United States 

Office of 

Personnel Management

The Federal Government’s Human Resources Agency

Benefits Administration Letter 

Number: 16-404 Date: October 17, 2016

Subject: 2016 Federal Benefits Open Season: FSAFEDS, FEDVIP and FEHB 

Program Significant Plan Changes 

This Benefits Administration Letter (BAL) is the fourth in our series of 2016 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, FEDVIP, and the FEHB Program

for 2017. 

This year’s Federal Benefits Open Season will run from Monday, November 14 through 

Monday, December 12, 2016. 

FSAFEDS

There is a new contractor for the Federal Flexible Spending Account Program 

(FSAFEDS). Effective September 1, 2016, WageWorks assumed the administrative 

responsibility for the FSAFEDS Program. 

FEDVIP

There are no 2017 FEDVIP significant changes. 

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 FEHB 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 2016 or reducing 

their service areas and terminating their enrollment codes. Since employees in these 

terminating plans and service area reductions must enroll in a new plan during Open 

Season or they will be enrolled in the Standard Option of the GEHA Benefit Plan (the 
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lowest-cost nationwide plan option for 2017 as determined by OPM) please 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. Again, 

enrollees in the terminating plans and enrollment codes who do not change their health 

plan by enrolling in another FEHB plan during Open Season will be enrolled in the 

Standard Option of the GEHA Benefit Plan (the lowest-cost nationwide plan option for 

2017 as determined by OPM). 

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 2017. 

Table 1: Plans Leaving the FEHB Program 

Table 2: FEHB Plan Reducing 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 do not enroll in a new plan, they will be enrolled in the 

Standard Option of the GEHA Benefit Plan (the lowest-cost nationwide plan 

option for 2017 as determined by OPM).

• 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, 2017; for most 

employees this will be Sunday, January 8, 2016. Enrollees will remain covered 

and receive the 2016 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 be 

enrolled in the Standard Option of the GEHA Benefit Plan (the lowest-cost 

nationwide plan option for 2017 as determined by OPM). 

• 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.
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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 2017; however, because some plans’ enrollment and 

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

Table 3: FEHB Plans Reducing Service Areas without Terminating Enrollment 

Codes 

What Must Employees Do?

Employees in the service areas being terminated should elect a new health plan for 2017; 

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 plans 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 services where they live and they will have to travel to their 

plan’s remaining service area to receive full benefits in 2017. 

• 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 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 plans in Table 3 have been instructed to notify enrollees that 

their respective service areas are being terminated. If enrollees do not choose another 

health plan, the enrollees will only have emergency services where they live and they will 

have to travel to their plan’s remaining service area to receive full benefits in 2017. 

However, because a plan’s enrollment and address lists may not be up-to-date, we

encourage you to accept belated changes.

Table 4: FEHB Plan Terminating Option and Enrollment Codes

What Must Employees Do? 

• Employees in the plan dropping an option (Table 4) may choose a new health 

plan during Open Season or remain with their current plan and be switched 
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automatically into the plan’s remaining option specified in Table 4. 

• New Coverage: Coverage under an enrollee’s new health plan or option will be 

effective the first day of the pay period beginning on or after January 1, 2017; for 

most employees this will be Sunday, January 8, 2017. Enrollees will remain 

covered and receive the 2016 benefits of the old plan or option until coverage 

under the new plan becomes effective.

What Must You Do? 

• Advise your employees who are enrolled in the plan that is dropping an option 

(Table 4) that if they do not choose a new health plan, they will be automatically 

transferred into the plan’s remaining option as specified in Table 4. 

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

Season.

• Follow up with employees in the plan and remind them that if they do not choose 

a new health plan, they will be automatically transferred into the plan’s remaining 

option specified in Table 4. 

• Belated changes: Some employees still might not receive instructions regarding 

their plan dropping an option. We encourage you to be liberal in accepting 

belated Open Season changes from employees enrolled in the plan dropping an 

option listed in Table 4.

What Will the Health Plan Do? 

• Plan Notification: The plan in Table 4 has been instructed to notify enrollees 

that their current plan option is being discontinued and that if they do not change 

to another plan during Open Season, they will be switched automatically into one 

of the plan’s remaining options specified in Table 4. 

Table 5: FEHB Plan Contract and Enrollment Code Merger with Terminating 

Enrollment Codes 

What Must You Do? 

• Advise your employees who are enrolled in the plan that is merging into another 

plan that if they do not choose a new health plan, they will be automatically 

transferred into the new plan and enrollment code as specified in Table 5. 

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

Season.

• Follow up with employees in the plan and remind them that if they do not choose 

a new health plan, they will be automatically transferred into the new plan and 

enrollment code as specified in Table 5. 

• Belated changes: Some employees still might not receive instructions regarding 

their plan merging with another plan. We encourage you to be liberal in 

accepting belated Open Season changes from employees enrolled in the plan 

dropping an option listed in Table 5.
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What Will the Health Plan Do? 

• Plan Notification: The plan in Table 5 has been instructed to notify enrollees 

that if they do not change to another plan during Open Season, they will be 

switched automatically into the surviving plan as specified in Table 5. 

Table 6: Plans Adding New Options And Enrollment Codes 

Table 7: Service Area Expansions Without New Enrollment Codes

Table 8: Service Area Expansions With New Options And Enrollment Codes

Table 9: Service Area Expansions Adding New Enrollment Codes

What Must You Do? 

You must include the merged plan, the plans with new options, and the plans with

expanded service areas (Tables 5-9) when you count the number of eligible employees 

and place your order for brochures. 

SUMMARY OF BENEFITS AND COVERAGE - REMINDER

As a result of the Affordable Care Act, FEHB plans have been providing a summary 

document on their websites which details information about health plan benefits and 

coverage. The summary document is also available on our website at 

www.opm.gov/healthcare-insurance/healthcare/plan-information/summary-of-benefits. 

In order to help FEHB enrollees better understand their coverage and allow them to easily 

compare different plans and plan options, the Summary of Benefits and Coverage (SBC) 

document includes information on the following: 

• Cost - deductibles, copayments, coinsurance, and out-of-pocket limits 

• Coverage - covered services, examples of covered services and excluded services

• Rights - rights to continue coverage as well as grievance and appeal rights 

• A statement that coverage under the plan qualifies as “minimum essential 

coverage” 

• A statement that the health coverage of the plan does meet the minimum value 

standard for the benefits the plan provides 

The SBC will continue to have a disclaimer indicating that the plan brochure remains the 

official statement of benefits. 

Plans will continue to provide information in their Open Season materials to their 

enrollees about where to find their SBC on their website as well as how to obtain a paper 

copy of the SBC. The plans may also have their SBC available at health fairs. 
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CONCLUSION

Again, this year’s Federal Benefits Open Season will run from Monday, November 14 

through Monday, December 12, 2016. 

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

for the most up-to-date information. Please note that 2017 Plan information will be 

posted on our website ahead of Open Season. 

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