Office of Personnel Management

Retirement and Insurance Service

1920 1954 1959 

 

1986 

Benefits Administration Letter

Number: 95-404 Date: September 15, 1995 

SUBJECT: FEHB Open Season: Significant Plan Changes

_____________________________________________________________________

_____

GENERAL

________________________________________________

______

 Purpose This Letter transmits lists of significant events affecting

certain health plans during the upcoming FEHB open

season. Some of these events will require action on the part

of agencies.

_____________________________________________________________________

_________

TERMINATIONS

________________________________________________

______

 Attachment 1 These plans are dropping out of the FEHB Program at the

end of 1995.

________________________________________________

______

 What Must Employees in these plans must choose a new health plan

 Employees Do? during open season.

Employees who do not choose a new health plan will be

considered to have cancelled their coverage and will not

have health benefits for 1996.

________________________________________________

______

 New Coverage Coverage under an enrollee's "new" health plan will be

effective the first day of the first pay period beginning on or

after January 1; for most employees, this will be January 7. 
Benefits Administration Letter 95-404

-2-

Enrollees will remain covered and receive benefits under the

"old" plan or code until the new coverage becomes effective.

________________________________________________

______
Benefits Administration Letter 95-404

-3-

 Plan Each plan on the list is supposed to notify its enrollees of

 Notification the plan's withdrawal and the need to select a new health

plan for 1996. However, some plans' enrollment records

and address lists may not be up to date.

________________________________________________

______

 Attachment 2 These plans are terminating an enrollment area that has a

separate enrollment code.

Employees in the terminating enrollment area must choose

a new plan during open season, since their enrollment code

will no longer be valid.

The effect of such a termination and the actions required of

both agencies and employees are the same as if the entire

plan were terminating.

________________________________________________

______

 What Must Agencies must notify employees in these terminating

 Agencies Do? plans and enrollment areas of the need to select a new

health plan to avoid losing coverage. This is especially

important since many employees will not receive a copy of

the FEHB Guide and will therefore be unable to check the

comparison chart to see if their plan will still be participating

in 1996.

We strongly recommend that you notify employees by

distributing copies of these lists to each employee, along

with your agency's notice to employees about open season.

We also recommend that, before the end of open season,

you follow up with employees in these plans who have not

submitted an SF 2809 and remind them to select a new

health plan.

________________________________________________

______

 Belated Changes Despite these precautions, there will be some enrollees who

do not "get the word" to change health plans during open
Benefits Administration Letter 95-404

-4-

season. We encourage you to be liberal in using your

authority to accept belated open season changes from

employees enrolled in a terminated health plan.

_____________________________________________________________________

_________

ENROLLMENT AREA REDUCTIONS

________________________________________________

______

 Attachment 3 These plans are significantly reducing an enrollment area,

but it does not involve terminating an enrollment code. 

Enrollees in the area being eliminated should choose a new

health plan for 1996.

Enrollees who do not choose a new health plan during open

season will have to travel to the plan's service area to obtain

medical care in order to receive full benefits from the plan.

________________________________________________

______

 Agency Action You may wish to distribute a copy of this list to each

 Required employee, along with your agency's notice to employees

about open season. If you don't distribute the lists, remind

employees to check their health plan brochure carefully to

see if there have been any changes to the plan's enrollment

area which would affect them and to change to the correct

enrollment code if necessary.

_____________________________________________________________________

_________

OTHER ENROLLMENT AREA CHANGES

________________________________________________

______

 Attachment 4 These plans are splitting their current enrollment area into

two separate areas with different enrollment codes. 

Enrollees should check their plan brochure to determine

which enrollment code they should be under and, if

necessary, complete SF 2809 to change to the correct

enrollment code.
Benefits Administration Letter 95-404

-5-

Enrollees who should change codes, but don't, will still have

free access among all plan providers. However, they will

pay a higher premium.

________________________________________________

______

 Attachment 5 These plans are consolidating enrollment areas, i.e.,

changing from two enrollment codes to one enrollment code. 

The enrollment areas will remain the same; however, they

will be included under one enrollment code. Enrollees in the

"departing" enrollment code will be transferred automatically

to the remaining enrollment code.

_____________________________________________________________________

_________

ADDITIONS AND EXPANSIONS

________________________________________________

______

 Attachment 6 These are new plans entering the FEHB Program in 1996. 

The list is in alphabetical order by state abbreviation. We

have indicated the general area served by each plan.

________________________________________________

______

 Attachment 7 These plans are expanding their enrollment area, with the

new area having a separate enrollment code. This list is in

alphabetical order by state abbreviation. We have given a

general description of the expanded areas.

________________________________________________

______

 Attachment 8 These plans are significantly expanding their enrollment

area without adding a new enrollment code. The list is in

alphabetical order by state abbreviation. We have included

a general description of the expanded areas.

________________________________________________

______

 Agency Action Be sure to include these new plans and expanded

 Required enrollment areas when you count the number of eligible
Benefits Administration Letter 95-404

-6-

employees and place your orders for brochures.

_____________________________________________________________________

_________

MISCELLANEOUS CHANGES

________________________________________________

______

 Attachment 9 These plans are merging with another plan at the end of

1995. Enrollees in the "old" plan(s) will be transferred

automatically to the "new" plan and need take no action. 

Any enrollees in the "old" plan(s) who do not wish to be

transferred to the "new" plan must choose a different health

plan during open season.

________________________________________________

______

 Attachment 10 These plans have changed their name for 1996. The list is

in alphabetical order by state abbreviation.

________________________________________________

______

 Attachment 11 These plans have changed enrollment codes. Enrollees in

these plans will be transferred automatically to the new

enrollment code.

_____________________________________________________________________

_________

Abby L. Block, Chief

Insurance Policy 

 and Information Division

Attachments
ATTACHMENT 1

PLANS DROPPING OUT OF FEHBP FOR 1996

Employees in these plans who do not change health plans during open season will not

have health benefits for 1996.

Plan Name Code General Location

Aetna HP of FL TJ S.W. FL

CIGNA HC of Arizona, Inc. B1 Southeastern AZ

Complete Health of Georgia QU Atlanta, Macon, Savannah, GA

Healthcare Delaware MR Delaware

MetLife HealthCare Network of WN Phoenix/Tucson 

Arizona

MetLife HealthCare Network of WM Northeast Ohio

Ohio

U-Care HMO, Inc. WC Madison, WI
ATTACHMENT 2

PLANS REDUCING THEIR ENROLLMENT AREA

BY TERMINATING AN ENROLLMENT CODE

Employees in these enrollment codes who do not change health plans during open

season will not have health benefits for 1996.

Plan Name Code Area Dropped

MetLife HealthCare Network U9 Austin

of Texas

MetLife HealthCare Network VU Corpus Christi

of Texas

MetLife HealthCare Network WP Houston

of Texas

MetLife HealthCare Network ZB San Antonio

of Texas

MetLife HealthCare Network ZC Bryan/College Station

of Texas
ATTACHMENT 3

PLANS SIGNIFICANTLY REDUCING THEIR ENROLLMENT AREA

WITHOUT TERMINATING AN ENROLLMENT CODE

Enrollees in the areas being dropped who do not change health plans during open

season will have to travel to the plan's service area to obtain medical care in order to

receive full benefits from the plan for 1996.

Plan Name Code Area Dropped

Pacific Health Plans WB The counties of Adams; Asotin;

(now PacifiCare of WA) Benton; Chelan - except for zip

codes 98852, 98816, and 98831;

Clallam; Clark; Columbia; Douglas -

except for zip codes 98830 and

98813; Ferry - except for zip code

99138; Franklin; Garfield; Grant;

Grays Harbor; Jefferson; Kittitas;

Klickitat; Lincoln; Mason; Pacific;

Skamania; Wahkiakum; Whatcom;

Whitman - except for zip codes

99111, 99125, 99136, 99143,

99170, 99171, and 99176; and

Yakima

PacifiCare of Oregon SS Washington counties of Cowlitz,

King, Lewis, Pierce, Snohomish,

Spokane, Thurston, and Walla

Walla

Partners HP of AZ TD Phoenix area

Principal Health Care WS Eastern Shore, MD

of Delaware
ATTACHMENT 4

PLANS SPLITTING AN ENROLLMENT AREA

Enrollees in these plans under the 1995 enrollment codes shown below should check

their plan brochure to determine which 1996 code they should be under. Employees in

these 1995 enrollment codes who should change codes, but do not, will still have free

access among all plan providers but will pay a higher premium for their coverage.

Plan Name 1995 Code 1996 Codes

HealthAmerica Pennsylvania ZN

ZN, 1N
ATTACHMENT 5

ENROLLMENT AREA CONSOLIDATIONS,

TRANSFERRING TWO ENROLLMENT CODES INTO ONE

Enrollees in the former enrollment code being dropped will be transferred automatically

to the remaining enrollment code unless they choose a different health plan during

open season.

Plan Name Former Codes Remaining Code

BlueLincs HMO N5, T9 N5

Empire BC/BS HEALTHNET 15, S7 S7

(This plan also has codes

S1 and S2, which are unaffected.)

HealthAmerica Pennsyl- ZP, 26 26

vania

Healthsource Tennessee HT, TQ HT

Kaiser Mid-Atlantic E3, E7 E3

PCA Family Health Plans Z5, FQ FQ

of Florida (formerly 

Family Health Plan of

Florida)

PCA Florida Z6, Z7, VL, PJ

VM, QW, PJ
ATTACHMENT 6

NEW PLANS ENTERING THE PROGRAM FOR 1996

State Plan Name Code General Location

AR Healthsource Arkansas 1H Central/Northern/SW AR

AR HealthWise Arkansas 1W Central Arkansas

AZ Samaritan HP 2S N. & C. AZ

CO CIGNA HC of Colorado 1C Denver

CO PruCare of Colorado 9C Denver/Boulder/Colorado 

Springs

CT M.D. Health Plan 1M All of Connecticut

CT PruCare of Connecticut 8C Fairfield and New Haven

CT Suburban Health Plan 1S Fairfield/New Haven/

Litchfield counties

FL CareFlorida Health Plan 5C Palm Beach, Clay, Duval, 

Martin, St. Lucie, Charlotte, Lee

FL CareFlorida Health Plan 5D Brevard

FL CareFlorida Health Plan 5E Dade/Broward

FL Florida 1st 3F Central Florida

FL PacifiCare of Florida 3P Dade/Broward/Palm Beach

Hillsborough/Pinellas

GA BlueChoice Healthcare 1B Augusta/Athens/Columbus

Plan Savannah

GA Healthsource Savannah 2H Savannah/Parts of SE GA
GA U.S. Healthcare of GA 2U Atlanta/Augusta/Macon areas

ATTACHMENT 6, continued

IA John Deere Family 1J Des Moines/Waterloo

Healthplan, Inc.

IA SecureCare of Iowa 3S Central Iowa

IA Heritage National 3J, 3K, Northern Illinois and 

Healthplan, Inc. 3L Eastern Iowa

IL Heritage National 3I, 3J Northern Illinois and 

Healthplan, Inc. Eastern Iowa

IL John Deere Family 1J Quad Cities

Healthplan, Inc.

IN PruCare of Indiana 2I Indianapolis area

KS MetraHealth of Kansas 4M Kansas City area

City

KS PruCare of Kansas City 1K Kansas City area

KY Bluegrass Family Health 2B Central KY

LA Advantage HP 1A, 2A New Orleans/Baton Rouge

LA MEDFIRST 2M Metro New Orleans

LA Ochsner/Sisters of 4Q, 4R Lake Charles/Alexandria/

Charity 4S, 4W New Orleans area/Baton 

Rouge

MA PruCare of Massachusetts 6M Central and Eastern Mass.

MD Preferred Health Network 4P Most of Maryland

MI Family Health Plan 1F Monroe County
MO MetraHealth of Kansas 4M Kansas City area

City

MO PruCare of Kansas City 1K Kansas City area
ATTACHMENT 6, continued

NC Principal Health Care of 1P Greater Charlotte

the Carolinas

NJ First Option HP of NJ 2F All of NJ

NJ PruCare of New Jersey 8P Most of New Jersey

NM HMO New Mexico 5H Most of New Mexico

NV Hometown Health Plan 4H Northern Nevada

NY MetraHealth of New York 3M New York City area

NY PruCare of New York 9P New York

OH AultCare 3A Greater Canton Area

OH Family Health Plan 1F NW Ohio

OH Healthsource Ohio 3H Dayton area

OH QualChoice 1Q Northeastern Ohio

OH Super Blue HMO 5M Northeast Ohio

OR PACC HMO 2P Most of W. OR

PR PCA Health Plans of 5P All of Puerto Rico

Puerto Rico

TN CareChoice 6C Most of Tennessee

TN HealthWise Tennesssee 2W Nashville area, Shelby

County

TN Heritage National 3T, 4T Eastern Tennessee

Healthplan of Tennessee, Inc.

TX CIGNA HC of Texas 3C Dallas/Ft. Worth

TX FHP of Texas 4F Houston/Gulf Coast Region
ATTACHMENT 6, continued

TX HMO Texas, L.C. 2T Houston area

TX PruCare of El Paso 6P El Paso County

UT IHC SelectMed 6S Northern Utah

UT Intergroup of Utah 1I Wasatch Front

VA Southern Health Service 5S Central Virginia

VA U.S. Healthcare of VA 1U Northern Virginia

WA PACC HMO 2P Most of S.W. WA

WV Carelink Health Plans 4C Central & Southern WV
ATTACHMENT 7

ENROLLMENT AREA EXPANSIONS

WITH A NEW ENROLLMENT CODE

State Plan Name New General Location

Code

AL Health Partners 5F Baldwin/Clark/Mobile

of Alabama areas

CA Aetna HP of CA 2X Southern CA

CT WellCare of New York 3V Fairfield/Litchfield 

GA PruCare of Atlanta 1Z Macon Area

IL BCI HMO, Inc. 3B Springfield area

IN Humana Care Plan 4I Indianapolis

KS Humana Kansas City, Inc. 7S Central Missouri/Springfield area

NY Community Blue 6Z Northeastern NY

OH Aetna HP of OH 4D Columbus

PA Aetna HP of C&E PA 4J Scranton/Wilkes Barre

PA HealthAmerica Penn. 1N Southern Alleghenies

RI U.S. Healthcare of Mass. 5U Rhode Island

VA HMO Virginia 4V Roanoke area
ATTACHMENT 8

SIGNIFICANT ENROLLMENT AREA EXPANSIONS

WITH NO NEW ENROLLMENT CODES

State Plan Name Code Added

AR Complete Health of QC Bradley, Cleburne, Conway,

Arkansas, Inc. Cross, Desha, Drew, Howard,

Hot Spring, Little River,

Montgomery, Ouachita, Polk, and

Pope counties

AZ FHP A3 Entire State minus portion of

Mohave County (The balance of

Mohave County is covered under

Enrollment Code K9. See

brochure for zip codes.)

CA Aetna HP of CA BU Fresno

CA Foundation Health C6 All of Tulare County and the

remaining portions of Riverside

and San Diego counties 

CA Lifeguard Health Plan CD San Francisco County

CA Omni Healthcare HN Full counties of Lake and 

Calaveras 

CA PacifiCare of California CQ Counties of Riverside, San

Bernardino, and San Luis Obispo

(refer to Brochure for zip codes)

CT ConnectiCare, Inc. TE The balance of Litchfield Co.

(now includes all of Connecticut)

CT Kaiser Permanente DM Most of Connecticut

CT Oxford Health Plan ZW Entire State of Connecticut
ATTACHMENT 8, continued

FL CAC United HealthCare 1X Portions of Florida

Plans of Florida (forPanhandle

(formerly Complete Health merly

of Florida) WR)

FL PCA Family Health Plans FQ Now covers most of the

of Florida (formerly State of Florida

Family Health Plan of FL)

FL PCA Florida PJ Now covers most of the State of

Florida

IL Dreyer HMO EU Cook, DuPage and Will

IL Group Health Plan MM Christian, Coles, Menard, 

Montgomery, Morgan and 

Sangamon, IL

IN Humana Health Plan D2 Southern Indiana

IN Maxicare Indiana GK Most of the State

KY Aetna HP of OH Z4 Boone, Campbell, Grant, 

Kenton counties

KY HealthWise of Kentucky DU Now covers most of the State of

Kentucky

LA Gulf South Health Plans LY New Orleans area

LA Maxicare Louisiana JA Baton Rouge area

MD CIGNA Mid-Atlantic XF St. Mary's County

MO BlueCHOICE M4 Barton, Dade, Jasper, Lawrence,

McDonald, and Newton counties
ATTACHMENT 8, continued

MO Physicians Health Plan VB All of Audrain, Montgomery,

of Greater St. Louis Dent, Wright, Scott, Maries,

Pulaski, Cape Girardeau,

Callaway, Moniteau, Stoddard, 

Randolph, Laclede, and New 

Madrid counties

NC Healthsource North RQ Bertie, Bladen, Brunswick,

Carolina Buncombe, Burke, Caswell,

Columbus, Cumberland,

Davidson, Duplin, Guilford,

Henderson, Hertford, Hoke,

Lincoln, McDowell, Montgomery,

New Hanover, Onslow, Pender,

Randolph, Richmond, Robeson,

Rockingham, Rowan, Sampson,

Scotland, Stanley, Transylvania,

and Wayne counties

NC PruCare of N. Carolina Q4 Raleigh area

NH Matthew Thornton NX The rest of state of New 

Health Plan Hampshire

NJ HIP Health Plan of New P9 Atlantic, Ocean, and Salem

Jersey counties

NV FHP K9 Reno area

NV Health Plan of Nevada NM Las Vegas and Reno areas

NV Humana Health Plan, Inc. TL Reno area

NY Blue Choice MK Genesee, Orleans, and Wyoming

counties

NY Capital District SG Capital District area

Physicians' Health Plan
ATTACHMENT 8, continued

NY Health Insurance Plan of 51 Orange and Rockland

Greater New York counties

NY Independent Health Assn. C1 Metro NYC area (Bronx, Kings,

New York, Queens, Richmond,

Nassau, Suffolk counties)

NY Physicians Health PD New York, Queens, Kings,

Services of New York Bronx, Richmond, Nassau, and

Suffolk counties

OK BlueLincs HMO N5 Oklahoma City, Tulsa

SW Oklahoma and Lawton

OR PacifiCare of Oregon SS Douglas, Lane, Jackson and

Josephine counties

OR SelectCare Plus SD Clotsop and Douglas counties 

PA Geisinger Health Plan N9 Bradford, Schuylkill,

Susquehanna, and Wayne 

counties

TN Healthsource TN HT Carter, Greene, Hawkins,

Johnson, Sullivan, Unicoi, and

Washington counties

TX PacifiCare of Texas VN Collin, Dallas, Denton, Ellis,

Hood, Hunt, Johnson, Kaufmann,

Navarro, Rockwall, Tarrant and

Wise counties

TX SANUS Health Plan ZF Lufkin area

TX SANUS Texas Health Plan V2 West Texas, including the San

Angelo and Stephensville areas

VA M.D. IPA JP Roanoke

VA PARTNERS NHP of NC EQ S.W. VA
ATTACHMENT 8, continued

WA SelectCare Plus SD The cities of Toledo, Vader and

Winlock in Lewis County

WI Humana Wisconsin Health X1 Southeastern Wisconsin

Organization

WV Advantage Health QJ Doddridge, Hancock, Harrison,

Lewis, Marion, Mason,

Monongalia, Pleasants, Putnam,

Tyler, Upshur, Wood counties
ATTACHMENT 9

PLAN MERGERS

Enrollees in these plans will be transferred automatically to the surviving plan unless

they choose a different health plan during open season.

Merging Plans Code Surviving Plan Code

Aetna HP of San Diego NI Aetna HPs of CA 2X

Aetna HPs of CA 2X

BCI HMO, Inc. & JL/LF BCI HMO, Inc. 3B

Blackhawk Health Assurance LH

Plan

Cigna Medical Group & 61 Cigna Healthcare SK

Cigna Healthcare of Calif. SK of Calif

Health Power Dayton XQ Health Power HMO XR

HealthPower/Family HealthNet XR

of Ohio

ValuCare BE PacifiCare of CQ

PacifiCare of California CQ California

Western Ohio Health Care VC/XH United HealthCare of VC/3U

and PHP, Inc. of Ohio Ohio, Eastern & 

Western Region (All VC 

enrollees will stay in 

code VC; all XH enrollees 

will be transferred 

automatically to code 3U)
ATTACHMENT 10

PLAN NAME CHANGES

State Old Plan Name Code New Plan Name

AL Southeast HealthPlan of XS, XY PCA Health Plans of

Alabama, Inc. WV Alabama, Inc.

CA Aetna HP of Northern CA BU Aetna HP of CA

CA MetLife HealthCare Network WA MetraHealth Care Plan

of California of California

CA Omni Health Plan HN Omni Healthcare

CA TakeCare Health Plan CY FHP,Inc.,dba FHP/TakeCare 

CO Comprecare/TakeCare D6 FHP of Colorado, Inc.

Health Plan

CO Exclusicare ZD Mutual of Omaha Companies/ 

Exclusive Healthcare, Inc.

DE Delaware Valley HMO, Inc. SP AmeriHealth HMO, Inc.

FL CAC-Ramsay QK CAC United HealthCare

Plans of Florida

FL Complete Health of Florida WR CAC United HealthCare

Plans of Florida (enrollment

code being changed to 1X)

FL Family Health Plan of FQ PCA Family Health Plans of

Florida Florida, Inc.

GA MetLife HealthCare Network WE MetraHealth Care Plan of

of Georgia Georgia

IA Exclusicare XG Mutual of Omaha Companies/ 

Exclusive Healthcare, Inc.
ATTACHMENT 10, continued

IL MetLife HealthCare Network WL MetraHealth Care Plans

of Illinois of Illinois

IL MetLife HealthCare Network 12 MetraHealth Care Plans

of St. Louis of St. Louis

IL TakeCare Health Plan FY FHP of Illinois, Inc.

of Illinois, Inc.

IN MetLife HealthCare Network WL MetraHealth Care Plans

of Illinois of Illinois

IN TakeCare Health Plan FY FHP of Illinois, Inc.

of Illinois, Inc.

KY TakeCare Health R8 FHP of Ohio, Inc.

Plan of Ohio, Inc.

LA Travelers Health Network X7 MetraHealth Care Plans

of Louisiana, Inc. of Louisiana, Inc.

MO MetLife HealthCare Network 12 MetraHealth Care Plans

of St. Louis of St. Louis

NC PruCare of Charlotte Q4 PruCare of North Carolina

NE Exclusicare XG Mutual of Omaha Companies/ 

Exclusive Healthcare, Inc.

NE Share Health Plan of NF United HealthCare Plan of

Nebraska the Midlands

NJ Delaware Valley HMO, Inc. FK AmeriHealth HMO, Inc.

NY Mohawk Valley Physicians MX, M9 MVP Health Plan

Health Plan GA

NY Patients'Choice XL Healthsource-NY
OH Health Power/Family XR Health Power HMO

HealthNet of Ohio

ATTACHMENT 10, continued

OH Principal Health Care R4 CIGNA HealthCare of Ohio,

of Ohio, Inc. Inc.

OH TakeCare Health R8 FHP of Ohio, Inc.

Plan of Ohio, Inc.

SC PruCare of Charlotte Q4 PruCare of North Carolina

TN PruCare of Nashville UA Prudential Options

TX Coastal Bend Health Plan T5 Principal Health Care of Texas,

Inc.

TX MetLife HealthCare Network U3 MetraHealth Care Plan, 

of Texas Inc.

TX Southwest, an Aetna HP TS Aetna HPs of N. TX, Inc.

VT Mohawk Valley Physicians VW MVP Health Plan

Health Plan

WA Pacific Health Plans WB PacifiCare of

Washington

WI HMO WISCONSIN W4 Unity Health Plans
ATTACHMENT 11

ENROLLMENT CODE CHANGES

Enrollees in these plans will be transferred automatically to the new enrollment code

unless they choose a different health plan during open season.

Plan Name Old Code New Code

CAC United HealthCare Plans of Florida WR 1X

(formerly Complete Health of Florida)

PacifiCare of Oklahoma PE 2N

Physicians Plus HMO 29 7P