Office of Personnel Management

Retirement and Insurance Service

1920 1954 1959 1986 

 

Benefits Administration Letter

Number: 96-203 Date: May 17, 1996 

SUBJECT: Empire Blue Cross & Blue Shield HEALTHNET Enrollment Areas

This is to advise you of the special belated open season opportunity that OPM has

authorized for certain enrollees in the FEHB health plan Empire Blue Cross & Blue

Shield HEALTHNET located in New York. 

Attached for your information is a notice OPM sent to personnel offices of Federal

employees who live in the affected ares. This notice explains the circumstances where

we have authorized belated open season enrollments for these employees.

Our source for personnel office addresses is the Central Personnel Data File (CPDF). If

your agency is not included in the CPDF, we cannot identify your field installations. 

Therefore, we request that you send a copy of the attachment to each of your field

installations that has employees in the affected counties. The counties are listed in the

attachment. 

Abby L. Block, Chief

Insurance Policy 

 and Information Division

Attachment
United States

Office of

Personnel Management Washington, D.C. 20415

In Reply Refer To: Your Reference:

May 17, 1996

MEMORANDUM FOR AGENCY HEADS AND PERSONNEL OFFICERS IN CERTAIN

 NEW YORK COUNTIES

FROM: LUCRETIA F. MYERS

ASSISTANT DIRECTOR

 FOR INSURANCE PROGRAMS

Subject: Empire Blue Cross & Blue Shield HEALTHNET Enrollment Areas

 

Introduction This is to inform you that OPM is authorizing a belated

open season enrollment opportunity for certain

employees enrolled in the Federal Employees Health

Benefits (FEHB) plan, Empire Blue Cross & Blue Shield

HEALTHNET, which serves a number of New York

counties. 

 

Erroneous enrollment

areas

The 1996 HEALTHNET brochure indicated that certain

counties formerly in Region I (enrollment codes S11 and

S12) would be in Region II (enrollment codes S21 and

S22), while other counties formerly in Region II, would

be in Region I. When we discovered this unapproved

change, we required the plan to withdraw these changes

and return to the 1995 regional configuration. 

The affected counties are: Albany, Columbia, Delaware,

Dutchess, Essex, Fulton, Greene, Montgomery, North

Saratoga, Orange, Putnam, Rensselaer, Schenectady,

Schoharie, South Saratoga, Sullivan, Ulster, Warren, and

Washington.

 

Effect on employees Since the premiums are different for the two regions,

some enrollees have been paying more than they should,

while others have been paying less. There is no effect on

benefits--benefits are the same, regardless of the

enrollment code.

 
3

What can employees do? Affected employees may make a belated open season

enrollment change. The change would be effective

retroactive to the first day of the first pay period

beginning in 1996.

Employees currently enrolled under enrollment codes

S11, S12, S21, or S22 may complete an SF 2809 to enroll

in the correct region or they may enroll in any other plan

for which they are otherwise eligible. However, since the

change will be retroactive, a change to another plan could

adversely affect enrollees who have received health care

from HEALTHNET during 1996. HEALTHNET would

then seek repayment for that care from the former

enrollee. The enrollee's new plan might not cover health

care received through HEALTHNET providers.

Employees are not required to correct their enrollment

code, but they may do so if they wish. 

 

How will employees learn

about this?

The plan is notifying the enrollees about the error in the

enrollment area and giving them the correct information. 

The notice advises the enrollees to contact their personnel

office for information about changing their enrollment.

The agency is not expected to notify enrollees

individually, but we request that you display the attached

announcement in areas where employees are likely to see

it. In addition, personnel offices must advise enrollees

who ask about this error and must accept SF 2809's from

employees who want to change their enrollment code. 

 

When can employees make

this change?

Employees who want to change their enrollment must

submit an SF 2809 to their employing office no later than

June 28, 1996.

 

Processing the SF 2809 Please note in the "Remarks" that this is a belated open

season change.

 

Attachment
4

United States

Office of

Personnel Management Washington, D.C. 20415

In Reply Refer To: Your

Reference:

ATTENTION:

Employees enrolled in the 

Empire Blue Cross & Blue Shield HEALTHNET health plan

There is an error on your brochure cover that incorrectly identifies counties in two of

the regions served by the Empire Blue Cross & Blue Shield HEALTHNET health plan. 

Since the premium rates for the regions are different, some employees may be paying

more and some less than the correct enrollment code would require.

The plan will send you a notice explaining this error and how it may affect you. Be

sure to read the notice carefully when you receive it. If you don't receive the notice,

you may contact the plan for information as follows:

Ms. Valerie A. Baginski

(212) 476-7802

If you find you are in the wrong enrollment code for the region in which you live, you

may change your enrollment to the correct enrollment code. Your personnel office can

give you information about the kind of changes you can make in your enrollment and

how to make them.

If you want to make an enrollment change because of this error, you must file your

Health Benefits Registration Form (SF 2809) with your employing office no later than

June 28, 1996.