There is good news and bad news for federal employes and retirees covered by the civil service health program.
On the one hand, 1.5 million of the subscribers -- 41 percent of the premium payers -- stand to get refunds from the Blue Cross-Blue Shield Association, the largest plan in the federal health program. Subject to approval by the Office of Personnel Management, the refunds would range from $18 to $374, depending on the kind of policy (self or family, high or low option).
Blue Cross-Blue Shield says it will return $465 million to the U.S. Treasury and another $289 million to people who currently hold policies. The company says the rebates are possible because of a dramatic decrease in medical claims this year.
On the other hand, federal employes and retirees not covered by Blue Cross-Blue Shield insurance won't be eligible for any of the refund money.
OPM has scheduled a public hearing for May 30 on the rebates and the subject of surpluses in the federal health program. Judging from the public interest, OPM's auditorium may not be big enough to hold all the people who have questions and comments about the situation.
At the risk of looking a gift horse in the mouth, here are some questions that OPM, and Congress, ought to ask before deciding if the rebate is to be allowed, and if so, who benefits: Is the idea of a one-shot rebate sound, or should the surplus piled up by many of the insurance companies (not just Blue Cross-Blue Shield) be used to improve benefits and hold down price increases in future years? If Blue Cross-Blue Shield is allowed to make refunds to its customers, should other health plans with big surpluses be encouraged to do the same? What about workers and retirees who paid premiums to Blue Cross-Blue Shield (some of the highest in the federal health program) for many years -- and helped create the surplus -- but dropped out in 1985? Why should the nearly half-billion dollars Blue Cross-Blue Shield proposes to return to the government go to the U.S. Treasury, rather than the federal health program that produced the surplus? Should the refund money be used to retire the deficit? Or buy a battleship? Or finance a dam in Oklahoma? Or should it be used to lower premiums and/or improve benefits for U.S. workers and retirees? Because the giant federal health program sets trends for the nation's health care industry, should the authority to approve or reject this unprecedented rebate be OPM's alone? Does Congress deserve a role? Finally there's this bottom line question: Whose money is this? Does the $754 million belong exclusively to Blue Cross-Blue Shield and its 1985 policyholders? Or do others have a stake (and a share) in how the funds are handled?
Naturally, if I had the answers I wouldn't be writing this column for a living. I'd be in Congress, or head of an insurance company.
If you want to make a presentation at the OPM hearings on the subject call Kevin Burns on 632-4670. If the phone is busy that means you are not the only one with questions and answers. Walk-in Interviews
The National Oceanic and Atmospheric Administration will be interviewing tomorrow afternoon in its Rockville office. NOAA is looking for 14 contract specialists, Grades 9 through 13, and a half-dozen procurement clerks, GS 4/5. For an interview, call Denise Ballerini on 443-8584.