Table 1.
Cost Impact of Benefit Expansion for Federal Employees Health Benefits (FEHB) Program
| Author, Year |
Study Design |
Data source/ Measurement Carveout? |
Benefits Expansion |
Change in Plan Cost PPPY |
Premium for Corresponding year |
Change in Plan Cost PPPY as Percentage of Insurance Premiums PPPY |
|---|---|---|---|---|---|---|
| Goldman 200623,34 | Pre-Post with Comparison | Claims for MH/SA from 1999 to those from 2002 for plan-holders and adult dependents in seven preferred provider organizations (PPO) in the FEHB program. Six plans were carved-out. |
Cost impact of the 1999 executive order | 6 plans, (−$24.50 to −$1.50) per covered person 1 plan, $5.00 per covered person |
$2,382 in year 2000a | 6 plans, (−1.03% to −0.06%) 1 plan, 0.21% |
| Azrin 200720 | Pre-Post with Comparison | Claims associated with children covered under the FEHB program and their utilization of MH/SA services in seven PPOs Six plans were carved-out. |
Cost impact of the 1999 executive order | 1 plan, $5.50 6 plans, (−$25.83 to −$4.56) per covered child (Includes OOP cost) |
$3,266 in year 2000b | 1 plan, 0.17% 6 plans, (−0.79% to −0.14%) (Includes OOP Cost) |
| Azzone 201121 | Pre-Post with Comparison | Claims for SA care only for plan-holders and adult dependents across six PPO plans Five plans were carved-out. |
Cost impact of the 1999 executive order | −$0.31 per covered person | $2,382 in year 2000a | −0.013% |
| Hustead 197825 | Pre-Post | Claims data for the two major carriers, Aetna and Blue Cross/Blue Shield (BC/BS) in 1973 No carve-out. |
First expansion of MH/SA benefits in FEHB | Not applicable | Not applicable | Not applicable |
a
Weighted single and family premium. Premium data obtained from FEHB-OPM for single (=$2,967) and family (=$6,466) FFS coverage. Covered persons to plan-holders ratio (=1.98) from Federal Civilian Workforce Statistics, The Fact Book 2006 Edition. Assumed 50% opt for single coverage. $2,382 = (2967*0.50+6466*0.50)/1.98
b
Premium data obtained from FEHB-OPM for family FFS coverage. Covered persons to plan-holders ratio (=1.98) from Federal Civilian Workforce Statistics, The Fact Book 2006 Edition. $3266 = 6466/1.98
Note: Abbreviations: FEHB, Federal Employees Health Benefits; MH/SA, mental health/substance abuse; PPPY, per person per year; SA, substance abuse.