Each of these plans provide specific membership requirements on the cover of its respective brochure. This fee is set by the employee organization and is not negotiated with OPM. Generally, the employee organization requires a membership fee or dues paid directly to the employee organization, in addition to the premium. Some of these plans are open to all Federal employees and annuitants who hold full or associate memberships in the organizations that sponsor the plans others are restricted to employees in certain occupational groups and/or agencies and annuitants who retired from such occupational groups and/or agencies. Plans sponsored by unions and employee organizations.The Governmentwide Service Benefit Plan (also referred to as the Federal Employee Program or FEP), is administered by the Blue Cross and Blue Shield Association on behalf of Blue Cross and Blue Shield Plans nationwide, and is open to everyone eligible to enroll under the FEHB Program.All FFS plans require precertification of inpatient admissions and preauthorization of certain procedures. This means that certain hospitals and other health care providers are “preferred providers.” Services received from a preferred provider usually have lower out-of-pocket expenses (i.e., a smaller copayment or coinsurance amount and/or a reduced or waived deductible). Most FFS plans offer services through a preferred provider organization (PPO). The enrollee/family member may choose his/her own physician, hospital, and other health care providers. Fee-for-Service Plansįee-for-service (FFS) plans reimburse the enrollee or the health care provider for the cost of covered services. Specific plan offerings are detailed on each respective plan’s brochure cover. It’s important to know that not all FFS plans or HMOs offer additional plan delivery systems. Some of these plans offer additional plan delivery systems as described below in the “Additional Plan Delivery Systems” section. Two types of plans participate in the FEHB Program: fee-for-service plans (FFS) and health maintenance organizations (HMOs). Flexible Spending Accounts Toggle submenu.Federal Employees Receiving Premium Conversion Tax Benefits.Transparency in Healthcare Toggle submenu. Coordination of Medicare and FEHB Benefits.Changes in Health Coverage Toggle submenu.
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