One of the ways that the FEHB program reduces costs and holds premium costs is by imposing restraint on health care provider choices including doctors, hospitals, laboratories for blood tests and x-rays. The only exception to this pattern is for federal retirees who are enrolled in Original Medicare (Medicare Part A and Medicare Part B), and who are enrolled in FEHB program national health plans such as Blue Cross Blue Shield or GEHA. Retirees enrolled in these national plans can go to almost any hospital or physician at no cost. This is because Original Medicare pays first for Original Medicare beneficiaries and the federal government uses its legal power to force Medicare-participating health care providers to “accept assignment” from Medicare, regardless of what the health care providers charge. “Accepting assignment” means that the health care provider accepts whatever Medicare pays. The health care provider then bills the federal retiree’s FEHB program health plan for the balance.
Different Types of National FEHB Program Health Plans
The following are the types of FEHB program plans: (1) Preferred provider organization (PPO) plans; (2) Preferred provider organization (PPO) plans associated with fee-for-service (FFS) plan for using out-of-network providers; (3) Local Health Maintenance Organizations (HMOs) with no HMOs being national plans; (4) High Deductible Health Plans (HDHPs) associated with an HSA; (5) Consumer-Driven Health Plans (CDHPs) associated with a CDHP; and (6) Point-of-Service (POS) plans. A full description of each type of FEHB program health plan, together with each program’s advantages and disadvantages, is presented in the following tables:
PPO/FFS
(PPO
associated
with an FFS plan for using out-of-network medical providers)
Space Suggestions for Choosing/Changing an FEHB Program Health Plan for Plan Year 2025
Now that a description and explanation of the several types of FEHB program health insurance plans have been presented, it is important to present suggestions for employees to choose or change an FEHB program health plan for plan year 2025.
Studies over the past have shown that a sizable percentage of federal employees often automatically choose low deductible health insurance plans that ultimately cost the employees more in premiums. Other studies found that many employees stick with the same plan each year rather than evaluating the options each year and choosing a better health plan. The result is higher premiums each year, an average of $2,032 or more annually.
Here are seven suggestions to consider when choosing or changing a health plan offered through the FEHB program:
A former career Federal employee, Ed has published a staggering 1,200+ separate articles on Federal Benefits and Retirement!
Just “Google” his name, and you are likely to find a plethora of sites that contain his writings. Drawn to its mission to reach, teach
and serve Feds, Serving Those Who Serve is the only financial planning practice with which Ed has chosen to affiliate in over
20 years teaching. In addition to conducting Federal Benefits seminars for Serving Those Who Serve, you can find Ed’s
writings here on our blog in the FedZone, and on Fed-Soup, MyFederalRetirement, FederalNews Radio and NITP.
He is a member of the Maryland Society of Accountants, the National Association of Enrolled Agents, the International Society of Certified Employee Benefits Specialists, the Financial Planning Association, the National Association of Health Underwriters,
and the Society of Financial Service Professionals. Since 1999, Ed has taught many thousands of Federal employees about
their benefits, in person and at Federal agencies all over the country. Ed is a true national treasure.
Edward A. Zurndorfer is a CERTIFIED FINANCIAL PLANNER™ professional, Chartered Life Underwriter, Chartered Financial Consultant, Chartered Federal Employee Benefits Consultant, Certified Employees Benefits Specialist and IRS Enrolled Agent in Silver Spring, MD. Tax planning, Federal employee benefits, retirement and insurance consulting services offered through EZ Accounting and Financial Services, and EZ Federal Benefits Seminars, located at 833 Bromley Street – Suite A, Silver Spring, MD 20902-3019 and telephone number 301-681-1652. Raymond James is not affiliated with and does not endorse the opinions or services of Edward A. Zurndorfer or EZ Accounting and Financial Services. The information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. While we are familiar with the tax provisions of the issues presented herein, as Financial Advisors of RJFS, we are not qualified to render advice on tax or legal matters. You should discuss tax or legal matters with the appropriate professional.
Checkbook’s FEHB comparison tool lets you easily compare 158 FEHB plans and helps instruct how Medicare Part B will integrate with your FEHB plan.
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2024 Forbes Best-in-State Wealth Management Teams
Best-In-StateWealth Management Teamsis based on an algorithm of qualitative criteria, mostly gained through telephone and in-person due diligence interviews, and quantitative data. This ranking is based upon the period from 3/31/2022 to 3/31/2023 and was released on 01/09/2024. Advisor teams that are considered must have one advisor with a minimum of seven years of experience, have been in existence as a team for at least one year, have at least 5 team members, and have been nominated by their firm. The algorithm weights factors like revenue trends, assets under management, compliance records, industry experience and those that encompass best practices in their practices and approach to working with clients. Portfolio performance is not a criteria due to varying client objectives and lack of audited data. Out of approximately 10,100 team nominations, 4,100 advisor teams received the award based on thresholds. This ranking is not indicative of an advisor’s future performance, is not an endorsement, and may not be representative of individual clients’ experience. Neither Raymond James nor any of its Financial Advisors or RIA firms pay a fee in exchange for this award/rating. Compensation provided for using the rating. Raymond James is not affiliated with Forbes or Shook Research, LLC.
Please see https://www.forbes.com/lists/wealth-management-teams-best-in-state/ for more info.
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STWS is owned and operated by Daniel Sipe and Tom Lee (the “Financial Advisors”). The Financial Advisors are registered financial professionals of Raymond James Financial Services, Inc. (“RJFS”), a broker-dealer registered with the Securities and Exchange Commission (“SEC”), and Raymond James Financial Services Advisors, Inc. (“RJFSA”), an investment adviser registered with the SEC, (collectively, with their affiliates, “Raymond James”).
Mr. Zurndorfer does not pay compensation to or receive compensation from STWS in connection with Presentations hosted by Mr. Zurndorfer. However, Mr. Zurndorfer does provide similar educational presentations at certain Federal Retirement Benefits Seminars (“Seminars”) hosted by STWS, for which Mr. Zurndorfer receives compensation from STWS. All presentations, seminars, articles and videos are informational in nature and are not geared toward the circumstances or goals of any particular attendee; they are not intended to be, and should not be relied upon as, investment advice to anyone or a solicitation of Raymond James’ services.
Mr. Zurndorfer is not affiliated with Raymond James, and is not authorized to provide investment advice on behalf of Raymond James, to solicit or refer investors to Raymond James, or to act for or bind Raymond James. The presentations, seminars, articles, videos, Mr. Zurndorfer, and the educational information provided therein are not sponsored or endorsed by Raymond James, and should in no way be considered an endorsement of, referral to, recommendation for, or offer to purchase any product or service from Raymond James or the Financial Advisors.
Federal government agencies, including the SEC, do not endorse or sponsor particular securities, issuers, products, services, professional credentials, firms, or individuals. Neither Raymond James, the Financial Advisors, STWS, nor Mr. Zurndorfer are affiliated with, endorsed by, or authorized to speak on behalf of the U.S. Government, the Federal Employee Retirement System, or any other Federal Government-sponsored benefits programs or retirement plans, including the Thrift Savings Plan (collectively, “Federal Benefits Plans”).
