Maybe it’s the holiday cheer talking, but selecting your health benefits for the year ahead should be as easy as pie. And if it’s not, this guide is here to help.
For federal employees and their families, the four-week period of open season coinciding with the holidays is the sole opportunity to modify, change or drop health insurance for the year ahead. More than 150 plan options are available for 2024 that offer different levels of coverage for basic preventatives and specific treatments — a reminder that while such a large marketplace might be overwhelming, it also offers a fair amount of choice.
And as any wise gift giver will say, shopping with a well-curated list helps avoid flashy distractions and ensures nothing is missing. And for procrastinators, well, let’s talk turkey: a checklist is all the more important.
Employees have until Dec. 11 deadline to make their selections. Benefits experts told Federal Times that even if you’re satisfied with your current plan, it most likely will change next year.
So whether you recently experienced a qualifying life event, you just onboarded with the federal government or you’re checking up on your coverage, this checklist will guide you through the steps of open enrollment.
Step 1: Check your premium changes
- DO remind yourself that just because the average premium increase is 7.7%, your individual premium might have gone up more or less — or not at all. Consider: of the more than 150 plan options available in 2024, eight had no change in their premiums. On the other hand, 47 plans increased more than the average.
- DO be cost-conscious in your budgeting, but remember that’s not the only cost, or consideration, that matters when selecting a health plan, said Dr. John Johnson, GEHA’s chief medical officer. For example, make a point to look into coinsurance, deductibles and remaining out-of-pocket costs for “specialty” treatments like in vitro fertilization or gender-affirming care.
- DO check on Medicare cost changes if you’re a retiree. The Centers for Medicare & Medicaid Services announced standard monthly Part B premium will be $174.70 in 2024, an increase of about $10. The annual deductible will be $240, up from $226 in 2023.
- DON’T forget to compare costs between self, self-plus-one, and family coverage, especially if you’re a two-person household. It might seem counterintuitive, but in 2024, there are 49 in which self and family options are less expensive than self-plus-one. There are 11 plans in which the premiums are negligibly different.
- DON’T waste time leafing through each page of your brochure to find cost changes. Skip to the back page of your FEHB plan brochure to see the enrollment tables, or Control + “F” to search your PDF for “2024 rate information.”
Further reading: FEHB brochures have ballooned in size over the years. In 1990, the average national plan had a brochure 29 pages in length; ten years later the average grew to 77 pages, according to Consumers’ Checkbook.
This article has tips and tricks on how to read yours efficiently.
Step 2: Check your existing plan’s availability
- DON’T assume your plan hasn’t changed in some way this year. There are about a dozen plan options leaving the federal government’s health insurance program in 2024, while others may be expanding. Check this list to see if your plan is affected.
- DO make sure you participate in open enrollment if you’ve received notice that your plan is leaving the government’s marketplace this year. Otherwise, you’ll be auto-enrolled by OPM in the lowest-cost plan.
Step 3: Brush up on new coverage for this year
- DO spend some time reflecting on whether you’ll need a new prescription or medical treatment in the year ahead, even if that could change. If so, it may be worth looking specifically at how plans are pledging to cover things like artificial reproductive technology, obesity drugs, maternity care or gender-affirming treatments, all of which are a priority set by OPM this year.
- DO scan Section Two of your brochure to get a near-comprehensive list of all the new benefits coming under your plan this year.
- DON’T neglect dental and vision coverage under the FEDVIP program, even though your medical insurance may offer some sideline perks for dentist and optometrist services.
- DO be a doomsday prepper. Well, sort of. Perhaps your open season shopping philosophy is to compare plans based on best coverage of risk. After all, isn’t that what insurance is for? In that case, peruse catastrophic maximums. For example, United Choice Plus Advanced, while not available everywhere in the country, doubled its max this year, from $3,000 for self-only last year to $6,000 this year.
- DO go to your actual carrier to see their formulary of covered generic and brand-name prescription medications.
Step 4: Know how your plan coordinates with Medicare
- DO note that half of all carriers offer plan options that provide additional benefits and incentives for those under Medicare Part B.
- DO be aware of auto-enrollment in prescription drug benefits if you have Medicare Parts A and B or just Part A. You should have received a notice about this already if you’re eligible. (Note the exception is Blue Cross Blue Shield plans, which will only auto-enroll you if you have both Parts A and B.)
- DO read up on some frequently asked questions about how Medicare intersects with FEHB coverage.
- DO mark plans that have offered a $2,000 cap on a Part D enrollee’s out-of-pocket drug spending a year early. Those are BCBS Standard option, all three MHBP options, Rural Carrier high option, and all three Aetna options.
RELATED
Further reading: More on Medicare coordination here.
Step 5: Don’t neglect savings accounts
- DON’T be among the 25% of government workers without a tax-free flexible savings account, “because every federal employee has some type of out of pocket expense year over year,” said Kevin Moss, a benefits expert with Consumers’ Checkbook. This can be used for over-the-counter medications and other uncovered costs, amounting to an average 30% in savings. (Try a savings calculator to tailor these calculations to your needs.)
- DO this if you’re a military family who pays for dependent care and is getting coverage under the FSAFeds program for the first time, as Military Times previously reported.
- DON’T try to carry over more than $640 of unused FSA funds into 2024, because that’s the maximum.
- DON’T let coverage lapse if this is important to you. You must re-enroll in an FSA each year.
Step 6: Source tools to help you
There are many ways to compare plans, from the tool offered by the Office of Personnel Management to the Consumers’ Checkbook tool to doing your own research based on this year’s plan brochures. You can also read up on different types of plans here.
Ask your friends, family members, colleagues or online forums about what they recommended and what providers they’ve had good, or bad, experiences with.
If you’re employed by one of these agencies, you get free access to Checkbook’s guide.
Readers can also take advantage of a 20% discount on the Guide by using the promo code FEDTIMES.
For more information about specific plan changes and coverage areas unique to 2024, check out the free Federal Times Open Enrollment Guide linked here.
Molly Weisner is a staff reporter for Federal Times where she covers labor, policy and contracting pertaining to the government workforce. She made previous stops at USA Today and McClatchy as a digital producer, and worked at The New York Times as a copy editor. Molly majored in journalism at the University of North Carolina at Chapel Hill.
