who decide to

enroll or change plans. These brochures must be readily

accessible to employees.
Benefits Administration Letter 96-403

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Agencies must maintain close control over the issuing

of plan brochures. Employees should be permitted to

take copies home for review. If an employee enrolls

or changes health plans, he/she should keep the

brochure for that plan. Other brochures should be

returned promptly to the office.

Wherever possible, agencies must give their former spouse

and TCC enrollees the same access to brochures as

employees. Agencies must tell their former spouse and TCC

enrollees how to obtain brochures and SF 2809 if they are

interested in changing plans. If the employing office

maintaining the former spouse or TCC enrollment is unable

to fill a request for a brochure (e.g., if the enrollee is in an

area not served by the plans for which the employing office

has brochures), the individual should be advised to call the

carrier at the telephone number listed in the FEHB Guide.

_____________________________________________

 How Do Agencies Agencies must request additional brochures

 Order More? directly from the plans.

_________________________________________________________________
Benefits Administration Letter 96-403

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MATERIAL FOR THE VISUALLY IMPAIRED

_____________________________________________

 What Is 1. 1997 FEHB Guide for Federal

 Available? civilian employees (RI 70-10). The content of this

booklet is the same as that of the RI 70-1; however, it

is printed in large type on 11 x 17 inch paper.

2. 1997 Fee-for-service Plan Cassette Tapes For

Visually Impaired Federal Civilian Employees. 

These are tone-indexed cassette tapes of the brochures

for the open fee-for-service plans.

_____________________________________________

 How Do Agencies OPM will arrange to have supplies of RI 70-10

 Get RI 70-10? shipped to each agency's headquarters distribution point

based on the quantities indicated by headquarters insurance

officers in May. This amount should be sufficient for open

season use, as well as for distribution to visually impaired

employees who become eligible to enroll during 1997.

Additional copies may be ordered in writing by the agency

headquarters Insurance Officer. The address is OPM/RIS,

Forms Analysis and Design, Room 4H28, Attn: RI 70-10,

Washington, DC, 20415, or FAX 202-606-0910.

Be sure to include an agency contact, telephone number, and

the shipping address.

_____________________________________________

 How Do Agencies Cassette tapes will be available directly

 Get Cassette from the plans upon written request from 

 Tapes? agency Headquarters Insurance Officers. Attached is the list

of plan contacts to use for ordering the cassette tapes.

_____________________________________________

 Agency All Federal agencies at the headquarters and

 Responsibilities installation levels should take affirmative steps to seek out

visually impaired employees and to communicate the

availability of the large-print FEHB Guide and the cassette

tapes.
Benefits Administration Letter 96-403

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_________________________________________________________________

SF 2809 (HEALTH BENEFITS REGISTRATION FORM) 

_____________________________________________

 How Do Agencies Agencies must order SF 2809 directly from 

 Order? GSA supply centers, just as they

order other OPM-issued Standard Forms. 

SF 2809 is available from GSA/Federal Supply 

Service using the normal FEDSTRIP/MILSTRIP 

procedures. Contact your purchasing or 

acquisitions office for your agency's 

procedures.

SF 2809 is not available from GSA Customer Service

Centers or from OPM.

_____________________________________________

 What Is the The National Stock Number (NSN) for SF 2809

 Cost? is 7540-01-231-6227, and the price is approximately $11.86

per hundred.

Please note that the August 1992 edition is the only

version of SF 2809 that can be used. 

_____________________________________________

 What Should Agencies must keep sufficient quantities of

 Agencies Do SF 2809 available to handle requests.

 With The Form? Employing offices should give an SF 2809 to employees and

former spouse and TCC enrollees who are enrolled in plans

that will not be participating in the Program after December

31, 1996.

_________________________________________________________________
Benefits Administration Letter 96-403

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PREMIUM RATES

_____________________________________________

 Notification OPM announces premium rate changes each year in a press

release. Agency payroll offices, however, must not use these

rates to update their payroll systems.

OPM's Office of Financial Control and Management will

issue a Payroll Office Letter providing the official enrollee

withholding and Government contribution rates and other

information relevant to payroll offices. 

This Letter will also provide agencies with 

information on obtaining an IBM-compatible 

floppy disk containing the 1997 FEHB rates.

_________________________________________________________________

Abby L. Block, Chief

Insurance Policy 

 and Information Division

Attachment
Benefits Administration Letter 96-403

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Open Fee-for-service Plan Audio Cassette Coordinators

Plan Contact Phone Fax 

Blue Cross and Paula Spurway (202)942-1274 (202)942-1265

Blue Shield

Alliance Larry Lindsey (202)939-6369 (202)939-6389

APWU Carroll Midgett (301)622-5554 (301)622-5591

GEHA Jane Overton (816)257-3330 (816)257-3233

Mail Handlers Mary Beth Lynch (301)517-2059 (301)517-2127

NALC Dave Lorenz (703)729-4677 (703)729-8109

Postmasters Linda Griffin (703)683-1664 (703)683-2937