You've heard this before: It's the season to do your health care homework. So pencil in a free moment on the calendar, between those Redskins games and the kids' soccer games.
Health insurance premiums are going up by an average of 7.9 percent next year for federal employees and retirees. That's less of an increase than in recent years and can be taken as good news for the Federal Employees Health Benefits Program, which insures more than 8 million Americans, including about 1.3 million in the District, Maryland and Virginia.
But as most federal employees and retirees well know, the average premium increase is not always a clear sign of how much additional cost they will be asked to shoulder. Hiding behind the average can be changes in co-payments and deductibles and, perhaps, slight benefit reductions.
Employees and retirees will not be able to evaluate how their coverage is changing until they receive their plan brochures for the 2005 "open season," which begins Nov. 8 and ends Dec. 13.
But employees and retirees can see what their favorite plans will cost next year by clicking on the FEHBP premium charts recently posted on the Web by the Office of Personnel Management (www.opm.gov/insure/health/05rates/index.asp).
Based on those charts, here is a snapshot of some popular insurance plans and the biweekly costs that will be paid by employees:
* Blue Cross and Blue Shield: Standard-option premiums are rising 3.7 percent for individuals and 4.6 percent for families. The rates for basic coverage are unchanged.
An individual will pay $50.71 biweekly for standard-option coverage, and a family will pay $118.06. An individual will pay $37.99 for basic coverage, and a family will pay $88.99.
* Government Employees Hospital Association: The cost to enrollees of GEHA standard-option coverage is increasing about 10 percent.
Enrollees will pay $33.28 for individual coverage and $75.62 for family coverage.
* Mail Handlers Benefit Plan: The standard-option premium jumps 40 percent for individuals and 37 percent for families.
Enrollees will pay $45.16 for individual coverage and $95.64 for family coverage.
Susan M. Fleming, a senior vice president at First Health, which manages the Mail Handlers plan, said the higher premiums, in part, reflected the movement of about 67,000 people out of the Mail Handlers high-option plan into its standard-option plan over the last year. She said the shift, insurance claims and past changes in the plan's structure contributed to the increases.
According to the OPM charts, some of the better-known health maintenance organizations in the Washington area, such as Aetna, Kaiser Permanente and M.D. IPA, will increase their premiums by less than 10 percent.
The enrollee share of the Kaiser premium is rising by 9 percent, for example. Kaiser's high-option individual coverage will cost $39.80 biweekly, and high-option family coverage will cost $94.74. Kaiser also will add a new option, standard, for 2005, with an individual rate of $32.04 and a family rate of $76.25.
Not all FEHBP plans are raising premiums. CareFirst BlueCross BlueShield, for example, is cutting its HMO premiums. Enrollees will pay $50.56, or $9.68 less biweekly, for individual coverage and $110.40, or $21.14 less, for family coverage.
A CareFirst spokesman said the company's claims experience for 2004 was better than anticipated, so the FEHBP plan made "a positive adjustment" in its rates.
FEHBP enrollees also need to do their homework on "health savings accounts," a new option for next year. OPM has set up a special Web site (www.opm.gov/hsa) to explain the new option.
Eighteen high-deductible plans will offer HSAs, which will be available to people who are not enrolled in Medicare and do not have other insurance or a flexible spending account that would pay the deductible. People not eligible for HSAs, typically retirees, will be eligible for a similar account, a "health reimbursement arrangement."
The HSA plans offer some tax advantages and require enrollees to take more responsibility for their health care spending.
But they do not have lower premiums, because OPM designed the high-deductible plans to fall within the pricing mainstream of the FEHBP.