Fee-for-service health plans--which let you pick your doctor, hospital and course of medical treatment--remain the most popular choice of federal workers and retirees participating in the Federal Employees Health Benefits Program.

But fee-for-service plans are losing some ground because their premiums are higher than those of many health maintenance organizations.

At one time, federal workers and retirees could choose from more than a dozen fee-for- service plans. Some plans were sponsored by white-collar unions (in part as a recruiting tool), which later dropped them because costs got out of hand. Either the plans had too few policyholders or offered benefits that attracted too many heavy users without appealing to people requiring low medical upkeep.

Among the union plans, only those offered by postal employee organizations survive. All the postal plans accept nonpostal members, although nonpostal members have to pay a fee to enroll. The Mail Handlers plan, for example, has many, many more members than union members. But it is popular because its premiums generally have been low.

Some federal employees who can't tell a postal clerk from a letter carrier are enrolled in the plan of the American Postal Workers Union, which represents mostly clerks. Others are members of the National Association of Letter Carriers plan.

Blue Cross-Blue Shield remains the largest federal health plan and is a favorite with retirees. But its high-option coverage, while providing excellent benefits, simply costs too much, considering what individuals or families are likely to get in return.

Shopping for health insurance is especially important this year because premiums next year will jump an average of 9.3 percent. But that is an "average" figure. Some plans are cutting premiums. Others will increase premiums less than 9.3 percent. A few will jump more than that.

During the open enrollment period, which starts next month, workers and retirees will have plenty of time to check out brochures and compare premiums, benefits and, if they are smart, check with their doctor and dentist to see whether they participate in the plan's preferred-provider option. If so, each visit should cost a lot less.

Future Federal Diaries will list premiums for postal workers (who pay less than nonpostal employees for the same coverage), as well as premiums of "special" plans open only to certain groups of employees in selected agencies. A future column also will list premiums for retirees. Retirees pay the same premiums as active-duty workers in the same plans, but retirees pay on a monthly basis. Active-duty workers pay biweekly.

Below are biweekly premiums for fee-for- service plans available to all federal workers. The listing shows only the amount the employee will pay, not the total premium, of which the government picks up about 72 percent.

* Alliance Health Plan: Self only, $55.59, down $6.77 from the 1999 premium. Family, $109, down $15.58.

* American Postal Workers Union Plan: Self only, $39.72, up $3.02 for nonpostal workers. Family, $84.20, up $5.91.

* Blue Cross-Blue Shield: self only, standard option (the most popular plan), $30.04, up $2.22. Family, standard option, $66.78, up $4.46. Self only, high option, $66.29, up $2.72. Family, high option, $134.35, up $4.73.

* GEHA (Government Employees Hospital Association): self only, $45.72, up $9.47. Family option, $92.67, up $19.46.

* Mail Handlers: Self only, standard option, $21.08, up $1.91. Family, standard option, $45.76, up $4.16. Self only, high option, $45.43, up $6.54. Family, high option, $86.13, up $12.50.

* National Association of Letter Carriers Plan: Self only, $46.87, up $3.73. Family, $92.66, up $6.87.

* Postmasters Plan: Self only, standard option, $43.61, up $1.77. Family, standard option, $88.89, up $2.90. Self only, high option, $122.15, up $6.38. Family, high option, $257.67, up $12.79.

Special People, Special Plans

When it comes to health insurance choices, some federal workers are more equal than others. Some of the best and best-priced health plans in the federal program are reserved for Secret Service personnel, Drug Enforcement Administration agents and diplomats. For a look at their premiums next year, check the Federal Diary tomorrow.

Mike Causey's e-mail address is causeym@washpost.com

Thursday, Sept. 30, 1999