Federal workers facing deadline on health plans

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In addition to nerves of steel, language skills, invisible ink and decoder rings, secret agents -- and their families -- need health insurance, too.

In fact, one of the big selling points CIA recruiters now use is the federal benefits package. While James Bond (aka 007) is a bachelor, many federal agents have spouses and children. So the federal vacation package (13 days to start, with 26 days per year for long-time employees) is important. So is the regular and special health insurance options available to CIA employees as well as FBI, Drug Enforcement Administration and the Department of Homeland Security personnel.

While the federal agents can choose from dozens of health plan options, like regular civil servants, they also have their own plans.

In addition to Blue Cross, GEHA, Kaiser and the American Postal Workers Union health plans open to all feds, workers in certain agencies also can go for specialized health insurance offered by exotic -- or bland-sounding -- names such as SAMBA, Foreign Service and the Association plan. Those three are limited to federal agents, people with foreign missions and, uh, the, uh, CIA.

All three plans are highly rated by Checkbook's Guide to Health Plans for Federal Employees. The publication, $8.95 at newsstands, is a hot ticket item during the federal health insurance open-enrollment period. It started earlier this month and runs through Dec. 12.

Whether you are a computer jockey with the Agriculture Department, a letter carrier in Anacostia or a secret agent based in Hong Kong, you must pick your 2006 health plan or else. The "or else" means that if you do nothing, you will continue in your current health plan.

Sticking with your current -- maybe longtime -- health plan is OK for many people. But if your plan is one of those that is raising premiums -- as much as 15 percent -- and/or changing or cutting benefits, doing nothing could cost you thousands of dollars in excess premiums or in things you must pay for because your plan won't.

Checking the "benefits changes" section of your health plan brochure is as important as checking to see if premiums are going up, or staying level.

HMOs -- managed-care plans that are usually limited to a specific geographic region -- are popular with many younger feds who like their slightly better dental benefits, and their maternity and well-baby benefits. Many like the preventive-medicine concept and don't object to the managed-care aspects where policyholders are limited to a range of doctors and medical facilities.

HMOs cover emergency situations worldwide, but not regular services if performed out of the HMO's area of coverage. HMOs include Kaiser, Aetna, MD-IPA, Coventry and CareFirst. HMO premiums are generally lower and co-payments are modest.

Fee-for-service plans permit you to pick your doctor and hospital (although they had better be in the preferred-provider network or else you will pay more) and most are good worldwide. Most federal workers and the vast majority of retirees belong to fee-for-service plans. They are especially good for retirees who split their year between two residences or who travel a lot.

Fee-for-service plans available to Washington-area feds include Blue Cross, AWPU, GEHA, National Association of Letter Carriers, Mail Handlers, Postmasters Benefit Plan for everyone and SAMBA, Foreign Service and Association for you-know-who.

A family of two, according to Checkbook's Guide, with average medical costs next year can expect to pay (in premiums and out-of-pocket costs) anywhere between $2,480-$3,900 in an HMO to a range of $3,120 to $9,130 in fee-for-service plans. Most federal workers pay their premiums with pretax dollars (cutting their annual tax bill $250 or more, depending on salary and bracket). The so-called premium-conversion benefit isn't available to retirees.

For federal workers, retirees and survivors, the government pays slightly more than 70 percent of the total premium based on a complex formula that uses the premiums of the largest plans in the program. Many feds don't appreciate that cost-sharing. So what's it worth?

Well, a single federal worker in Blue Cross standard option, the most popular plan, next year will pay about $1,010 in premiums. But for people who must pay the full premium -- ex-spouses and others who don't get any government contribution to their plan -- the cost will be about $5,130.

Mike Causey, senior editor at Federal News Radio AM 1050, can be reached at 202/895-5132 or mcausey@federalnewsradio.com.