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Frequently Asked Questions Insurance

Workers' Compensation and FEGLI

  • The Affordable Care Act requires OPM to contract with insurance companies to offer Multi-State Plan (MSP) options in every State and the District of Columbia.  OPM brings significant experience to this task, having administered the Federal Employees Health Benefits (FEHB) Program for more than 50 years.  The FEHB Program provides health insurance coverage to approximately 8 million Federal employees, annuitants, and family members.  OPM contracts with health insurance companies to offer a wide variety of FEHB coverage options throughout the country.  In the MSP Program, consumers benefit from OPM’s experience with contract negotiation and oversight of insurers.
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  • An MSP Program issuer must ensure that the provider network of each of its MSP options, as available to all enrollees, meets the following standards: • is sufficient in number and types of providers to ensure that all services will be accessible to enrollees without unreasonable delay; • is consistent with the network adequacy provisions of section 2702(c) of the Public Health Service Act; and • includes essential community providers in compliance with 45 C.F.R. § 156.235. In addition, an MSP Program issuer must make its provider directory for each MSP available to the Exchange for publication online pursuant to guidance from the Exchange and to potential enrollees in hard copy upon request. In the provider directory, an MSP Program issuer must identify providers that are not accepting new patients.
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