Healthcare and Insurance
Healthcare and Insurance is organized into two major groups -- Federal Employee Insurance Operations (FEIO) and National Healthcare Operations (NHO). FEIO is responsible for the Governmentwide administration of health benefits and insurance programs and services for Federal employees, retirees, and their families, through the Federal Employees Health Benefits Program (FEHBP). These programs and services offer employees choice, value, and quality, and help maintain the Government’s position as a competitive employer.
FEIO negotiates and administers health benefits contracts for the Federal Government, along with the Federal Employee Group Life Insurance (FEGLI) program covering employees, retirees, and their families. FEIO is also responsible for administering three voluntary, enrollee-pay-all programs: long term care insurance program; flexible spending accounts for medical and dependent care expenses; and a group dental and vision insurance program.
National Healthcare Operations NHO, established by the Affordable Care Act (ACA) is the OPM component responsible for implementing and overseeing the Multi-State Plan Program (MSPP). Under the Act, at least two Multi-State Plans will be offered on each Affordable Insurance Exchange beginning in 2014. Multi-State Plans will be one of several health insurance options that small employers and uninsured individuals will be able to choose from. In total, exchanges are expected to provide health insurance coverage for 31 million Americans.
NHO also helps to administer the Federally-run Pre-Existing Conditions Insurance Plans (PCIP) in States that do not establish PCIP programs themselves. NHO does this on behalf of the US Department of Health and Human Services, which has primary responsibility for the PCIP program. The PCIP program is an entirely new program created under the ACA. This program makes health insurance available to individuals who have been denied coverage by a private insurance company because of a pre-existing condition, have been uninsured for at least six months, and are U.S. citizens or are residing in the U.S. legally. PCIP covers a broad range of health benefits, including primary, specialty, hospital care, and prescription drugs. States have the option to administer their own program or defer program administration to the Department of Health and Human Services. PCIP operates in 24 states and the District of Columbia and covers more than 45 percent of the U.S. population.
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