FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM: 1966 OPEN SEASON

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP87-00868R000100100021-2
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 11
• Document Creation Date: December 22, 2016
• Document Release Date: November 9, 2009
• Sequence Number: 21
• Publication Date: September 21, 1966
• Content Type: MEMO

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071K' BTN. NO.890-19
UNITED STATES CIVIL SERVICE COMMISSION ?1 // A,
BULLETIN NO. 890-19
Washington, D.C. 20115
September 21, 1966
SUBJECT: Federal Employees Health Benefits Program: 1966 Open Season
Heads of Departments and Independent Establishments:
Section 890.301(d)(2) of the Federal Employees Health Benefits Regulations
states:
"During the period November 14 to November 30, 1966, an
employee who is not registered to be enrolled may register
to be enrolled, and any enrolled employee or annuitant may
change his enrollment from one plan or option to another,
or from self alone to self and family, or both."
Accordingly, there will be an open season from November 14 through 30, 1966.
The purpose of this open season is to give every employee eligible to par-
ticipate in this program an unrestricted opportunity to change his health
benefits registration.
I ask agencies to cooperate in fulfilling this purpose by observing the
attached instructions governing'the open season. These instructions are
generally the same as were followed for the 1961 and 1963 open seasons.
They differ from the 1965 open season primarily in that general distribution
will be made to employees of the Governmentwide and comprehensive plan bro-
chures. If an installation health benefits official needs more information
or assistance, he should contact the Health Benefits Officer at his agency
headquarters who may, if necessary, call the Commissionis Bureau of Retire-
ment and Insurance (Code 183, Extension 6384).
During this open season, annuitants who are enrolled also will be permitted
to change their enrollments. Open season changes for annuitants are handled
by their retirement systems; agency employing offices have no responsibility
for annuitantst enrollment changes.
Nicholas J. Oganovic
Executive Director
INQUIRIES: Bureau of Retirement and Insurance, 343-6384
(Code 183, Extension 6384)
CODE: 890, Federal Employees Health Benefits
DISTRIBUTION: FPM Supplement 890-1
BULLETIN EXPIRES January 31, 1967
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1966 OPEN SEASON INSTRUCTIONS
1. Permissible Changes.
The following changes in registration may be made by employees during
the open season:
a. Any eligible employee who is not registered to be enrolled may
register to enroll;
b. Any employee who is enrolled may change from one plan or option to
another plan or option, or from self only to self and family (or
the reverse), or any combination of these changes.
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New enrollments and enrollment changes permitted by other sections of the
Regulations may continue to be made, as usual, between November 14 and 30,
1966. Such changes should not be classified as open season changes.
2. Mandatory Changes.
a. Two comprehensive plans, the Physicians and Surgeons Association,
Los Angeles, California, and the Physicians Association of Clackamas
County, Oregon, will no longer participate in this Program effective
at the end of this year (1966). Another comprehensive plan, the
California County Medical Societies' Foundation for Medical Care,
is eliminating Riverside County, California, from its enrollment
area, also effective at the end of 1966. Therefore, all employees
enrolled in the two plans which will no longer participate, and all
employees enrolled in the Foundation for Medical Care who live in
Riverside County, California, must change to other plans in order
to continue their health benefits protection under this Program.
If they do not do so during this open season, their enrollments
will be considered as having been cancelled. Employing offices
should identify their affected employees and wherever possible,
contact each such employee to inform him of the need to change
his enrollment. The Foundation for Medical Care will also contact
those enrollees who live in Riverside County.
If an employee affected by one of these changes does not file an
open season change to another plan, the employing office must pre-
pare SF 2809 for the employee cancelling his enrollment effective
at the end of the last pay period which begins in December 1966.
A notice of such cancellation, and the reason therefor, must be
given to the employee, and a copy of the notice must be filed with
the employing office copy of SF 2809.
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b. Two comprehensive plans, Kaiser Foundation Health Plan, Southern
California Region (Los Angeles), and Kaiser Foundation Health Plan,
Northern California Region (Oakland), are eliminating their low
options. Any employee who is enrolled in the low option of either
of these Kaiser Foundation Health Plans may, of course, change to
another plan if he wishes to do so during the open season. Em-
ployees who do not submit open season changes will be automatically
transferred to the Plans' remaining (high) options. An employee
enrolled in the low option of either plan who wishes to continue
in the remaining option need, therefore, take no action. However,
payroll offices must change their records to show the remaining
(high) option code and also change salary withholdings and con-
tributions. Official personnel folders must also be noted so
that the next SF 2809 or 2810 processed will show the correct en-
rollment code number. Payroll offices should make appropriate
adjustments on the first SF 2811 submitted to the plans after the
beginning of the first pay period in January and show under "Remarks"
the number automatically transferred from the Low Option codes (04
and 05) to the High Option codes (01 and 02). There is no need to
submit to the plans a listing of names or any documents for the
enrollees involved.
3. Timely Registration.
To be considered timely filed, an open season change (Health Benefits
Registration Form, Standard Form 2809) must be received by the em-
ploying office no later than November 30, 1966. The employing office
does, of course, have authority to accept and process a late registra-
tion if it determines, under Section 890.301(b) of the Regulations,
that the employee was unable for cause beyond his control to take
timely advantage of the scheduled open season. Belated open season
changes should be so identified under Remarks on SF 2809 and properly
documented in the official Personnel Folder (see Section S5-3b of
FPM Supplement 890-1).
4. Agency Responsibilities.
a, Revised instructions and brochures. The open season instructions
pamphlet (BRI 41-117) will be revised to inform employees of their
open season opportunity to enroll or change enrollment. The bro-
chures describing the various plans are also being revised to re-
flect the new Government contributions and any benefit and premium
rate changes. The brochure for each plan will show on one of the
last pages what changes, if any, are being made in the plan. The
revised 41-117 and the brochures will be printed on blue paper to
distinguish them from the present yellow brochures. Yellow bro-
chures will be obsolete and should be destroyed upon receipt of
the new blue ones.
b. Material to be given employees. Every employing office must give to
each eligible unenrolled employee, and to each enrolled employee (re-
gardless of the plan in which he is enrolled), the following revised
open season (blue)material:
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Attachmde to Btn. No. 890-19 (3)
BRI 41-117, Open Season Instructions
The brochure of the Governmentwide Indemnity Benefit Plan (BRI 41-25)
The brochure of the Governmentwide Service Benefit Plan (BRI 41-24),
together with the Basic Surgical-Medical Benefits Folder
(fee schedule) applicable to the particular area, The
Folders are also being revised and reprinted on blue
paper. Local Blue Cross-Blue Shield plans are responsible
for furnishing these folders to installations.
In addition, employing offices must give to each employee in an
area served by a group- or individual- practice plan the brochure
of that plan.
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c. Employee organization brochures. No general distribution of em-
ployee organization plan brochures need be made but such a brochure
must be furnished an employee if he requests it. Each employee who
is already a member of an employee organization sponsoring a plan,
whether or not he is enrolled in its plan, will receive a revised
brochure through the mail directly from the Civil Service Commission.
However, to satisfy requests from nonmembers, every employing office
must have on hand a stock of brochures of each employee organization
which its employees are eligible to join. In this connection, it is
important that employing offices are aware that membership in the
following employee organizations is open to practically all Federal
employees (regardless of the agency in which they work) either on a
regular- or associate- membership basis:
AFGE Health Benefit Plan (BRI 41-26)
Alliance Health Benefit Plan (BRI 41-170)
Government Employees Hospital Association Benefit Plan (BRI 41-48)
NALC Health Benefit Plan (BRI 41-51)
National Postal Union Health Benefit Plan (BRI 41-57)
Every employing office must have a supply of these five brochures
to meet employee requests. Any method may be used by an agency for
making employee organization plan brochures available upon request
so long as an employee is not denied a brochure if he asks for one.
Employing offices are also reminded of the requirement in S21-3c of
FPM Supplement 890-1 for maintaining reference sets of all brochures.
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d. When material should be distributed. Brochures and other materials
will be delivered to central supply points of agencies as they are
printed. These supply points should set their redistribution
schedules so that all agency installations will have all open season
material as soon as possible, but not later than November 10, 1966.
Installations may make their distribution as soon as they receive
their supplies of both Governmentwide plan brochures, group- and
individual-practice plan brochures for their area, if any, and the
employee organization plan brochures which employees of the agency
are eligible to join (see para. 4c of this Bulletin). However,
materials received must be issued to employees no later than
November 14, 1966, even if not all the brochures have been received
by that time.
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e. Emergency supplies of material. If, for any reason, regular distri-
bution channels fail to timely supply the required brochures and
instructional materials to an employing office by the second week
in November, the employing office should obtain emergency supplies
of the material by wiring or phoning its own supply center or
agency headquarters health benefits officer. Headquarters officials
should inform all employing offices whom to contact for this purpose.
Some emergency supplies will be located in each of the Commissions
regional offices and where normal distribution channels fail, the
Commissionts regional offices may be able to help.
f. Standard Forms 2809 and 2809-A. Standard Form 2809 should not be
generally distributed, but should be given to an employee only if
he asks for it to change his registration. SF 2809-A should not
be generally distributed at this time, but since BRI 41-117 reminds
employees that they should each have a copy, it is possible that
there may be a stepped-up demand for the SF 2809-A in conjunction
with the open season, and installations should be prepared for it.
g. Changes in salary withholdings for health benefits. Some plans
are increasing their subscription charges. Therefore, the Schedule
of Subscription Charges which was issued with FPM Supplement 890-1,
Installment 11, will become obsolete for payroll periods commencing
with the first pay period which begins on or after January 1, 1967.
A new schedule will be issued before that date to all payroll offices.
h. Counselling. Agencies are also responsible for counselling employees
who ask for help on health benefits matters. Counselling activities
should be limited to answering questions about the health benefits
program and the application of health benefits law and regulations
to particular circumstances. Counsellors should try to answer any
specific questions on benefits by reference to the brochure but if
there is doubt about the answers, the employee should be told to
contact the local office or representative of the plan. Employees
should not, of course, be counselled as to which plan is "best."
i. Promotional activity prohibited. As in the past, agencies and in-
stallations should not permit the use of Government facilities or
official time for unauthorized promotion of plans by carrier repre-
sentatives. Carriers are authorized to reprint and distribute their
own brochures but they have been informed that this can be done only
at their own (not the plants) expense and without use of agency
facilities,
NOTE: Agencies should, of course, use their facilities to distribute
the Service Benefit Plants Basic Surgical-Medical Benefit
Folder, as this is an integral part of the Plants brochure.
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5, Publicity.
Agencies and installations are urged to inform employees, in advance,
of the dates and purpose of the open season. Following is a suggested
text for an announcement which may be adopted for publication in house
organs, posting-on bulletin boards, "memo to employees," etc.
"All employees enrolled in plans offered under the Federal Employees
Health Benefits Program will have an opportunity to change their enroll-
ment during the open season scheduled for November 14-30, 1966. Eligible
employees who are not enrolled will be able to enroll during this open
season;
"Changes enrolled employees may make are:
From one plan to another
From one option to another option in the same or a
different plan
From self only to self and family, or the reverse.
The brochures for all health benefits plans participating in this pro-
gram have been revised; most have changed benefits or rates or both.
These new brochures are printed on blue paper to distinguish them from
the present yellow brochures, which are obsolete after January 1, 1967.
"Before November 14, 1966, the /name of installation office making distri-
butionTwill distribute to each eligible employee an open season instruc-
tions pamphlet (BRI 41-117) and brochures of the two Government-wide plans
/and brochures of group or individual-practice plan(s) serving the area
in which employees of this installation are located/. Members of employee
organizations which sponsor health benefits plans will receive brochures
of the organization's plan through the mail direct from the Civil Service
Commission.
"Any employee who does not receive the appropriate brochures and the
instruction pamphlet by November 14, 1966, should contact /name of person
or office location, telephone number7. Any employee who is interested
in an employee organization plan brochure will be able to obtain a copy
on request from /name of person or office, room number, and phone number
or explain here if brochures will be available to be picked up by
employees at various points in the installation/. If, after studying
the brochures and pamphlet BRI 41-117, an empl2yee has a question, he
should contact /name of office or person.7 at /location or telephone
number or both],
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"An employee who does want to change his enrollment, or who is not now
enrolled and wants to enroll, must complete a new Health Benefits Regis-
tration Form (Standard Form 2809). The completed registration form
must be received in /name of office7no later than November 30, 1966.
(Explain here where and how to get SF 2809)".
NOTE: Installations with enrollees in a plan or option which is
being discontinued should add another paragraph along the
following lines=
"If you are enrolled in /name of discontinued plan or option7 you must
change your enrollment because the /plan or option7is being discontinued.
Be sure to carefully read the pamphlet BRI 41-117 for additional details."
6. Procedures.
a. Effective Date of Open Season Changes.
The effective date of an open season change from not enrolled
to enrolled is the first day of the first pay period which begins
on or after January 1, 1967, and which follows a pay period in
any part of which the employee was in a pay status. (However,
enrollment of a new employee who happens to register for the
first time during the open season is effective the same as for
all new employees.)
The effective date of an open season change in enrollment is the
first day of the first pay period which begins on or after January 1,
1967, regardless of whether or not the employee was in pay status
during the preceding pay period.
For an open season change belatedly filed and accepted, the
effective date is the first day of the first pay period which
begins on or after January 1, 1967 and after the SF 2809 is
received in the employing office. The requirement of having
been in a pay status during the preceding pay period also applies
to belatedly filed changes from not enrolled to enrolled.
b. If Employee Does Not Change.
An employee who does not want to change his registration need take
no action during the open season; except for the mandatory changes
indicated in item 2, his current registration will continue. If
he is enrolled and does not change enrollment, any changes in bene-
fits and rates made by his plan will automatically apply to him.
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C. If Employee Changes.
An employee who wishes to change from not enrolled to enrolled, or
from one plan or option to another, or from self only to self and
family (or the reverse), or any combination of these changes, must
complete and submit SF 2809 to his employing office. Open season
SF 2809's generally should be processed the same as registrations
handled at other times; however, we would like to emphasize these
points:
(1) The number of the event permitting the change, to be given
in Part D of the form, is 1 (one); the date of the event
should be omitted. If there is a change from one plan or
option to another, show the old enrollment code number in
the appropriate section of Part D.
(2) If the employee changes his registration but remains with
the same plan (e.g., if he changes options or changes from
self only to family but within the same plan), the employing
office should strike through the carrier's control number
preprinted in the upper-right corner of SF 2809 and insert,
in the space below that number, the old carrier's control
number, which may be obtained from the last health benefits
form in the employee's official personnel folder. No
SF 2810 should be prepared in these cases.
(3) If the employee changes to a different plan during the open
season, he acquires a new carrier's control number. The
preprinted number in the upper-right corner of the SF 2809
on which he registers to enroll in the new plan becomes his
new carrier's control number, and the old number should not
be inserted in the space below the preprinted carrier's
control number. In such cases, SF 2810 must be prepared by
the employing office to notify the losing carrier that the
employee has changed to another plan. In completing the
SF 2810, the old carrier's control number must be used.
Also, check Item C on the SF 2810, and give the effective
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date of the action as the day before the day on which the
new enrollment becomes effective. Do not send the original
of this SF 2810 to the employee. *
d. Importance of Prompt Action on Change Forms.
Payroll offices should process open season SF 2809's and 2810's
and send them to the carriers on a daily basis. Losing carriers
must be notified as soon as possible of a termination of enroll-
ment by reason of a "Change in Plan" so that they do not
guarantee, or give, benefits to employees or family members
after termination of enrollment. It is also important that
gaining carriers be notified of new enrollments so that employees
and covered family members may promptly receive identification
cards as evidence of the new coverage. We cannot emphasize too
strongly the necessity for processing Forms 2809 and 2810 promptly.
e. Changing Payroll Records.
Payroll offices should adjust their controls for enrollment changes
and rate changes after the carriers' copies of SF 2809 and SF 2810
have been transmitted. The payroll office should post to the
SF 2809 and SF 2810 the SF 2811 report number which is used to
send the document to the carriers.
Particular care should be taken to insure that appropriate with-
holdings and Government contributions are posted to payroll
records beginning with the first pay period which begins on or
after January 1, 1967.
*If changes from any one plan are numerous enough to require
daily processing of many SF 2810's to the same losing carrier,
notices to that carrier may be processed in batches of about
25 on one SF 2810. On this one SF 2810, complete Items 5 and
7 of Part A, and give the name of the losing plan in Item 6.
Check Part C and under Remarks say "(number) multiple open
season terminations due to changes from your plan--see attached
list." The agency certification also should be completed.
Prepare a list in duplicate showing, in columnar arrangement,
the name, date of birth, carrier's control number, and enroll-
ment code number of each employee terminating coverage with the
carrier. Attach one copy of the list to the carrier copy and
one to the payroll office copy of the SF 2810 as their action
copies. Destroy the original and employing office copies of
SF 2810. The employing office copy of the open season SF 2809
electing the change in plans, will suffice to show the
transaction.
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f. Employees Who Separate or Transfer.
(1)
If the losing office knows that the employee will transfer,
retire, or separate before the effective date of the open
season change, it should not process the open season SF 2809.
Instead, the losing office should--
(a)
If the employee is transferring or retiring, have the
employee complete his open season SF 2809, and have
the authorized agency official note his initials and
date in Part F of the Form to show that the open
season registration was timely submitted. The name
of the losing installation and the signature of its
certifying officer should not appear on the SF 2809.
i. In transfer cases, return the SF 2809 to the em-
ployee and instruct him to give it to the gaining
employing office as soon as he enters on duty
there. The gaining office should process the
open season SF 2809 as if the form had been timely
filed with it.
ii. In retirement cases, attach the SF 2809 to other
health benefits documents and the SF 2806 when
they are submitted to the retirement system.
NOTE: Losing and gaining offices must prepare transfer-
out and transfer-in SF 2810=s as usual, transferring
the old enrollment in effect at the time of the
employee s transfer or retirement.
(b) If the losing office knows that an employee will resign
or otherwise be separated (not for retirement) before
the effective date of the open season change, the open
season SF 2809 should not be accepted.
(2) If an open season change has been processed but the employee
unexpectedly transfers or retires before the effective date
of that change, the losing office should--
(a) Void all open season forms and transfer the existing
enrollment (if any) to the gaining office.
(b) Tell the employee that his open season change has been
voided, and if possible, have him complete a new SF
2809 and handle it as stated in paragraph f (1)(a) above.
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(c) If it is impossible to take this action quickly, the
losing office should notify the gaining office that
the employee's open season change was timely filed,
has been voided, and that a new open season SF 2809
may be belatedly accepted by the gaining agency.
(3) If an open season change has been processed but the employee
separates (including separation because of death) before the
effective date of the change:
(a) If the change did not involve a change in plans, note
in Remarks on all copies of the SF 2810 terminating
the enrollment "Separated (or died)--Open Season SF 2809
void." On the carrier copy, also give the SF 2811
report number by which the open season SF 2809 was sent
to the carrier.
(b) If the change involved a change in plans, void the
open season SF 2809. Also prepare SF 2810 terminating
the old enrollment, and note in Remarks on all copies
of the SF 2810 terminating the enrollment "Termination
supersedes 'Change in Plan' SF 2810 dated (give date)."
Also, on the carrier copy, give the SF 2811 report
number by which the "Change in Plan" SF 2810 was sent.
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