OPM previously suspended all new enrollments in the program after a recent surge in fraudulent activity that impacted hundreds of federal employees with Flexible Spending Accounts. OPM’s inspector general said the suspension came “out of an abundance of caution,” and to try to prevent further fraud in the program.

Enrollments in FSAFEDS, including any enrollments based on Qualifying Life Events (QLEs), will reopen Aug. 1, OPM wrote in an email to agency benefit officers Thursday afternoon, shared with Federal News Network. Also beginning Aug. 1, the program will transition to a “.gov” website domain, FSAFEDS.gov, rather than the current domain, FSAFEDS.com.

Enrollees who missed a QLE deadline due to the pause on enrollments should still be able to make modifications once the enrollment pause is lifted, OPM said. Employees who are in that situation will have to call FSAFEDS at 877-372-3337 to request a change to the effective date for the QLE.

Additionally, federal employees will be able to get reimbursed for any claims that were incurred after the effective date for the QLE, OPM said.

OPM is also taking more long-term steps to address security concerns in FSAFEDS, including transitioning to Login.gov, the government’s platform for accessing government benefits and services online.

Once the enrollment pause is lifted next month, any federal employees who create new FSAFEDS accounts or update their enrollments following a QLE will have to complete identify verification using Login.gov.

Overall, the switch to Login.gov for FSAFEDS users will take place in a phased approach. Beginning this October, FSAFEDS users who created their accounts during or after 2023 will be required to complete identity verification steps through Login.gov to be able to continue accessing their accounts. Feds who created their accounts prior to 2023 will then have to go through the same verification process starting in January 2025.

“Enhanced identity verification is one of several steps we’ve taken to combat fraud in the FSAFEDS program,” OPM wrote in Thursday afternoon’s email.

Along with pausing FSAFEDS enrollments for several weeks, OPM also for a short time suspended claims payments from getting distributed to enrollees. All reimbursement payments were paused on June 16, and subsequently restarted on June 26.

During the 10-day payments pause, several federal employees told Federal News Network they did not receive any advance notice that the reimbursement payments would be paused.

OPM said it has been working with third-party vendor HealthEquity, which manages the Flexible Spending Account program, to strengthen security measures and secure all accounts impacted by the fraud. A HealthEquity spokesperson has referred all questions on the situation to OPM.

OPM said it will continue to communicate with federal employees and agency benefits officers in the coming days and weeks with any new updates on the situation.

The post OPM to lift pause on FSAFEDS enrollments in August first appeared on Federal News Network.

The Veterans Benefits Administration is shifting to a system of mostly voluntary overtime where employees can work for a maximum of 20 hours of overtime each month.

VA Under Secretary for Benefits Joshua Jacobs told reporters VBA has relied on mandatory overtime for the past seven years to keep up with its increasing workload.

“We’re producing and delivering veteran benefits at a very high level. But as I’ve said before, I have never thought that mandatory overtime is a sustainable operating practice,” Jacobs told reporters in a call Tuesday.

VBA has delivered record-breaking level of benefits to veterans for the past three years, and is on track to break yet another record by the end of this fiscal year.

The agency processed 1.98 million disability benefits claims from veterans and their survivors in fiscal 2023 — a nearly 16% increase from the year prior. VBA issued $163 billion in total benefits in FY 2023.

VBA is seeing a higher volume of claims because of the PACT Act, a 2022 law that expanded VA health care and benefits eligibility for veterans exposed to toxic substances during their military service. VBA recently granted its millionth benefits claims under the PACT Act.

Jacobs said VBA is on pace to process 30% more claims in fiscal 2024 compared to last year. The agency, so far this year, has awarded $112 billion to veterans and their survivors in compensation and benefits.

VBA currently has a claims backlog of about 277,000 — nearly 30% of its total inventory of claims.

VBA is also growing its workforce to keep up with demand.  Since October 2022, VBA has grown its workforce by nearly 33%, to more than 34,000 employees.

“Our growing workforce has gone above and beyond to deliver these earned benefits, and we remain focused on achieving our primary mission, which is delivering timely, high-quality and equitable decisions for veterans and their survivors with a world-class customer experience,” Jacobs said. “At the same time, we’re laser-focused on ensuring that our workforce can achieve these outcomes sustainably in the long term.”

Jacobs said VBA ended mandatory overtime, based on feedback from VBA employees and his own “personal concern about the ability of our workforce to sustainably deliver benefits at the scale that we have been doing for a very long time.”

“My goal is to leave this organization better than I found it. And I was concerned that a continuation of mandatory overtime perpetually would be very problematic for our ability to continue delivering at the levels we have been,” he said.

Jacobs said VBA plans to keep growing its workforce until it reaches 36,000 employees — but added that the agency is “constantly evaluating our numbers.”

“We are very focused on evaluating incoming receipts, the total production, and then making sure we revalidate that our assumptions and our goals remain accurate,” he said.

The Veterans Health Administration is becoming more selective with its hiring, after it saw record workforce growth last year. The agency is also seeing higher workforce retention.

VA is also looking to shed about 10,000 jobs in its fiscal 2025 budget request. Most of those job cuts would come from VHA. VA expects to achieve the reduced headcount through attrition.

Jacobs, however, said VBA has the funding it needs to continue workforce growth.

“We are fine from a discretionary perspective. We have the funds that we need to deliver the historical level of benefits that we have been delivering,” he said.

Jacobs said VBA is also seeing higher retention rates for its employees, compared to its six-year average retention rate. He added that as VBA continues to hire, employees have had opportunities to advance into higher positions.

“As we’ve increased hiring, that hiring has both come from employees outside of VBA, but also employees within VBA,” Jacobs said. “As we’ve provided more opportunities, more employees have chosen to stay — in addition to the mission.”

VBA will keep mandatory overtime in place for some employees. That includes workers who process claims for military sexual trauma, radiation exposure, Camp Lejeune contaminated water and pensions.

“We have a workload that requires more timely decisions, and so we want to focus on continuing to bring that work, the total inventory down to improve the timeliness,” Jacobs said.

“As we’re training those new employees, we’re going to continue the mandatory overtime,” he added. “We will assess, as we watch our work in those areas progress, if and when we can make changes to that policy, and transition them to voluntary overtime. But right now, our assessment is that we need to maintain that policy, to continue making improvements for veterans who have filed those claims.”

VBA held a national quality stand-down and wellness day last month, with a focus on addressing burnout and the mental health of its workforce, as well as improving overall work quality. Jacobs said the agency is also rethinking training for its new employees and “refresher” courses for existing staff.

“Investing in our employees matters and can ultimately yield significant returns for our veterans and survivors. Because we know what’s good for our employees is good for those we serve. This stand-down was a necessary part of our effort to improve the accuracy of our claims decisions and support our employees. But it’s certainly not going to stop there,” he said.

VBA expects its employees to work in the office at least five days per two-week pay period, adhering to a VA-wide policy and the Biden administration’s goal of bringing federal employees back to the office at least 50% of the time.

The post VA ends mandatory overtime for most employees processing benefits claims first appeared on Federal News Network.

Government employee recruitment often relies on the appeal of the mission. Still people want to be paid and have some financial security. A recent study of state and local emergency response employment seems to indicate one important factor in attracting job candidates, namely having a defined benefit pension plan. Tyler Bond, research director for the National Institute on Retirement Security joins  the Federal Drive with Tom Temin.

Interview Transcript: 

Tom Temin
So tell us, I think I know or can guess what the answer is. But are the existence of defined benefit pension plans important to recruiting public sector employees?

Tyler Bond
Yes. The evidence that we’ve seen through a number of reports strongly suggest that defined benefit pensions are essential for recruiting and retaining public sector employees, especially those public sector employees who work in public safety. So police officers, firefighters, corrections officers, other public safety employees really value the reliability and security of a defined benefit pension. And our new report, I think really speaks to that.

Tom Temin
One of the reasons possibly, as you outlined in the report, is that these types of employees tend to complete their career and retire on that benefit that was offered at their point of employment to a much greater degree than those in the private sector.

Tyler Bond
Yes. Certainly, what we saw with the public safety employees is that once they start working for the fire department or the police department, if they make it past the first few years, they’re very likely to stay through a full career and retire from that plan. Now, it should be said that, especially in the case of a firefighter, a career may be 20 years. And so often what you’ll see is a firefighter who has a second career. Sometimes they begin that second career while they’re still firefighting, sometimes they start that second career after firefighting. But yes, we do see that in our research, we found that 52% of 25 year old new hires are expected to retire from the pension plan that they join when they begin their public safety career.

Tom Temin
Now, this was based on survey of those people that are the recipients. Did it also include the view of recruitment viability of the hiring organizations?

Tyler Bond
So we collected data directly from 28 state and local public pension plans. So we’re using the plans own data about the behavior of their employees. But I think we’ve seen in the real world that employers are realizing the value of a defined benefit pension. So in Connecticut, there’s a town called Trumbull, Connecticut that in 2014, close their defined benefit plan moved all their police officers into 401k style defined contribution plan. At the end of last year, after less than a decade of having their police officers in the defined contribution plan. The town council in Trumbull voted unanimously to reopen the defined benefit plan. And so starting this year, police officers will go back into the defined benefit pension plan. And we’ve seen up in Alaska, they closed their two statewide public sector pension plans on July 1 of 2006. So 18 years ago to the day, and most police officers and firefighters in Alaska participate in one of those plans. And they’re reaching crisis levels of staffing shortages in Alaska right now because of the lack of a defined benefit pension plan. So to give you a concrete example, the city of Fairbanks, Alaska does not have police officers on patrol between 8am and noon every day because they’re so understaffed in their police department. And the lack of a pension is not the only factor, but it is a contributing factor to that staffing shortage.

Tom Temin
Well, I guess everything is in the details. That leads to a couple of questions. But first, let me remind people who we’re speaking to. Tyler Bond is the research director for the National Institute on Retirement Security. And briefly, do you have any evidence or hunch as to whether these results are projectable to federal level law enforcement and public safety and first responders?

Tyler Bond
So we’ve seen that the federal government has retained a pension for its employees for decades now, even when the system was reformed in the 80s and the Civil Service Retirement System was closed in favor of the Federal Employees Retirement System. It still retained a defined benefit pension component to that system. So I think at the federal government level, as well as at the state and local government levels, there is a recognition that it’s important to maintain a defined benefit pension in order to recruit and retain employees who want to make a career out of public service. There’s data from the Bureau of Labor Statistics that suggests that the average tenure for a public sector employee is twice the average tenure of a private sector employee. I think the public sector, especially in certain professions, has really retained that career employment model. And having a pension helps to bolster that.

Tom Temin
Right. When they went from [Civil Service Retirement System (CSRS)] to [Federal Employees Retirement System (FERS)], the pension got much smaller as a percentage of top three salary years and so forth with the added provision of Social Security, and then the TSP and so forth. So you have that kind of three legged stool which exists in most municipalities, I guess. So the question is, what is the correct percentage for the people that have to bear the burden of this pension cost? Is it 100% of the salary for the rest of their lives. Is it 80%? That would seem to be a crucial question. How much is the pension?

Tyler Bond
So it’s very uncommon, in my experience, to see a pension that awards 100% of salary at retirement, the exact amount varies from plan to plan. And I think it’s important to keep in mind that it’s the local stakeholders, the plan sponsors that set those amounts. And so they look at what their workforce needs, and they determined provisions of their pension plan benefits in accordance with what their workforce needs.

Tom Temin
Well. Let me ask you about the affordability side, because when the federal government doesn’t have an affordability problem, because it can print money without regard to whether it actually raises that money in revenue, that is not available in general to state and local governments, unless they want to float bonds, which are probably not great fiscal policy for paying pensions. But you look at some of the places like Chicago or some of the big Midwestern states where upwards of 25, 35, almost 50% of revenues they raise are going to public pensions and health care benefits. There’s no money left for the schools, roads, bridges, etc. How do we get around that in the long term?

Tyler Bond
So most state and local government pension plans are well funded, a lot of plans have been moving in an upward trajectory in recent years. Most state and local pension plans received the majority of their revenue from their investment earnings. On average, it’s only about a quarter of revenues into the plan that come from taxpayer dollars in the form of employer contributions. Where we see the outliers in places like Chicago and Kentucky and elsewhere. There’s really a history of underfunding the pension plan that goes back decades. And that is largely contributing to the problem there. The money wasn’t put in when it should have been. And that’s contributing to the problems they have now. It’s not really a flaw in the design of the plan itself, because we see so many other plans are doing well. And there’s a number of plans that are at or above 100% funding today.

Tom Temin
So the lesson then is have a funding strategy that doesn’t depend ever and ever increasingly on year to year revenues to keep your pension going.

Tyler Bond
That’s right. Just like anyone saving for retirement, you have to put in the money and let that money grow over time. So it’s there for you when you retire. A pension, the same logic applies, you need to contribute the money so that money can be invested and the investment earnings can grow since they represent such a significant portion of plan assets. If the money’s not put in, then that’s when we see plans tend to get into trouble.

The post How important to recruiting is a traditional pension plan? first appeared on Federal News Network.

When to start, and what you need

Justin Pierce and James Campbell, both fiduciaries and Federal Retirement Consultants℠ with the Federal Employee Benefit Advisors, said the best time to start seriously thinking about it is roughly five years from retirement. That’s also the best time, they noted, to contact a Federal Retirement Consultant℠.

“I would say, the sooner, the better,” Campbell said. “For sure, once you’re getting within five years of retirement is a great time to start to talk with one of us, or definitely once you get 59.5 and older. Even if you think you’re going to work maybe until 70, there are some strategies that we can start to help you with to maximize your retirement.”

Estimated annuity statement: Aside from that, the first thing a federal employee planning to retire will need to do is request their estimated annuity statement. This document takes into account years of service, projected salary during your three highest-paid years, and an estimate of what you would get from your annuity if you retired on a certain date. This doesn’t lock you into specifics, nor will it draw negative attention from agency leadership; it’s purely informational, a best-guess look at what you can expect from federal retirement.

This document can be requested multiple times, either from the Government Retirement and Benefits (GRB) platform, or directly from human resources. The final time you request it should be about six months before your retirement date, as much of the information transfers directly over to retirement forms.

SF50: The next form to request, also about six months before your retirement date, is the SF50: Notice of Personnel Action. This will be a record of the entirety of your career, from your start date in federal service and what grade you started at, through pay raises, step increases and locality adjustments — everything needed to calculate your retirement and annuity.

Federal employees planning for retirement can also get this form from GRB or HR.

“It’s not a bad idea to [review the SF50] when you’re six months out, just to see that everything is correct, because OPM does make mistakes. They’re human too. So if you can correct it sooner, then it’s a little bit easier than having to go back,” Pierce said.

SF 3807 and SF 2801: These are the actual federal retirement forms that will be submitted to the agency. SF 3807 is for Federal Employee Retirement System (FERS) employees, is about 15 pages long, and requires feds to make big, permanent decisions about some key retirement benefits. SF 2801 is somewhat longer, and for Civil Service Retirement System (CSRS) employees, but is otherwise comparable.

These are the forms that will pull data directly from the estimated annuity statement. But Pierce and Campbell cautioned that these are very difficult documents to get right the first time; paperwork errors are the most common cause of retirement process delays. Consultants like FEBA’s can help ensure that these documents are filled out correctly and completely.

SF 2818: Prospective retirees will also need to complete their Federal Employee Group Life Insurance (FEGLI) retirement form (SF 2818), which will determine how they take their life insurance into retirement. The Office of Personnel Management encourages retirees to confirm their beneficiaries and review survivor benefit options at this time as well.

What comes next?

All of this paperwork, Pierce and Campbell said, should be submitted to the agency as early as allowed, usually 90 days before retirement. This gives the agency as much time as possible to process it, because there will be delays, Campbell said. Then on the date of your retirement, that packet goes from your agency to OPM. OPM does have a processing backlog; it can take up to 90 days for them to begin processing your retirement packet.

Retirees can expect their first, estimated annuity payment within two to three months. OPM refers to this as “interim” pay: Usually, it’s about 60-70% of what your actual annuity will be. More is held back than is actually required for projected taxes and benefits payments while the exact calculations are happening. Once those calculations are finished, the total amount underpaid will be paid back.

That’s why it’s important to save up a lump sum ahead of retirement to cover those first few months between the last paycheck and the first full annuity payment. Many federal employees will save up annual leave time, which is paid out in one lump sum at the end of your employment, to help get over the hump. Others rely on the Thrift Savings Plan accounts, but it’s important to remember that it will be two to four weeks before TSP recognizes you’ve retired; during that time, there will be a blackout period where you won’t be able to withdraw money. So if TSP figures into your early retirement plans, it’s important to withdraw what you need before actually retiring.

But the main thing prospective retirees need to remember to make this process as quick and painless as possible is to fill out the paperwork correctly.

“One of the biggest things that’s going to cause you delays in your retirement processing is incorrect or incomplete paperwork,” Campbell said. “This happens all the time, and this is what really slows down the process.”

The post Planning for federal retirement? Here’s how, and when, to get your documents in order first appeared on Federal News Network.

The program suspended all reimbursement payments beginning June 16 as an effort to further strengthen anti-fraud and security measures, Federal News Network confirmed with a government source who explained the issue on the condition of anonymity.

“At this time, the FSAFEDS is holding all claims payments out of an abundance of caution,” FSAFEDS wrote Tuesday in a post on X. “FSAFEDS has taken this action due to recently discovered fraudulent claims activity. We are working to resolve and restore all claims payment activities as soon as possible.”

The pause on reimbursement payments, however, has been lifted and payments to employees should resume soon, Federal News Network has learned. FSAFEDS plans to process all reimbursements currently on hold by the end of the week.

“We apologize for any inconvenience you may have experienced during this period,” an FSAFEDS official wrote to a federal employee in an email Wednesday, obtained by Federal News Network. “FSAFEDS reimbursements have resumed as of today. All reimbursements currently on hold will be processed by close of business Friday, June 28.”

The payment suspension comes after a recent surge in fraudulent activity in the FSAFEDS program, which has been affecting hundreds of employee accounts. It also comes a few weeks after the Office of Personnel Management, which administers the program, suspended all new FSAFEDS enrollments.

OPM said it has been working with third-party vendor HealthEquity, which manages the FSAFEDS program, to strengthen security measures and secure all accounts impacted by the fraud. A HealthEquity spokesperson referred all questions on the situation to OPM.

The new security measures have included adding Login.gov requirements and using identity verification for anyone setting up a new account or changing their enrollments. OPM has also provided agencies with a list of personnel affected by the fraudulent charges, according to a Facebook post from the Army Benefits Center.

But even with the efforts to strengthen security, there are still employees seeing fraudulent charges in their account statements weeks after the issue was first reported.

Several federal employees told Federal News Network they did not receive any advance notice from OPM, FSAFEDS or their employing agency that the reimbursement payments would be paused.

There have also been some mixed messages regarding OPM’s response to the FSAFEDS fraud surge. For instance, in a June 13 announcement, the Coast Guard said during the hold on enrollments, “claims for reimbursement will still be permitted.”

Many employees wrote to Federal News Network expressing frustrations and concerns with the lack of communication on the FSAFEDS pause on payments. Based on multiple accounts from federal employees, it also appears that employees working at FSAFEDS themselves had limited information on the situation during the pause.

“All participant payments as of June 16 have been paused by direction of OPM until further notice. We have not been given a reason for the pause,” an FSAFEDS customer service representative wrote Tuesday in an online chat conversation with one federal employee. “OPM has paused payments and we just have to wait for them to release the pause. Believe me, I wish I had more info for you.”

Federal News Network obtained chat messages sent through the FSAFEDS customer service channel from several federal employees, under the condition of anonymity due to the sensitivity of personal health account information and the ongoing fraud in the FSAFEDS program.

“Currently, we are unaware of why OPM did not send out an email notification to our participants at this time,” an FSAFEDS representative said in a different chat conversation with a federal employee. “OPM has placed a pause on all reimbursements [and] payments with an unknown reason for an unknown length of time. Our team is aware of the financial stress this may cause for some at this time and hopefully the payments will resume back to their normal scheduled processing shortly.”

Some employees said they received notice that a claim had been accepted and that they would be getting a reimbursement payment, only to find that no payments had been made in their accounts even several days later. For instance, one federal employee, speaking anonymously, said after submitting a dependent care claim on June 20, she received a notification from FSAFEDS that the claim had been approved and processed.

“But the funds never appeared in my bank account,” the employee wrote in an email to Federal News Network. “This leaves many parents in a lurch if we planned to use our dependent care claims to offset the cost of summer child care this summer. I contribute vigorously to my dependent care accounts during the first half of the year, so I have ample funds to pay for summer child care, and now I’m having to come out of pocket to pay child care, even though I have funds in my dependent care account.”

Federal employees impacted by the pause in reimbursement payments are expected to be made whole by the end of the day on Friday.

The post FSAFEDS to restart payments after 10-day suspension on reimbursements first appeared on Federal News Network.

Beginning in 2025, OPM is adding stricter eligibility requirements to try to root out ineligible enrollees in the Federal Employees Health Benefits (FEHB) program — something that’s been high on GAO’s radar for at least the last few years. A 2022 GAO report showed that OPM spends up to $1 billion each year on ineligible participants erroneously enrolled in FEHB.

“One of the biggest benefit systems in the country, and for decades, nobody checked these things,” Comptroller General Gene Dodaro told lawmakers on the House Oversight and Accountability Committee during a June 13 hearing.

Each year, GAO releases a report of the programs and spending areas across the federal government that could lead to significant cost savings for agencies. The changes that GAO recommends aren’t always complex, but to be able to implement the measures, agencies need resources, Dodaro said.

“This isn’t rocket science — I mean, it’s basically looking at those things and doing some good auditing,” Dodaro said. “It could be tackled as soon as the resources could be marshaled to do it.”

Agencies often ‘slow to act’

By putting more controls in place and creating stricter measures on who can actually enroll — and stay enrolled — in FEHB, OPM should be able to more effectively address the cost issues, GAO said. Identifying ineligible dependents has remained a top challenge for FEHB since 2018, according to OPM’s inspector general office.

“[OPM] recognized the significance of the issue, but like in a lot of cases, people are slow to act on a recommendation,” Dodaro told committee lawmakers. “That’s why we keep following up.”

Addressing the FEHB spending challenges will involve a multi-pronged approach from OPM. It’s a matter of finding and removing currently enrolled ineligible FEHB members and preventing new members from enrolling in error, while also making long-term data updates to more easily root out ineligible enrollees in the future.

OPM is already gearing up to take some of these steps beginning in 2025. Starting next year, federal employees will be required to provide eligibility documentation for any family members they want to add to their insurance coverage during Open Season. But on top of that, Dodaro said an audit of current FEHB enrollees is necessary.

“[OPM] has not yet gone back and looked at all the people that are already in the system as to whether they have legitimate numbers of … people who are eligible for services,” Dodaro said. “They could sample across federal agencies, they could get some participation. But there has to be a thorough audit done of existing people that are on the federal employee’s health benefit systems.”

OPM is planning to start on this path as well. During this year’s Open Season, agencies will be required to validate the eligibility of a random sample of FEHB participants. That sample must comprise at least 10% of elections for both Self-Plus-One and Self-and-Family enrollments. Where possible, OPM is also encouraging agencies to validate larger portions of enrollees. If agencies find ineligible members through that data collection, they’ll have to follow OPM’s instructions for removing them.

A centralized FEHB database

But another major barrier for OPM to make improvements, Dodaro said, is the agency’s lack of a central database of FEHB enrollees. Without a centralized system, it’s much more difficult to identify and remove erroneously enrolled FEHB participants.

“Current FEHB eligibility determination and enrollment is highly decentralized and requires cooperation between nearly 100 employing offices responsible for determining eligibility and enrolling more than 8 million members,” OPM said in April. “If funded, OPM could extend this same central enrollment system to all FEHB enrollments, which would allow OPM to manage and make consistent all FEHB enrollments and remove individuals who cease to be eligible for the program.”

OPM, as part of its fiscal 2025 budget request, is proposing legislation to build a centralized enrollment system for FEHB. With a central database, OPM would be able to more quickly address the problem and avoid the spending errors. That system, if it’s implemented, would be modeled after the centralized system OPM just recently built for the upcoming Postal Service Health Benefits program.

During the oversight committee hearing, Dodaro said OPM Acting Director Rob Shriver’s background in insurance should help OPM make headway and get the changes underway — as would asking the Office of Management and Budget for additional support.

“He knows what the shortcomings are,” Dodaro, speaking about Shriver, told House committee members last week. “The question he’s wrestling with is how can he implement all these things that need to be implemented as soon as possible, like getting a central repository in place.”

The post Centralized FEHB database key to OPM cost savings, GAO says first appeared on Federal News Network.

Employees have reported fraudulent FSAFEDS deductions in paychecks as recently as June 7, Federal News Network has learned. FNN could not confirm the number of employees who have continued to see fraudulent deductions. The FSAFEDS fraud was originally estimated to impact approximately “several hundred” employees.

The Office of Personnel Management operates the FSAFEDS program through a contract with HealthEquity, a third-party vendor.

HealthEquity referred all questions to OPM. An OPM spokesman said the agency was continuing to work with the HealthEquity “to secure impacted accounts, refund impacted individuals, and implement additional anti-fraud controls.”

OPM did not answer specific questions about further reports of fraud impacting the program. “At this time, there is no evidence that OPM or our vendors’ systems have been compromised in any way,” the spokesman said.

But agencies have continued to warn their employees about the potential for FSAFEDS fraud. In a June 13 notice, the Coast Guard alerted employees to OPM’s temporary pause in new FSAFEDS enrollments.

“Your vigilance is crucial in helping address this issue promptly and effectively,” the Coast Guard wrote in the alert. “FSAFEDS appreciates your cooperation and understanding and will continue to communicate any new updates with members in the coming days and weeks.”

The ongoing pause in the FSEFEDS enrollment function also applies to current employees who experience a qualifying life event (QLE), such as the birth of a child or a marriage. OPM said employees will be able to retroactively adjust their elections due to a QLE after the pause is lifted.

Employees can also submit claims for reimbursement while the pause is in effect.

John Hatton, vice president for policy and programs at the National Active and Retired Federal Employees Association (NARFE), said the situation was “obviously concerning.”

“The questions now are how OPM and federal agencies are going to identify all unauthorized deductions, and ensure every federal employee is made whole; and how quickly can OPM get FSAFEDs enrollments back up and running so this employment benefit remains available to federal employees,” Hatton said in a statement. “We’re thankful the OPM OIG has identified this problem, and hope law enforcement is able to identify and prosecute the individuals responsible for these fraudulent activities.”

FSAFEDS fraudsters used personal data

The FSAFEDS fraud stems from bad actors using federal employee information to either create fraudulent accounts or fraudulent reimbursement claims, according to one government source. The source said HealthEquity has been introducing new anti-fraud and security measures, including requirements to use Login.gov, which features multifactor authentication.

But Linda Miller, the founder CEO of Audient Group, LLC and former deputy executive director of the Pandemic Response Accountability Committee, questioned why OPM didn’t require HealthEquity to use stronger fraud controls in the first place.

“There needs to be really stringent identity theft-based fraud controls at the front end, and anybody that is administering a program like this should be expected to have a baseline level of those kinds of controls,” Miller said. “Anytime you’re dealing with a service that involves money being exchanged, [multifactor authentication] is the floor, not the ceiling, when it comes to anti-fraud controls.”

Miller said it’s easier than ever for fraudsters to leverage stolen personal data, including that of federal employees, that can be found for sale on the deep or dark web.

“In my experience with federal agencies, across the board with some exceptions, there’s not really a lot of attention on the possibility that fraud or identity theft could be happening,” Miller said. “The awareness of this issue is so small compared to the impact and the size of the problem.”

The post Some feds continue to see fraudulent FSAFEDS deductions first appeared on Federal News Network.

For federal employees, a bill pending in the Senate would bring expanded coverage of fertility treatments through the Federal Employees Health Benefits (FEHB) program.

But the Right to IVF Act, which Sens. Tammy Duckworth (D-Ill.), Patty Murray (D-Wash.) and Cory Booker (D-N.J.) introduced last week, did not garner the 60 votes needed to move forward with a floor vote Thursday afternoon. Almost all Republicans voted against the measure to advance the legislation, resulting in a 48-47 tally.

The legislation rolls together three previous bills all aiming to improve access and insurance coverage for in-vitro fertilization (IVF). In part, the bill would have impacts specifically on FEHB enrollees. One component of the Right to IVF Act aims to set higher requirements for FEHB carriers to offer IVF coverage.

The Office of Personnel Management increased FEHB carrier requirements for IVF treatments for plan year 2024. But the legislation looks to further extend the requirements of IVF to cover both treatments and medications, as well as expanding to more types of assisted reproductive technology (ART).

The Democrat-led bill currently has 48 cosponsors. Generally, it focuses on establishing broader access to IVF and ART and lowering treatment costs, which without insurance can add up to tens of thousands of dollars in costs.

“Federal workers — myself included — know how expensive paying for IVF out of pocket can be, and the cost has put it out of reach for far too many,” Stacey Young, president of the Department of Justice Gender Equality Network (DOJ GEN), a federal employee advocacy group, told Federal News Network.

The push for a vote on the IVF bill represents a mindset shift toward the presidential campaign now just five months away, the Associated Press reported. Duckworth and other co-sponsors of the bill have said the legislation is also a response to the overturning of Roe v. Wade in 2022, and other more recent efforts to limit access to fertility treatments and medications.

“Today, women and families … are worried about what comes next, including the erosion of reproductive freedoms nobody thought were at risk. This includes access to services like IVF,” Senate Majority Leader Chuck Schumer (D-N.Y.) said Tuesday on the Senate floor. “The Right to IVF Act establishes a nationwide right to IVF and eliminates barriers for the millions of families looking to use IVF to start and grow a family.”

The Biden administration also came out in support of the legislation and called for its passage.

“The administration looks forward to working with Congress … in order to protect access to fertility services, eliminate barriers for families in need of high-quality, affordable fertility services, and ensure that federal agencies have the resources to implement these benefits,” the Office of Management and Budget wrote in a statement of administrative policy Wednesday.

DOJ GEN has continually called for better federal health care coverage of infertility treatments. The group is one of many stakeholders that pushed for the advancement of the Right to IVF Act in the Senate.

“Supporting this bill should be a no-brainer,” Young told Federal News Network. “Our nation’s public servants should have affordable access to the full range of reproductive health care, including IVF and other forms of assisted reproductive technology.”

But some lawmakers, along with DOJ GEN, have said even without the legislation, OPM should still work to add more coverage for FEHB enrollees. For plan year 2024, OPM already expanded IVF coverage requirements for FEHB carriers to provide, at a minimum, coverage of the cost of drugs related to an IVF procedure for three cycles annually. OPM has also encouraged FEHB carriers to go beyond the minimum requirements — and so far, 24 carriers have done so.

DOJ GEN leaders said they’re grateful for the efforts OPM has made so far in the FEHB requirements. But the advocacy group wants OPM now to take things a step further. DOJ GEN is asking OPM to expand health carrier requirements to cover IVF treatments, on top of medications, for plan year 2025.

“OPM has the opportunity to break new ground again in 2025 by mandating not only coverage of IVF medications, but also medical treatments,” DOJ GEN wrote in a letter to OPM Acting Director Rob Shriver in May. “Medical treatments comprise the lion’s share of the cost of IVF. Many of our members can attest first-hand to the financial strains that paying out of pocket for IVF placed on them. Some had to drain their savings; borrow money from family members; or forgo treatments entirely. Others left DOJ for private-sector jobs that offered full IVF coverage, taking their invaluable skills and institutional knowledge with them.”

OPM declined to comment on whether there were any plans underway to further expand coverage requirements for IVF in the health insurance program. But some federal health experts have said with just a few months before Open Season, it’s likely too late to expand the coverage as early as plan year 2025 — though it would be possible in future health plan years.

Betsy Campbell, chief engagement officer at national infertility association RESOLVE, said the calls for better insurance coverage of fertility treatments have been growing.

“We know that hundreds of federal employees have been reaching out to OPM to request this coverage, and we’ve started to see some progress with OPM,” Campbell said in an interview with Federal News Network. “The next step is actually adding the medical procedure of IVF. So we’re hopeful that OPM will listen to their employees and add this highly desired benefit.”

RESOLVE has also been encouraging the adoption of a more inclusive definition of infertility that would help LGBTQ+ employees as well as unpartnered individuals access IVF and other fertility benefits through FEHB — but she said the efforts should go beyond simply updating the definition.

“There appears to still be some work, because donor sperm and donor eggs aren’t necessarily covered by all the plans,” Campbell said. “And that, of course, is needed by same-sex couples and non-partnered people when building their families. It’s one thing to have an inclusive definition, but you also have to cover the elements that are needed for these communities to build their families as well.”

A 2021 survey from Mercer, in partnership with RESOLVE, found that a vast majority of employers that increased fertility treatment coverage and benefits did not see a significant increase in medical plan costs.

Additionally, Campbell said, these types of benefit adjustments can significantly impact recruitment and retention of employees.

“You don’t want to provide yet another reason for them to leave federal employment to go to a private employer that is providing fertility benefits,” Campbell said. “Often employers don’t realize there’s a gap in this coverage until it’s pointed out. I think we’re seeing OPM trying to fill this gap piece by piece … Now it’s time to also cover these medically necessary procedures to help their employees build their families.”

The post Senate GOP blocks bill to expand IVF access as advocates call for better FEHB coverage first appeared on Federal News Network.

OPM’s inspector general office shared more information about the pause on Thursday, saying it comes “out of an abundance of caution,” and to try to prevent further fraud, the OIG said in a special fraud alert.

In addition to new enrollments, the enrollment pause also applies to any current enrollee in FSAFEDS who experiences a qualifying life event (QLE), such as a marriage or the birth of a child.

During the pause, current FSAFEDS enrollees are still able to make reimbursement claims. Once OPM chooses to resume the enrollment functionality, FSAFEDS will retroactively adjust any elections based on QLEs. But currently, OPM has not set a date for when the functionality will resume.

The pause comes after several hundred federal employees currently enrolled in FSAFEDS experienced recent fraudulent activity on their accounts. Scammers have used the employees’ personal information to either create new, fraudulent FSAs, or otherwise make fraudulent reimbursement claims on existing FSAs.

HealthEquity, the vendor that administers FSAFEDS, previously notified OPM of the recent rise in fraudulent activity.

“OPM is working with the vendor to secure impacted accounts, compensate impacted individuals and implement additional anti-fraud controls,” an OPM spokesperson said in an email statement.

The fraudulent activity in FSAFEDS is relatively limited in scope, since it’s affecting just a few hundred federal employees’ accounts. In total, the scammers have managed to shore up a couple hundred thousand dollars, Politico first reported last week.

Since becoming aware of the fraud, HealthEquity has already taken additional security measures by implementing Login.gov requirements and setting up dual-factor authentication for federal employees to be able to log in to their FSAFEDS accounts.

A HealthEquity spokesperson declined to comment with any additional details on the current status of the affected FSAFEDS accounts, or if there would be further changes to security protocols.

There’s currently no evidence that the fraudulent activity is coming from a compromise in either OPM’s or HealthEquity’s online systems, but the investigation into the source of the fraud is ongoing.

In the meantime, the accounts of any affected individuals have been secured, and OPM is in the process of reimbursing all impacted enrollees in full.

Agency benefits officers and payroll providers are advising federal employees who use FSAFEDS to review and verify their leave, earnings and FSA account statements. If employees notice any suspicious charges or activity, they can call FSAFEDS at 877-372-3337.

Each year during Open Season, federal employees have the option to enroll in FSAFEDS, but as of last plan year, less than 20% of eligible feds actually have an account set up in the health program.

FSAFEDS lets current federal employees set aside pre-tax dollars from their paychecks to go toward covering eligible health care, prescription, dental, vision and child and adult day care expenses. Enrollees will usually pay for the medical costs out of pocket and are then reimbursed using funds from an FSA.

For 2024, employees who are enrolled in an FSA can contribute up to $3,200 for the entire year. The funding has to be used within a given plan year, but there is an option to roll over up to $640 to the following year. Many federal health experts highly recommend opening and contributing to an FSA, as it lets participants save money by contributing to health expenses pre-tax.

The overall eligibility pool for FSAFEDS has also recently expanded. Beginning in January, for plan year 2024, OPM made active-duty service members as well as members of the Active Guard Reserve eligible to start a Dependent Care Flexible Spending Account (DCFSA). The program expansion made about 400,000 active-duty service members newly eligible for the benefits of FSAs.

The post OPM pauses new FSAFEDS enrollments after fraud surge first appeared on Federal News Network.

The Department of Veterans Affairs has made a major change in the rules for veterans who left military service with other-than honorable discharges. It opens the possibility of healthcare coverage for those who may have been discharged for willful misconduct or even moral turpitude. For detail, the Federal Drive with Tom Temin spoke with Anthony Kuhn, managing partner of the law firm Tully Rinckey.

Interview transcript: 

Tom Temin Veterans Affairs has made a major change in the rules for veterans who left military service with other than honorable discharges. It opens the possibility of health care coverage for those who may have been discharged for willful misconduct or even moral turpitude. Details from the managing partner of the law firm Tully Rinckey, Anthony Kuhn. Anthony, good to have you back.

Anthony Kuhn Thanks for having me. Always a pleasure.

Tom Temin So, this is — seems revolutionary in the history of VA, because it’s been axiomatic that you have to have a good discharge to get benefits. So, what’s going on here?

Anthony Kuhn Yes, it is. You know, there’s been some steps in this direction in the past, but the VA hasn’t really committed to this initiative like they have with this new rule change. So, in the past, individuals who were separated for mental health conditions and, primarily they’re looking to try to take care of individuals who develop those conditions in combat. But it doesn’t — it’s not exclusive. So, there’s going to be other situations where individuals maybe developed PTSD symptoms or mental health issues in their military service, maybe in training, or even traumatic experiences that they suffered while on active duty. So, the VA here is — they’re changing the rule to try to expand, to capture those individuals. In the past, you had to file — you had to submit an application to the board for correction of military records and hope to get a discharge upgrade. There were some memoranda published by individuals, high-ranking individuals that directed the boards in the past to give liberal consideration to those individuals. Well, this is kind of a skirt around. So, now they’re looking at giving the VA the power to determine whether those individuals might be eligible for VA benefits that they otherwise wouldn’t be eligible for.

Tom Temin And is there any estimates that you’ve seen of how many people might be affected by this potentially?

Anthony Kuhn Well, I would expect it to be at least in the tens of thousands, given the number of applications that we file and the number of veterans that have flooded the boards with discharge upgrade requests in the past few years. There was — Secretary Hagel issued a memo back in 2018, which I just referred to a couple of minutes ago here. That memo urged veterans who had mental health conditions, especially post-traumatic stress disorder and things of that nature, to apply for a discharge upgrade. And what they had to show was that the stressors that they suffered through in the military were the foundation, really, for the misconduct, or that the misconduct could be tied to those things. And the way we did that is we would submit these applications to the board. We would show that this individual had good, service in the military, good honorable service. And then something traumatic happened to that individual. And then the misconduct followed, because the individual often struggled to deal with those mental health concerns. So, again, now the VA is saying that you can do that. You can still get your discharge upgrade. You can still file with the boards for correction of military records, which are unrelated to the VA. It’s a completely separate agency and organization. But now you can actually go to the VA and you can make that same argument. And hopefully the VA will make a quicker decision because the boards can take up to two years to make that decision. So, it’s creating another avenue. And maybe if one avenue doesn’t work, you try this avenue, and now you’ve got multiple avenues where you might be able to to seek service-connected compensation and medical treatment for the conditions.

Tom Temin And just as an aside, getting the upgrade in the discharge in the first place is probably desirable outside of being able to access VA benefits. It could help your career and prospects in other zones. Fair to say?

Anthony Kuhn Yes, absolutely. So, if you want your discharge upgraded for all purposes, employment, benefits, you can still go to the board for correction of military records and file that application. And if they grant a discharge upgrade and often when PTSD is involved or other mental health conditions, military sexual trauma, things of that nature, when those types of conditions come into play, the board will often grant the discharge upgrade. At least most of the boards. Air Force can be pretty tough on the case regardless, but most of the branches will liberally grant those discharge upgrades. So, this gives you another avenue now to to seek just VA benefits so they won’t upgrade your discharge. They’re not going to issue a new DD214, the release from active duty. They’re not going to make those changes because it’s a different agency. But they’re going to, I think, take a more liberal approach and start looking to help individuals with mental health concerns combat related hardships, things of that nature. They’re going to look to assist those individuals better than they have in the past.

Tom Temin We’re speaking with attorney Anthony Kuhn, managing partner of Tully Rinckey. And besides a rule change, this is kind of a theory change in recognizing that certain things that happened while on military duty or while in active service are, in fact, manifestations of damage that can happen to someone as a result of that service. That’s there’s an expansion there.

Anthony Kuhn Yes, there is. So in the past, there was a there was an avenue that most people didn’t know about, and it was kind of difficult. You could file with the VA, and you would request that the VA consider your discharge to be something other than dishonorable, for the purposes of the VA only. So, most people didn’t know about that. It’s very rare that veterans figure that out and are able to accomplish that. We’ve done that here, but most veterans aren’t aware of that. In fact, I did it with a Korean War veteran who had fought, I think, 40 years to try to establish his claim, and nobody was ever able to establish his claim. And the way that we were able to establish this claim is that I actually filed his board for correction of military records application, and at the same time, I filed with the VA for them to consider his discharge to be something other than dishonorable. And in those arguments, I included all the evidence that this individual had actually been shot in combat. He then came home, was treated and went back and was injured again in combat. So, this is an individual that they weren’t giving benefits to. So, it was a pretty easy decision, I think, for the VA. And they very quickly turned it over, and awarded him all of the benefits that he would have been entitled to, had gotten an honorable discharge, but he didn’t have an honorable discharge. Eventually, I was able to fix that as well at the board for correction of military records, but that took a lot longer. So, now, this process should speed that up. It gives us another avenue to try to get veterans the benefits that they should be entitled to, because nobody should get shot in combat and have to fight for 40 years to establish VA benefits.

Tom Temin Even with this new process, though, the veteran is still subject to the discretion of a VA judging official.

Anthony Kuhn They will be. So what they’re going to look for is cognitive impairments, mental health concerns, combat-related hardships, things of that nature. So individuals are going to still have to meet that burden and establish that those, conditions exist in order to qualify for VA benefits. But it should be a much quicker, much easier process than filing through the board for correction of military records and, for example, having to prove that there was an error or injustice in the way that the individuals separated.

Tom Temin And in general, it’s sometimes surprising how little recent veterans, or maybe not-so-recent veterans, are aware of all of the services that is available to them from VA. I mean, it’s just that’s the way the world works. And for those that have a less-than-honorable discharge, they might have figured, well, that’s the end of me in VA. See you later, Charlie. How does the word get out to people that they have a chance now, perhaps to have that upgrade or to get those benefits despite the discharge status they do have?

Anthony Kuhn And that’s exactly right. There are so many individuals out there that don’t even really understand the definition of veteran, because it’s different everywhere you go. So, some organizations will help veterans, but they define veteran differently than the VA. For me, you know, I want to give someone credit for going to basic training and making it through and serving in the military regardless of what happened that ended their military career. To me, that’s a veteran, but the VA disagrees. The VA says that a veteran is someone with an honorable discharge. So, there are questions about who are veterans and who’s going to obtain these benefits. So, I mean, it starts there, and it’s going to work through the VA to decide who they want to issue these benefits to, because some of these people are going to run into the issue of whether they’re actually a veteran. The VA is now saying that — they haven’t come out and clearly said this — but they’re at least inferring that they’re going to have to consider some of these people veterans regardless of what their discharge status is, because they say only veterans are entitled to VA benefits. So, it’s going to be interesting to see what they do with the definition of veteran as well moving forward.

Tom Temin Attorney Anthony Kuhn is managing partner of Tully Rinckey. Thanks so much for joining me.

Anthony Kuhn My pleasure. Anytime. Thanks for having me.

Tom Temin And we’ll post this interview at federalnewsnetwork.com/federaldrive. Hear the Federal Drive on demand. Subscribe wherever you get your podcasts.

 

The post VA rule change could mean health care benefits for a million more veterans first appeared on Federal News Network.

Here are six benefits that affect a federal employee’s retirement, as well as a brief overview of what to consider about each when planning to retire:

Pension

There are actually two federal employee pension systems: The Civil Service Retirement System (CSRS) and the Federal Employee Retirement System (FERS). Most federal employees these days are on FERS; only federal employees who began their service before January 1, 1984 are on CSRS. CSRS offered feds an annuity that amounts to a percentage of the average of their three highest-earning years of employment. FERS offers a pension that is a lower percentage of their high-three, but combines it with Social Security benefits and the Thrift Savings Plan, the government’s version of a 401k plan.

The FERS pension formula is 1% of your high-three average salary, multiplied by your years and months of service. If you retire at age 62 or older and have 20+ years of service, that percentage becomes 1.1%. So someone who is 62, with 20 years of service and a high-three average of $70,000 would receive an estimated annual pension of around $15,400, or about $1,283 monthly.

Social Security

Federal employees pay 6.2% of every paycheck into Social Security, the second leg of the FERS retirement income tripod. The government matches that, which means 12.4% of every paycheck is going toward their retirement. It’s more complicated with CSRS employees, who should consult a financial adviser who specializes in federal retirement to see if they qualify for Social Security.

FERS retirees need 40 quarters of qualified employment to earn Social Security benefits, which will then be based on their highest 35 years of earnings. They can begin taking Social Security at age 62, but that’s technically considered early retirement. Feds who chose to do that will receive the smallest payments, but will also receive the most payments over time. The payment amount goes up a percentage every year until age 70, when it maxes out. Feds who retire at 70 will get the biggest payments, but the fewest. It does not grow after 70; feds who don’t claim Social Security at age 70 are leaving money on the table for no reason.

TSP

Finally, there’s the TSP. The government’s version of a 401k plan consists of five core funds: G, C, I, F and S. Then there are the Lifecycle funds, which consist of a blend of each of the core funds targeted at a specific retirement year.

The TSP is one of the most important and beneficial government benefits. While it is one of the simplest 401k structures, it can do a great job of accumulating retirement dollars while you work if used correctly. The biggest reason for that is the matching contribution: The government will match up to 5% of each paycheck if you invest that much in your TSP.

Another benefit is that unlike the pension or Social Security, TSP has liquidity. Retirees have far more control over how much they withdraw from it. Finally, the contribution limits are huge; federal employees and retirees can find out what those limits are and keep up with yearly changes at TSP’s website.

While TSP is a great accumulation tool, it has limitations in the pre-retirement and income phases because of the lack of diversification. It is vitally important to consult with a financial professional who truly understands TSP, its options and the rules that apply to it so you can Maximize it later in your career and into retirement.

FEHB

The Federal Employee Health Benefits (FEHB) program is the government’s health insurance, of which it pays 72%; employees only pay 28% of the cost. Feds can take their FEHB into retirement as long as they were covered for five consecutive years, up to their retirement date. That also includes qualified family members, who can also be added during major life events or any Open Season.

One common myth about the FEHB in retirement is that it gets more expensive. But what’s actually happening is the same yearly deduction is being split across 12 pension payments, rather than 26 paychecks. So the payments are larger, but fewer. However, the deductions do come out after taxes in retirement, unlike when feds are working.

Survivor benefits

If a retired federal employee passes away before their spouse, that spouse does get some benefits. However, those are difficult to calculate and generally require the help of a qualified financial adviser to determine. In addition, there are differences between how that’s calculated between FERS and CSRS.

FEGLI

Finally, there’s the Federal Employee Group Life Insurance (FEGLI). This is often the most confusing because most people don’t know which option they have or what they’re paying. Those options are:

• Basic: Costs $10-30+ per pay period. It’s very inexpensive while you work but the price increases dramatically in retirement. It pays your adjusted base salary rounded to the next thousand, plus $2,000.
• Option A: Cheapest at $2 per pay period, then $6 per pay period once you turn 60 (regardless of if you’re retired). It pays $10,000.
• Option B: Pays up to five times your salary. It’s generally a good deal while you’re young but becomes expensive as you get older because the cost rises every five years. This can create a life insurance trap as you get older if you don’t understand the price increase and plan accordingly.
• Option C: Optional family coverage with up to five multiples. Each multiple is $2,500 for children or $5,000 for spouses.

See a fiduciary

These are just basic overviews of very complicated federal benefits. Unfortunately, federal agencies don’t have retirement officers anymore, and call centers don’t offer personalized advice on benefits. Meanwhile, fiduciaries are financial advisers required to act in your best interests. Only 11% of financial advisers are fiduciaries. However, of those, few are trained in the intricacies of federal benefits, which require deep and specialized knowledge.

Justin T. Pierce and James M. Campbell are fiduciaries as well as federal retirement consultants (FRCs). They are the managing partners of Federal Employee Benefit Advisors and have a whole team of FRCs. Join Justin T. Pierce and James M. Campbell in their next complimentary webinar.

The post Navigating the complexities of federal retirement benefits first appeared on Federal News Network.

More than 175 House and Senate Democrats are urging the Office of Personnel Management to require every FEHB carrier to expand their offerings and cover costs for both infertility treatments and medications, starting in plan year 2025.

That requirement “would reflect the reality that IVF is one of the most effective treatments for families struggling with infertility, and growing in popularity, with its usage nearly doubling from 2012 to 2021,” the lawmakers, led by Rep. Gerry Connolly (D-Va.) and Sen Tammy Duckworth (D-Ill.), wrote in a letter to OPM Tuesday.

Starting just this year, FEHB carriers already began covering, at a minimum, two forms of artificial insemination and associated drugs, as well as the costs of IVF-related medications for at least three cycles of treatments. The requirements for carriers cover the cost of medications, but not necessarily the cost of the IVF treatment itself.

OPM did not note any plans to increase infertility treatment coverage for 2025 in its most recent call letter to carriers from February. But Kevin Moss, marketing director at Consumers’ Checkbook, said that’s not necessarily surprising. OPM is running up against the clock for FEHB negotiations ahead of plan year 2025.

“I would be surprised to see a change this big happening this late for a new plan year,” Moss said.

There are only a few months left before benefits are locked in with the federal insurance program’s carriers. FEHB health plans have to submit their rates and benefits for the 2025 plan year by May 31. From there, OPM will negotiate and finalize benefit negotiations by July 31 for the upcoming plan year.

During that process, an OPM spokesperson said the agency will work with carriers to promote expanded access to comprehensive IVF services. In particular, OPM is strongly encouraging carriers to offer more comprehensive IVF coverage, beyond the minimum required level.

“OPM expects carriers to provide quality options for gender-affirming care and services, maternal health, fertility, obesity management, mental health and substance use disorder treatment, and telehealth benefits” the agency wrote in its February call letter.

In their letter, lawmakers expressed appreciation for the steps OPM has already taken to broaden infertility treatment coverage in FEHB by offering some coverage of related medications. It’s a significant change, considering that IVF treatments can cost tens of thousands of dollars out of pocket for just one cycle — and 35% of that price tag comes from prescription drug costs, the lawmakers said.

But the lawmakers said offering further benefits would help agencies better compete for employees, who may seek different job opportunities with better insurance coverage elsewhere.

“While significant work remains to be done to improve IVF access, which includes ensuring comprehensive plan designs are inclusive of LGBTQ and solo individuals who rely on medical intervention to build their families, your leadership in making sure FEHB plans cover IVF medications represents meaningful progress in expanding access to fertility treatments, which will ultimately prove life-changing for families across the country,” the lawmakers said in their letter to OPM Director Kiran Ahuja.

An OPM spokesperson said that 24 plans are currently covering a greater portion of the IVF procedure, beyond the drug costs and above the minimum requirements in FEHB. For instance, Blue Cross Blue Shield Association is covering up to $25,000 per year in IVF costs.

Still, the current coverages available through FEHB may leave room for improvement.

“There is some coverage in some of the plans, but it is fairly limited and leaves couples with a lot of out-of-pocket expenses,” Tammy Flanagan, a federal benefits and retirement specialist at Retire Federal, told Federal News Network. “We will see how much this is expanded later this year when the plans announce their benefit changes for 2025.”

Regardless, it’s important for enrollees to carefully review all available information when selecting a plan during Open Season, the OPM spokesperson said.

OPM is also ramping up preparations for the launch of the Postal Service Health Benefits (PSHB) program next year. The program will cover about 2 million Postal Service employees, annuitants and their family members. In March, OPM conditionally approved 32 carrier options for PSHB in 2025.

This year, Open Season will run from Nov. 11 to Dec. 9. During that time, both FEHB and PSHB enrollees can make elections and changes to their health care options for plan year 2025.

The post Lawmakers urging expanded IVF coverage for FEHB enrollees first appeared on Federal News Network.

The House is once again nearing a finish line to address two provisions limiting Social Security benefits for some federal annuitants.

But it’s still up in the air what direction Congress will take. Many lawmakers are pushing for a full repeal of the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Others are instead looking to keep the provisions, but reform their calculations.

The Social Security Fairness Act, a bill that would eliminate WEP and GPO, has broad bipartisan support, gaining 316 House co-sponsors and 53 in the Senate. But during a House Ways and Means Committee hearing, some Republicans and other stakeholders called for different answers.

“Fully repealing the WEP and GPO would violate the principles of fairness and equity that these provisions were intended to protect,” Bipartisan Policy Center Chief Economist Jason Fichtner told lawmakers on the committee’s Social Security subcommittee Tuesday. “[But] given data limitations at the time the WEP and GPO provisions were first established in law, these provisions create an overly complex structure.”

In response to Tuesday’s hearing, Reps. Abigail Spanberger (D-Va.) and Garret Graves (R-La.) are doubling down in their push for the passage of the Social Security Fairness Act, reintroduced in January 2023.

“Throughout our time in Congress, we have heard from tens of thousands of Americans who have been adversely impacted and impoverished by these harmful policies,” the representatives wrote to committee members in a letter shared exclusively with Federal News Network. “With the Ways and Means Committee so focused on ensuring retirement security for all Americans, there is no time like the present for Congress to act … We believe that full repeal is the best solution.”

The WEP and GPO reduce — and in some cases eliminate — Social Security benefits for some federal retirees and other public sector workers, as well as their spouses, widows and widowers. For years, some members of Congress have been urging a full repeal of the two provisions to give affected annuitants a full Social Security benefit amount. Advocates have said WEP and GPO are unfair to those who work in the public sector.

The Windfall Elimination Provision (WEP) originated in 1983, and it reduces Social Security benefits for anyone who receives an annuity from their time in government, but who also worked in a Social Security-covered job, typically a private sector position. WEP impacts roughly two million individuals, including employees in the Civil Service Retirement System (CSRS) who were hired to the federal government prior to 1984.

The Government Pension Offset (GPO) dates back to 1977, and impacts the Social Security benefits of the spouses, widows or widowers of any individual with a government pension. If two-thirds of a government pension is more than the value of the Social Security benefit, then the GPO can entirely eliminate a Social Security benefit.

Despite agreeing that the WEP and GPO formulas are outdated, a few witnesses at the subcommittee hearing said they still wanted to maintain what they said was equity between public and private sector workers.

“The WEP and GPO are necessary features in a system with Social Security’s basic design, but their current forms failed to achieve their intended purposes in large part because there are simplified approximations reflecting previous data limitations,” said Charles Blahous, a senior research strategist at George Mason University. “Appropriate reforms could result in greater parity.”

Bills such as the Equal Treatment of Public Servants Act and the Public Servants Protection and Fairness Act may provide the framework for reforming rather than repealing WEP and GPO. The two bills operate slightly differently, but either one would provide at least some relief to CSRS annuitants.

One option on the table to address WEP and GPO would adjust the current Social Security benefit formula. Specifically, it would change the formula to make proportional calculations based on workers’ earnings in Social Security-covered jobs, versus their total earnings in both covered and non-covered jobs. Current annuitants would also have their penalties reduced and receive rebates.

“Much good can come from a relatively straightforward change that would make the Social Security benefit proportional or prorated for workers with non-covered earnings,” Fichtner said.

For now, it’s unclear what exact language lawmakers will choose, should they decide to move forward with a reform rather than a full repeal of WEP and GPO.

And while expressing appreciation for the subcommittee hearing, Spanberger and Graves still said a full repeal of WEP and GPO will bring the most relief to those negatively affected.

“We have heard from tens of thousands of Americans who have been adversely impacted and impoverished by these harmful policies,” the lawmakers said in their letter to the committee. “These WEP [and] GPO victims have had their Social Security benefits unfairly reduced — and in some cases altogether eliminated — because they chose a life of public service. It is time to offer them a remedy.”

One main concern from opponents of a full repeal of WEP and GPO is the cost of the change. Some raised concerns that giving full Social Security benefits to CSRS annuitants and other public sector retirees would negatively impact the solvency of Social Security overall — or in other words, the ability to continue paying out benefits on time and in full to beneficiaries.

“There’s some back and forth on what the solution for Social Security going forward is, and what we need to do about that. That general debate is going to continue to be in the background and you can’t really separate a repeal of WEP and GPO from that,” NARFE Staff Vice President John Hatton said in an interview. “A lot of Congress members agree these are unfair provisions. But they probably don’t want to do this without some type of cost offset, because they don’t want to hurt the solvency of Social Security more. That’s going to be the challenge for us.”

NARFE, or the National Active and Retired Federal Employees Association, has been a long-time advocate of a full repeal of both WEP and GPO. Despite maintaining that stance, Hatton said in the short-term, any type of reform to the system would still be a step in the right direction.

“If we can get some progress, actually made and passed into law, we’ll take that as a win and keep on working on this issue going forward,” Hatton said. “We’ll continue to work towards repeal, but we will certainly take what we can get if there is a consensus that finds a compromise.”

The post Repeal or reform? House lawmakers weigh responses to WEP, GPO first appeared on Federal News Network.

Starting in Open Season this fall, agencies will be required to validate participant eligibility of a random sample comprising at least 10% of FEHB elections for both Self-Plus-One and Self-and-Family enrollments.

OPM noted that 10% is the minimum for validation, and is encouraging agencies to validate larger portions of enrollees when possible. Agencies have to report their enrollment reviews to OPM by July 2025. If agencies find ineligible members through the sample collection, they’ll also have to follow instructions for promptly removing them, OPM said in a benefits administration letter Wednesday.

“Today’s actions build on years of progress addressing issues in FEHB enrollments,” OPM said. “Collectively, these requirements ensure that agencies are verifying documentation provided during each of the key periods when an employee might make a change.”

The new requirements for agencies come after a 2022 Government Accountability Office report found that OPM may be spending up to $1 billion each year on ineligible enrollees in the governmentwide health insurance program, which covers 8 million participants.

“The longer OPM delays its efforts to establish a monitoring mechanism to identify and remove ineligible program members, the more ineligible members and related improper payments in the program may continue to accrue, costing the program millions, or up to approximately one billion dollars per year, according to OPM’s own estimate,” GAO said in the 2022 report.

Beginning in 2025, federal employees will also be required to provide eligibility documentation for any family members they want to add to their insurance coverage during Open Season.

Identifying ineligible dependents has remained a top challenge for FEHB since 2018. In 2021, OPM first put regulations in place to monitor family member eligibility during a member’s initial enrollment, or during qualifying life events. Before 2021, OPM was not asking FEHB enrollees for any verification of family members’ eligibility for health insurance coverage, and instead only using “self-certification.”

OPM’s new requirements, announced this week, now mark even stricter requirements, now verifying family members who get added to FEHB elections during Open Season, the time of year when many participants are actually adding new individuals to their plans.

OPM also just recently completed an FEHB “Master Enrollment Index” that’s meant to root out any irregularities in existing FEHB enrollments. OPM said it will then further review any irregularities that the index finds, and keep agencies informed of those reviews.

The challenges in FEHB eligibility verification have gained attention in Congress as well. The FEHB Protection Act, which Sens. Rick Scott (R-Fla.) and Tom Carper (D-Del.) introduced in March, would similarly require OPM to verify eligibility before adding new members to the health care program. If enacted, the bill would also require an audit of FEHB to remove any invalid members who are currently enrolled.

“By confirming eligibility, we have the potential to save taxpayers hundreds of millions of dollars annually,” Carper said about the bill. “I look forward to working with my colleagues and OPM to ensure they have the resources and tools needed to end improper payments and root out fraud in the FEHB.”

As part of its fiscal 2025 budget request, OPM is also proposing legislation to build a centralized enrollment system for FEHB — which could help relieve some of the challenges of ineligible members in the system. That system would be modeled after the centralized system OPM has just recently built for the upcoming Postal Service Health Benefits program.

“Current FEHB eligibility determination and enrollment is highly decentralized and requires cooperation between nearly 100 employing offices responsible for determining eligibility and enrolling more than 8 million members,” OPM said. “If funded, OPM could extend this same central enrollment system to all FEHB enrollments, which would allow OPM to manage and make consistent all FEHB enrollments and remove individuals who cease to be eligible for the program.”

The post Stricter FEHB requirements from OPM aim to root out ineligible members first appeared on Federal News Network.

One of the few remaining policies from a series of 2021 executive orders lets federal employees still take up to four hours of paid administrative leave to get COVID-19 vaccine booster shots, the Office of Personnel Management said in an April 12 memo.

“The administration strongly encourages federal employees to get recommended doses of updated COVID-19 vaccines even when receiving those vaccines is not a job requirement,” OPM Director Kiran Ahuja said in the memo addressed to agency heads. “Vaccines remain the best tool we have in our toolbox to combat COVID-19. They are safe, effective and free.”

For federal employees, the offered administrative leave will cover the time it takes to get the COVID-19 booster shot, as well as feds’ travel time to and from the vaccination site. As is standard, employees should get approval from their supervisors before taking leave for this purpose, OPM said. Four hours is the maximum OPM is allotting, but federal employees should only take off as much time as they actually need to get the shot.

In a departure from previous OPM guidance, federal employees can no longer take administrative leave when accompanying a family member who’s getting vaccinated, if they experience an adverse reaction to a vaccine, or if they’re experiencing COVID-19 symptoms and waiting to get tested. In these instances, OPM said employees should now use regular sick leave instead, or some other type of either paid or unpaid leave.

Alongside OPM’s new COVID-19 leave guidance, a memo from the Office of Management and Budget Friday officially brought the Safer Federal Workforce Task Force — and any related guidance from that task force — to an end. OMB initially stood up the task force in early 2021 as a way to ensure a safe and healthy federal workplace and pandemic preparedness.

The administration said although COVID-19 continues to pose health concerns, there’s no longer a real need for a full task force or larger leave policies for federal employees.

Even with the task force now ending, however, agencies should continue to maintain and implement their workplace safety plans, OMB said. Those safety plans were one of the initial requirements for agencies under the 2021 executive orders.

Moving forward, in the absence of the task force, OPM is now taking on the responsibility of considering any further personnel policy or leave changes related to the COVID-19 pandemic or any other public health emergencies.

The Safer Federal Workforce Task Force’s website will remain online, but it’ll no longer be updated, OMB said.

The administration’s sunsetting of the Safer Federal Workforce Task Force also comes almost a year after the White House officially ended the COVID-19 national public health emergency on May 11, 2023.

Around that same time last year, the administration officially lifted a COVID-19 vaccine requirement for federal employees. That mandate, though, was never fully enforced in the first place because it was tied up in various court cases, which blocked most of the requirements.

Regardless, by the start of 2022, 98% of federal employees had already either complied with the vaccine mandate or requested an exemption.

The post Feds can still take administrative leave to get COVID-19 booster shots first appeared on Federal News Network.