Jane Dotson
Blue Cross and Blue Shield is a health insurance company that offers personalized healthcare across the country through its 33 independent, community-based, and locally operated health insurance companies. It has been providing health insurance to federal employees, retirees, and their families through its Federal Employee Program (FEP) since 1960. The FEP covers over 5.5 million federal employees and is the number one health insurance choice for federal employees. The Blue Cross Blue Shield Association (BCBSA) negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Service Benefit Plan. This raises the question: is Blue Cross Blue Shield federally funded?
| Characteristics | Values |
|---|---|
| Type of Insurance | Health Insurance |
| Who it covers | Federal employees, retirees, and their families |
| Number of people covered | 5.5 million |
| Number of doctors and hospitals in the network | 2 million+ |
| Number of retail pharmacies in the network | 55,000+ |
| Whether it provides overseas coverage | Yes |
| Whether a referral is needed to see a specialist | No |
| Whether it is approved by the Office of Personnel Management | Yes |
| Whether it is approved to participate in the Postal Service Health Benefits Program | Conditionally approved |
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What You'll Learn
Blue Cross Blue Shield Association (BCBSA)
The Blue Cross Blue Shield Association (BCBSA) is a national federation of 33 independent, community-based and locally operated Blue Cross Blue Shield health insurance companies. Together, these companies provide healthcare coverage for one in three Americans.
BCBSA is the trade association for the independent, locally operated Blue Cross and Blue Shield member companies. It negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program (FEP). This plan has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960.
FEP covers over 5.5 million federal employees, retirees, and their families across the U.S. and overseas. The local Blue Cross Blue Shield companies are the primary points of contact for Service Benefit Plan members and are responsible for processing claims and providing customer service. BCBSA is proud to support the Federal Employee Education & Assistance Fund (FEEA) and the National Active and Retired Federal Employees Association (NARFE).
The Blue Cross Blue Shield Federal Employee Program® is the top choice of health insurance for U.S. federal employees, with 99% of members choosing to stay with the program year after year. The program offers access to a Preferred provider network that includes more doctors, hospitals, and specialists than any other network. It also provides members with rewarding incentive programs and innovative tools and resources that put care at their fingertips.
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Federal Employees Health Benefits (FEHB) Program
The Federal Employees Health Benefits (FEHB) Program offers federal employees, retirees, and their survivors a wide range of health plans to choose from, including Consumer-Driven and High Deductible plans, Fee-for-Service (FFS) plans, Preferred Provider Organizations (PPO), and Health Maintenance Organizations (HMO). The FEHB Program is designed to help individuals and their families meet their healthcare needs.
Blue Cross and Blue Shield's Federal Employee Program (FEP) is a part of the FEHB Program and has been providing health insurance to federal employees since 1960. FEP is the number one health insurance choice for federal employees, covering over 5.5 million federal employees, retirees, and their families across the U.S. and overseas. The program offers access to a Preferred provider network that includes more doctors, hospitals, and specialists than any other network. FEP also provides coverage for annual physicals, immunizations, and screenings when visiting a Preferred provider, as well as telehealth services for minor injuries, illnesses, mental health support, and more.
The Blue Cross Blue Shield Association (BCBSA) negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Service Benefit Plan. The 33 local Blue Cross and Blue Shield companies are the primary points of contact for Service Benefit Plan members and are responsible for claims processing and customer service. OPM requires FEHB plans to be accredited to ensure that plan operations meet nationally recognized standards.
The FEHB Program provides flexibility in certain situations to assure benefits coverage. For example, Fee-for-service carriers may be expected to relax their pre-certification requirements, such as notification within two business days of an emergency admission. Similarly, Fee-for-service carriers and HMOs may need to relax requirements if members are treated at non-plan or non-PPO facilities. The program also encourages FEHB plans to provide immediate payment for work-related injuries, with subsequent reimbursement from the Office of Workers' Compensation Programs (OWCP).
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Blue Cross and Blue Shield Service Benefit Plan
Blue Cross and Blue Shield's Federal Employee Program, also known as the Service Benefit Plan, has been providing health insurance to federal employees, retirees, and their families for over 60 years. The program is the number one health insurance choice for federal employees, with 99% of members choosing to stay with the plan year after year.
The Service Benefit Plan is a fee-for-service plan with a Preferred Provider Organization. It qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. The plan is sponsored and administered by the Blue Cross and Blue Shield Association and participating Blue Cross and Blue Shield Plans.
All federal employees, Tribal employees, and annuitants who are eligible to enroll in the Federal Employees Health Benefits Program may enroll in the Service Benefit Plan. Postal Employees and Annuitants are no longer eligible for this plan unless they are under Temporary Continuation of Coverage.
The Blue Cross and Blue Shield Association (BCBSA) negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Service Benefit Plan. The 33 local Blue Cross and Blue Shield companies are the primary points of contact for Service Benefit Plan members and are responsible for processing claims and providing customer service.
The Service Benefit Plan offers a wide range of benefits to its members, including access to a Preferred provider network with more doctors, hospitals, and specialists than any other network. The plan also provides coverage for annual physicals, immunizations, screenings, and telehealth services. In addition, the plan's prescription drug coverage is considered Creditable Coverage, meaning that members do not need to enroll in Medicare Part D and pay extra for prescription drug coverage.
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Blue Cross Blue Shield Federal Employee Program
The Blue Cross and Blue Shield Federal Employee Program, also known as the Federal Employee Program (FEP), is a health insurance program for federal employees, retirees, and their families. The program has been in existence since 1960 and currently covers over 5.5 million people across the US and overseas.
FEP is committed to providing federal employees and their families with quality health care benefits and coverage. The program offers access to a Preferred provider network that includes over 2 million doctors and hospitals, as well as over 55,000 retail pharmacies. FEP also provides coverage for annual physicals, immunizations, and screenings, as well as telehealth services for minor injuries, illnesses, mental health support, and more.
The Blue Cross Blue Shield Association (BCBSA) negotiates annually with the US Office of Personnel Management (OPM) to determine the benefits and premiums for the Service Benefit Plan. The 33 local Blue Cross and Blue Shield companies are the primary points of contact for Service Benefit Plan members and are responsible for processing claims and providing customer service.
FEP is also committed to supporting federal employee organizations such as the Federal Employee Education & Assistance Fund (FEEA) and the National Active and Retired Federal Employees Association (NARFE). The program has also been conditionally approved to participate in the Postal Service Health Benefits Program, which will offer health insurance to United States Postal Service employees, retirees, and eligible family members.
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Postal Service Health Benefits Program
The Postal Service Health Benefits (PSHB) Program is a separate program within the Federal Employees Health Benefits (FEHB) Program, administered by the Office of Personnel Management (OPM). Starting on January 1, 2025, the PSHB Program will provide health insurance to eligible Postal Service employees, Postal Service annuitants, and their eligible family members. This includes Postal Service claimants and death benefit beneficiaries receiving FECA compensation benefits.
PSHB is the primary health benefits insurance available through the Postal Service for Postal Service compensators. It covers the same set of comprehensive health benefits as FEHB plans, and PSHB plans are offered by many of the same carriers. The PSHB plan year runs from January 1 through December 31 each year.
Under the PSHB Program, all Postal claimants are considered employees and are not required to enroll in Medicare Part B to maintain enrollment in PSHB, regardless of their Medicare eligibility status. However, certain Medicare-eligible Postal Service annuitants and their Medicare-eligible family members must enroll in Medicare Part B to remain enrolled in a PSHB plan.
Eligible individuals under the PSHB Program include Postal Service employees, annuitants, and their family members. A surviving spouse or survivor annuitant may also be eligible to continue PSHB enrollment after the death of a Postal Service employee or annuitant.
The Blue Cross Blue Shield Association (BCBSA) is the trade association for the independent, locally operated Blue Cross and Blue Shield member companies. BCBSA has provided health insurance to the federal employee workforce as part of the FEHB Program since its inception in 1960. Today, they cover over 5.5 million federal employees, retirees, and their families across the U.S. and overseas.
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Frequently asked questions
The Blue Cross Blue Shield Federal Employee Program (FEP) is a health insurance program that has been providing health insurance to federal employees, retirees, and their families since 1960.
All federal employees, tribal employees, and annuitants who are eligible to enroll in the Federal Employees Health Benefits Program can enroll in the Blue Cross Blue Shield Federal Employee Program.
The program covers annual physicals, immunizations, screenings, and telehealth services for minor injuries, illnesses, mental health support, dermatology care, and more. It also provides overseas coverage for those working or travelling outside the U.S.
The program covers over 5.5 million federal employees, retirees, and their families across the U.S. and overseas.
