United States 

Office of 

Personnel Management 

The Federal Government’s Human Resources Agency

Benefits Administration Letter

Number: 12-405 Date: October 1, 2012

Subject: 2012 Federal Benefits Open Season: FSAFEDS and FEHB Program Significant 

Plan Changes 

This Benefits Administration Letter (BAL) is the fifth in our series of 2012 Federal Benefits Open 

Season BALs for the Federal Flexible Spending Account Program (FSAFEDS), the Federal 

Employees Dental and Vision Insurance Program (FEDVIP) and the Federal Employees Health 

Benefits (FEHB) Program. This BAL provides information on significant plan changes for 

FSAFEDS and the FEHB Program for 2013. There are no significant plan changes for FEDVIP. 

This year’s Federal Benefits Open Season will run from Monday, November 12, through Monday, 

December 10, 2012. 

FSAFEDS 

The maximum contribution for a Health Care Flexible Spending Account (HCFSA) has changed 

from $5000 to $2500 for 2013. The maximum contribution for a Dependent Care Flexible 

Spending Account (DCFSA) remains $5000 for 2013. 

SHPS Human Resource Solutions, the third party administrator of FSAFEDS, is now ADP Benefit 

Services KY, Inc. You may notice references to ADP Benefit Services KY, Inc. on 

www.FSAFEDS.com, as well as in program materials and communications over the next several 

months during the transition to the new name. 

FEHB Program 

The remainder of this letter provides important information on the significant changes affecting 

certain plans in the FEHB Program for the upcoming Open Season. The first attachment to this 

BAL identifies the plans and their corresponding significant changes. Some of these events will 

require action on the part of agencies and enrollees. 

Please note there are plans leaving the FEHB Program at the end of 2012 or reducing their service 

areas. Since employees in these terminating plans and service area reductions must enroll in new 

plans during Open Season if they wish to continue health insurance coverage in 2013, we ask you 

to distribute this list throughout your agencies. It is your responsibility to monitor employees who 

are covered by these terminating plans or service area reductions and follow up with those who 

have not submitted an enrollment change before the end of Open Season. 
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TIP: Distribute the attached list of significant FEHB plan changes to all employees so they can 

check to see if their plan or service area will continue to participate in the FEHB Program in 2013. 

Table 1: Plan Leaving the FEHB Program 

Table 2: Plans Reducing Their Service Areas and Terminating Enrollment Codes

What Must Employees Do?

Employees in terminating plans (Table 1) or service area reductions with terminating 

enrollment codes (Table 2) must enroll in a new health plan during Open Season if they 

want coverage. If they do not enroll in a new plan, they will not have FEHB coverage in 

2013.

New Coverage: Coverage under an enrollee’s new health plan will be effective the first 

day of the pay period beginning on or after January 1, 2013; for most employees this will 

be Sunday, January 13, 2013. Enrollees will remain covered and receive the 2012

benefits of the old plan until coverage under the new plan becomes effective.

What Must You Do?

You must notify employees enrolled in the plans listed in Tables 1 and 2 to select new 

plans. Advise your employees if they do not choose new plans, they will not have FEHB 

coverage in 2013. 

Distribute copies of this list to employees with your agency’s notice about Open Season

along with copies of the second attachment, FastFacts: What to do When Your Health 

Plan is Terminating Coverage in Your Area or Leaving the Federal Employees Health 

Benefits (FEHB) Program. 

Follow up with employees in these plans and remind them to select new plans.

Belated changes: Some employees still might not receive instructions to change plans 

during Open Season. We encourage you to be liberal in accepting belated Open Season 

changes from employees enrolled in terminating plans or plans with service area 

reductions and terminating enrollment codes.

What Will Health Plans Do?

Plan Notification: The plans in Tables 1 and 2 have been instructed to notify enrollees of the 

need to select new plans for 2013; however, because some plans’ enrollment and address lists may 

not be up-to-date, we encourage you to accept belated changes.

Table 3: Plan Reducing its Service Area Without Terminating Enrollment Codes

What Must Employees Do?

Employees in the service area being terminated should elect a new health plan for 2013; however, 

employees who do not choose a new health plan will only have emergency services where they live

and will have to travel to their plan’s remaining service area to receive full benefits.

What Must You Do?

You must notify employees enrolled in the plan listed in Table 3 to select a new plan. 

Advise your employees if they do not choose a new plan, they will only have emergency 
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services where they live and they will have to travel to their plan’s remaining service area 

to receive full benefits in 2013. 

Distribute copies of this list to employees with your agency’s notice about Open Season 

along with copies of the second attachment, FastFacts: What to do When Your Health 

Plan is Terminating Coverage in Your Area or Leaving the Federal Employees Health 

Benefits (FEHB) Program.

Follow up with employees in this plan and remind them to select a new plan.

Belated changes: Some employees still might not receive instructions to change plans 

during Open Season. We encourage you to be liberal in accepting belated Open Season 

changes from employees enrolled in the plan reducing its service area.

What Will Health Plans Do? 

Plan Notification: The plan in Table 3 has been instructed to notify enrollees that their service 

area is being terminated. If enrollees do not choose another health plan, the enrollees will have to 

travel to their plan’s remaining service area to receive full benefits in 2013. However, because a 

plan’s enrollment and address lists may not be up-to-date, we encourage you to accept belated 

changes. 

Table 4: Plan Name Change 

Table 5: New Plans Entering the FEHB Program 

Table 6: Plans Adding New Options and Enrollment Codes 

Table 7: Service Area Expansions with New Enrollment Codes

Table 8: Service Area Expansions without New Enrollment Codes 

Table 9: Plan Separating a Service Area and Creating New Enrollment Codes in Addition 

to the Existing Code, and Offering a New Option With New Enrollment Codes 

What Must You Do? 

You must include the new plans, the plans with new options, the plans with expanded service 

areas, and the plan separating a service area and offering a new option (Tables 5-9) when you 

count the number of eligible employees and place your order for brochures. 

Conclusion 

Again, this year’s Federal Benefits Open Season will run from Monday, November 12 through 

Monday, December 10, 2012. 

We encourage you and your employees to visit our website at www.opm.gov/insure/openseason

for the most up-to-date information. Please note that 2013 Plan information will be posted on our 

website beginning in late October. 
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We look forward to working with you to ensure Federal employees have a successful Open 

Season. 

Sincerely,

John O’Brien

Director

Healthcare and Insurance

Attachments