In open season for insurance plans, look beyond premium

Tuesday, November 23, 2010; 9:09 AM

Open season, the period when federal employees can choose health insurance plans, runs through Dec. 13.

Employees are always concerned about the amount they pay for insurance through the Federal Employees Health Benefits Program. But the premium isn't the only thing to examine.

Walton Francis, a health economist and primary author of "Checkbook's 2011 Guide to Health Plans for Federal Employees," says they should also focus on out-of-pocket costs, the various types of plans, their particular health situation and the insurance companies their doctors use.

The Federal Diary spoke with Francis about this year's offerings. Here is an edited version of that conversation:

Diary: What are the important things federal employees should pay attention to during open season?

Francis: There are many examples of things people ought to do that they mostly don't do. What people need to do is pay serious attention. It may not take a lot of time, maybe only 10 or 15 minutes. But you need to pay serious attention to what's going on in your life and how your health plan looks compared to the alternatives.

Compared with Blue Cross standard - which is what most people are in - GEHA standard, if you switch, you will save $1,400 [for the family plan]; M.D. IPA, an HMO, $1,800, on average; Blue Cross basic, $1,900; GEHA high deductible, $2,000; Aetna consumer-driven and high deductible, also $2,000; Kaiser standard HMO, $2,500; and APWU (American Postal Workers Union) consumer-driven, also $2,500.

That's serious money on the table.

A second example is what you can save with flexible savings accounts, in your out-of-pocket costs. Probably 90 percent of federal employees ought to use FSA.

A third example: Suppose you have an illness that your plan doesn't cover as well as it used to, because of a benefit change. Let's say you need a new drug and it's not a preferred drug with plan A, but it is with plan B. That could be a multi-hundred-dollar difference.

I'm giving you three examples of why paying attention is a vital thing to do. And that's the No. 1 piece of advice. Pay attention and do some homework.

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