"Self-only" and "family" are the standard choices when signing up for federal health insurance benefits. But a dental-vision benefits package awaiting approval in Congress would add a category: "self-plus-one."
For years, retirees and employees with no children have complained about the terms of self and family coverage in the Federal Employees Health Benefits Program.
In FEHBP, premiums for family coverage are the same, regardless of whether the enrollee is insuring only a spouse or a spouse and any number of children. Some retirees who have two people on their policy feel they are being overcharged. Self-only coverage, of course, is geared to individuals and is not a solution for these couples.
Provisions in the House and Senate bills would create a dental-vision package outside of FEHBP and would permit a third tier of coverage, self-plus-one, in order to encourage flexibility in the pricing of benefits, a Senate aide said.
Many dental-vision plans in the private sector provide three enrollee categories, and Congress hopes that the Office of Personnel Management, which would oversee the new benefit, and insurance companies will see if the added category encourages more federal employees and retirees to take advantage of the proposed benefit, the aide said.
A House aide described the new category as "a break with tradition" but one that makes sense. In purchasing dental and vision coverage, enrollees often view it less as insurance and more like buying a service at a discount, the House aide said.
FEHBP has resisted a third-tier category because it would alter the balance between premiums and claims in some large health insurance plans. Retirees, childless couples and single parents with one child would probably sign up for self-plus-one coverage, assuming it would be cheaper than family coverage. The shift also could force up premiums for everyone else in the program.
Although self-plus-one is sometimes interpreted as a way to provide domestic partner benefits, the dental-vision bill would prohibit such coverage by generally limiting eligibility to a spouse of an employee or retiree or an unmarried dependent child 21 years of age or younger.
Although FEHBP offers some limited dental and vision coverage, it has been described as paltry and outdated. The proposed dental-vision benefit would be modeled along the lines of the federal long-term care insurance program, where the government tries to leverage its size to obtain affordable group rates for enrollees. Enrollees would be required to shoulder all the costs of premiums.
Types of coverage and premiums would be determined by OPM through negotiations with one or more contractors selected to provide the proposed benefits. According to the bill, the benefits would be available no earlier than 2006.
Web Welcome Premature
Are 1,800 employees of the Defense Security Service moving to OPM next year?
Yesterday morning, an internal Web test at OPM inadvertently appeared on the Internet, welcoming the Defense employees to OPM. The welcome package noted that the Defense employees, who perform background checks on job applicants and for security clearances, would transfer Feb. 20.
But OPM spokesman Scott Hatch said "nothing is official" on the transfer, which has been under study since January 2003. He said the Pentagon and OPM have not signed the "memorandum of understanding" that is needed to start the transfer.
The Web welcome to the Defense employees "was all preparation for if and when this happens," Hatch said. The welcome package could be viewed on the Internet for only 15 minutes yesterday, he said.
IRS Gets Its Numbers Wrong
Speaking of glitches, some Internal Revenue Service employees were informed on their Oct. 13 payroll receipt that "Election Day Is Tues., November 4, Administrative Leave for Voting May Be Granted."
An IRS spokesman said a correction, reminding employees that Nov. 2 is the day to vote, will appear on Oct. 28 payroll stubs. Employees also will see a correction posted on the IRS's internal Web site.
"The number 4 was entered in error," the spokesman said.
Diary associate Eric Yoder contributed to this column.