United States 

Office of 

Personnel Management

The Federal Government’s Human Resources Agency 

Benefits Administration Letter 

Number: 04-406 Date: October 27, 2004 

Subject: 2004 Federal Employees Health Benefits (FEHB) Program Open Season: 

Ordering and Distribution of Material 

OVERVIEW 

Open Season Materials 

Attached is a list of carrier contacts for ordering health plan brochures and a list of carrier 

addresses for sending enrollment forms for the 2004 FEHB Open Season. Each list includes 

names, phone and fax numbers and email addresses for each plan. 

The prepaid plan list includes health maintenance organization (HMO) plans; plans offering a 

point of service (POS) product (other than managed fee-for-service plans); and consumer-driven 

and high deductible health plans (HDHP). We’ve also included a list of the open fee-for-service 

plans. This list includes names, phone and fax numbers and should be used when ordering plan 

cassette tapes for the visually impaired employees. 

The following materials will be available during the 2004 open season: 

•	 Plan brochures. These brochures are the statements of benefits, exclusions, and 

limitations. 

•	 Materials for the visually impaired. 

•	 Revised SF 2809 (Health Benefits Election Form) – See BAL 04-405 for instructions on 

the revised form. 

• FEHB Guides (see BAL 04-401) 

PLAN BROCHURES 

All Plan brochures are available for downloading from the FEHB web site: 

www.opm.gov/insure. Please encourage your employees to use the web site as their primary 
resource. 

Shipping and Packing 

The plan brochures will be packaged in groups of 25 and boxed at up to 250 items per container. 

How Do We Get Fee-for-Service Plan Brochures? 

Fee-for-service plans will ship a supply of their brochures to each of your designated distribution 

points. In addition, all plan brochures will be on the 2004 FEHB Open Season web site at 

www.opm.gov/insure/health. Fee-for-service plans will get a distribution list that shows the 

quantity they are to ship to each distribution point (generally 15% of the eligible FEHB 

population). 

How Do We Get Health Maintenance Organization (HMO), Consumer-Driven and High 

Deductible Health Plan Brochures? 

You must order these brochures directly from the plans (see attached list). The personnel official 

designated for each agency installation must determine the number of employees working at or 

serviced by the installation that are eligible to enroll in each plan, i.e., the number of employees 

located in the plan’s service area. The installation must then contact each plan in its area and 

provide the plan with the following: 

•	 An estimate number of eligible employees. (Be sure to include Spouse Equity and 

Temporary Continuation of Coverage (TCC) enrollees in this estimate). 

•	 The address to which the plan should ship the brochures. 

The plan will compute a quantity equal to 15% of the number of eligible employees and will 

send that number to each agency installation. We encourage you to ask your employees who are 

considering a change but have not yet decided to use the electronic versions of the plan 

brochures that are on the FEHB Open Season web site at www.opm.gov/insure/health. Plan 

brochures are also accessible to the visually impaired at the same web site. 

How Do We Get Brochures for Plans with a Point of Service Product? 

Fee-for-service plans with a point of service product will ship a supply of their brochures to each 

of your designated distribution points. 

For HMOs with a point of service product, you must order plan brochures directly from the plans 

as described above. 

What Should We Do With Them? 

Each employee currently enrolled will receive a brochure directly from his/her plan. You 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. 

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Maintain close control over issuing plan brochures. Employees should be allowed to take copies 

home for review. If an employee enrolls or changes health plans, he/she should keep the 

brochure for that plan. The employee should return other brochures to the personnel office. 

You must give your Spouse Equity and TCC enrollees the same access to brochures as 

employees. Tell your Spouse Equity and TCC enrollees how to obtain brochures and SF 2809 

enrollment forms if they are interested in changing plans. The employing office maintaining the 

enrollment should tell the individual to call the plan at the telephone number listed in the FEHB 

Guide if they cannot fill a request for a brochure, (e.g., if the enrollee lives in an area not served 

by the plans for which the employing office has brochures). 

MATERIAL FOR THE VISUALLY IMPAIRED 

What Is Available? 

•	 2005 fee-for-service plan cassette tapes for visually impaired employees. These are 

tone-indexed cassette tapes of the brochures for the open fee-for-service plans. Each plan 

brochure is available on the FEHB web site in electronic formats suitable for the visually 

impaired. 

Agency Responsibilities 

All Federal agencies at the headquarters and installation levels must take steps to seek out 

visually impaired employees and to let them know that the cassette tapes and the FEHB web site 

are available. All of the information in each health plan brochure is also available in 

electronic formats accessible to the visually impaired on the web site. Please encourage 

your employees to visit the web site at www.opm.gov/insure. 

PREMIUMS 

OPM announces premium changes each year in a news release. Agency payroll offices, 

however, must not use these rates to update their payroll systems. OPM’s Center for Financial 

Services will issue a Benefits Administration Letter (BAL) giving the official enrollee 

withholding and Government contribution rates and other information relevant to payroll offices. 

 The BAL will also provide agencies with information on obtaining a PC-compatible floppy disk 

containing the 2005 FEHB rates. 

We encourage you and your employees to visit the web site at www.opm.gov/insure. The web 

site will be updated regularly with current information including new plan terminations and 

more.

 Sincerely, 

Frank D. Titus 

 Assistant Director 

For Insurance Services 

Attachments 

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OPEN FEE-FOR-SERVICE PLAN CONTACTS 

FOR ORDERING AUDIO CASSETTE TAPES 

PLAN CONTACT PHONE FAX 

APWU Ken Perlberg (301) 622-5731 (301) 622-5712 

BCBS Paula Spurway (202) 942-1274 (202) 942-1263 

GEHA Lisa McDonald (816) 257-3334 (816) 257-3333 

Mail Handlers Gloria Gedrich (301) 517-2032 (301) 517-2127 

NALC Cal Engle (703) 729-8101 (703) 729-8109 

PBP Health Plan Brenda Tanner (703) 548-5922 (703) 836-8937 

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