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the underlying statute prohibits entry of new national plans. Because OPM requires plans to price offerings closely to the health care costs of enrollees, and to offer comprehensive benefits, there is broad similarity in plan offerings. However, total premiums can vary substantially, and in 2010 the lowest cost plan option had a self-only premium cost of about $ 2,800 and the highest cost plan option for self-only enrollment was about $ 7,200. As an example of benefit variation, a cap of about $ 5,000 a year on potential out-of-pocket costs for self-only enrollment is found in a number of plans, but in some plans the cap may reach $ 15,000 or more (HMOs typically have no cap, but control potential cost exposure by using copayments).
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337:, as one of the few ways by which employers could escape wage and price control limitations on employee wages. The government originally proposed a system that would revolve around a dominant government-directed plan, but unions and employee associations, which had sponsored their own plans, protested. Reflecting the political pressure thus created, the Congress modified the Executive Branch proposal and all existing plans were "grandfathered" into the program.
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In the FEHB program the federal government sets minimal standards that, if met by an insurance company, allows it to participate in the program. The result is numerous competing insurance plans that are available to federal employees. Local plans have ready access to participation in the program, but
365:(HMOs). The FEHBP's cost is about $ 40 billion in 2010, including both premiums and out-of-pocket costs. About four million employees and annuitants are enrolled, totaling eight million people when
314:. The government contributes 72% of the weighted average premium of all plans, not to exceed 75% of the premium for any one plan (calculated separately for individual and family coverage).
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The FEHB program allows some insurance companies, employee associations, and labor unions to market health insurance plans to governmental employees. The program is administered by the
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metropolitan area, plans open to all federal employees and annuitants include 10 fee-for-service and PPO plans, seven HMOs, and eight high-deductible and consumer-driven plans.
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In 2010 about 250 plans participate in the program. About 20 plans are nationwide or almost nationwide, such as the ones offered by some employee unions such as the
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The FEHB program has on several occasions been proposed as a model for national health insurance or a program that could directly enroll the uninsured. In the
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Gruber, Jonathan. March 2009. Choosing a
Medicare Part D Plan: Are Medicare Beneficiaries Choosing Low-Cost Plans? Henry J. Kaiser Family Foundation.
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in 2003, the
Congress modeled the reformed Medicare Advantage program and the new Medicare Part D Prescription Drug program after the FEHB program.
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Anderson, Odin, and Joel May. 1971. The
Federal Employees Health Benefits Program, 1961โ1968: A Model for National Health Insurance? In
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Please help improve this article by looking for better, more reliable sources. Unreliable citations may be challenged and removed.
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Cain, Harry. 1999. Moving
Medicare to the FEHBP Model, or How to Make an Elephant Fly. Health Affairs 18 (4): 25โ39.
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is a system of "managed competition" through which employee health benefits are provided to
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Francis, Walton, and the editors of
Washington Consumers' CHECKBOOK. 2009 and prior years.
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on behalf of its member companies. There are about 230 locally available plans, almost all
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U.S. Office of
Personnel Management Web Site for Federal Employee Health Plans.
551:. Washington, D.C.: Center for the Study of Services. Also available online at
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Health Plan: The Only
Practical Solution to the Soaring Cost of Medical Care
523:. Chicago: Center for Health Administration Studies, University of Chicago.
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proposed opening enrollment in this plan to all
Americans. In enacting the
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There are three broad types of plans available on the FEHB program:
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Putting
Medicare Consumers in Charge: Lessons from the FEHBP
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The program was created in 1960. Employer sponsorship of
544:. 2009. Washington, D.C.: American Enterprise Institute.
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CHECKBOOK's Guide to Health Plans for
Federal Employees
151:. Unsourced material may be challenged and removed.
380:(PPO), usually offered in combination; HMOs; and
16:U.S. government employee health benefits coverage
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353:, and by national insurance companies such as
333:in the United States became prevalent during
613:United States Office of Personnel Management
319:United States Office of Personnel Management
560:http://www.kff.org/medicare/upload/7864.pdf
160:"Federal Employees Health Benefits Program"
53:Learn how and when to remove these messages
587:, including health, dental, vision, life,
89:. Please do not remove this message until
282:Learn how and when to remove this message
264:Learn how and when to remove this message
211:Learn how and when to remove this message
109:Learn how and when to remove this message
384:and other consumer-driven plans. In the
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85:Relevant discussion may be found on the
347:National Association of Letter Carriers
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359:Blue Cross and Blue Shield Association
618:Health insurance in the United States
417:Health insurance in the United States
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149:adding citations to reliable sources
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479:Walton Francis and editors, p. 54.
470:Walton Francis and editors, p. 23.
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553:http://www.guidetohealthplans.org
537:. Reading, Mass.: Addison-Wesley.
461:Walton Francis and editors, p. 4.
296:Federal Employees Health Benefits
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567:http://www.opm.gov/insure/health
435:Congressional Research Service.
363:Health maintenance organizations
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91:conditions to do so are met
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589:flexible spending accounts
488:Odin Anderson and Joel May
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437:"Laws Affecting the FEHBP"
405:Medicare Modernization Act
397:2004 presidential campaign
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506:Walton Francis, pp. 8โ9.
497:Walton Francis, pp. 4โ6.
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312:United States government
569:. Retrieved 2010-01-28.
562:. Retrieved 2010-01-28.
555:. Retrieved 2010-01-28.
533:Enthoven, Alain. 1980.
530:. Retrieved 2020-01-28.
236:Some of this article's
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201:December 2018
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241:may not be
607:Categories
513:References
401:John Kerry
399:, Senator
367:dependents
171:newspapers
76:neutrality
39:improve it
87:talk page
45:talk page
411:See also
357:and the
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80:disputed
325:History
321:(OPM).
304:Program
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440:(PDF)
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355:Aetna
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