USPS Health Insurance Marketplace Launch Gives OPM Plenty To Do In A Busy 2023

Oleh Admin 18 Feb, 2023 Posting Komentar

A sweeping postal service reform bill signed last year placed postal workers and retirees in a separate health insurance market from the rest of the federal workforce.

The Postal Services Reform Act requires the Office of Human Resources Management to establish a separate Postal Services Health Benefits Program (PSHB) within the Federal Workers Health Benefits Program (FEHB) from January 2025.

The Postal Service Health Benefits Program offers health insurance plans…

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A sweeping postal service reform bill signed last year placed postal workers and retirees in a separate health insurance market from the rest of the federal workforce.

The Postal Service Health Benefits Program provides health insurance plans for eligible and retired USPS employees and eligible family members. However, the law only establishes requirements for post-healthcare plans, which do not apply to plans offered under the FEHB.

Meanwhile, OPM faces a tight schedule to build a parallel healthcare marketplace and online infrastructure for postal workers and retirees before open enrollment ends in 2024.

Jay Cavallo, OPM's chief information officer, said the establishment of the PSHB is "a huge initiative for us at OPM," but added that the agency is undertaking a number of other major IT modernization projects this year.

Speaking at the ATARC Computer Modernization Summit on Feb. 8, Cavallo said Congress had given OPM "a very short window of opportunity" to build a new PSHB system based on Postal Reform Act specifications.

"They didn't ask us how long it would take, but I have that time," Cavallo said.

The postal health insurance market has a consistent set of specifications that do not apply to federal employees who are subject to the FEHB. The Postal Reform Act would require all future postal retirees to enroll in Medicare Part B, with a goal of saving the USPS tens of billions over the next few years.

"So they're very different requirements than the existing healthcare benefits system for federal employees. That means we need to double check the system and make sure they're enrolled and eligible for Medicare,” Cavalo said.

The law expects OPM to establish and administer a parallel health insurance market for postal workers and retirees, comparable to that of the FEHB.

But almost all future postal retirees will need to enroll in Medicare, which requires OPM to integrate some unique features into the PSHB system that aren't built into the FEHB infrastructure.

“Of course the registration has to be available, we have to be able to verify eligibility. We need to be able to raise money from the Postal Service to pay for the plans that employees choose [and] distribute that money to each service provider," Cavallo said.

Because future post-retirees will need to enroll in Medicare Part B, Cavallo said health care providers will offer different plans than those under the FEHB.

The Postal Reform Act requires OPM to ensure, to the extent possible, that PSHBs include all FEHB plans with at least 1,500 enrolled or retired USPS employees by January 2023.

"As this is a small segment of the market, it will be a smaller aircraft than the 160 to 170 aircraft currently available at FEHB," Cavallo said of the PSHB.

According to the February 2022 Congressional Research Report, the PSHB will also cover plans offered by other non-FEHB insurers when OPM deems it appropriate.

John Hutton, vice president of policy and programs at the National Association of Active and Retired Federal Employees (NARFE), said OPM "should be able to implement PSHB without major changes to coverage."

"Some of these smaller packages may or may not still qualify for package options in the email program," Hutton said. “We definitely want OPM not only to increase these plans to the 1,500 mark, but also to include as many plan options as possible in the email program to avoid losing existing coverage in the FEHB. Being documented doesn't mean people lose faith. You just don't have to choose a different diet.

The USPS Postal Service Reform Act is expected to save an estimated $22.6 billion over the next decade by enrolling USPS employees and Medicare retirees. Along with the rest of the federal government, the USPS is the nation's largest contributor to the Medicare Trust Fund.

Last year, OPM released guidance on PSHB to answer frequently asked questions about the new healthcare system for postal workers and retirees.

Current USPS employees and retirees will remain in the FEHB for the remainder of 2023 and 2024, but are no longer in the FEHB plan as of January 1, 2025. Their current FEHB registration will continue through January 2025 unless they have already changed.

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During the 2024 inaugural season, eligible individuals must enroll in the PSHB plan to obtain health insurance either through active employment with the USPS or through retirement from the USPS.

Under the PSHB, USPS employees and retirees have access to individual, supplemental individual, or family insurance.

If a USPS employee or retiree enrolls in FEHB in 2024 and does not elect a PSHB plan in 2025, OPM will automatically enroll them in a plan offered by the individual's FEHB insurer. If they do not have such a plan, OPM will enroll them in the cheapest non-deductible national PSHB plan that does not require a membership fee.

Enrollment in the PSHB plan does not stop enrollment in the Federal Employees Dental and Vision Insurance Program (FEDVIP), Federal Employee Accounts Program Flexible Spending (FSAFEDS), Federal Employees Group Life Insurance (FEGLI), or other insurance and benefit programs, including federal. . Long Term Care Insurance (FLTCIP)

"The Office of Branch Services and Operations will provide updates ahead of the PSHB's 2024 inaugural season to ensure a smooth transition for all eligible employees and sizes," the spokesperson said.

In 2025, insurers with PSHB and FEHB plans must ensure that PSHB and FEHB plans have similar benefit and cost-sharing requirements, with certain exceptions.

PSHB premiums are set separately from FEHB premiums. This means PSHB insurers set premiums based on how much healthcare is consumed by USPS employees, retirees, and their families.

The annual USPS contribution is calculated using the same statutory formula currently used under the FEHB, but only based on awards from PSHB plans.

Current postal retirees or USPS employees age 64 and older are not required to enroll in Part B as part of their transition to PSHB at the beginning of the program.

However, USPS representatives and employees may voluntarily enroll in Medicare Part B during a special enrollment period with no late enrollment fees. This private registration will begin in April 2024 and will last for six months.

Hutton said NARFE encouraged OPM to launch PSHB with "as little disruption as possible" given the loss of plans for postal workers and retirees, as well as significant changes in coverage for them.

"I think the biggest challenge for OPM with this is the confusion and lack of transparency," Hutton said. "FEHB provides quality health coverage to federal employees and retirees, including postal workers and retirees, and ensures that changing this new program truly is their top priority."

OPM is building PSHB on a cloud-based platform and plans to use the project as a model to eventually bring FEHB to the cloud as well.

"My brief was, 'This system isn't going to be on-premises, it's going to be a cloud solution.'" "The existing FEHB system is in place," Cavallo said. We will bring back the cloud-based platform.

However, OPM is developing the PSHB market as one of several major IT modernization projects this year.

The agency received funding from the Technology Modernization Fund to modernize its public-facing website and accelerate adoption of a zero-sum cybersecurity architecture.

Meanwhile, Cavallo said, OPM must also find a solution for a central executive "at the end of its lifespan."

“There are thousands of apps I want to rewrite, make user-centric, and cloud-based. I just don't have enough time," Cavallo said.

As a solution, Cavallo said, OPM is looking at moving the mainframe to the cloud "in simulated mode so I don't have to spend $14, 15, 16 million on hardware once I get them out in the meantime tool".

Cavallo said his team's monthly project review typically takes about six hours, as OPM averages about 100 projects per month.

“Obviously there are some of these projects that are more important than others. But that doesn't mean we can't do something in parallel," Cavallo said. “The federal government must continue to modernize, although it has done all this, my work is not yet done. Because tomorrow I have to renew what we did right.”