Tuesday Tidbits

David Ermer–Uncategorized–
First the FEHBlog wants to correct a goof made in a post last month. In discussing upcoming changes to Federal Employees Group Life Insurance premiums, the FEHBlog erroneously noted that OPM planned to hold a FEGLIP Open Season next month — September 2015. The FEHBlog clearly was reading into FEGLIP the FEHBP’s approach of allowing members to change plans before prices change. However, in the case of FEGLI, the Open Season actually will occur in September 2016 after certain premiums change in January 2016. Moreover, as Fedsmith explains, the FEGLI Open Season changes will not take effect until October 2017. Live and learn.

Following up on the Weekend Update, the FEHBlog calls your attention to this Federal Times article indicating the federal information technology leaders are giving their support to the OPM chief information officer who has been under fire.  The FEHBlog expects that it is not easy to retain experienced information technology personnel in the federal service.

The ACA sets annual limits on out of pocket costs for in-network self only and other than self only coverage. Last year, HHS announced in the 2015 ACA notice of benefit and payment parameters that HHS intends that a self only out of pocket limit be embedded in the other than self only out of pocket limit. Surprisingly, HHS failed to include this change in the rules themselves. Rather than correct the error, the ACA regulators circled the wagons in ACA FAQ XXVII and insisted that group health plans must implement the embedding rule for 2016.  OPM has joined them by imposing the embedding rule on all FEHBP carriers for 2016. (Currently, some FEHB plans offer embedded out of pocket limits and others do not, and choice has been a hallmark of the FEHBP historically.)  Business Insurance reports that last Friday,

Reps. Paul Ryan, R-Wis., chairman of the House Ways and Means Committee; John Kline, R-Minn., chairman of the House Education and Workforce Committee; and Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee, asked {HHS Secretary Sylvia Burwell by letter] what statutory authority Obama administration regulators have to set such caps. They also questioned why the policy change was made in the preamble, and not in the regulation itself.
The committee chairmen said they have “become increasingly concerned about agencies’ actions to implement the law that appears to exceed the statutory authority delegated to them by Congress.”
In addition, “While HHS has termed this change to be a ‘clarification,’ the relevant statute is clear — these are two distinct and separate limits,” the lawmakers wrote.
Employer benefits lobbying groups say they welcome congressional questioning of the HHS cost sharing limit.

These benefit mandates, while good hearted, raise premiums and push plans closer to the ACA’s 40% excise tax thresholds.

Speaking of ACA FAQs, the regulators issued number XVIII today. This FAQ highlights the fact that HHS has begun to implement another onerous ACA burden on health plans — uniform quality reporting. This obligation will sit on top of OPM’s own FEHBP quality reporting requirements.