Office of Personnel Management

Retirement and Insurance Group

1920 1954 1959 

 

1986 

Benefits Administration Letter

Number: 95-213 Date: March 22, 1995 

SUBJECT Federal Employees Health Benefits:

Survey of Open Season Needs

_________________________________________________________________

The purpose of this Letter is to request your help in our

planning for the 1995 and future open seasons. We need your

input on various aspects of open season material and issuances.

Attached is a survey on open season needs. We are asking

specific questions relating to the FEHB Guides, health plan

brochures, and Benefits Administration Letters.

You will need to share this survey with your field installations. 

However, we wish to receive responses only from headquarters

Insurance Officers. Please instruct your field installations to

send their responses to you, so that you can send us a consensus

response.

Please FAX your responses to the Insurance Policy and Information

Division, Office of Insurance Programs, at 202-606-0633. Since

we are now in the preliminary stages of planning for the next

open season, we would like to have your responses by April 5.

Thank you for your help with this.

Attachment
SURVEY OF AGENCIES' OPEN SEASON NEEDS

FEHB Guides

 1. OPM provided enough FEHB Guides (RI 70-1) for 60% of your agency's

eligibles last year. Did you acquire or produce any additional

copies? _____

 2. What was your process for distributing FEHB Guides last year? _______

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 3. If you handed them out when employees asked for one, how many were

requested by employees? _____

 4. Did you have enough to satisfy all employee requests? _____

 5. Did you have too many? _____ If so, how many were left over? _____

 6. In all, what percentage of your original supply from OPM did you use? 

_____

 7. Would you be interested in OPM's arranging for additional copies to

be available through a special rider at your agency's expense? _____

 8. OPM plans to make the FEHB Guide information available on OPM

Mainstreet. Will having the information on OPM Mainstreet decrease

your need for printed FEHB Guides? _____ How many employees would

be able to access the information electronically? _____ Do you have

the capability of downloading the information and including it in

your letter to employees about Open Season? _____

 9. Do you anticipate a decrease in the number of Guides you will need

for the next Open Season? _____ If so, briefly detail size and

cause of decrease. _________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Health Plan Brochures

 1. Did you receive enough of each plan's brochure to meet employee

requests? _____ If not, briefly describe the problem(s) you faced

and how they were resolved. ________________________________________

_____________________________________________________________________
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_____________________________________________________________________

_____________________________________________________________________

 2. We are reviewing the current distribution system for Fee-for-Service

Plan brochures. How would you (as the insurance officer for your

agency) prefer to order these brochures? (Circle one)

a. Through OPM as we currently do (fixed percentage shipped to

negotiated delivery points); or,

b. Directly from the plans, as we do for Prepaid Plan brochures

(except that the insurance officer would have to place a

consolidated order for the entire agency that could not exceed

the percentage you currently get); or,

c. Other (describe your own ideas and how they would improve upon

the current system). ___________________________________________ 

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Benefits Administration Letters

SIGNIFICANT EVENTS (BALs 94-405 and 94-408)

Over the past few years, we've expanded this issuance from a simple listing

of terminating plans to a large number of lists detailing several different

kinds of significant events. We'd like to know whether you find the

information in the attachments useful. In previous years we prepared one

issuance summarizing all significant plan changes. For 1994, we issued the

BAL in two parts. Part I showed events that required some action on the

part of agencies. Part II showed events that did not require agency

action.

For each type of event shown below, indicate whether you find the

information useful by using the following codes:

A - Useful

B - Not useful

C - No opinion

 1. Plans Dropping out of the FEHB (Employees who don't change plans lose

health benefits) _____

 2. Plans Reducing Their Service/Enrollment Area by Terminating an
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Enrollment Code (Enrollees who don't change plans lose health

benefits) _____
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 3. Plans Reducing Their Service/Enrollment Area without Terminating an

Enrollment Code (Enrollees who don't change plans have to travel to

the plan's remaining service area for medical care to receive full

benefits) _____

 4a. Partial Service/Enrollment Area Transfers from One Existing

Enrollment Code to Another Existing Enrollment Code (Enrollees who

don't change codes have to travel to the area served by their code

for medical care to receive full benefits) _____

 4b. Partial Service/Enrollment Area Transfers from One Existing

Enrollment Code to Another Existing Enrollment Code (Enrollees who

don't change codes can use any plan doctor but will pay a higher

premium) _____

 5. New Plans Entering the Program _____

 6. Service/Enrollment Area Expansions with a New Enrollment Code _____

 7. Significant Service/Enrollment Area Expansions with No New Enrollment

Codes _____

 8a. Plans Splitting a Service/Enrollment Area (Enrollees who don't change

codes have to travel to the area served by their code for medical

care to receive full benefits) _____

 8b. Plans Splitting a Service/Enrollment Area (Enrollees who don't change

codes can use any plan doctor but will pay a higher premium) _____

 9. Service/Enrollment Area Consolidations, Transferring Two Enrollment

Codes into One (Enrollees in the code being dropped are transferred

automatically to the remaining code) _____

10. Plan Mergers (Enrollees in the merging plans are transferred

automatically to the surviving plan) _____

11. Plans Dropping an Option (Enrollees in the option being dropped are

transferred automatically to the remaining option) _____

12. Plan Name Changes _____

13. Enrollment Code Changes (Enrollees in the old code are transferred

automatically to the new code) _____

In 1994 the Part I Significant Events BAL was issued September 15; Part II

was issued October 3. We'd like to know the latest date(s) you think you

can get the Significant Events BAL(s) in order to get them out to your
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field installations in time for the information to be of benefit to them

for open season.

 Latest Date(s) _________________________

LIST OF CARRIER CONTACTS

We'd also like to know the latest date you feel you can get the list of

carrier contacts in order to get the list out to your field installations

in time for them to order brochures. (In 1994 the BAL transmitting the

list - 94-407 - was issued September 22.)

 Latest Date ___________________________

_______________________________________________________

Print or Type Name of Headquarters Insurance Officer

_______________________________________________________

Print or Type Name of Agency

_______________________________________________________ ________________

Signature of Headquarters Insurance Officer Date