Friday, March 30, 2012


Happy New Year! OPM kicked off the new FEHBP contracting year yesterday by issuing the annual call letter for benefit and rate proposals at the OPM AHIP FEHBP carrier conference. OPM's Healthcare and Insurance Director John O'Brien gave the keynote speech. Carriers have until the end of May to submit their benefit and rate proposals for 2013. Mr. O'Brien announced that he expects ten new plans to join the FEHBP for 2013.

Mr. O'Brien also discussed the new minimum loss ratio based pricing methodology for community rated FEHB plans (except for those using traditional community rating). This methodology replaces the similarly sized subscriber group or SSSG methodology that has been in use for decades. OPM issued a final rule implementing this change, which was tested for the current plan year. The rule, which will be published in the Federal Register on Monday is available here.

Earlier this week, the FEHBlog noticed press reports that the Federal Trade Commission might issue a decision approving the Express Scripts Medco merger (with changes) by today. The order has not been forthcoming. The news, however, evidently did provoke trade associations of drug stores to bring their own anti-trust lawsuit against the two PBMs in a federal court located in Pittsburgh PA. The Legal Newsline reports that "A coalition of public interest groups and leading competition advocates are calling on state attorneys general to block [this proposed merger."

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