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Enrollment in FEHBP Plans in Rural Areas

Analysis completed by: Timothy D. McBride, Courtney Andrews, Keith Mueller
Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
May 20, 2003

Recent proposals to reform the Medicare program and add an outpatient prescription drug benefit to the program have used the Federal Employees Health Benefit Program (FEHBP) as the model for how private plans could be incorporated into the Medicare program. The information presented here is the enrollment patterns in FEHBP plans in every county in the U.S. This study of the health plan enrollment decisions made by rural retirees and federal workers could provide insights into how an FEHBP plan may work when applied to Medicare. Presented below are links to the states of the U.S. Each of these provides a link to a table that provides a county-by-county listing of that state, with detail on FEHBP enrollment patterns in that state.

The FEHB Program The Federal Employees Health Benefit Program is a program designed to provide health insurance options to federal workers all across the U.S. Under FEHBP, all federal workers and retirees have access to a range of choices of health insurance plans. In all areas everywhere in the country, there are seven carriers offering 12 different plans nationwide to rural retirees and current workers. So, on this dimension of choice, all federal workers have access to at least 12 plans in their area, and perhaps more. In many areas, an additional six plans are offered for specific groups (e.g., the Secret Service) that others can join if they pay a fee to join the group. Finally, in 2001, there were over 200 other plans that were available in specific regions. The vast majority of these plans were HMOs, though some were PPO plans. All FEHBP plans offer a range of benefits that include prescription drug coverage. However plans can vary significantly on dimensions such as the premium charged, and the out of pocket costs paid by enrollees (that is, deductibles, copayments, limits).

For additional information on the FEHB program, consult the OPM's web site.

Data Source This analysis presented here was completed by the Rural Policy Research Institute (RUPRI) Center for Health Policy Analysis, based on data provided by the U.S. Office of Personnel Management (OPM) for decisions made by federal FEHBP enrollees in 2001. The information presented here on enrollment patterns in FEHBP plans, differentiated across rural and urban areas. This provides an important alternative view of beneficiary choice - that is, it shows the choices enrollees actually made. We believe this distinction is important because, in a sense, people are showing us with the choice they made what choices were viable among the choices they theoretically had. In other words if you look at what a person actually chose, then they reveal to us their preference among the options they faced - the choice made must have been the best choice they had from the available options.

The data shown here do not report enrollment in any category that is less than 10 enrollees, to protect the confidentiality of the persons living in those regions. In addition, enrollment is not reported when disclosure could reveal enrollment in a category that is less than 10 enrollees.

State-by-State FEHBP Enrollment Analysis

State-by-State FEHBP Enrollment Analysis, by County and Plan

SOURCE: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis; analysis of data obtained from the U.S. Office of Personnel Management.