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Open Enrollment: The Top 10 Things to Consider

Employees purchasing insurance through DC SHOP who don’t reside in the Washington area will need to make sure that they purchase one of the 56 plans with a national provider network, rather than one of the 56 focused on the District region. CareFirst, for instance, is offering a number of plans that use the same national provider database as the standard and basic federal employee benefits plans offered through Blue Cross Blue Shield. Doctors should be able to tell patients whether they can accept plans in the exchange. The DC Health Link site also has a list of providers with links to their websites.

7. Watch for Higher Deductibles

Many congressional staffers joining the exchanges will need to be aware of some changes that could affect their personal budgets, since the plan that CareFirst is referring to as its “featured plan” in promotional documents provided to congressional aides has significantly higher deductibles but comparable or lower out-of-pocket maximums. For instance, the in-network family deductible for the standard Blue Cross federal employee benefits plan has a $700 family deductible, as compared to a $2,000 deductible for the featured offering on DC SHOP. On the other hand, some benefits are more substantial in the DC SHOP plan once you reach the deductible. For instance, there are no out-of-pocket costs after the deductible for X-rays and other lab services with the exchange offering CareFirst is promoting.

8. Keep Your Dental and Vision Coverage

Designated staffers who like their vision and dental coverage through federal benefits programs can keep it. They are still eligible to enroll in, cancel or make a change to coverage under the Federal Employees’ Dental and Vision Program during the open enrollment period. The deadline is the same — Dec. 9.

9. FEHBP Returns With Retirement

Members and designated staff will be eligible to return to the FEHBP upon qualifying for retirement. To qualify for employer-provided health insurance during retirement, the OPM requires enrollment or coverage under DC Health Link, the FEHBP or both for five years preceding retirement.

10. Info Sessions Can Help

The House chief administrative officer tried to address some unanswered questions during a staff briefing on Nov. 7, which is now available to watch online. Senate staffers will get a similar presentation on Nov. 19, according to a Senate aide. Representatives from the House CAO’s Office of Payroll and Benefits and the four carriers will host daily open houses in Longworth Room 1310 through Friday. The Senate’s health fair is on Dec. 3, according to the aide. Official details have not yet been released.

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