Happy New FEHB Contracting Year!

OPM kicked off the new FEHB Program year by publicly issuing its call letter for 2009benefit and rate proposals at the annual carrier conference this week. Steve Barr of the Washington Post published a column about the call letter today. My partner Scott Jamison was at the carrier conference today. Scott summarized the comments of OPM representatives about the call letter, which has not yet been posted on OPM’s web site

  • OPM wants plans to incent their enrollees to seek clinically effective care. OPM singled out disease managements programs as a good example of the kind of thing it was looking for. OPM expects carriers in their benefit and rate proposals to project the return on investments they expect from such design change, which I understand to be easier said than done.
  • OPM is asking plans to design “suboptions” for Medicare eligible annuitants that are simple, transparent and, voluntary. The suboptions should to incent annuitants to enroll in Medicare Parts B, C, and/or D.
  • OPM generally will not accept benefit increases without offsetting reductions. However, OPM will accept, within reason, additional costs for plans to enhance their coverage of hearing-related services for adults (item 3).
  • OPM also asked plans to consider durable medical equipment coverage for hi-tech assistive devices that would facilitate communication, but expects any such enhancements in this area to be cost-neutral.
  • OPM will continue to “reward” carriers for their health information technology efforts by publicizing the ones making the greatest strides in this area on its website, and indicated that, as in past years, a carrier letter requesting information on this initiative would be forthcoming.

Carriers must submit their 2009 benefit and rate proposals by the end of May 2008. Negotiations then ensue over the proposals. Those negotiations conclude in mid-August 2008, followed by the production of 2009 plan brochures and the Open Season for 2009 enrollment which runs from early November through early December 2008.