Wed. Nov 20th, 2024

OPM Encourages Federal Employees to Review Health Coverage During 2024 Open Season

November 13, 2024 , ,

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Washington, D.C. – The 2024 Federal Benefits Open Season is now underway, running from November 11th through December 9, 2024. Employees and annuitants can use Open Season to reassess their health, dental, and vision coverage and ensure their plans are cost-efficient and address the care enrollees and their families need.

“During Open Season, we want to give enrollees the opportunity to review their coverage, compare coverage options and make the choice that is right for them – whether that may be to make changes or keep their current coverage,” said Rob Shriver, Acting Director of the U.S. Office of Personnel Management (OPM). “This year, we’re proud to offer expanded benefits, including enhanced fertility coverage, behavioral health services, and new resources for Postal employees enrolling in the new Postal Service Health Benefits Program.”

This Open Season is the inaugural launch of the Postal Service Health Benefits (PSHB) Program for nearly 2 million Postal employees and annuitants, along with their eligible family members, making the program larger than any exchange rolled out under the Affordable Care Act. More than 90% of Postal employees will be automatically enrolled into the corresponding PSHB plan that most closely resembles their current Federal Employees Health Benefits (FEHB) plan, if the FEHB carrier is offering that plan in PSHB. If Postal enrollees like that plan, they do not have to do anything further during this year’s Open Season.

For 2025, the FEHB Program has 42 participating Carriers offering 64 Plans and a total of 130 plan options. All plans include fertility benefits, covering artificial insemination and the drug components of IVF for up to three cycles. Additionally, 25 plans provide enhanced IVF coverage, offering full or partial coverage of the associated medical procedures.

For 2025, the Federal Employees Dental and Vision Insurance Program (FEDVIP) has twelve dental and five vision carriers. Eligible individuals can enroll in a dental and/or vision plan for themselves and eligible family members, including spouses, unmarried dependent children under age 22 or over age 22 if incapable of self-support. 

Federal employees may use Open Season to elect pre-tax contributions to health care and/or dependent care flexible spending accounts under the Federal Flexible Spending Account Program (FSAFEDS).  

BENEFITS HIGHLIGHT

OPM recently announced 2025 plans and premiums for the FEHB Program and FEDVIP. Among the notable changes for 2025, for the first time, all who are covered under healthcare will have the opportunity to choose from multiple plans offering coverage for IVF services and procedures. All plans will cover drug costs associated with IVF procedures up to 3 cycles annually.  Additionally, 25 FEHB plans with 45 plan options are also offering IVF coverage above the required benefit.

Additionally, OPM emphasized that carriers must offer comprehensive behavioral therapy – covering appropriate diet and exercise regimens, for those prescribed anti-obesity medications and access to available mental health and substance abuse treatment. OPM emphasized access and availability of behavioral provider networks in view of recent public health crises, including the COVID-19 pandemic, youth mental health, and the opioid epidemic.

PREPARING FOR OPEN SEASON 

Below are sample questions to help review your benefits and needs for health care coverage:

What are my and/or my family’s expected health care needs for 2025? 

  • Questions while reviewing your FEHB Program: Am I interested in starting a family?  Do I need surgery? Will my medication needs change? Does my plan provide a pharmacy mail order option for prescriptions?
  • Questions while reviewing FEDVIP: Do I need routine dental care? Will I need a crown or root canal? Does my child need braces? Do I need glasses and/or contact lens? Am I considering laser vision correction surgery?
  • Questions while reviewing FSAFEDS: Do I have out-of-pocket expenses I need to consider, such as deductibles, copays, day care, elder care, or over-the-counter drugs and medicines? Does my child need braces or use acne treatment? Do I plan to send my children (under 13) to in-home care or summer camp?

FAST FACTS

  • Established in 1960, the FEHB Program is the world’s largest employer-sponsored health benefits program.
  • The FEHB Program provides healthcare benefits for about 8.3 million individuals, including 2.3 million employees, 1.9 million annuitants, and an estimated 4.1 million family members.
  • The annual Open Season gives federal employees, annuitants, and other eligible individuals the opportunity to review their FEHB and FEDVIP plan options, make changes, and enroll for the upcoming benefit year that begins January 1, 2025.

RELEVANT RESOURCES 

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