Feds' health premiums to increase 3.8 percent

Tuesday - 9/27/2011, 12:55pm EDT

Walton Francis, editor of "Checkbook's Guide to Health Plans for Federal Employees," speaking to WFED's Emily Kopp

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Federal employees enrolled in the Federal Employees Health Benefits Program will pay 3.8 percent more, on average, for health insurance in 2012. They will see no significant changes in benefits, the Office of Personnel Management said today.

The rate increase is the lowest since 2008. It is just over half of last year's average price hike. On average, enrollees with self-only coverage will pay $2.32 more per bi-weekly pay period, and those with family coverage will pay $6.18 more, OPM said.

"With an emphasis on preventive medicine and keeping costs low, we've been able to deliver quality care at affordable rates," OPM director John Berry said in a written statement. "These benefits help us compete for the top talent we need to tackle our nation's challenges, and they keep our workers healthier and more productive as they serve and protect the American people."

But unions say that any premium increase hurts federal workers already under a two-year pay freeze.

"It is still a 3.5 percent average increase for 2012 on top of a 7.2 percent increase for enrollees in 2011," said National Treasury Employees Union president Colleen Kelley in a written statement. "Federal workers will have to absorb these increased costs with a frozen paycheck."

Some will pay lower premiums

Enrollees in the most popular plan will pay slightly less for health insurance in 2012. The 44 percent of participants enrolled in the Blue Cross and Blue Shield standard plan will pay about $20 less for coverage in 2012. Enrollees in the basic option will pay $102 more for single coverage and $239 more for family coverage per year. Together, the Blue Cross and Blue Shield plans cover the majority of participants.

Plans offered by the Government Employees Health Association, which covers seven percent of participants, will increase rates by five percent-to-seven percent. Premiums for health maintenance organizations will increase an average 6.7 percent, while fee-for-service plans will see an average increase of 3.2 percent. Retirees and postal workers may see larger increases, however.

Nationwide, health insurers are raising premiums by 4-8 percent, according to OPM's estimates.

Rates for dental and vision benefits, which are not part of the FEHB plan, will change slightly. Dental premiums will rise by one percent. Vision premiums will decrease by 1.6 percent.

Insurers found savings in streamlined drug management

"Each year we work with health plans to encourage them to look within their business and look at ways they can achieve savings. One of the things we emphasized this year was pharmaceutical costs," said John Foley, OPM director of planning and policy analysis.

Pharmacy costs make up about 30 percent of the total program costs. Foley said cost savings would come from better management of drugs and the expiration of patents on some popular medicines.

"We continued to work with health plans around pharmacy and asked them to take a particular look at dispensing generic drugs and the arrangements they had for managing the pharmaceutical benefit and they came in with proposals to do that," he said.

For further savings, OPM has proposed reducing costs by buying prescription drugs directly from a pharmacy benefit manager. It estimates that would save $1.6 billion over the next decade. But OPM would need Congress to pass a law allowing it to conduct negotiations. It has included the request in its 2012 budget proposal.

Foley said other factors contributed to keeping the premium increase low.

Currently, 8 million people are enrolled in FEHB. "We have a robust, competitive market that encourages our plans to keep their rate increases within line," said John O'Brien, OPM director of healthcare and insurance. OPM negotiates rate increases based on the most recent year's user statistics.

"The experience of our population in the past year, in terms of their cost and utilization trends, allow us to have what we're very happy about and consider very reasonable rate increases for federal employees going forward," he said, adding that people tend to use health insurance less in poor economic conditions.

Over the past year, the plan has added 280,000 adult children, ages 22-to-26, of enrollees. But OPM officials said that had no impact on keeping premiums low.

More health and wellness coverage added

In response to a request from OPM in March, insurers are adding health and wellness offerings.

Blue Cross and Blue Shield plans to offer health club memberships for $25 per month in 2012. It has added financial incentives for diabetics who take advantage of education opportunities.

OPM's March call letter urged insurers also to boost options aimed at reducing obesity, reduce racial and ethnic health disparities, increase affinity products for same-sex partners, and increase the number of health care providers with geriatrics training.