OPM Seeks Mix of Incentives, Cost Controls in FEHB

Following is the annual “call letter” from OPM to insurance companies that outlines the terms of the FEHB program for the upcoming calendar year.

During rate and benefit negotiations for the 2020 plan year, OPM will continue to focus on maintaining and improving quality and affordability in the FEHB Program in accordance with the Agency’s five-year Strategic Plan. We congratulate Carriers on the significant progress made in the 2019 plan year, including lower average premium increases and improvements in PPA scores. We ask that you continue to offer innovative proposals that focus on OPM’s strategic priorities, as described in this Call Letter. Our quality initiatives for the upcoming plan year relate to preventive services, patient safety, and mental health and substance use disorder services. To maintain the focus on affordability of plan premiums, Carriers are also asked to review pharmacy benefits, to further implement value-based benefit design, and to address potential fraudulent payments

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