Finding feds' G-spot

Monday - 10/17/2011, 2:00am EDT

In some cultures, insulting a man's wife, horse, hound dog or favorite football team (not necessarily in that order) means a duel to the death. There are some places it is best not to go.

Call it the G (as in GETAWAY) Spot. It can mean pleasure or pain.

For some federal workers and retirees, the touch-it-and-you-die G Spot is their "group" health plan: The FEHBP. Many love and appreciate the cradle-to-grave coverage, variety of choices (and premiums) and that the government pays on average about 70 percent of the premium. And they like the annual open seasons and the fact that nobody can be rejected because of age, health, hobbies, vices or preexisting conditions.

But a large number of workers and retirees are convinced that the program — which covers members of Congress, federal judges, CIA operatives , IRS agents, Social Security programmers and postal clerks — is among the worst in the nation. Many of the objections come from childless couples who resent paying the same premiums as families with lots of kids. Or seniors who wonder why they have to pay for people who need maternity benefits. Or younger workers who see no value in paying for the ailments of the elderly.

Friday's column, which pointed out that the FEHBP program is a group plan, hit a nerve. For instance:

  • "I have a bit of a problem with the underlying assumptions of the quotes you cite. Insurance exists for the catastrophic. The other aspects of insurance are just decorations. The catastrophic events are, by their nature, unpredictable. They can hit anyone no matter what age. I've known fitness buffs who spend their lives eating tofu and whole grains and then end up in 7 years of cancer treatments. Before the birth of my premature son, health costs were a budgetary curiosity. After our first $100k bill from Children's Hospital (back in the 80's when $100k meant something), the reason for our insurance because painfully apparent. I didn't know anything about a "Catastrophic Limit" on my insurance policy. I soon discovered that the catastrophic limit is really the only number that matters." Drew

  • "I am over 60 and not likely to need maternity coverage, or care for injuries from ski jumping or skateboarding. My younger colleagues are a lot less likely than I am to need coverage for cardiac bypass surgery. My family is statistically much less likely than my African American colleagues to need treatment for Sickle Cell Anemia but more likely to have to deal with Tay Sachs. The list could go on and on. The bottom line is that we have a really good health insurance plan that most folks envy. The plan is so good in great part because of the benefits of spreading risks through a group plan. I suggest that my fellow Feds, have a nice wine to celebrate our good fortune rather than a long whine about "improvements" they want. Cheers!" Larry of SSA

  • "Its a bit amazing people are complaining that they should get a break in health care costs and not enjoy the benefits of the large group purchasing power of the FEHB programs. I would suggest they opt out and find something more cost effective for them. There are others ways to reduce your medical costs such as NO INSURANCE like millions of the people paying the federal taxes which fund our paychecks. These same people are going to complain when they need a new heart and their bills total 1 million dollars in a matter of months or develop multiple sclerosis and have $10,000 in medical expenses. Live a fairly healthy life style as well but I would never suggest that it guarantees a medical expense free life. The comments seems extremely short sighted." Kim, D.O.T.

  • "Another important consideration regarding health insurance premium fairness is that retired people on Medicare who also have an FEHB insurance plan not only pay the extra Medicare premium but Medicare is also the primary insurance. Medicare pays most of the costs and the FEHB plan is only responsible for deductibles and copayments. A Blue Shield official said they consider me a premium customer because I pay the same premiums as younger federal employees not on Medicare but their costs are generally less to cover me because Medicare is paying most of the costs. Yet the premium is still the same for the plan as for employees with no Medicare. What the FEHBP needs is a series of low cost Medicare supplemental insurance plans that retirees can buy only when they retire and terminate the regular FEHB insurance.