Civil Service Federal Employees Federal Employees Federal Employees

Retirement Group Life Health Benefits Retirement

System Insurance Program System

United States

Office of Personnel Management

Retirement and Insurance Service

Benefits Administration Letter

Number: 98-411 Date: September 22,1998 

Subject: 1998 Federal Employees Health Benefits (FEHB) Program: Significant Plan

Changes

PURPOSE

This letter transmits lists of significant events affecting certain plans during the upcoming FEHB

open season. Please note that some of these events will require action on the part of agencies and

enrollees. Please also note that an unusually high number of plans are dropping out of the

Program at the end of 1998. Since employees in these plans must enroll in new plans during open

season if they are to continue insurance coverage in 1999, we ask that you disseminate this list

widely within your agencies.

TERMINATIONS

Attachment 1: Plans Dropping Out of FEHB for 1999

Attachment 2: Plan Terminating its Standard Option

Attachment 3: Plans Reducing Their Service Areas by Terminating an Enrollment Code

1. What must employees do? Employees in terminating plans (Attachment 1) or in

terminating codes (Attachment 3) must choose a new health plan during open season.

(Standard option enrollees in the plan in Attachment 2 will be transferred to the plan’s

high option automatically.)

2. 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, 1999; for most employees this will

be January 3. Enrollees will remain covered and receive benefits under the old plan until

coverage under the new plan becomes effective. [However, please note that we recently

proposed a regulatory change that will make all open season changes effective on

January 1, regardless of when the pay period begins. We will provide you with more

information about this as soon as possible.]

3. Plan notification. The plans in Attachments 1 and 3 have been instructed to notify
Benefits Administration Letter 98-411 2

enrollees of the need to select new health plans for 1999. However, some plans’

enrollment and address lists may not be up to date.

4. What must agencies do? Agencies must notify employees in these terminating plans

and enrollment codes of the need to select new plans 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 plans will still be

participating in 1999.

We strongly recommend that you notify your 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 open season ends, you follow up with employees in these

plans who have not made a new election and remind them to select new plans.

5. Belated changes. Despite these precautions, there are likely to be some employees

who do not get the word to change plans during open season. We encourage you to be

liberal in using your authority to accept belated open season changes from employees

enrolled in terminating plans/enrollment codes.

SERVICE AREA REDUCTIONS

Attachment 4: Plans Significantly Reducing Their Service Areas Without Terminating an 

 Enrollment Code

Enrollees in the service areas being terminated should consider choosing new plans for

1999. Enrollees who do not choose new plans will have to travel to their plan’s remaining

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

Attachment 5: Plans Splitting a Service Area

Enrollees in these plans should consider changing their code (or plan) during open season. 

Otherwise, they will have to travel to the area served by their enrollment code to obtain

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

Agency Action Required. You may wish to distribute a copy of these lists to each employee,

along with your agency’s notice to employees about open season. If you don’t distribute the lists,

remind employees to check their new health plan brochures carefully to see if there have been any

changes to their plans’ service areas that will affect them.

OTHER SERVICE AREA CHANGES

Attachment 6: Service Area Consolidations

These plans are consolidating their services; i.e., changing from one or more enrollment

areas to one. The service areas will remain the same, but they will be included under one

enrollment code. Enrollees in the “departing” enrollment codes will be transferred

automatically to the remaining enrollment code.
Benefits Administration Letter 98-411 3

Attachment 7: New Plans Entering the Program for 1999

Attachment 8: Service Area Expansions With a New Enrollment Code

Attachment 9: Significant Service Area Expansions Without New Enrollment Codes

Agency Action Required. Be sure to include these new plans and expanded service areas when

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

MISCELLANEOUS CHANGES

Attachment 10: Plan Mergers

These plans are merging with another plan at the end of 1998. Enrollees in the “old” plans

will be transferred automatically to the “new” plans and need take no action. Any

enrollees in the old plans who do not wish to be transferred to the new plans must choose

different plans during open season.

Attachment 11: Plan Name Changes

Attachment 12: Enrollment Code Changes

Attachment 13: Plans Adding a Point of Service Product

Attachment 14: Plan Dropping a Point of Service Product

This plan is dropping its point of service product (POS) for 1999. Individuals who

enrolled in this plan primarily to have access to POS may want to consider changing plans

during open season.

Abby L. Block, Chief

Insurance Policy

and Information Division
Benefits Administration Letter 98-411 4

ATTACHMENT 1

PLANS DROPPING OUT OF FEHB FOR 1999

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

health benefits for 1999.

Plan Name Code General Location

Alliance Health Network 5A Pennsylvania

BACE YD n/a

BlueChoice Healthcare Plan 1B Georgia

CIGNA HealthCare Mid-Atlantic XF Washington, DC, Maryland, Virginia

CIGNA of Ohio R4 Ohio

Community Blue J7, 6Z New York

Community Health Plan Plus 8S South Dakota

Companion HealthCare SE South Carolina

Exclusive Healthcare 8K Kansas and Missouri 

Exclusive Healthcare 7E Nevada

Exclusive Healthcare 6E Texas

FHP Illinois (Principal Health Care of

Illinois)

FY Illinois and Indiana

Foundation Health Oklahoma 6G Oklahoma

Green Bay Health Protection Plan 4L Wisconsin

Harris Methodist Health Plan SC Texas

Healthsource Arkansas 1H Arkansas

Healthsource Georgia 7H Georgia

Healthsource Ohio 3H Ohio

Healthsource TN HT Tennessee

Health Advantage 3D Arkansas

HMO Maine CU Maine

HMO Blue GM Idaho

HMSA’s Community Hlth Program 9Q Hawaii
Benefits Administration Letter 98-411 5

HPC Health Plans of GA WU Georgia

Healthplan Southeast 3E Florida

IHC SelectMed 6S Utah

Integrity Health Plan 4G Mississippi

Matthew Thornton Health Plan NX New Hampshire

Maxicare Illinois FV, VG Illinois

Maxicare North Carolina Q5, TA North and South Carolina

Maxicare Northern California CX California

Maxicare Wisconsin WG Wisconsin

MD Health Plan 1M Connecticut

Medfirst Health Plans 2M Louisiana

Medica Primary 11 Minnesota

North Central Health Protection Pln 8R Wisconsin

NYLCare Health Plans of Midwest XA Illinois

NYLCare Health Plans of NY HK, HV New York, New Jersey, Connecticut

Ochsner Health Plan 4Q, 4R,

4S, 4W

Louisiana

Oxford Health Plans-CT ZW Connecticut

Oxford Health Plans-NYC GC New York

Oxford Health Plans-PA 3W Pennsylvania

Physicians Health Services of NJ 7B New Jersey

Preferred Health Network 4P Washington, DC, and Maryland

Premier Blue 5N Kansas

PrimeCare Health Plan WK Wisconsin

Principal Health Care of Nebraska GU Nebraska

Principal Health Care of Texas T5 Texas

Prudential HealthCare HMO 2I Central Indiana

QualChoice 1Q Ohio

QualChoice of VA 2Q Virginia

QualMed Oregon Health Plan AF Oregon
Benefits Administration Letter 98-411 6

Southern Health Services 5S Virginia

Suburban Health Plan 1S Connecticut

United HealthCare of AR QC Arkansas

United HealthCare of CA

(formerly MetraHealth Care Plan)

WA California

United HealthCare of GA UQ Georgia

United HealthCare of IL FP Illinois

United HealthCare of LA RY Louisiana

United HealthCare of MS QV Mississippi

United HealthCare of NY 3M New York

United HealthCare of TN QR Tennessee

United HealthCare of TX U3 Texas
Benefits Administration Letter 98-411 7

ATTACHMENT 2

PLAN TERMINATING ITS STANDARD OPTION

Group Health Cooperative of Puget Sound, Washington, Code 54, is dropping its Standard

Option for 1999. Standard Option enrollees will be transferred automatically to the plan’s High

Option unless they change plans during open season.
Benefits Administration Letter 98-411 8

ATTACHMENT 3

PLANS REDUCING THEIR SERVICE AREAS 

BY TERMINATING AN ENROLLMENT CODE

Enrollees in these enrollment codes who do not change health plans during open season will

not have health benefits for 1999.

Plan Name Code Terminated Area Dropped

Care Choices (MI) KZ Eastern Michigan

Care Choices (MI) BA Western Michigan

HMO Health Ohio OH Central Ohio

Health Options (FL) E8

 TH

 XN

Jacksonville/Gainesville area

Orlando/Central FL area

Escambia/Santa Rosa/Okaloosa area

HealthPartners Health Plans

(AZ)

 QS Yuma County

Humana Kansas City (MO) 7S Central Missouri/Springfield area
Benefits Administration Letter 98-411 9

ATTACHMENT 4

PLANS SIGNIFICANTLY REDUCING THEIR SERVICE AREAS

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 their plan’s remaining service area to obtain medical care in order to

receive full benefits from the plan in 1999.

Plan Name Code Area Dropped

Aetna U.S. Healthcare XC

3G

2U

Indiana: Boone, Hamilton, Hancock,

Hendricks, Johnson, Madison, Marion,

Morgan, and Shelby counties

South Carolina: Beaufort, Kershaw,

Sumter, and York counties

Georgia: Carroll County

BCI HMO (IN) 3B Porter County

Beacon Health Plans (FL) 4K Orange, Osceola, and Seminole

counties

Exclusive Healthcare (IA & NE) 9Y Iowa: Buena Vista, Clay, and Sac

counties

Nebraska: Burt County

Foundation Health (So. CA)

Foundation Health (N.CA)

6R

C6

These plans are merging with Health

Net of CA, Code LB. Enrollees who

do not choose a different plan will be

automatically transferred to LB. Note,

however, the following areas currently

served by Foundation Health will not

be served by Health Net: the entire

counties of Amador and Lassen, and

portions of Calaveras, El Dorado,

Fresno, Kern, Nevada, Placer,

Riverside, San Bernadino, and Tehama

counties.

Health Net (CA) LB Monterey County

HealthPartners Health Plans (AZ) 2S The counties of Gila, LaPaz, Mohave,

Yavapai, Coconio, and Apache, and

most of Pinal County
Benefits Administration Letter 98-411 10

Heritage National Healthplan (IL) 3J Boone, DeKalb, Kane, McHenry, Ogle,

and Stephenson counties

Humana Health Plan of Texas

(previously PCA HP of Texas)

TW Corpus Christi, Houston, and San

Antonio

Humana Medical Plan (FL) EE

JH

Glades, Hendry, Indian River, Martin,

Okeechobee, and St. Lucie counties

Manatee, Polk, and Sarasota counties

Intergroup of Arizona A7 Graham, Greenlee, and La Paz counties

Maxicare Indiana GK Southeastern counties

Omni Healthcare (CA) HN Butte, Del Norte, Humboldt, Marin,

San Francisco, San Mateo, Santa Clara,

and Sonoma counties

PacifiCare of Arizona A3 Mojave County

PacifiCare of Nevada K9 Nevada: Douglas, Lyon, and Storey

counties

Arizona: Mojave County

PacifiCare of Ohio R8 Clark, Greene, Miami, Montgomery,

Preble, Shelby, and Champaign counties

PacifiCare of Texas GF Medina, Navarro, and Wilson counties

PacifiCare of Utah 9K (was KU) Cache and Washington counties

PacifiCare of Washington WB Chelan, Douglas, Ferry, Kitsap,

Okanogan, Skagit, and Whitman

counties

Partners National Health Plan of

North Carolina

EQ Bladen, Brunswick, Columbus, Duplin,

Edgecombe, Greene, Halifax, Martin,

Nash, New Hanover, North hampton,

Pender, Pitt, Sampson, Warren, Wayne,

and Wilson counties.

PrimeHealth of Alabama (AL) AA Bibb, Blount, Colbert, Cullman,

Franklin, Jackson, Jefferson,

Lauderdale, Lawrence, Limestone,

Madison, Marion, Marshall, Morgan,

Shelby, St. Clair, Talladega,

Tuscaloosa, Walker, and Winston

counties

Priority Health (MI) BQ Portions of Gratiot County 
Benefits Administration Letter 98-411 11

Prudential HealthCare HMO (VA) V6 The city of Fredericksburg and the

counties of Spotsylvania and Caroline

QualMed Washington (ID & WA) TM Idaho: Ada, Benewah, Boise, Bonner,

Boundary, Canyon, Elmore, Gem,

Kootenai, Latah, Owyhee, Payette, and

Shoshone counties

Washington: Okanogan County

Regence HMO Oregon 7A Crook, Deschutes, Gilliam, Grant,

Harney, Hood River, Jefferson, Lake,

Sherman, Wasco, and Wheeler counties

Regence Health Maintenance of

Oregon

6B Oregon: Hood River County

Washington: Klickitat and Skamania

counties

SelectCare HMO (MI) K6 Portions of Livingston County

United HealthCare of Florida QK Orlando/Jacksonville areas

United HealthCare of Mid-Atlantic BL Virginia

The Wellness Plan (MI) K3 Monroe County
Benefits Administration Letter 98-411 12

ATTACHMENT 5

PLANS SPLITTING A SERVICE AREA

Enrollees in these plans under the 1998 enrollment codes shown below should check their

plan brochures to determine which 1999 code they should be under. Enrollees in these

1998 codes who should change, but do not, will have to travel to the area served by their

enrollment code to obtain medical care to receive full benefits from the plan.

Plan Name 1998 Code 1999 Code

Aetna U.S. Healthcare 5B (Houston/San Antonio) 5B (Houston)

8X (San Antonio)

PacifiCare of Arizona A3 A3 (Metropolitan AZ -

counties of Maricopa,

Pima, and Pinal

7R (Rural AZ -

counties of Apache,

Cochise, Coconino,

Gila, Graham,

Greenlee, LaPaz,

Navajo, Santa Cruz,

Yavapai, and Yuma
Benefits Administration Letter 98-411 13

ATTACHMENT 6

SERVICE AREA CONSOLIDATIONS–

TRANSFERRING TWO OR MORE ENROLLMENT CODES INTO ONE

Enrollees in an enrollment code being dropped will be transferred automatically to the

remaining code unless they choose a different health plan during open season.

Plan Name Code(s) Being Dropped Remaining Code

HealthAmerica Pennsylvania ZN, SW, 4N 26

HealthPartners of Alabama 5F, Z9 DF

Humana Health Plan of Texas S5, UV TW (formerly the code

for PCA HP of TX. See

Attachment 10 -Mergers)

QualMed of OH/WV

(formerly Advantage HP of OH/WV)

 QL QJ
Benefits Administration Letter 98-411 14

ATTACHMENT 7

NEW PLANS ENTERING THE PROGRAM FOR 1999

State Plan Name Code General Location

CA Western Health Advantage 5Z Northern California

GA Athens Area Health Plan Select 8Y Athens Metro area

LA SMARTPLAN 8D Louisiana

NC Generations Family Health Plan 8B Chapel Hill/Durham/Raleigh areas

NY MDNY HEALTHCARE 5Y Nassau and Suffolk counties

NY Partners Health Plans 7Y The Northern, Capital, and MidHudson regions of NY

TX HealthFirst HMO 8E Texas

WA, ID HealthPlus 8F Most of Washington, and the Idaho

counties that border WA
Benefits Administration Letter 98-411 15

ATTACHMENT 8

SERVICE AREA EXPANSIONS

WITH A NEW ENROLLMENT CODE

State Plan Name New Code General Location

MI Aetna U.S. Healthcare 8Z Greater Detroit Metro area

NV Aetna U.S. Healthcare 8L Southern Nevada/Las Vegas area

OK Aetna U.S. Healthcare 8V Northeast Oklahoma

WA Aetna U.S. Healthcare 8J Western and Southeast Washington
Benefits Administration Letter 98-411 16

ATTACHMENT 9

SIGNIFICANT SERVICE AREA EXPANSIONS 

WITHOUT NEW ENROLLMENT CODES

State Plan Name Code General Location of New Area

AL VIVA Health Plan 4B Autauga, Bibb, Blount, Calhoun,

Chilton, Clarke, Colbert, Conecuh,

Cullman, Dale, Elmore, Franklin,

Jackson, Lauderdale, Limestone,

Madison, Marion, Marshall, Morgan,

Shelby, and Tuscaloosa counties

FL Aetna U.S. Healthcare 8A Miami area

IA SecureCare of Iowa 3Q Cedar Rapids/Waterloo areas

IN United HealthCare of

Kentucky

DU Indiana counties of Clark, Floyd, and

Harrison

IN,

KY

Aetna U.S. Healthcare RD Southern Indiana and the Kentucky

counties of Anderson, Fayette, Henry,

Jessamine, Larue, Madison, Trimble,

and Woodford

LA Vantage Health Plan 7V Northern Louisiana

MD Free State Health Plan LD Washington, DC

MO BlueCHOICE 9G Butler, Carter, Ripley, and Wayne

counties

OH Prudential Midwest Northern

Ohio

Q9 Youngstown area (Columbiana,

Mahoning, and Trumball counties)
Benefits Administration Letter 98-411 17

ATTACHMENT 10

PLAN MERGERS

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

they choose a different plan during open season.

Merging Plans Codes Surviving Plans Codes

Blue Shield of CA Access+HMO 

CareAmerica HP 

SJ

BG

Blue Shield of CA

Access+HMO

SJ

CareFirst Health Plan (MD)

Columbia Medical Plan (MD)

Free State Health Plan (MD)

JQ

67

LD

Free State Health Plan

(plan will expand to cover

Washington, DC in 1999)

LD

Foundation Health (So. CA)

Foundation Health (N. CA)

Health Net of California

6R

C6

LB

Health Net of California LB

FHP of New Mexico

Presbyterian Health Plan

P2

W8

Presbyterian Health Plan P2

Group Health Cooperative of Puget

Sound (WA)

Group Health Northwest (WA & ID)

54

VR

Group Health Cooperative of

Puget Sound

54, VR

Humana Health Plan of Texas

PCA Health Plans of Texas

S5

UV

TW

Humana Health Plan of Texas TW

United HealthCare Select (MO & IL)

United HealthCare Choice (MO)

H8

VB

United Healthcare Select H8
Benefits Administration Letter 98-411 18

ATTACHMENT 11

PLAN NAME CHANGES

State Old Plan Name Code New Plan Name

CO Foundation Health of Colorado 2D QualMed of Colorado

CT,MA,

ME,NH,

NY, VT

Harvard Community Health Plan 68 Harvard Pilgrim HealthCare

Guam FHP of Guam JK PacifiCare Asia Pacific

MI Blue Care Network of East MI

Blue Care Network - SE MI

Blue Care Network-Health

Central

Blue Care Network-Great Lakes

KN, K5

LX

LN

KR, KF,

G7

Blue Care Network of Michigan

MO, IL PARTNERS HMO RN Health Partners of the Midwest

NH, MA CHP/Kaiser Permanente K1 Kaiser Permanente

NY Community Health Plan PW, QB Kaiser Permanente

NY CHP/Kaiser Permanente QH Kaiser Permanente

NY Vytra Healthcare J6 Vytra Health Plans

OH Prudential HealthCare HMO

Cincinnati

S3 Prudential HealthCare Midwest -

Southwestern OH

OH Prudential HealthCare HMO

Central OH

AY Prudential HealthCare Midwest

OH Prudential HealthCare HMO

Northern OH

Q9 Prudential HealthCare Midwest

OH, WV Advantage HP of Ohio/West

Virginia

QL, QJ QualMed Plans for Health of

Ohio/West Virginia

OR, WA Health Maintenance of Oregon 6B Regence Health Maintenance of

Oregon

PA Advantage HP of Pennsylvania 24 QualMed Plans for Health of PA

TX Kaiser Foundation HP of Texas UK HMO Texas, L.C.
Benefits Administration Letter 98-411 19

VT Community Health Plan 8M Kaiser Permanente

WA, OR SelectCare SD Providence Health Plan
Benefits Administration Letter 98-411 20

ATTACHMENT 12

ENROLLMENT CODE CHANGES

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

choose a different plan during open season.

Plan Name Old Code New Code

CIGNA HealthCare of California SK 9T

OPTIMA Health Plan (VA) V9 9R

PacifiCare of Utah KU 9K
Benefits Administration Letter 98-411 21

ATTACHMENT 13

PLANS ADDING A POINT OF SERVICE PRODUCT

Plan Name Code Location

Blue Cross Blue Shield Service

Benefit Plan - Standard Option

10 Connecticut, Minnesota, North Dakota

Bluegrass Family Health 2B Central/Eastern Kentucky
Benefits Administration Letter 98-411 22

ATTACHMENT 14

PLANS DROPPING A POINT OF SERVICE PRODUCT

Individuals who enrolled in these plans primarily to have access to the point of service

products they offered in the past may want to consider changing plans.

Plan Name Code Location

HMO New Mexico 5H New Mexico

Presbyterian Health Plan P2 (formerly

W8)

New Mexico