What's New in FEHB for 2024

Every year it’s important to review what’s new in FEHB. As in previous years, there are significant premium, benefit, and plan availability changes that will affect both active and retired federal employees. We’ll walk you through important changes that will impact your pocketbook and choice of FEHB plan in 2024.

Plans

There are far fewer plans available in 2024. There were 271 FEHB plans in 2023 and there are 156 FEHB plans available in 2024. Most of the reduction in plans is due to Humana exiting the FEHB market. Humana had many plan options in the markets they served. Besides Humana, there are additional HMO plans no longer available next year. UnitedHealthcare Choice Plus Advanced in Florida and Georgia, United HDHP in Iowa and Kentucky, Indiana University Health Plan, AultCare in Ohio, and Aetna Open Access in Kansas and Missouri are all plan options going away. Remember: If your plan is no longer available next year, you must choose a new plan, or you will be auto-enrolled in the least expensive national PPO plan, GEHA Elevate.

Besides plans leaving, there can also be service area changes that could impact your choice of available plans. Kaiser Permanente in Colorado is both adding and removing counties for High, Standard, and Prosper plans, Blue Shield of California High Open Access is dropping counties, and Capital Health Plan in Florida, Health Alliance in Michigan, and HealthPartners in South Dakota are all adding counties. There is one national PPO plan leaving, NALC Value.

There are not many new plan options for 2024. Compass Rose has changed their plan offerings and now offer both a high and standard option. They have all also expanded their enrollment criteria by granting Veterans Affairs (VA) employees and retirees with eligibility. Sentara High has a new plan available in Northern Virginia.

Benefits

Every federal employee and annuitant should check Section 2 of the official FEHB plan brochure for their current plan and any other plan they’re considering. This is the “What’s New for 2024” section where the plan will inform you of important benefit changes. While some plans will have very few changes and may only mention a premium change, other plans may have very different benefits in 2024 that could alter your plan decision.

For example, United Choice Plus Advanced is increasing the catastrophic out-of-pocket maximum from $3,000 to $6,000 for self-only enrollees and from $6,000 to $12,000 for self plus one and self & family enrollees.

There are some new benefits being offered by plans next year. MHBP plans are offering enhanced maternity programs as a wellness benefit, SAMBA plans are offering doula coverage, BCBS plans are offering both marital and family counseling and medically necessary genetic testing.

Improved Fertility Coverage

By far the biggest FEHB benefit change will be improved fertility coverage. OPM mandated that all FEHB plans in 2024 must provide coverage of artificial insemination procedures and IVF-related fertility drugs. Families that need these services will still face high out-of-pocket costs, however. The plan cost share will still need to be paid for fertility services, in some cases as high as a 50% coinsurance. Also, some plans, like Aetna Advantage, don’t count out-of-pocket costs for fertility services towards the out-of-pocket maximum.

The fertility coverage available to you from FEHB plans is somewhat determined by where you live. FEHB plans based in Hawaii, HMSA & Kaiser, have covered IVF for many years because of laws passed in Hawaii. And, historically, IVF coverage has been more widely available in HMO plans.

Next year you can find improved IVF coverage in the following HMO plans:

• Presbyterian High, Standard, and Wellness in NM
• Geisinger Standard and Basic in PA
• UPMC HDHP and Standard in PA
• Calvo’s Selectcare in Guam
• TakeCare HDHP, High, and Standard in Guam
• Triple S Salud in Puerto Rico
• SelectHealth HDHP and High in UT
• Baylor Scott & White Basic and Standard in TX
• Health Alliance HMO in IA/IL
• Priority Health High, Standard, and Value in MI
• Sentara Health HDHP and High in VA

Two restricted enrollment PPO plans offer improved IVF coverage in 2024 – Rural Carrier and Foreign Service.

And, importantly, one national PPO plan with open enrollment has gone above and beyond the OPM mandate. BCBS Standard now has a $25,000 annual maximum for assisted reproductive technologies (ART). Artificial insemination procedures and fertility drugs do not count towards the $25,000 annual maximum. Do keep in mind though that BCBS Standard has the highest premium of any national PPO plan.

Higher Premiums

Overall, the average enrollee share of premium is rising 7.7% in 2024. This is slightly below last year, which was an 8.7% increase. When combined, however, this two-year period is one of the highest periods of increased premiums FEHB enrollees have faced in recent history.

Federal annuitants that are enrolled in Medicare Part B and pay the standard premium, will see those premiums rise from $164.90/month to$174.70/month, a 5.9% increase.

Higher Contribution Limits for Tax Preferred Savings Accounts

With higher premiums and the potential for higher out-of-pocket healthcare costs in 2024, it’s essential that active federal employees maximize the opportunity to save some money by using tax preferred savings accounts.

Health Savings Accounts (HSA) are available from High-Deductible Health Plans (HDHP). HDHPs contribute a portion of the premium into the HSA as a monthly premium pass through. The total amount contributed to the HSA varies by plan, but ranges from $900 to $1,200 for self-only enrollees and $1,800 to $2,400 for self plus one and self & family enrollees. In 2024, the HSA contribution limit from the FEHB plan and employee is increasing to $4,150 for self-only enrollees and $8,300 for self plus one and self & family enrollees.

Only about 20% of all federal employees utilize a Flexible Spending Accounts (FSA). The FSA is a great way to save about 1/3 of the cost of a qualified health care expense when paid through the FSA. FSA contribution limits for 2024 will rise to $3,200 with up to $640 available to rollover into a new plan year if you stay enrolled in the FSA program.

Improved Prescription Drug Coverage for Annuitants

There are 17 FEHB plans that will have offer a new Part D prescription drug plan in 2024. Plan members that have Medicare Part A or Medicare Parts A & B will be auto-enrolled in the Part D plan, except for BCBS plans which will only auto-enroll members that have both A & B.

• BCBS Basic, Standard, FEP Blue Focus
• NALC High
• MHBP Standard, Value, Consumer Option
• APWU High
• Rural Carrier High
• Foreign Service High
• SAMBA Standard, High
• HealthPartners Standard, High
• Aetna Direct Consumer Option
• Aetna Open Access Basic High – DC, MD, VA

Impacted members will receive communication of the new Part D coverage from their insurance plan and will have the opportunity to opt-out if they wish. You'll have to carefully consider whether to keep Part D coverage. The Part D prescription drug coverage is supposed to be as good or better than what’s available in the FEHB plan, at no extra premium. Additionally, BCBS Standard, Rural Carrier High, Foreign Service, and the MHBP and Aetna plans have all added a $2,000 prescription drug out-of-pocket max, which could have a major impact on annuitants that face moderate to high prescription drug expenses.

High income annuitants will be subject to an Income Related Monthly Adjustment Amount (IRMAA) for Part D coverage. However, the Part D IRMAA is much lower for Part D than Part B. For the first tier of IRMAA, individuals with yearly income above $103,000 but less than $129,000 and couples with income above $206,000 and below $258,000, you’ll pay an extra $12.90/month for Part D compared to an extra $69.90/month for Part B. The enhanced Part D benefits will outweigh Part D IRMAA for most.

The Final Word

Your FEHB plan will change for 2024. The premium most likely has changed. Most FEHB plans will see increased premiums next year, but not all plan premiums increased. Some FEHB plans available in 2023 aren’t available in2024. There could be an important benefit that you use that has a new pre-authorization requirement, or there could be a newly available benefit for you to use next year. Make sure you review section 2 of the official plan brochure to see how your plan is changing.

Federal employees and annuitants will both face higher health care costs in 2024. Active employees have access to tax preferred savings accounts while working. These accounts are an important way to save on qualified health care expenses and not enough federal employees take advantage of the FSA.

Annuitants will face both higher FEHB plan premiums and a higher Medicare Part B premium. However, new Part D prescription drug coverage available from certain FEHB plans will be an important way for annuitants that face moderate to high prescription drug costs to save money.