Thank you for visiting the Federal Employees Health Benefits (FEHB) Program's carrier application and information web pages. We created the following pages for health insurance companies interested in participating as a health carrier in our Program. There are three screens:

• This first screen provides information on the types of health insurers that the Office of Personnel Management (OPM) can approve for participation in the FEHB program.
• The second screen will ask you to enter specific identifying data such as your name and professional title, your health insurance company and its address. Completing this screen does not constitute submission of your application. We use this information to follow-up with you concerning your interest and your progress in completing the application.
• The third screen will automatically appear once you complete the data we requested on the second screen. On this screen you will find links to the downloadable application files. To apply for participation in the FEHB Program, you must complete all files. OPM must receive your application by January 31.

What types of health insurers qualify for participation in the FEHB Program?

We will consider applications only from comprehensive, prepaid medical plans. The FEHB Program contracts only with health benefits carriers that offer a complete line of medical services, such as doctor's office visits, hospitalization, emergency care, prescription drug coverage, and treatment of mental conditions and substance abuse. We do not have the authority to contract with companies that offer limited services, such as dental and/or vision plans, prescription drug plans, supplemental insurance and disability insurance. We can not consider applications from fee-for-service carriers.

We especially invite qualified applicants from the states that the Department of Health and Human Services (HHS) has determined to be medically underserved -- Alabama, Arizona, Idaho, Illinois, Louisiana, Mississippi, Missouri, Montana, New Mexico, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming.

We also encourage applicants that HHS, Centers for Medicare and Medicaid Services (CMS), determines to be Federally qualified or that are an approved Competitive Medical Plan (CMP)

We invite you to apply if you believe you qualify to participate in the FEHB Program. Please go to the next screen. If you have a question, please call our HMO contracts office at 202-606-0755 or 202-606-0737 and ask to speak with a contract specialist.

2023 Carrier Letters

Letter	Date	Subject
2023-01	01/18/2023	Prevention and Treatment of Obesity
2023-02	01/25/2023	FEHB and Medicare Part D Prescription Drug Coordination

2022 |2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999

2022 Carrier Letters

Letter	Date	Subject
2022-01	01/10/2022	COVID-19 Over-the-Counter Tests, Vaccines, and Therapeutics
2022-02	01/31/2022	Consolidated Pharmacy Benefits Guidance for the FEHB Program
2022-03	02/17/2022	Federal Employees Health Benefits Program Call Letter
2022-04	03/16/2022	Technical Guidance and Instructions for 2023 Benefit Proposals
		Attachment A: Brochure Creation Tool 508 Guidance
		Attachment B: Instructions for the 2022 and 2023 FEHB Formulary Information Completion and Submission
		Attachment C: 2022 FEHB Drug Formulary Template
		Attachment D: 2023 FEHB Drug Formulary Template
		Attachment E: FEHB Benefit Difference Comparison Chart
2022-05	03/15/2022	Contraceptive Coverage in the FEHB Program
2022-06	03/31/2022	Reconciliation Instructions for 2022 Rates – Community Rated Carriers
		Attachment A: Reconciliation Tables Attachments – III and IIIA
2022-07	03/31/2022	Colonoscopies
2022-08	03/31/2022	COVID-19 Over-the-Counter Tests
2022-09	05/02/2022	2023 Rate Instructions - Community-Rated Carriers
		Attachment A: Part 1 – 2023 Community Rated Guidelines
		Attachment B: Part 2 – 2023 Proposal Instructions
		Attachment C: Proposal Table Attachments – I, II, IIA
2022-10	05/16/2022	2023 Rate Proposal File – Experienced-Rated Carriers
		Attachment A: 2023 Experienced Rated Rate Proposal
2022-11	05/24/2022	Coverage of Monoclonal Antibodies Directed Against Amyloid in the FEHB Program
2022-12	07/13/2022	No Surprises Act, Reporting on Pharmacy Benefits and Drug Costs, and Other Provisions of the Consolidated Appropriations Act, 2021
2022-13	07/21/2022	Federal Employees Health Benefits Plan Performance Assessment 2024 Clinical Quality, Customer Service, and Resource Use (QCR) Measure Set
		Attachment 1: 2024 Clinical Quality, Customer Service, and Resource Use (QCR) Measure Set
2022-14	08/11/2022	Claims Data Requirements for All Community-Rated HMOs – Except State-Mandated Traditional Community-Rated HMOs
		Attachment A: 2021 MLR - 2023 ACR Mandatory Claim Layouts
2022-15	08/08/2022	Removing Ineligible Children from Federal Employees Health Benefits (FEHB) Program Coverage
2022-16a	08/15/2022	Changes to the Standard Contract for Contract Year 2023 - CR-HMO
2022-16b	8/15/2022	Changes to the Standard Contract for Contract Year 2023 - ER-HMO
2022-16c	8/15/2022	Changes to the Standard Contract for Contract Year 2023 - FFS
2022-17	08/19/2022	Contraception
2022-18	8/19/2022	Post-Acute Sequelae of COVID (PASC)
2022-19	12/5/2022	Plan Performance Assessment 2023 Procedural Manual
		Attachment 1: 2023 FEHB Plan Performance Assessment Procedure Manual
		Attachment 2: 2023 Planned HEDIS and CAHPS Reporting User Guide
		Attachment 3: 2022 CAHPS Code List
		Attachment 4: 2023 CAHPS Sample Crosswalk
		Attachment 5: 2023 Quality Improvement Corrective Action Plan Template
		Attachment 6: 2023 Corrective Action Plan Follow-up Report
2022-20	12/8/2022	Clarifying the Applicability of the PBM Transparency Standards
2022-21	12/8/2022	COVID-19 Countermeasures

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2021 Carrier Letters

Letter	Date	Subject
2021-02	02/09/2021	Consolidated Pharmacy Benefits Guidance for the FEHB Program
2021-03	02/17/2021	Federal Employees Health Benefits Program Call Letter
2021-04	03/10/2021	Reconciliation Instructions for 2021 Rates – Community-Rated Carriers
		Attachment A: Part 1 – 2022 Community Rated Guidelines
		Attachment B: Part 2 – 2022 Proposal Instructions
		Attachment C: Proposal Table Attachments – I, II, IIA
2021-05	04/07/2021	Technical Guidance and Instructions for 2022 Benefit Proposals
		Attachment A: Instructions for 2021 and 2022 FEHB Formulary Information Completion and Submission
		Attachment B: 2021 FEHB Drug Formulary Template
		Attachment C: 2022 FEHB Drug Formulary Template
		Attachment D: FEHB Benefit Difference Comparison Chart
2021-06	04/15/2021	Family Member Eligibility Verification for Federal Employees Health Benefits (FEHB) Program Coveragee
		Attachment 1 – Benefits Administration Letter 21-202: Family Member Eligibility Verification for Federal Employees Health Benefits (FEHB) Program Coverage
		Attachment 2 – FEHB Family Member Eligibility Documents
		Attachment 3 – Information Provided Does Not Verify Family Member Eligibility
		Attachment 4 – Receipt of Eligibility Verification Documents
2021-07	04/27/2021	2022 Rate Instructions -- Community-Rated Carriers
		Attachment A: Part 1 – 2022 Community Rated Guidelines
		Attachment B: Part 2 – 2022 Proposal Instructions
		Attachment C: Proposal Table Attachments – I, II, IIA
2021-09	05/04/2021	Update on Aggregate Healthcare Cost and Utilization Data Reporting Requirements
		Attachment 1 – Pharmacy Cost and Utilization Template and Instructions
2021-10	05/19/2021	Enrollment Reporting Data Requirements (Revised)
2021-11	05/24/2021	Announcement of the 2023 Clinical Quality, Customer Service, and Resource Use (QCR) Measure Set
		Attachment A: QCR Measure Set
2021-12	06/04/2021	Enrollment Transactions and Enrollment Reconciliations for Annuitants
2021-13	07/07/2021	New FEHB Carriers’ FEHB Websites and Mobile Applications Accessibility Requirements
2021-14a	08/13/2021	Changes to the Standard Contract for Contract Year 2022 – CR HMO
2021-14b	08/13/2021	Changes to the Standard Contract for Contract Year 2022 – ER HMO
2021-14c	08/13/2021	Changes to the Standard Contract for Contract Year 2022 – FFS
2021-15	09/13/2021	CL 2021-15 Federal Employees Health Benefits (FEHB) Program - Changes to SF 2809 834 File Format
		Attachment A: FEHB Data-Hub SF 2809
2021-16	09/16/2021	Strengthening Parity in Mental Health and Substance Use Disorder Benefits
2021-17	11/22/2021	Claims Data Requirements for All Community-Rated HMOs - except Traditional Community-Rated HMOs
		Attachment A: 2020 MLR-2022 ACR Mandatory Claim Layouts
2021-18	11/22/2021	Federal Employees Health Benefits Plan Performance Assessment Postponement of All Lines of Business Benchmark Implementation
2021-19	12/14/2021	2022 Plan Performance Assessment Procedural Manual
		Attachment 1: 2022 FEHB Plan Performance Assessment Procedure Manual
		Attachment 2: 2022 Planned HEDIS and CAHPS Reporting
		Attachment 3: 2022 CAHPS Code List
		Attachment 4: 2022 CAHPS Sample Crosswalk
		Attachment 5: 2022 Corrective Action Plan Template
		Attachment 6: 2022 Corrective Action Plan Follow Up Report

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2020 Carrier Letters

Letter	Date	Subject
2020-01	02/10/2020	Federal Employees Health Benefits Program Call Letter
2020-02	03/11/2020	Information for Carriers on Coronavirus
2020-03	03/24/2020	Technical Guidance and Instructions for 2021 Benefit Proposals
		2020 FEHB Drug Formulary Template
		2021 FEHB Drug Formulary Template
		Attachment VI: FEHB Benefit Difference Comparison Chart
2020-04	03/25/2020	Reconciliation Instructions for 2020 Rates - Community-Rated Carriers
		Attachment III & IIIA - Reconciliation Form
2020-05	03/25/2020	Insurance Benefits Processing During Disruption of Normal Agency Operations
		Attachment – BAL 20-201 Insurance Benefits Processing During Disruption of Normal Agency Operations
2020-06	03/31/2020	Mid-Year Formulary Changes
2020-08	04/23/2020	Coverage of Diagnostic Testing, Preventive Services, and Telehealth for COVID-19
2020-09	04/28/2020	2021 Rate Instructions – Community-Rated Carriers
		Attachment A: Part 1 – 2021 Community Rated Guidelines
		Attachment B: Part 2 – 2021 Proposal Instructions
		Attachment C: Proposal Tables Attachments I, II, and IIA
2020-10	05/05/2020	Announcement of the 2022 Clinical Quality, Customer Service, and Resource Use (QCR) Measure Set
		Attachment 1: 2022 Clinical Quality, Customer Service and Resource Use Measure Set
2020-11	05/05/2020	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2020
		Attachment A: Financial Reporting and Audit Guide
		Attachment B: Schedule of Selected Balances
2020-12	06/25/2020	Enrollment Data Reporting Requirements
2020-13	06/18/2020	Claims Data Requirements for All Community-Rated HMOs – except Traditional Community-Rated HMOs
		OPM-OIG Claim Layout Instructions and Formatting Requirements – except Traditional Community-Rated HMOs
2020-14	10/06/2020	COVID-19 2020 Scoring
2020-15	10/27/2020	Federal Employees Health Benefits (FEHB) Plan Performance Assessment Methodology
2020-16	11/05/2020	Removal of Ineligible Family Members from Enrollments
		Attachment 1 – Sample Employing Office /Tribal Employer Letter – Request for Verification of Family Member Eligibility
		Attachment 2 – Sample Employing Office/Tribal Employer/Carrier Letter – Receipt of Eligibility Verification Documents
		Attachment 3 – Sample Employing Office/Tribal Employer/Carrier Letter – Verification Documents Not Received
		Attachment 4 – Sample Employing Office/Tribal Employer Letter – Information Provided Does Not Verify Family Member Eligibility
		Attachment 5 – FEHB Family Member Eligibility Documents
		BAL 20-203 – Federal Employees Health Benefits Program: Removal of Ineligible Family Members from Enrollments
2020-17	11/19/2020	Aggregate Healthcare Cost and Utilization Data Reporting Requirements
		Attachment A: Pharmacy Cost and Utilization Instructions
		Attachment B: Pharmacy Cost and Utilization Template
2020-18	11/23/2020	Update on Mid-Year Formulary Changes
		Attachment A: Mid-Year Formulary Change OPM Notification Instructions
		Attachment B: Mid-Year Formulary Change OPM Notification
2020-19	12/21/2020	COVID-19 Vaccines and Diagnostic Tests
2020-20	12/22/2020	2021 Plan Performance Assessment Procedure Manual
		Attachment 1: 2021 Plan Performance Assessment Procedure Manual
		Attachment 2: 2021 HEDIS and CAHPS Planned Reporting Document
		Attachment 3: 2021 CAHPS Code List

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2019 Carrier Letters

Letter	Date	Subject
2019-01	03/14/2019	Federal Employees Health Benefits Program Call Letter
2019-02	04/04/2019	Reconciliation Instructions for 2019 Rates - Community-Rated Carriers
		Attachment III - Reconciliation Tables
2019-03	04/25/2019	Announcement of the 2021 Clinical Quality, Customer Service, and Resource Use Measure Set and Measures under Consideration for Addition to the 2020 Farm Team
		Attachment 1: 2021 Clinical Quality, Customer Service and Resource Use Measure Set
2019-04	05/09/2019	Data-Hub Enhancements to Increase Timeliness of Transactions
2019-05(a)	04/30/2019	2020 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
2019-05(b)	04/30/2019	2020 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
2019-05(c)	04/30/2019	2020 Technical Guidance and Instructions for Preparing Benefit Proposals for Fee-ForService Carrier
		Attachment II (a): FEHB Benefit Difference Comparison Chart
2019-06	05/07/2019	2020 Rate Instructions – Community-Rated Carriers
		Attachment A: Part 1 – 2020 Community Rated Guidelines
		Attachment B: Part 2 – 2020 Proposal Instructions
		Attachment C: Proposal Tables Attachments I, II, and IIA
2019-07	07/15/2019	Claims Data Requirements for All Community-Rated HMOs - except Traditional Community-Rated HMOs
		Attachment A: OPM/OIG Claim Layout Instructions and Formatting Requirements
2019-09	09/06/2019	Consumer Assessments of Healthcare Providers and Systems (CAHPS) Surveys Oversampling
2019-10	09/06/2019	Consolidated Pharmacy Benefits Guidance for the FEHB Program
2019-11	09/11/2019	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2019
		Attachment A: Financial Reporting and Audit Guide
		Attachment B: Schedule of Selected Balances
2019-12	11/26/2019	2020 Plan Performance Assessment Procedure Manual
		Attachment I: 2020 Plan Performance Assessment Procedure Manual
		Attachment II: 2019 CAHPS Carrier Subcode List

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2018 Carrier Letters

Letter	Date	Subject
2018-01	01/23/2018	Federal Employees Health Benefits Program Call Letter
2018-02	02/12/2018	Technical Correction to Reporting Products and QCR Scoring
2018-03	03/07/2018	FEHB Program Carrier Letter: 2017 Annual Accounting Statement Financial Reporting
		Attachment A - AAS Spreadsheet
		Attachment B - Instructions for Automated AAS - for CY 2017 Final
		Attachment C - AAS Certification 2017
2018-04	03/27/2018	Reconciliation Instructions for 2018 Rates - Community-Rated Carriers
		Attachment III - Reconciliation Form
2018-05	04/20/2018	2019 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		2019 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		2019 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment A - 2018 FEHB Drug Formulary Template v1.8
		Attachment B - FEHB Benefit Difference Comparison Chart - In-Network Benefits
2018-06	05/07/2018	2019 Rate Instructions - Community-Rated Carriers
		Part 1 - 2019 Community Rating Guidelines
		Part 2 - 2019 Proposal Instructions
		Attachment I - 2019 Rate Proposal - Small Carriers
2018-07	06/14/2018	2020 Clinical Quality, Customer Service, and Resource Use Measures
		Attachment 1: 2020 Clinical Quality, Customer Service and Resource Use Measure Set
2018-08	06/28/2018	Updated Guidance on OPM’s Letter of Credit System
		Attachment A: User Manual for Experience Rated Carriers
		Attachment B: Letter of Credit System Guidelines
2018-09A	7/25/2018	Changes to the Standard Contract for Contract Year 2019
		Attachment A: Proposed Changes to Standard 2019 Community-Rated Health Benefits Contract
2018-09B	7/25/2018	Changes to the Standard Contract for Contract Year 2019
		Attachment A: Proposed Changes to Standard 2019 Experience-Rated Health Benefits Contract
2018-09C	7/25/2018	Changes to the Standard Contract for Contract Year 2019
		Attachment A: Proposed Changes to Standard 2019 Fee For Service Health Benefits Contract
2018-10	7/30/2018	Update on Coverage for FDA Approved Drugs, Devices and Biological Products
2018-11	8/3/2018	Federal Employees Health Benefits Program: Removal of Eligible Individuals from Existing Enrollments
2018-12	8/13/2018	Claims Data Requirements for All Community-Rated HMOs - except Traditional Community-Rated HMOs
2018-13	08/22/2018	Accreditation Requirements for FEHB Carriers
2018-14	9/26/2018	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2018
		Attachment A: Financial Reporting and Audit Guide
		Attachment B: Schedule of Selected Balances
2018-15	10/27/2018	2019 Plan Performance Assessment Procedure Manual
		Attachment I: 2019 Plan Performance Assessment Procedure Manual
		Attachment II: 2019 CAHPS Carrier Subcode List

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2017 Carrier Letters

Letter	Date	Subject
2017-15	12/14/2017	Federal Employees Health Benefits (FEHB) Plan Performance Assessment – Consolidated Methodology
2017-14	12/08/2017	Reports to OPM of Information Security Incident and Data Breach
2017-13	11/20/2017	OPM Federal Employees Health Benefits(FEHB) Fraud, Waste and Abuse
		Attachment 1: FEHB Fraud and Abuse Definitions
		Attachment 2: Mandatory Information Sharing via Written Case Notifications and Referrals to OPM-OIG
		Attachment 3: Case Notifications/Status Update Format
		Attachment 4: OPM OIG Exposure Request Form
		Attachment 5: Fraud and Abuse Annual Report
		Attachment 6: Federal Employees Health Benefits Program Statement about Fraud, Waste and Abuse (FWA) Annual Report Certification
2017-12	11/17/2017	2018 Plan Performance Assessment Procedure Manual and Corrective Action Plans for 2017
		Attachment I: 2018 Plan Performance Assessment Procedure Manual
		Attachment II: 2018 CAHPS Carrier Subcode List
		Attachment III: Quality Improvement Corrective Action Plan Template for 2017
2017-11	11/16/2017	2019 Clinical Quality, Customer Service, and Resource Use Measures
		Attachment I: 2019 QCR Measure Set
2017-10	10/27/2017	Plan Performance Assessment Best Practices Workgroup
2017-09a	09/05/2017	Change to the Standard Contract
		Attachment A: Proposed Changes to Standard 2018 Community Rated Health Benefits Contract
2017-09b	09/05/2017	Change to the Standard Contract
		Attachment A: Proposed Changes to Standard 2018 Experience Rated Health Benefits Contract
2017-09c	09/05/2017	Change to the Standard Contract
		Attachment A: Proposed Changes to Standard 2018 Fee-For-Service Health Benefits Contract
2017-08	08/02/2017	Summary of Benefits and Coverage (SBC) and Uniform Glossary
		Attachment 1 - SBC Template for FEHB Plans
		Attachment 2 - Uniform Glossary
		Attachment 3 - Instructions for Completing the SBC – Group Health Plan Coverage
		Attachment 4 - Frequently Asked Questions about SBCs
2017-07	07/17/2017	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2017
		Attachment 1 - Financial Reporting And Audit Guide Federal Fiscal Year 2017
		Attachment 2 - Schedule of Selected Balances
2017-06	07/10/2017	Claims Data Requirements for All Community-Rated HMOs - except Traditional Community-Rated HMOs
2017-05	05/12/2017	2018 Rate Instructions - Cover Letter
		Part 1 – 2018 Community Rating Guidelines
		Part 2 – 2018 Proposal Instructions
		Attachments – Proposal Tables Attachments I, II, and IIA
2017-04	04/18/2017	2017-04(a)   2018 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Attachment 2017-04(a2-a)   FEHB Benefit Difference Comparison Chart In-Network Benefits Spreadsheet
		2017-04(b)   2018 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		2017-04(c)   2018 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment 2017-04(a7)   2018 FEHB Drug Formulary Template
2017-03	04/12/2017	Reconciliation Instructions for 2017 Rates -- Community-Rated Carriers
		Attachment 1: Reconciliation Tables
2017-02	03/16/2017	Plan Performance Assessment Community Rated Adjustment
2017-01	01/11/2017	Federal Employees Health Benefits Program Call Letter

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2016 Carrier Letters

Letter	Date	Subject
2016-15	12/06/2016	Federal Employees Health Benefits (FEHB) Program and Federal Employees Dental and Vision Insurance Program (FEDVIP) Coverage Exception for Children of Same-Sex Domestic Partners
2016-14	11/21/2016	2017 Plan Performance Assessment Carrier Manual and Corrective Action Plan Template for 2016
		Attachment 1 – Attachment 1: Attachment 1: 2017 Plan Performance Assessment Carrier Manual
		Attachment 2 – Attachment 2: Quality Improvement Corrective Action Plan Template for 2016
		Attachment 3 – Attachment 3: 2017 CAHPS Carrier Subcode List
2016-13	10/26/2016	State Tax Preemption
2016-12(c)	08/24/2016	Change(s) to the Standard Contract – All Fee-For-Service Carriers
		Attachment A: Proposed Changes to Standard 2017 Fee-For-Service Health Benefits Contract
2016-12(b)	08/24/2016	Change(s) to the Standard Contract – All Experience Rated Health Maintenance Organizations
		Attachment A: Proposed Changes to Standard 2017 Experience-Rated HMO Health Benefits Contract
2016-12(a)	08/24/2016	Change(s) to the Standard Contract – All Community Rated Health Maintenance Organization Carriers
		Attachment A: Proposed Changes to Standard 2017 Community-Rated HMO Health Benefits Contract
2016-11	08/01/2016	Plan Performance Assessment Improvement Increment
		Attachment 1: Example of Improvement Scoring Final
		Attachment 2: FAQs for the Improvement Increment Methodology
2016-10	05/18/2016	Claims Data Requirements for Non-State Mandated Community-Rated Carriers
2016-09	05/17/2016	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2016
		Attachment 1 – FEHB 2016 Audit Guide
		Attachment 2 – SCHEDULE OF SELECTED BALANCES 2016
2016-08	05/05/2016	2017 Rate Instructions — Community-Rated Carriers
		Part 1 – 2017 Community Rating Guidlines
		Part 2 – 2017 Proposal Instructions
2016-07	04/20/2016	2017 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		2017 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment 1: Drug Formulary Worksheet for Non-Discrimination Analysis
2016-06	04/05/2016	Reconciliation Instructions for 2016 Rates -- Community-Rated Carriers
2016-05	03/30/2016	Instructions for Following the 180-day Timeline with Audit Resolution, Preparing Supporting Documentation for Audit Resolution Review and Completing Work Plans
		Attachment 1: Experience-Rated Final Audit Timeline
		Attachment 2: HMO Audits Final Audit Timeline
		Attachment 3: Information System Timeline – Final Audit Report
		Attachment 4: Contested Claims Checklist
		Attachment 5: Claim Cover Sheet
2016-04	03/04/2016	Updated FEHB Guidance on Population Health and Wellness
2016-03	02/26/2016	Federal Employees Health Benefits Program Call Letter
2016-02	02/16/2016	2018 Clinical Quality, Customer Service, and Resource Use Measures for the Federal Employees Health Benefits (FEHB) Plan Performance Assessment
2016-01	01/12/2016	Federal Employees Health Benefits (FEHB) Program: Enrollment Options Following the Termination of a Plan or Plan Option Final Rule Published

2015 Carrier Letters

Letter	Date	Subject
2015-19	11/06/2015
		Federal Employees Health Benefits (FEHB) Plan Performance Assessment – Measure Collection (Includes HEDIS and CAHPS)
		Attachment 1A: HEDIS 2015 Measures Contributing to Exemplary and Most Improved Statuses
		Attachment 2A: Carrier Subcode List
		Attachment 2B: 2016 CAHPS Survey Participation Form
		Attachment 2C: SAMPLE CROSSWALK
2015-18	10/05/2015	FEHB Program coverage for Children of Same-Sex Domestic Partners After Obergefell v. Hodges
2015-17	09/18/2015
		Changes to the Standard Contract
		Attachment A
		Attachment B
		Attachment B(2)
		Attachment C
		Attachment C(2)
2015-16	09/17/2015	Federal Employees Health Benefits (FEHB) Program: Self Plus One Final Rule Released
2015-15	08/16/2015	2017 Clinical Quality, Customer Service, and Resource Use Measures for the Federal Employees Health Benefits (FEHB) Plan Performance Assessment
2015-14	07/28/2015	Updated FEHB Guidance on Preventive Care
2015-13	07/09/2015	Reporting under IRC section 6055 for Federal Employees Health Benefits (FEHB) Program Carriers
2015-12	06/23/2015	Covered Benefits for Gender Transition Services
2015-11	05/12/2015	Claims Data Requirements for Non-Traditional Community-Rated Carriers
2015-10	05/12/2015	Federal Employees Health Benefits (FEHB) Plan Performance Assessment – Methodology
2015-09	5/8/2015	2016 RATE INSTRUCTIONS -- Community-Rated Carriers
		Changes for 2016
		2016 PROPOSAL INSTRUCTIONS
2015-08	4/29/2015	Federal Employees Health Benefits (FEHB) Program: Self Plus One Enrollment Communication Strategy
		Attachment 1: FAQs
		Attachment 2: Self Plus One Enrollment Type FastFacts
2015-07	4/24/2015	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2015
		Attachment 1: 2015 Audit Guide
		Attachment 2: Schedule of Selected Balances
2015-06	4/24/2015	Reporting 2015 CAHPS Results
		Attachment 1: 2015 CAHPS FEHB Sub-Code List
		Attachment 2: SAMPLE CROSSWALK
2015-05	3/27/2015	Reconciliation Instructions for 2015 Rates -- Community-Rated Carriers
2015-04	03/23/2015	Notification of Data Breach
2015-03	3/17/2015	2015-03a 2016 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		2015-03b 2016 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		2015-03c 2016 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment 1: Specialty Benchmark File
		2016 Part One ADC Questions
2015-02	3/13/2015	Federal Employees Health Benefits Program Call Letter
2015-01	3/2/2015	Calendar Year 2014 Annual Accounting Statement Financial Reporting
		Attachment 1: Carrier Worksheet
		Attachment 2: Instructions for the FEHBP Automated Accounting Spreadsheet
		Attachment 3: CERTIFICATION OF ANNUAL ACCOUNTING STATEMENT

2014 Carrier Letters

Letter	Date	Subject
2014-30	12/30/2014	Federal Employees Health Benefits (FEHB) Program: Self Plus One Enrollment
		Attachment 1: SELF PLUS ONE UPDATE STATUS REPORT
2014-29	12/19/2014	Office of Personnel Management (OPM) Federal Employees Health Benefits (FEHB) Fraud, Waste and Abuse
		Attachment 1: Definitions
		Attachment 2: Mandatory Information Sharing via Written Case Notifications and Referrals to OPM-OIG
		Attachment 3: CASE NOTIFICATION / STATUS UPDATE FORMAT
		Attachment 4: OPM / OIG EXPOSURE REQUEST FORM
		Attachment 5: FWA Report
		Attachment 6: Federal Employees Health Benefits Program Statement about Fraud, Waste and Abuse (FWA) Annual Report Certification
2014-28	12/03/2014	Additional Information on the Performance Areas for the Federal Employees Health Benefits (FEHB) Plan Performance Assessment
		Attachment 1: Revised Performance Assessment Measure Set
		Attachment 2: Contract Oversight Performance Area
2014-26	11/07/2014	Federal Employees Health Benefits (FEHB) Program Carrier Guidance on Ebola Virus
2014-25	10/21/2014	CLER 2.0
2014-24	10/15/2014	Measuring Healthcare Quality in the Federal Employees Health Benefits (FEHB) Program
2014-23	10/02/2014	Coverage of Children of Same-Sex Domestic Partners under the FEHB Program
		Attachment 1: States that authorize same-sex marriage
2014-22	09/10/2014	Health Benefit Exchange Authority Financial Sustainability Temporary Amendment Act of 2014
2014-21	08/18/14	Change to the Standard Contract (Community-Rated HMO)
		Attachment 1: Proposed Changes to Standard 2014 Community-Rated HMO Health Benefits Contract
		Attachment 2: Change to the Standard Contract (Experience-Rated HMO)
		Attachment 2A: Proposed Changes to Standard 2014 Experience-Rated HMO Health Benefits Contract
		Attachment 3: Change to the Standard Contract (Fee-For-Service)
		Attachment 3A: Proposed Changes to Standard 2014 Fee-For-Service Health Benefits Contract
2014-20	08/25/2014	2015 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS 5.0H Adult Questionnaire (Commercial)
		Attachment 2: 2015 CAHPS Survey Participation Form
		Attachment 3: 2014 CAHPS FEHB Sub-Code List
		Attachment 4: CAHPS Sample Crosswalk
		Attachment 5: Healthcare Organization Questionnaire (HOQ) Screenshot
2014-19	08/07/2014	Initial Guidance on FEHB Plan Performance Assessment
2014-18	07/29/2014	Claims Data Requirements for Non-Traditional Community-Rated Carriers
2014-17	06/13/2014	Gender Identity Disorder/Gender Dysphoria
2014-16	05/07/2014	2015 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment 1: 2015 Community Rating Guidelines
		Attachment 2: 2015 Proposal Instructions
2014-15	05/07/2014	Affordable Care Act (ACA) Medical Loss Ratio (MLR) in the Federal Employees Health Benefits (FEHB)
2014-14	05/02/2014	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2014
		Attachment 1: FEHB 2014 Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances (Unaudited)
2014-13	04/22/2014	Update on Coverage for FDA Approved Drugs, Devices and Biological Products
2014-12	04/15/2014	2015 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		2015 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		2015 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		2015 Automated Data Collection Questions Technical
		Technical Guidance Specialty Benchmark File
2014-11	04/14/2014	Federal Employees Health Benefits (FEHB) Program Family Member Audit
2014-10	04/14/2014	Updated FEHB Accreditation Requirements
2014-09	04/07/2014	Reconciliation Instructions for 2014 Rates -- Community-Rated Carriers
2014-08	04/03/2014	Reporting 2014 CAHPS Results
		Attachment 1: Sub Code List
		Attachment 2: Sample Crosswalk
2014-07	03/26/2014	Information Concerning the Final Rule for the Federal Employees Health Benefits Program Regarding Members of Congress and Congressional Staff
2014-06	03/25/2014	Benefits Plus Testing Group
2014-05	03/24/2014	Federal Employees Health Benefits (FEHB) Program: Self Plus One Enrollment
2014-04	03/20/2014	Supplemental Guidance: Management of Obesity in Adults
2014-03	03/20/2014	Federal Employees Health Benefits Program Call Letter
2014-02	02/06/2014	Calendar Year 2013 Annual Accounting Statement Financial Reporting
		Carrier Worksheet
		Instructions for the FEHBP Automated Accounting Spreadsheet
		Certification of Annual Accounting Statement
2014-01	1/22/2014	Audit Requirements for 2012 MLR Pilot Program Carriers

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2013 Carrier Letters

Letter	Date	Subject
2013-25	12/31/13	2014 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS® 5.0H Adult Questionnaire (Commercial)
		Attachment 2: 2014 CAHPS Survey Participation Form
		Attachment 3: FEHB Subcode List
		Attachment 4: CAHPS Sample Crosswalk
2013-24	12/03/2013	Mental Health and Substance Abuse Parity
2013-23	11/15/13	Continuation of FEHB Coverage and Premium Payment Procedures During the Government Shutdown
		Attachment 1: Procedures for Requesting Additional Funds
2013-22	10/09/13	Measuring Quality Healthcare in the Federal Employees Health Benefits Program (FEHBP)
		Attachment 1: HEDIS Measures Required for 2014
		Attachment 2a: Reporting HEDIS Metrics to the National Committee Quality for Assurance (NCQA)
		Attachment 2b: HEDIS FEHB Plan Name and Carrier-Code List
		Attachment 3: Quality Improvement Corrective Action Plan (CAP)
		Attachment 4: Quality in FEHB Healthcare Updates
2013-21	8/23/2013	Immunizations Provided by Government Health Clinics
2013-20	7/03/2013	Coverage of Same-Sex Spouses
2013-19	6/26/2013	Deadlines for Open Season 2013 Deliverables
2013-18	06/26/2013
		The Blue Button® Initiative – Updating Guidance
		Attachment: Data Elements Available For Members to Download
2013-17	06/25/2013
		Change to the Standard Contract (Community-Rated HMO)
		Attachment 1: Proposed Changes to Standard 2013 Community-Rated HMO Health Benefits Contract
		Attachment 2: Change to the Standard Contract (Experience-Rated HMO)
		Attachment 2A: Proposed Changes to Standard 2013 Experience-Rated HMO Health Benefits Contract
		Attachment 3: Change to the Standard Contract (Fee-For-Service)
		Attachment 3A: Proposed Changes to Standard 2013 Fee-For-Service Health Benefits Contract
2013-16	6/07/2013	Patient-Centered Outcomes Research Institute (PCORI) and HRA Fee
2013-15	5/23/2013	Transitional Reinsurance Program Fee under the Affordable Care Act
2013-14	5/13/2013	Health Insurance Providers Fee under the Affordable Care Act (ACA)
2013-13	5/10/2013	Applications for Premium Remittance Shortfalls
		Attachment 1: FEHB Carriers premium remittance shortfall worksheet
2013-12	4/30/2013	Audit Requirements for Adjusted Community-Rating Plans
2013-11	4/29/2013
		Rate Instructions - Community-Rated Carriers
		Attachment 1: Part 1 - 2014 Community Rating Guidelines
		Attachment 2: Part 2 - 2014 Proposal Instructions
2013-10	4/29/2013	Management of Obesity in Adults
2013-09	4/22/2013
		2014 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		2014 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		2014 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2013-08	4/10/2013	Affordable Care Act (ACA) Medical Loss Ratio (MLR) in the Federal Employees Health Benefits (FEHB) Program
2013-07	4/05/2013
		Reporting CAHPS Results
		Attachment 1: FEHB Subcode List
		Attachment 2: CAHPS Sample Crosswalk
2013-06	3/29/2013	Reconciliation Instructions for 2013 Rates — Community-Rated Carriers
2013-05	03/29/2013
		Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2013
		2013 Financial Reporting and Audit Guide
		Schedule of Selected Balances
2013-04	03/21/2013	Federal Employees Health Benefits Program Call Letter
2013-03	03/11/2013	Patient-Centered Outcomes Research Institute Fee
2013-02	2/12/2013
		Calendar Year 2012 Annual Accounting Statement Financial Reporting
		Attachment 1: Carrier Worksheet
		Attachment 2: Instructions for the FEHBP Automated Accounting Spreadsheet
		Attachment 3: Certification of Annual Accounting Statement
2013-01	1/24/2013	Patient Centered Medical Homes (PCMH) within the Federal Employees Health Benefits (FEHB) Program

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2012 Carrier Letters

Letter	Date	Subject
2012-25	12/27/2012	Office of Personnel Management (OPM) Quality Evaluation of Federal Employees Health Benefits (FEHB) Carriers
		Attachment 1: HEDIS Measures Required for 2013
		Attachment 2: HEDIS FEHB Plan Name and Carrier-Code List 2013
2012-24	12/14/2012	2013 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1 - CAHPS® 5.0H Adult Questionnaire (Commercial)
		Attachment 2 - 2013 CAHPS Survey Participation Form
		Attachment 3 - FEHB Subcode List
		Attachment 4 - 2013 CAHPS Sample Crosswalk
2012-23	9/4/2012	Offshore Contracting
2012-22	8/10/2012	Summary of Benefits and Coverage (SBC) and Uniform Glossary
		Attachment 1: ACA FEHB SBC Template
		Attachment 2: Uniform Glossary of Health Coverage and Medical Terms
		Attachment 3: What This Plan Covers and What it Costs Instruction Guide for Group Coverage
		Attachment 4: FAQs
2012-21	8/08/2012	Change to the Standard Contract
		Attachment 1: Proposed Changes to Standard 2013 Community-Rated HMO Health Benefits Contract
		Attachment 2: Change to the Standard Contract
		Attachment 2A: Proposed Changes to Standard 2013 Experience-Rated HMO Health Benefits Contract
		Attachment 3: Change to the Standard Contract
		Attachment 3A: Proposed Changes to Standard 2013 Fee-For-Service Health Benefits Contract
2012-20	7/12/2012	Change in Federal Employees Health Benefits Program Experience- rated Carrier Reporting
2012-19	7/12/2012	2013 Rate Instruction Update – Community-Rated Carriers
		Attachment 1: 2013 Community Rated Guidelines
2012-18	6/18/2012	FEHBA Preemption of State Law re: Subrogation and Reimbursement
2012-17	6/6/2012	Reducing Readmissions, Preventable Complications and Prematurity Background
		Attachment 1: Events/Year Health Care Associated Conditions except when properly documented as "Present on Admission"
		Attachment 2: Readmission & Prematurity Data
		Attachment 3: Readmission & Prematurity Data (Pregnancy)
2012-16	6/5/2012	Implementation of the Electronic CLER 2809, SF 2810 and CLER 2810
		Attachment 1: FEHB CLER 2809 Companion Guide
		Attachment 2: CLER 2810 Companion Guide
		Attachment 3: SF 2810 Companion Guide
2012-15	5/25/2012	Audit Requirements for Adjusted Community-Rating Plans
2012-14	5/09/2012	Update on Tribal Employer Participation in the Federal Employees Health Benefits Program
		Attachment 1: Carrier Questions
		Attachment 2: Sample POI
		Attachment 3: When FEHB Coverage Ends for Tribal Employee(s)
2012-13	4/19/2012	2013 Rate Instructions - Community-Rated Carriers
		Attachment 1: 2013 Community Rating Guidelines
		Attachment 2: 2013 Proposal Instructions
2012-12	4/19/2012	2013 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Attachment 1: 2013 Technical Guidance and Instructions for Preparing Benefit and Service Area Proposals for New HMOs
		Attachment 2: 2013 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service
2012-11	4/09/2012	Reporting 2012 CAHPS Results
		Attachment 1: Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2012-10	4/05/2012	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2012
		Attachment 1: Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2012-09	3/29/2012	Federal Employees Health Benefits Program Call Letter
2012-08	3/26/2012	Rate Reconciliation Instructions for Community Rated HMOs
2012-07	3/23/2012	Enrollment Transactions and Enrollment Reconciliation for Annuitants
2012-06	3/20/2012	Tennessee High Risk Assessment Tax (AccessTN Program)
		Attachment 1: Preemption-Tennessee Letter 2809
2012-05	3/15/2012	Paperless Reimbursement Guidance for FEHB and FEDVIP Carriers
2012-04	2/16/2012	Indian Tribe Participation in the FEHB Program
		Attachment 1: Questions and Answers from the Carrier Workgroup
		Attachment 2: Timeline for Initial Enrollment Opportunity
2012-03	2/3/2012	Guidance to Reduce Enrollment Reconciliation Discrepancies
		Attachment 1: Notice Of Issue With Family Enrollment
		Attachment 2: Notice Of Intent To Disenroll
		Attachment 3: Notice Of Assistance Letter
2012-02	1/25/2012	HEDIS® 2012 Data Collection for all FEHB Carriers
		Attachment 1: HEDIS® Measures Required for 2012
		Attachment 2: HEDIS® FEHB Plan Name and Carrier-Code List
2012-01	1/4/2012	Guidance on Testing and Implementation of the SF2809 Electronic File in the HIPAA 5010 format
		Attachment: HIPAA Transaction Standard Companion Guide for SF 2809

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2011 Carrier Letters

Letter	Date	Subject
2011-22	12/28/2011	2012 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment A: CAHPS Health Plan Survey 4.0H Adult Questionnaire (Commercial)
		Attachment B: Survey Participation Form
		Attachment C: FEHB Subcode List
		Attachment D: Sample Crosswalk
2011-21	12/19/2011	Blue Button Initiative
		Attachment 1: Blue Button Icon
		Attachment 2: Blue Button Overview Presentation
		Attachment 3: "How Blue Button Works" Presentation
		Attachment 4: Sample data dictionary
2011-19	10/13/11	Criteria for Demonstrating Compliance with Contractual Requirement for Enrollment Reconciliation
2011-18	9/23/11	Additional Information on the One Percent Loading for Community-Rated HMO Carriers
2011-17a	9/23/11	Change to the Standard Contract
		Attachment 1: Proposed Changes to Standard 2012 Community-Rated HMO Health Benefits Contract
2011-17b	9/23/11	Change to the Standard Contract
		Attachment 1: Proposed Changes to Standard 2012 Experience-Rated HMO Health Benefits Contract
2011-17c	9/23/11	Change to the Standard Contract
		Attachment 1: Proposed Changes to Standard 2012 Fee-For-Service Health Benefits Contract
2011-16	7/13/11	Measuring Performance of Healthcare Delivery
		Attachment 1
		Attachment 2
2011-15	7/8/11	New Premium Rating Methodology for Most Community Rated Carriers
		Attachment: MLR Regulations
2011-14	6/23/11	Additional Information on Contract Security Clauses
		Attachment 1: 2011 Security Clause Amendments
		Attachment 2: Contractor Staffing Change Report
2011-13	6/17/11	Fraud and Abuse: Mandatory Information Sharing via Written Case Notifications to OPM's Office of the Inspector General
		Attachment 1: Case Notification/Status Update Format
		Attachment 2: OPM/OIG Exposure Request Form
2011-12	5/28/11	Gender Reassignment
2011-11	5/13/11	Audit Requirements for Adjusted Community-Rating Plans
2011-10a	5/4/11	2012 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
2011-10b	5/4/11	2012 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
2011-10c	5/4/11	2012 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2011-09	4/27/11	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2011
		Attachment 1: Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2011-08	4/26/11	2012 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment 1: Part 1 - 2012 Community rating Guidelines
		Attachment 2: Part 2 - Proposal Instructions
2011-07	4/8/11	Reporting 2011 CAHPS Results
		Attachment 1: 2011 CAHPS FEHB Sub-Code List
		Attachment 2: Sample Crosswalk
2011-06	4/4/11	Reconciliation Instructions for 2011 Rates -- Community-Rated Carriers
		Attachment: Rate Recconciliation Instructions
2011-05	2/10/11	Federal Employees Health Benefits Program Call Letter
2011-04	3/23/11	Calendar Year 2010 Annual Accounting Statement Financial Reporting
		Attachment A: AAS Spreadsheet
		Attachment B: Patient-Centered Medical Homes (PCMH)
		Attachment C: Certification of Annual Accounting Statement
2011-03	2/10/11	Change in Federal Employees Health Benefits Program Experience- rated Carrier Reporting Requirements and Submission Process
2011-02	2/3/11	Demonstrating Value through Clinical and Financial Integration
		Attachment A: Payment Bundling
		Attachment B: Patient-Centered Medical Homes (PCMH)
		Attachment C: Accountable Care Organizations (ACOs)
2011-01	1/20/11	Survey and Administration of 2011 Plan Tobacco Cessation Benefits
		Attachment A: Smoking Cessation Benefits Report
		Attachment B: 2011 Smoking Cessation Benefit Report
		Attachment C: Smoking Cessation Benefit Flyer

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2010 Carrier Letters

Letter	Date	Subject
2010-23	12/20/10	2011 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS Health Plan Survey 4.0H Adult Questionnaire (Commercial)
		Attachment 2: Survey Participation Form
		Attachment 3: FEHB Subcode List
		Attachment 4: Survey Participation Form
2010-22	12/10/10	New 2011 FEHB Contract Security Clauses
		Attachment A: New 2011 FEHB Contract Security Clauses
		Attachment B: Contractor Staffing Change Report
2010-21a	12/08/10	HEDIS® Data Collection
2010-21b	12/08/10	HEDIS® Data Collection for Fee-for-Service Carriers
2010-20	10/19/2010	Internal Claims and Appeals and External Reviews under the Affordable Care Act
2010-19	09/10/2010	Tobacco Litigation Records Retention
2010-18	08/31/2010	Patient Protection and Affordable Care Act
2010-17	07/15/2010	Disputed Claims and the Carriers' Reconsideration Files
2010-16	06/17/2010	Medicare Secondary Payer Recovery Requirements
		Part 1: 2011 Community Rating Guidelines
2010-15a	06/16/2010	Change to the Standard Contract for Community-Rated HMOs
		Attachment A: Proposed Changes to Standard 2010 Community-Rated HMO Health Benefits Contract
2010-15b	06/16/2010	Change to the Standard Contract for Experience-Rated HMO Carriers
		Attachment A: Proposed Changes to Standard 2010 Experience-Rated HMO Health Benefits Contract
2010-15c	06/16/2010	Change to the Standard Contract for Fee-For-Service Carriers
		Attachment A: Proposed Changes to Standard 2010 Fee-For-Service Health Benefits Contract
2010-14	05/25/2010	Clarification of Data Breach Notification Requirements
2010-13	05/18/2010	Audit Requirements for Adjusted Community-Rating Plans
2010-12a	05/17/2010	Additional Information and Instructions on the Technical Guidance for the 2011 Contract Year for HMO carriers
2010-12b	05/17/2010	Additional Information and Instructions on the Technical Guidance for the 2011 Contract Year for NEW HMO carriers
2010-12c	05/17/2010	Additional Information and Instructions on the Technical Guidance for the 2011 Contract Year for FFS carriers
2010-11a	05/17/2010	2011 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals for HMO carriers
2010-11b	05/17/2010	2010 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
2010-11c	05/17/2010	2011 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2010-10	05/04/2010	2011 RATE INSTRUCTIONS -- Community-Rated Carriers
		Part 1: 2011 Community Rating Guidelines
		Part 2: Proposal Instructions
2010-09	04/26/2010	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2010
		Attachment 1: Financial reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2010-08	04/09/2010	The Health Data Warehouse
2010-07	04/08/2010	Reporting 2010 CAHPS Results
		Attachment 1: FEHB Subcode list
		Attachment 2: Sample Crosswalk
2010-06	04/07/2010	Federal Employees Health Benefits Program Call Letter
2010-05	03/18/2010	Reconciliation Instructions for 2010 Rates -- Community-Rated Carriers
2010-04	02/22/2010	Pharmacy Benefits Management (PBM)
2010-03	01/28/2010	Calendar 2010 Annual Accounting Statement Financial Reporting
		Attachment 1: Carrier worksheet
		Attachment 2: Annual Reporting Instructions for Experienced Rated Plans
		Attachment 3: Annual Accounting Statement
2010-02	01/20/2010	Guidelines on HEDIS® Measures for Fee-for-Service Carriers
2010-01	01/20/2010	HEDIS® Data Collection

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2009 Carrier Letters

Letter	Date	Subject
2009-17	11/9/2009	2010 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: Survey Instructions
		Attachment 2: Survey Participation Form
		Attachment 3: FEHB Subcode List
		Attachment 4: Sample Crosswalk
2009-16	10/5/2009	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2009
		Attachment 1: Requirements for Federal Fiscal Year 2009 Audited Financial Statements
		Attachment 2: Federal Employees Health Benefits Program (FEHBP) Experience-Rated Carriers Schedule of Selected Balances
		Attachment 3: Schedule of Selected Balances
2009-15c	9/2/2009	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2010 Experience-Rated HMO Health Benefits Contract
2009-15b	9/2/2009	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2010 Experience-Rated HMO Health Benefits Contract
2009-15a	9/2/2009	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2010 Community-Rated HMO Health Benefits Contract
2009-14	9/2/2009	OPM's Letter of Credit System
		Attachment 1: User Manual for Experienced-Rated Carriers
		Attachment 2: Letter of Credit (LOC) System Guidelines
2009-13	7/9/2009	Federal Funding Accountability and Transparency Act
2009-12	5/21/2009	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2009
		Attachment 1: Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2009-11(a)	5/1/2009	2010 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
2009-11(b)	5/1/2009	2010 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
2009-11(c)	5/1/2009	2010 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2009-10	4/22/2009	Inspector General Reform Act of 2008
2009-09	4/22/2009	2010 Rate Instructions -- Community-Rated Carriers
		Attachment 1:   Part A: Community Rating Guidelines 2010
		Attachment 2:   Part B: Proposal Instructions 2010
2009-08	4/20/2009	Federal Employees Health Benefits Program Call Letter
2009-07	4/10/2009	Reporting 2009 CAHPS Results
		Attachment 1: FEHB Plan Sub code List
		Attachment 2: CAHPS Sample Crosswalk
2009-06	4/10/2009	Audit Requirements for Adjusted Community-Rating Plans
2009-05	2/27/2009	Reconciliation Instructions for 2009 Rates -- Community-Rated Carriers
2009-04	2/20/2009	Health Information Technology and Transparency
2009-03	2/13/2009	Calendar 2008 Annual Accounting Statement Financial Reporting
		Attachment 1: Carrier worksheet
		Attachment 2: Annual Reporting Instructions for Experienced Rated Plans
		Attachment 3: Annual Accounting Statement
2009-02	1/27/2009	HEDIS® Measures for Fee-for-Service Carriers
2009-01	1/27/2009	HEDIS® Data Collection

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2008 Carrier Letters

Letter	Date	Subject
2008-19	12/19/2008	2009 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment: CAHPS® 4.0H Adult Questionnaire (Commercial) Survey Instructions
		Attachment: Survey Participation Form
		Attachment: 2009 FEHB Plan Report
		Attachment: Sample Crosswalk
2008-18	12/05/2008	Federal Employees Health Benefits Program
2008-17	11/10/2008	Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 - Federal Employees Health Benefits Program Carrier Guidance
2008-16	10/09/2008	HIT and Transparency Report for 2008
		Attachment: Federal Employees Health Benefits (FEHB) ProgramReport on Health Information Technology (HIT) and Transparency
2008-15	09/10/2008	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2008
		Attachment 1: Requirements for Federal Fiscal Year 2008 Audited Financial Statements
		Attachment 2: Schedule of Selected Balances
2008-13c	06/12/2008	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2009 FFS Health Benefits Contract
2008-13b	06/12/2008	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2009 Experience-Rated HMO Health Benefits Contract
2008-13a	06/12/2008	Change to the Standard Contract
		Attachment: Proposed Changes to Standard 2009 Community-Rated HMO Health Benefits Contract
2008-12	05/20/2008	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2008
		Attachment 1: Financial Reporting and Audit Guide
		Attachment 2: Schedule of Selected Balances
2008-11	05/13/2008	2009 RATE INSTRUCTIONS-Revision -- Community-Rated Carriers
2008-10	04/21/2008	Reporting 2008 CAHPS Results
		Attachment 1: 2008 Plan Subcodes
		Attachment 2: Sample Crosswalk
2008-09	04/15/2008	Audit Requirements for Adjusted Community-Rating Plans
2008-08	04/14/2008	2009 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment
2008-07c	04/11/2008	2009 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2008-07b	04/11/2008	2009 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
2008-07	04/11/2008	2009 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
2008-06	03/11/2008	March 11, 2008 Federal Employees Health Benefits Program Call Letter
2008-05	02/27/2008	February 27, Reconciliation Instructions for 2008 Rates -- Community-Rated Carriers
2008-04	01/31/2008	Guidelines on HEDIS ® Measures for Fee-for-Service Carriers
2008-03	01/25/2008	Calendar 2007 Annual Accounting Statement Financial Reporting
		Attachment 1: Statement of Cash Flows for Calendar year 2007
		Attachment 2: Annual Reporting Instructions for Experienced-Rated Carriers
		Attachment 3: Certification of Contract Year 2007 Annual Accounting Statement
2008-02	01/24/2008	HEDIS® Data Collection
2008-01	01/11/2008	The Massachusetts Health Care Reform Act
		Attachment 1:Massachusetts Schedule HC
		Attachment 2: Massachusetts Schedule HC

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2007 Carrier Letters

Letter	Date	Subject
2007-27UPDATED	02/21/2008	Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS® 4.0H Adult Questionnaire (Commercial) Survey Instructions
		Attachment 2: Survey Participation Form
		Attachment 3: FEHB Plan Report
		Attachment 4: Sample Crosswalk
2007-27	01/07/2008	2008 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS® 4.0H Adult Questionnaire (Commercial) Survey Instructions
		Attachment 2: Survey Participation Form
		Attachment 3: FEHB Plan Report
		Attachment 4: Sample Crosswalk
2007-26	10/16/2007	Preventative Care for Adults
2007-25	10/15/2007	Health Information Technology (HIT) and Transparency Report
		Attachment: Report on Health Information Technology (HIT) and Transparency
2007-24	08/28/2007	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2007
		Attachment 1: Requirements for Federal Fiscal Year 2007 Audited Financial Statements
		Attachment 2: Federal Employees Health Benefits Program Experience-Rated Carriers Schedule of Selected Balances (UNAUDITED)
2007-23	08/27/2007	Federal Employees Health Benefits Program Procedures for Provider Overpayment Recoveries
2007-22	06/25/2007	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2007
		Attachment: Financial Reporting and Audit Guide
2007-21	06/22/2007	Notification of Data Breach
2007-20	06/07/2007	2008 Health Savings Accounts Contribution Limits
		Attachment: HSA Index Amounts for 2008
2007-19	06/07/2007	Civilian Board of Contract Appeals
2007-18	05/16/2007	FEHB Carrier Letter Listserv
2007-17c	04/23/2007	Change to the Standard Contract
		Attachment : Proposed Changes to Standard 2008 Fee-For-Service Health Benefits Contract
2007-17b	04/26/2007	Change to the Standard Contract
		Attachment : Proposed Changes to Standard 2008 Experience-Rated HMO Health Benefits Contract
2007-17a	04/23/2007	Change to the Standard Contract
		Attachment : Proposed Changes to Standard 2008 Community-Rated HMO Health Benefits Contract
2007-16	04/25/2007	Waiver of Requirements for Continued Coverage During Retirement
2007-15	04/24/2007	Debarred Providers in the Federal Employees Health Benefits Program
		Attachment 1: FEHBP Carrier letter 1993-01 - Debarred Providers in the Federal Employees Health Benefits Program
		Attachment 2: FEHBP Carrier letter 1993-20 - Debarred Providers in the Federal Employees Health Benefits Program
2007-14	04/23/2007	Reporting 2007 CAHPS Results
		Attachment 1: FEHB Plan Sub-codes
		Attachment 2: Sample Crosswalk
2007-13c	04/12/2007	2008 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
2007-13b	04/12/2007	2008 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
2007-13a	04/12/2007	2008 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
2007-12	03/30/2007	Notifying OPM's Office of the Inspector General Concerning Fraud and Abuse Cases in the FEHB Program
		Attachment 1: FEHBP Data Exposure Request Form
2007-11	03/28/2007	Implications of Medicare Anti-Kickback Statute for Coordination of Benefits
2007-10	03/27/2007	2008 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment 1: 2008 FEHB RATE INSTRUCTIONS - COMMUNITY-RATED PLANS
2007-09	03/22/2007	Audit Requirements for Adjusted Community-Rating Plans
		Attachment 1: Medical Claim Field Requirements
		Attachment 2: Pharmaceutical Claim Field Requirements
		Attachment 3: US OPM, Office of The Inspector General, Office of Audits Media Specifications Form
2007-08	03/13/2007	High Deductible Health Plan Options
2007-07	03/07/2007	Federal Employees Health Benefits Program Call Letter
2007-06	02/28/2007	Omnibus Budget Reconciliation Act of 1990 (OBRA '90) IPPS Pricer Program Usage
2007-05	02/28/2007	Medicare Part B Adjustments to the Omnibus Budget Reconciliation Act of 1990 (OBRA'90) Pricing
2007-04	02/26/2007	Calendar 2006 Financial Reporting
		Attachment 1: Federal Employees Health Benefits Program Annual Reporting Instructions for Experience-Rated Carrier
		Attachment 2: Supplemental Schedule of Health Benefit Charges Paid for Calendar Year 2006
		Attachment 3: Certification of Annual Accounting Statement (Carrier)
2007-03	02/21/2007	Reconciliation Instructions for 2007 Rates-- Community-Rated Carriers
		Attachment: OPM Reconciliation Guidelines – 2007
2007-02	02/16/2007	2008 Standard Contract Changes
2007-01	02/12/2007	HEDIS® Data Collection

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2006 Carrier Letters

Letter	Date	Subject
2006-32	12/28/2006	Standard Contract Amendments
		Attachment: Standard Contract Amendments
2006-31	12/27/2006	2007 Consumer Assessment of Healthcare Providers and Systems Program Requirements
		Attachment 1: CAHPS® 4.0H Adult Questionnaire
		Attachment 2: Survey Participation Form
		Attachment 3: CAHPS Plan codes
		Attachment 4: Sample Crosswalk
2006-29	12/21/2006	The Tax Relief and Health Care Act of 2006
		Attachment: The Tax Relief and Health Care Act of 2006
2006-28	11/28/2006	Federal Acquisition Regulation (FAR) Changes that Impact Federal Employees Health Benefit Program (FEHBP) Carrier Contracts
2006-27	11/02/2006	HealthierFeds Physical Activity Challenge
2006-26	10/26/2006	Federal Employees Dental and Vision Insurance Program (FEDVIP) and Non-FEHB Supplementary Dental and Vision Coverage under the Federal Employees Health Benefits (FEHB) Program
2006-25	09/14/2006	The Office of Personnel Management's Strategy for Pandemic Influenza
2006-24	09/14/2006	The President's Executive Order Promoting Quality and Efficient Health Care in Federal Government Health Care Programs
2006-23	07/14/2006	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2006
		Attachment: Requirements for Federal Fiscal Year 2006 Audited Financial Statements
2006-22	07/24/2006	Federal Employees Health Benefits Program Fee-For-Service Plan and Experience-rated HMO Reports
		Attachment to Carrier Letter 2006-22
2006-21	07/17/2006	Guidance on HEDIS® Measures for Fee-for-Service Plans
2006-20	06/13/2006	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year 2006
		Attachment 1: FINANCIAL REPORTING AND AUDIT GUIDE Federal Fiscal Year 2006
2006-19	06/08/2006	Raffles Conducted by Federal Employees Health Benefits Program Health Plans
2006-18	06/08/2006	Raising the Level of Transparency in the FEHB Program
2006-17	05/17/2006	Delivering Plan Brochures Electronically
2006-16c	05/15/2006	Change to the Standard Contract
		Attachment 1: Changes to Standard 2007 Fee-For-Service Health Benefits Contract
2006-16b	05/15/2006	Change to the Standard Contract
		Changes to Standard 2007 Experience-Rated HMO Health Benefits Contract
2006-16a	05/15/2006	Change to the Standard Contract
		Changes to Standard 2007 Community-Rated HMO Health Benefits Contract
2006-15	05/09/2006	Organ/Tissue Transplant Benefits
		2007 Organ/Tissue Transplants and Diagnoses
2006-14	05/08/2006	Audit Requirements for Adjusted Community-Rating Plans
2006-13(c)	05/01/2006	2007 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment 1: 2007 FEHB Proposal Instructions
2006-13(b)	05/01/2006	2007 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
		Attachment 1: 2007 FEHB Proposal Instructions
2006-13(a)	05/01/2006	2007 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Attachment 1: 2007 FEHB Proposal Instructions
2006-12	05/01/2006	CL 2006-12 of May 1, 2006, 2007 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment 1: 2007 FEHB Rate Instructions - Community-Rated Plans
2006-11	04/21/2006	CL 2006-11 of April 21, 2006, Reporting Requirement of HEDIS Measures for Fee-for-Service Plans
2006-10	04/21/2006	CL 2006-10 of April 21, 2006, Reporting 2006 CAHPS Results
		Attachment 1: FEHB Subcode ID Crosswalk
		Attachment 2: Sample Crosswalk
2006-09	04/04/2006	Federal Employees Health Benefits Program Call Letter
2006-08	03/30/2006	Checklists for Large Provider Agreements
		Attachment 1: General Checklist for Large Provider Agreements
		Attachment 2: Specific Checklist for Pharmacy Benefit Management (PBM)LPA's Providing a Retail Pharmacy Network and/or Mail Order Pharmacy
2006-07	03/30/2006	CL 2006-07 of March 30, 2006, 2006 FEHB Carrier Conference
2006-06	03/15/2006	Disclosure of Creditable Prescription Drug Coverage to the Centers for Medicare & Medicaid Services (CMS)
2006-05	03/15/2006	Reconciliation Instructions for 2006 Rates -- Community-Rated Carriers
		Table of Contents
		Attachment 1: OPM Reconciliation Guidelines-2006
		Attachment 2: Reconciliation Instructions
		Attachment 3: Reconciliation
		Attachment 3A: Reconciliation Backup Forms
		Attachment 3B: Section 1 ?General Questionnaire
		Attachment 4: Documentation of 2006 Community Rates and Riders
		Attachment 5: Certificate of Accurate Pricing
		Attachment 6: Carrier Contacts
2006-04	02/01/2006	Extended Coverage for Employees Called to Active Military Duty
		Attachment 1: BAL 06-401: Extended Coverage for Employees Called to Active Military Duty
		Attachment 2: P.L. 108-375 Processing Table
2006-03 UPDATED	02/21/2006	2006-03 Updated of February 21, 2006, HEDIS® Data Collection Letter 2006-03
2006-03	02/01/2006	HEDIS® Data Collection
2006-02	02/01/2006	Meeting with OPM Personnel
2006-01	01/24/2006	2006 Consumer Assessment of Health Plans Survey Requirements
		Attachment 1: CAHPS® 3.0H Adult Questionnaire (Commercial) SURVEY INSTRUCTIONS
		Attachment 2: Survey Participation Form
		Attachment 3: FEHB Plan List
		Attachment 4: Sample Crosswalk

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2005 Carrier Letters

Letter	Date	Subject
2005-14c UPDATED	09/22/2005	(UPDATED) Change to the Standard Contract
		Attachment A UPDATED - Changes to Standard 2006 Fee-For-Service Health Benefits Contract
		Attachment B UPDATED - Amendments to Standard 2005 Fee-For-Service Health Benefits Contract
2005-14b UPDATED	09/22/2005	(UPDATED) Change to the Standard Contract
		Attachment A UPDATED - Changes to Standard 2006 Experience-Rated HMO Health Benefits Contract
		Attachment B UPDATED - Amendments to Standard 2005 Experience-Rated HMO Health Benefits Contract
2005-14a UPDATED	09/22/2005	(UPDATED) Change to the Standard Contract
		Attachment A UPDATED - Changes to Standard 2006 Community-Rated HMO Health Benefits Contract
		Attachment B UPDATED - Amendments to Standard 2005 Community-Rated HMO Health Benefits Contract
2005-14c	08/30/2005	Change to the Standard Contract
		Attachment A - Changes to Standard 2006 Experience-Rated HMO Health Benefits Contract
		Attachment B - Amendments to Standard 2005 Experience-Rated HMO Health Benefits Contract
2005-14b	08/30/2005	Change to the Standard Contract
		Attachment A - Changes to Standard 2006 Experience-Rated HMO Health Benefits Contract
		Attachment B - Amendments to Standard 2005 Experience-Rated HMO Health Benefits Contract
2005-14a	08/30/2005	Change to the Standard Contract
		Attachment A - Changes to Standard 2006 Community-Rated HMO Health Benefits Contract
		Attachment B - Amendments to Standard 2005 Community-Rated HMO Health Benefits Contract
2005-13a	05/25/2005	2006 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Attachment - 2006 PROPOSAL INSTRUCTIONS
2005-13b	05/25/2005	2006 Technical Guidance and Instructions for Preparing benefits and Service Area Proposals for New HMOs
		Attachment - 2006 PROPOSAL INSTRUCTIONS
2005-13c	05/25/2005	2006 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment - 2006 PROPOSAL INSTRUCTIONS
2005-12	05/17/2005	2006 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment - 2006 FEHB RATE INSTRUCTIONS
2005-11	05/17/2005	Rating Process for Community-Rated Plans
		Attachment - Community Rating Instructions
2005-10	04/19/2005	Federal Employees Health Benefits Program Annual Call Letter
		Appendix A - Federal Employees Health Benefits Program Annual Call Letter Checklist
		Appendix B - FEHB High Deductible Health Plans
2005-09	03/30/2005	Reconciliation Instructions for 2005 Rates -- Community-Rated Carriers
		Attachment - Table of contents
2005-08	03/30/2005	Carrier Responsibilities - Reconsideration Process and Medical Necessity Determinations
		Attachment 1- Carrier Responsibilities in Disputed Claims Process
		Attachment 2 - Disputed Claims and the Carriers' Reconsideration Files
2005-07	03/23/2005	Office of Personnel Management's (OPM) Requirement to Provide Section 508 Web Accessible Compliant Health Plan Brochures for the Visual Impaired
		Attachment 1- File Manager Instructions
		Attachment 2 - Proposed 2006 Brochure Language Changes
		Attachment 3 - Brochure Template Design and Layout Revisions
		Attachment 4 - Supplemental Pages
2005-06	03/16/2005	FEHB Carrier Conference
		Attachment - Carrier Conference Agenda
2005-05	02/23/2005	Additional Payroll Office Changes under e-Payroll
		Attachment 1 - Attachment - State Memo
2005-04	02/10/2005	HEDIS® Data
2005-03	02/09/2005	Calendar 2004 Financial Reporting
		Attachment 1 - Instructions for Automated AAS
		Attachment 2 - AAS Spreadsheet
		Attachment 3 - Certification of Annual Accounting Statement
2005-02	01/18/2005	Prescription Drug Availability
		Attachment - Director's letter concerning prescription drug availability for emergency relief workers
2005-01	01/14/2005	2005 Consumer Assessment of Health Plans Survey Requirements
		Appendix A - CAHPS Questionnaire
		Appendix B - Survey Participation Form
		Appendix C - FEHB Sub-code list
		Appendix D - Sample Crosswalk

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2004 Carrier Letters

Letter	Date	Subject
2004-13	11/03/2004	Updated SF 2809
2004-12	10/04/2004	The West Virginia Health Care Provider Tax Act of 1993
2004-11	09/27/2004	Brochure Development, Production, and Distribution for 2005
2004-10	09/14/2004	Guidance for the Preparation of Audited Financial Statements for Federal Fiscal Year
2004-09 (a)	09/08/2004	Standard Contract Changes
2004-09 (b)	09/08/2004	Standard Contract Changes
2004-09 (c)	09/08/2004	Standard Contract Changes
2004-08	07/07/2004	Payroll Office Changes
		Attachment - National Aeronautics and Space Administration (NASA)
2004-07 (a)	06/30/2004	2005 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Attachment - 2005 FEHB Proposal Instructions
2004-07 (b)	06/30/2004	2005 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
		Attachment - 2005 FEHB Proposal Instructions
2004-07 (c)	06/30/2004	2005 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Attachment - 2005 FEHB Proposal Instructions
2004-06	05/07/2004	2005 RATE INSTRUCTIONS -- Community-Rated Carriers
		Attachment 1 OPM Community Rating Guidelines
2004-05	05/05/2004	Reconciliation Instructions for 2004 Rates. Community-Rated Carriers
		Attachment 1 OPM Reconciliation Guidelines
		Attachment 2 Reconciliation Instructions
		Attachment 4
		Attachment 5 Certificate of Accurate Pricing
		Attachment 6
2004-04	04/19/2004	Federal Employees Health Benefits Program Annual Call Letter
		Attachment 1 Federal Employees Health Benefits Program Annual Call Letter --- Checklist
		Attachment 2 FEHB High Deductible Health Plans Criteria
2004-03	03/22/2004	The Colorado High Risk Health Insurance Act
		Attachment 1
2004-02	03/15/2004	Calendar 2003 Financial Reporting
		Attachment 1 - Summary statement spreadsheet
		Attachment 2 - Financial reporting instructions
		Attachment 3 - Certification of Annual Accounting Statement
2004-01	03/04/2004	HEDIS Data Collection

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2003 Carrier Letters

Letter	Date	Subject
2003-35	12/17/2003	2004 Consumer Assessment of Health Plans Survey Requirements
		Appendix A - Adult Questionnaire
		Appendix B- Survey Participation Form
		Appendix C- FEHB Plan and Subcode
		Appendex D- Sample Crosswalk
2003-34	12/10/2003	Using the FEHB Disenrollment Regulations on CLER Discrepancies; Pseudo Social Security Numbers
		Attachment 1 - Notice of Intent to Disenroll
		Attachment 2 - Summary of Requirements and Recommendations for CLER for Both FEHB Carriers and Government Agencies
2003-33	11/03/2003	HIPAA compliant enrollment transactions
		Enclosure - HIPAA Transaction Standard Companion Guide
2003-32	10/30/2003	Continuing Health Care for Federal Workers in the World Trade Center and the Pentagon
2003-31	10/08/2003	Financial Reporting Instructions for Federal Fiscal Year 2003 (Experience-rated Carriers)
		Enclosure B1 - Guidelines and Table of Contents
		Enclosure B2 - Preliminary Reporting Package Requirements
		Enclosure B3 - Final Reporting Package Requirements
2003-30-A	10/02/2003	Changes to the Standard Contract- Community-rated HMOs
		Enclosure
2003-30-B	10/02/2003	Changes to the Standard Contract- Experience-rated HMOs
		Enclosure
2003-30-C	10/02/2003	Changes to the Standard Contract- Fee-for-Service
		Enclosure
2003-28	09/05/2003	Avoiding Potential Misuse of Social Security Numbers in the Federal Employees Health Benefits Program
2003-27	08/18/2003	Financial Reporting and Auditing Requirements for Federal Fiscal Year 2003
2003-26	08/13/2003	Brochure Development, Production and Distribution for 2003 (letter only)
		Enclosure 1 - Sample Rate Sheet
		Enclosure 2A - Fee-for-service Brochure Examples
		Enclosure 2B - HMO Brochure Examples
		Enclosure 3 - Additional Guidance for Typesetting Brochure Cover Enclosure 4 - Printing, Distribution, and Shipping Specification for FEHB Brochure Enclosure 5 - Brochure Quantity Forms for Fee for Service and HMO Plans
		Enclosure 6 - Shipping Labels
		Enclosure 7 - Instructions for Creating PDF Versions of your FEHB Brochure
2003-25	08/13/2003	Revised FEHB Quality Assurance and Fraud and Abuse Reports
		Attachment 1 - 2004 Quality Assurance Report
		Attachment 2 - 2004 Fraud and Abuse Report
2003-24	08/12/2003	Accuracy of Health Plan Web Site Information
2003-23	06/18/2003	Industry Standards for Fraud & Abuse (F&A) Programs
2003-22	05/16/2003	Director Kay Coles James' HealthierFeds Campaign
		Attachment - April is National Donate Life Organ and Tissue Donor Awareness Month
		Attachment - May is High Blood Pressure Awareness Month
2003-21	05/136/2003	CAHPS Survey Data & Crosswalk Reminder
		Appendix C - Plan Subcode List
		Appendix D - Sample Crosswalk
2003-20	05/09/2003	Patient Safety Information on the FEHB Web Site
2003-19	05/06/2003	2004 Rate Instructions for Experience-Rated Plans
2003-18(a)	05/06/2003	2004 Technical Guidance and Instructions for Preparing HMO Benefit and Service Area Proposals
		Enclosure
2003-18(b)	05/06/2003	2004 Technical Guidance and Instructions for Preparing Benefits and Service Area Proposals for New HMOs
		Enclosure
2003-18(c)	05/06/2003	2004 Technical Guidance and Instructions for Preparing Proposals for Fee-For-Service Carriers
		Enclosure
2003-17	04/30/2003	The State of Missouri Pharmacy Assessment
		Enclosure
2003-16	04/30/2003	Surcharges and Assessments Under the New York Health Care Reform Act of 2000
		Enclosure
2003-15	04/18/2003	Federal Employees Health Benefits Program Annual Call Letter
		Enclosure - Checklist
2003-14	04/18/2003	2004 RATE INSTRUCTIONS - Community-Rated Carriers
		Enclosure
2003-13	04/16/2003	Administrative Changes
2003-12	03/25/2003	Reconciliation Instructions for 2003 Rates—Community-Rated Carriers
		Enclosure
2003-11	03/18/2003	LEVEL ORANGE ALERT
2003-10	03/10/2003	Emergency Prescription Drug Availability
2003-09	03/04/2003	Calendar 2002 Financial Reporting
		Enclosure B - Automated AAS (for electronic submissions)
		Enclosure C - Instructions for Automated AAS (for electronic submissions)
		Enclosure D - Certification of Annual Accounting Statement (for both electronic and paper submissions)
		Enclosure E - Annual Reporting Package (for paper submissions)
		Enclosure F - Summary Statement Form (for paper submissions)
2003-08	03/04/2003	Brochure changes for 2004
2003-07	02/21/2003	Proposed Regulations
		Enclosure
2003-06	02/19/2003	2003 Medicare Match
		Enclosures
2003-05	02/04/2003	MHSA Parity Implementation Report
		Attachment
2003-04	01/24/2003	Processing FEHB Enrollments
2003-03	01/24/2003	FEHB Carrier Conference
2003-02	01/21/2003	HEDIS® Data and QA and Fraud and Abuse Reporting
		Attachment 1 — Fraud & Abuse Report
		Attachment 2 — FFS Quality Assurance Report
		Attachment 3 — HMO Quality Assurance Report
2003-01	01/13/2003	The State of Massachusetts Assessment on Pharmacies
		Enclosure

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2002 Carrier Letters

Letter	Date	Subject
2002-39	12/16/2002	2003 Consumer Assessment of Health Plans Survey Requirements
		Enclosure A - CAHPS® 3.0H Adult Commercial Questionnaire
		Enclosure B - Survey Participation Form
		Enclosure C -FEHB Sub-codes
		Enclosure D - Sample Crosswalk
2002-38	11/14/2002	FEHB Enrollments from the Transportation Security Administration
2002-37	10/09/2002	Electronic Enrollment Changes for 2003
		Enclosure 1, Individual File Layout
		Enclosure 2, Participating Federal Agencies
2002-36	10/04/2002	Federal Employees Health Benefits (FEHB) Program Study on the Cost of Mandated Benefits
		Enclosure
2002-35	09/25/2002	Financial Reporting Requirements for Federal Fiscal Year 2002
		Enclosure B1
		Enclosure B2
		Enclosure B3
		Enclosure B4
2002-34	09/25/2002	Federal Employees Health Benefits (FEHB) Program Study on the Cost of Mandated Benefits
		Enclosure
2002-33	09/25/2002	Federal Employees Health Benefits (FEHB) Program Waiver
		Enclosure
2002-32	09/24/2002	Federal Employees Health Benefits Program Proposed Regulation
		Attachment
2002-31	09/23/2002	FEHB/DOD Demonstration Project
		Attachment
2002-30	09/11/2002	Accelerated Timeframes for Financial Statement Reporting
2002-29	09/05/2002	Unsigned SF 2809s
2002-28	08/29/2002	Additional Brochure Changes for 2003
2002-27	08/22/2002	Additional Brochure Changes for 2003
2002-26	08/08/2002	Brochure Development, Production and Distribution for 2002 (letter only)
		Enclosure 1 - Sample Rate Sheet
		Enclosure 2A - FFS Brochure Examples
		Enclosure 2B - HMO Brochure Examples
		Enclosure 3 - Additional Guidance for Typesetting Brochure Cover Enclosure 4 - Printing, Distribution, and Shipping Specification for FEHB Brochure Enclosure 5 - Brochure Quantity Forms for Fee for Service and HMO Plans
		Enclosure 6 - Shipping Labels
		Enclosure 7 - Instructions for Creating PDF Versions of your FEHB Brochure
2002-25	07/30/2002	Audit Guide
		Summary of Audit Guide Changes
		FEHBP Experience-Rated Carrier and Service Organization Audit Guide
2002-24-A	07/30/2002	Changes to the Standard Contract — Community-rated HMOs
		Enclosure
2002-24-B	07/30/2002	Changes to the Standard Contract — Experience-rated HMOs
		Enclosure
2002-24-C	07/30/2002	Changes to the Standard Contract — Fee-for-Service
		Enclosure
2002-23	07/12/2002	Placement of ID Numbers in CLER
2002-22	07/02/2002	Brochure Changes for 2003
2002-21	06/28/2002	Amendment to 2003 RATE INSTRUCTIONS -- Community-Rated Carriers
2002-20	05/28/2002	ORP Payroll Office Number and CLER Update
2002-19	05/15/2002	CAHPS Survey Data & Crosswalk Reminder
		Sample Completed Crosswalk
		List of FEHB Codes and Plan Names
2002-18	05/05/2002	Postponement of January 1 Effective Date for Open Season Elections
2002-17	04/23/2002	Brochure Changes for 2003
2002-16(a)	04/18/2002	Technical Guidance and Instructions for Submitting 2003 HMO Benefit and Service Area Proposals
		Enclosure
2002-16(b)	04/18/2002	Technical Guidance and Instructions for Submitting 2003 HMO Benefit and Service Area Proposals for New HMOs
		Enclosure
2002-16(c)	04/18/2002	Technical Guidance for 2003 Benefit Proposals - Fee-For-Service Carriers
		Enclosure
2002-15	04/18/2002	2003 Rate Instructions -- Community-Rated Carriers
		Enclosure
2002-14	04/16/2002	Federal Employees Health Benefits Program Annual Call Letter
2002-13	04/12/2002	2003 Rate Instructions for Experience-Rated Plans
		Enclosure
2002-12	03/22/2002	Reconciliation Instructions for 2002 Rates— Community-Rated Carriers
		Enclosure
2002-11	03/22/2002	2002 Medicare Match
		Enclosure A — Medicare Data Release Agreement
		Enclosure B — Report Description — Annuitant Medicare Match Lists
		Enclosure C — Annuitant Medicare Match
2002-10	03/01/2002	Accelerated Timeframes for Financial Statement Reporting
		March 20 Meeting Agenda
		Schedule of Reporting Requirements
2002-09	02/28/2002	Training for the FEHB Clearinghouse Project
2002-08	02/19/2002	FEHB Carrier Conference
		Attachment
2002-07	02/12/2002	MHSA Parity Implementation Report
		Attachment
2002-06	02/05/2002	Payroll Office Numbers and Processing Electronic Enrollment
		Attachment
2002-05	02/01/2002	Calendar 2001 Financial Reporting (Experience-Based Carriers)
		Enclosure A — Certification of Annual Accounting Statement
		Enclosure B — Annual Reporting Package
		Enclosure C — Summary Statement of FEHHBP Financial Operations
2002-04	01/30/2002	Department of Defense enrollment transfers
2002-03	01/29/2002	FEHB Routine Reporting Requirements for 2002
2002-02	01/28/2002	Health Insurance Portability and Accountability Act
2002-01	01/11/2002	FEHB Quality Assurance Requirements
		Enclosure A — Fraud and Abuse Report spreadsheet
		Enclosure B — FFS - FEHB 2001 QA Report spreadsheet
		Enclosure C — HMO - FEHB 2001 QA Report spreadsheet

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2001 Carrier Letters

Letter	Date	Subject
2001-41	12/03/2001	2002 Consumer Assessment of Health Plans Survey Requirements
		Appendix A - Survey Instructions
		Appendix B - Vendor Selection Form
		Appendix C - FEHB Plan Names, Carrier Codes and Subcodes
		Appendix D - Sample Crosswalk
2001-40	11/29/2001	Federal Employees Health Benefits Program (FEHB): Suspension of FEHB Coverage to use TRICARE
		Attachment
2001-39	11/08/2001	Clearinghouse: Electronic File Layout of SF 2809 and SF 2810
		Enclosure 1 — CLER 2809 Corrective Action File Layout
		Enclosure 2 — CLER 2810 Corrective Action File Layout
2001-38	10/29/2001	Guidance to Carriers on Services Related to Anthrax
2001-37	10/18/2001	Connecting Agency HR Offices to the FEHB Clearinghouse Project
2001-36	10/16/2001	FEHB Fall Carrier Conference
2001-35	10/108/2001	Correct Payroll Office Numbers for the Department of Defense
2001-34	10/01/2001	2001 Fiscal Year Financial Reporting
		Enclosure: Encl B Table of Contents
		Enclosure: Est Summary Statement
		Enclosure: FY Statements
		Enclosure: Summary Instructions
		Enclosure: Summary Statement
2001-33	09/21/2001	Revised Electronic Enrollment Changes for 2002
		Enclosure — Individual File Layout
2001-32	09/21/2001	Revised Encryption Instructions for Sending Data to the FEHB Clearinghouse
		Enclosure — Encryption Instruction for Sending Data to CLER
2001-31	09/12/2001	Compassionate Response to the National Disaster
2001-30	09/12/2001	Encryption Instructions for Sending Data to the FEHB Clearinghouse
		Enclosure Replaced by the enclosure to CL 2001-32.
2001-29	09/07/2001	Electronic Enrollment Changes for 2002
		Enclosure 1 — Individual File Layout Replaced by the enclosure to CL 2001-33.
		Enclosure 2 — Participating Federal Agencies
2001-28	09/05/2001	FEHB Fall Carrier Conference
2001-27	08/27/2001	Coverage for FDA-Approved Drugs, Devices, and Biological Products
2001-26	08/08/2001	Audit Guide (fee-for-service plans and experience-rated HMOs only)
		Enclosure — Audit Guide
		Summary of 2001 Audit Guide Changes
2001-25	08/06/2001	Brochure Development, Production and Distribution for 2002 (full version, with all attachments — 47 pages, 1.4 Meg file)
2001-25	08/06/2001	Brochure Development, Production and Distribution for 2002 (letter only)
		Enclosure 1 - Sample Rate Sheet
		Enclosure 2A - FFS Brochure Examples
		Enclosure 2B - HMO Brochure Examples
		Enclosure 3 - Additional Guidance for Typesetting Brochure Cover Enclosure 4 - Printing, Distribution, and Shipping Specification for FEHB Brochure Enclosure 5 - Brochure Quantity Forms for Fee for Service and HMO Plans
		Enclosure 6 - Shipping Labels
		Enclosure 7 - Instructions for Creating PDF Versions of your FEHB Brochure
2001-24	08/02/2001	Amendments to the Standard Contract
		Enclosure — Fee-for-service Plans
		Enclosure — Experience-Rated HMOs
		Enclosure — Community-Rated HMOs
2001-23	07/31/2001	Revised patient safety standards
2001-22	07/18/2001	Postponement of January 1 Effective Date for all Open Season Elections
2001-21	06/22/2001	Input File Layout for the FEHB Clearinghouse
		Enclosure A, Enrollment File Layout
		Enclosure B, CLER Requirements Document
2001-20	06/21/2001	HIPAA Workgroup
2001-19	05/30/2001	Accreditation
2001-18-NEW	05/22/2001	Contract Year 2002 Brochure Language and Format -- Carriers of New FEHB Plans
		Enclosure -- Patterns
2001-18	05/22/2001	Contract Year 2002 Brochure Language and Format -- All Carriers
		Enclosure FFS 1 - FFS Pattern
		Enclosure FFS 2 - FFS Edit List
		Enclosure HMO 1 - HMO Pattern
		Enclosure HMO 2 - HMO Edit List
2001-17	05/08/2001	Reminder to Provide CAHPS Survey Data & Crosswalk
		Enclosure A, Crosswalk
		Enclosure B, FEHB Subcode Plan Name List
2001-16	05/07/2001	Verification of accreditation status (for HMO plans)
2001-15	05/01/2001	2002 Rate Instructions - DoD Demonstration Project - Community Rated Carriers
		Enclosure
		Enclosure 2, Plan Participation in DoD/FEHB Demonstration Project
2001-14	05/01/2001	Federal Employees Health Benefits (FEHB) Program: January 1 Effective Date for all Open Season Enrollments and Changes
2001-13	04/25/2001	FEHB Clearinghouse Update
		Enclosure
2001-12	04/24/2001	Health Insurance Portability and Accountability Act: Privacy Regulations
2001-11(a)	04/18/2001	Technical Guidance for 2002 Benefit and Service Area Proposals - HMOs
		Enclosure
2001-11(b)	04/18/2001	Technical Guidance for 2002 Benefit and Service Area Proposals -- New HMOs
		Enclosure
2001-11(c)	04/19/2001	Technical Guidance for 2002 Benefit Proposals - FFS
		Enclosure
2001-10	04/10/2001	2002 Rate Instructions - Community Rated Carriers
		Enclosure
2001-09	04/10/2001	Call Letter for Contract Year 2002
2001-08	04/04/2001	2002 Rate Instructions for Experience-Rated Plans
2001-07	03/22/2001	Reconciliation Instructions for 2001 Rates--Community-Rated Carriers
		Enclosure
2001-06	03/20/2001	2001 Medicare Match
		Enclosure
2001-05	03/14/2001	Brochure edits for 2002
		Enclosure
2001-04	02/13/2001	HEDIS® Data (HMO Carriers Only)
2001-3A	02/06/2001	2000 Financial Reporting (Experience-Rated Carriers) (the enclosures are linked from the web version of the letter)
2001-3B	02/06/2001	2000 Financial Reporting (Community-Rated Carriers)
2001-02	02/06/2001	FEHB Routine Requirements
		Attachment
2001-1	02/02/2001	Administrative Changes

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2000 Carrier Letters

Letter	Date	Subject
2000-55	12/20/2000	Federal Employees Health Benefits Children's Equity Act of 2000
2000-54	12/07/2000	Reminder of Reporting Requirements for Carriers Participating in the Department of Defense and Federal Employees Health Benefits Program Demonstration Project in 2000
		Enclosure 1
2000-53	12/07/2000	LIVE WEBCAST: At 9:30 a.m. EST on Monday, December 11, 2000
2000-52	11/29/2000	Federal Employee Assistance Program Headquarters Contacts
2000-51	11/27/2000	2001 Consumer Assessment of Health Plans Survey (letter only)
		Enclosure 1 - CAPHS® Adult Questionnaire (Commercial)
		Enclosure 2 - Vendor Selection Form
		Enclosure 3 - Crosswalk
		Enclosure 3 - 2001 FEHB Sub-Code Plan List
2000-50	11/15/2000	Compliance With The Americans With Disabilities Act (ADA)
2000-49	10/26/2000	Health Insurance Portability and Accountability Act: Standards for Electronic Transactions and Standards for Privacy of Individually Identifiable Health Information
2000-48	10/11/2000	2000 Fiscal Year Financial Reporting
		Enclosures
2000-47	10/11/2000	Open Season Enrollment Issues
2000-46	09/29/2000	How do you like the carrier web page?
2000-45	09/12/2000	Coverage for Pastoral Counselors in Medically Underserved Areas
2000-44	09/12/2000	Updating Plan Information
2000-43A	09/08/2000	Amendments to the Standard Contract for Fee-for-Service Carriers
		Enclosure
2000-43B	09/08/2000	Amendments to the Standard Contract for Experience-Rated HMO's
		Enclosure
2000-43C	09/12/2000	Amendments to the Standard Contract for Community-Rated Carriers
		Enclosure
2000-42	09/01/2000	Electronic Enrollment Changes NOTE: The information in this letter has been modified by CL 2001-29 of Sept. 7, 2001.
		Enclosure 1 - Individual File Layout
		Enclosure 2 - Agencies Participating in Employee Express
2000-41	09/01/2000	Brochure Development, Production and Distribution for 2001
2000-41	09/01/2000	Brochure Development, Production and Distribution for 2001 (letter only)
		Enclosure 1 - 2001 Rate Information Page
		Enclosure 2A - FFS Brochure Examples
		Enclosure 2B - HMO Brochure Examples
		Enclosure 3 - Additional Guidance for Typesetting Brochure Cover Enclosure 4 - Printing, Distribution, and Shipping Specification for FEHB Brochure Enclosure 5 - Sample Brochure Quantity Forms
		Enclosure 6A - Agencies Shipping Label
		Enclosure 6B - DoD Project Shipping Label
		Enclosure 6C - National Computer Systems Shipping Label
2000-40	08/25/2000	Fall Conference Registration and Synopsis
2000-39	08/25/2000	MinnesotaCare Tax
2000-38	07/28/2000	Five Steps to Safer Health Care
2000-37	07/25/2000	FEHB Fall Plan Conference CORRECTION and ADDITION
2000-36	07/25/2000	Verification of accreditation status (for HMO plans)
2000-35	07/21/2000	Audit Guide for Experience-rated Carriers
		Attachment — FEHBP Experienced-rated Carrier and Service Organization Audit Guide
2000-34	07/21/2000	New Public Health Service Smoking Cessation Guideline
2000-33	07/21/2000	New Survey Contractor Selected
2000-32A	07/17/2000	FEHB Clearinghouse (Experience-rated Carriers)
2000-32B	07/17/2000	FEHB Clearinghouse (Community-rated Carriers)
2000-31	07/07/2000	Contract Year 2001 Brochure Language and Format
		FFS Attachment Part 1
		FFS Attachment Part 2
		FFS Attachment Part 3
		HMO Attachment Part 1
		HMO Attachment Part 2
		HMO Attachment Part 3
2000-30	07/07/2000	FEHB Fall Plan Conference
2000-29	06/21/2000	The Department of Defense (DoD) and Federal Employees Health Benefits (FEHB) Program Demonstration Project
2000-28	06/21/2000	Correction to Letter 2000-25
2000-27	06/06/2000	New Vendor for Medicare Part B Claims Adjudication
2000-26	05/31/2000	Electronic Enrollment
2000-25	05/31/2000	PlanSmartChoice and the FEHB Website
2000-24	05/15/2000	FEHB Carrier Web Page
2000-23	05/08/2000	Plain language for your 2001 brochure
		Plain language for your 2001 brochure - FFS Part I of 3
		Plain language for your 2001 brochure - FFS Part II of 3
		Plain language for your 2001 brochure - FFS Part III of 3
		Plain language for your 2001 brochure - HMO Part I of 3
		Plain language for your 2001 brochure - HMO Part II of 3
		Plain language for your 2001 brochure - HMO Part III of 3
2000-22	05/05/2000	Open Season Material & Reimbursement of Printing Costs
2000-21A	05/05/2000	Technical Guidance for Benefit Proposals
2000-21B	05/05/2000	Technical Guidance for Benefit and Service Area Proposals
2000-21C	05/05/2000	Technical Guidance for Benefit and Service Area Proposals
2000-20	05/05/2000	Updated Participation in the DoD/FEHB Demonstration Project
2000-19	05/01/2000	2001 RATE INSTRUCTIONS - DoD Demonstration Project — Community Rated Carriers
2000-18A	04/19/2000	2001 Rate Instructions for Experience-Rated Plans
2000-18B	04/19/2000	2001 RATE INSTRUCTIONS — Community-Rated Carriers
2000-17	04/11/2000	Call Letter for Contract Year 2001 — Policy Guidance
2000-16	04/04/2000	2001 ADDITIONAL RECONCILIATION INSTRUCTIONS Community-Rated Carriers Only
2000-15	03/27/2000	Corrections to FEHB Program Carrier Letters
2000-14	03/22/2000	Reconciliation Instructions for 2000 Rates — Community-Rated Carriers
2000-13	03/21/2000	Request for Feedback on Disenrollment Regulations
2000-12	03/06/2000	2000 Medicare Match
2000-11	03/01/2000	Mental Health and Substance Abuse Parity Evaluation
2000-10	03/01/2000	Premium conversion
2000-09	02/28/2000	FEHB Routine Reporting Requirements
2000-08	02/28/2000	Reporting Requirements for Carriers Participating in the Department of Defense and Federal Employees Health Benefits Program Demonstration Project.
2000-07	02/28/2000	Doing What Counts for Patient Safety: Federal Actions to Reduce Medical Errors and Their Impact.
2000-06	02/09/2000	HEDIS® Data
2000-05C	02/09/2000	1999 Financial Reporting
2000-05E	02/09/2000	1999 Financial Reporting
2000-04	01/27/2000	Processing Annuitant Enrollments
2000-03	01/19/2000	Consumer Assessment of Health Plans Survey
2000-02	—	Family Centered Activities by FEHB Health Carriers
2000-01	01/04/2000	Department of Defense and Federal Employees Health Benefits Program Demonstration Project

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1999 Carrier Letters

Letter	Date	Subject
1999		Year 2000 Compliance
1999-62	12/21/1999	FEHB Clearinghouse
1999-61	12/21/1999	Y2K Service Interruptions
1999-60	12/16/1999	Tobacco Litigation
1999-59	12/13/1999	Payroll Office Changes
1999-58 full CR contract	11/23/1999	Federal Employees Health Benefits Program Standard Contract
1999-58 CR amend	11/23/1999	Year 2000 Amendments to the Standard Contract for Community-Rated Carriers
1999-58	11/23/1999	Amendments to the Standard Contract for Community-Rated Carriers
1999-57	11/02/1999	Department of Defense and Federal Employees Health Benefits Program Demonstration Project
1999-56	10/28/1999	New FEHB Election Forms
1999-55	10/28/1999	Plan Performance Data Collection
1999-54	10/27/1999	Open Season Enrollment Issues
1999-53A	10/21/1999	1999 Fiscal Year Financial Reporting
1999-52	10/20/1999	Mental Health and Substance Abuse Parity
1999-51	10/19/1999	The 2000 FEHB Web Site
1999-50	10/05/1999	Implications of Medicare Anti-Kickback Statute for Coordination of Benefits
1999-49	09/28/1999	DoD/FEHB Demonstration Project and Health Fairs
		DoD/FEHB Demonstration Project and Health Fairs - Enclosure
1999-48	09/22/1999	Correction to Carrier Letter 1999-046
1999-47	09/20/1999	FEHB Press Release and Rates for 2000
1999-46	09/08/1999	2000 Plan Brochure Development, Production and Distribution
1999-45	09/15/1999	Fall Conference
1999-44	09/07/1999	Electronic Enrollment Correction
1999-43	09/07/1999	Transitional Care under the Patients' Bill of Rights
1999-42	09/02/1999	The Guide to Federal Employees Health Benefits Plans for Year 2000 and the FEHB web site.
1999-41	08/30/1999	Electronic Enrollment NOTE: The information in this letter has been modified by CL 2001-29 of Sept. 7, 2001.
1999-40	08/27/1999	Greenbrier Clinic, Inc., Compliance Plan
1999-39	08/27/1999	Class Deviation from Federal Acquisition Regulation (FAR) 31.205-46(a)(2)(i), Maximum Per Diem Rates Under the Federal Travel Regulations (FTR)
1999-38A	08/18/1999	Amendments to the Standard Contracts for Fee-for-Service Carriers
1999-38B	08/18/1999	Amendments to the Standard Contracts for Community-Rated Carriers
1999-38C	08/18/1999	Amendments to the Standard Contracts for Experience-Rated HMOs
1999-37	08/17/1999	Revisions to the original fee-for-service brochure language
1999-36A	08/13/1999	1999 Contract Amendments
1999-36B	08/13/1999	1999 Contract Amendments
1999-36C	08/13/1999	1999 Contract Amendment
1999-35	08/13/1999	The Debt Collection Improvement Act of 1996 (DCIA)
1999-34	08/06/1999	Notification of certain enrollment changes
1999-33	07/22/1999	Verification of accreditation status
1999-32	07/19/1999	Brochure language concerning Breast Reconstruction
1999-31	07/19/1999	Revisions to the original HMO brochure language
1999-30	07/16/1999	The Department of Defense (DoD) and Federal Employees Health Benefits (FEHB) Program Demonstration Project
1999-29	07/14/1999	Contract Year 2000 Brochure Language and Format
1999-28	06/18/1999	Results of IPA Audits of Experience-Rated Carriers
1999-27	06/07/1999	Mental Health and Substance Abuse Parity
1999-26	06/18/1999	OIP Plain Language Style and Usage Guide
1999-25	05/25/1999	Contract Year 2000 Brochure Language and Format
1999-24	05/18/1999	Request for Feedback on the Carrier Information System
1999-23	05/17/1999	Cryosurgery for Localized Prostate Cancer
1999-22	05/06/1999	1999 FEHB Customer Satisfaction/CAHPS Survey
1999-21	04/28/1999	Participation in the DoD/FEHB Demonstration Project
1999-21DoD	05/06/1999	2000 RATE INSTRUCTIONS DOD Demonstration Project Community Rated Carriers
1999-20	04/28/1999	Delayed Annuitant Medicare Match Data
1999-19	04/19/1999	United States of America and State of Florida, ex rel. Louis H. Mueller v. Eckerd Corporation, Case Number 95-2030-Civ-T-17C (M.D. Fla.)
1999-18A	04/13/1999	Year 2000 Compliance
1999-18B	04/13/1999	Year 2000 Compliance
1999-17A	04/16/1999	2000 RATE INSTRUCTIONS Community Rated Carriers
1999-17B	04/28/1999	2000 Rate Instructions for Experience-Rated Plans
1999-16	04/09/1999	Annual Call Letter for Contract Year 2000
		Call Letter Enclosure - FFS
		Call Letter Enclosure - HMO
		Call Letter New Enclosure - HMO
1999-15	03/26/1999	Correction to Reconciliation Instructions For 1999 Rates Community-Rated Carriers
1999-14	03/19/1999	Reconciliation Instructions For 1999 Rates - Community-Rated Carriers
1999-13	03/16/1999	Table 1 -- Reporting Under The FEHB Program
1999-12	03/05/1999	1998 and 1999 Contract Amendments on Cost Accounting Standards
1999-09	02/18/1999	Correction to Disenrollment and Reconciliation Carrier Letter
1999-08	02/09/1999	FEHB Reporting Requirements
1999-07	02/09/1999	Disenrollment and Reconciliation
1999-06	02/05/1999	1999 Medicare Match
1999-05	02/01/1999	Military Retirees FEHB Coverage Demonstration Project
1999-04	01/22/1999	Surcharges and Taxes on Connecticut Hospital Services
1999-03	01/21/1999	Revision of the Guide to Federal Employees Health Benefits Plans
1999-02	01/15/1999	Employee Express Evaluation
1999-01	01/15/1999	FEHB Plain Language Initiative

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If you want to apply to participate in the FEHB Program, please do the following:

• Download each of the following Microsoft Word files;
  • Application for FEHB
  • Drug Free Workplace Certification
  • Sample Experience-Rated HMO Contract
  • Sample Community-Rated HMO Contract
  • Anti-lobbying form
• Complete the application and certifications as directed;
• Send the completed application to OPM by January 31; and
• Complete the information form in the next tab. We will then be able to contact you with any significant updates to the materials you downloaded.

Carrier Application Information Form

Report	Frequency	Required of	Date Due	Contact
Agreements and Certifications
Certification re Disclosure of Lobbying Activities	At approval	All	Before approval	Health Insurance Specialist
OMB SF LLL, Disclosure of Lobbying Activities (relates to certification)	When applicable	All	As needed	Health Insurance Specialist
Certification re Drug-Free Workplace	At approval	All	Before approval	Health Insurance Specialist
Benefit and Brochure Related
Benefit Proposal	Annual	All; by plan type	May 31	Health Insurance Specialist
Brochure Quantity Form	Annual	All; by plan type	As directed	Health Insurance Specialist
Plan Contracting Officials Form	Annual/not less than annual	All	May 31/and when officials change	Health Insurance Specialist
Plan Address Form	As updates are needed	All	As needed	Health Insurance Specialist
Service area statement	With request to expand service area	HMOs	With benefit proposal, when applicable	Health Insurance Specialist
Debarment/Suspension
FEHB Carrier debarment/suspension actions	Semi-annual	All	Apr 15 and Oct 15	Ofc Of Inspector/Gen/Internet, Debar (debar@opm.gov)
Enrollment Reporting
Table 1-Summary of FEHBP Enrollment	Annual	All	Apr 30	FEIO/OPS (alexander.dashevsky@opm.gov)
FEHB Quality Assurance
Customer Satisfaction Survey Results (CAHPS)	Annual		Feb 1	(cahps@opm.gov)
HEDIS	Annual		As directed by NCQA auditor	(hedis@opm.gov)
Quality Assurance Report	Annual	All	Jul 1	(fehbqareport@opm.gov)
Fraud and abuse cases report	Annual	All	Mar 31	Health Insurance Specialist
Financial Reports
All reports associated with the Annual Accounting Statement and required by the FEHBP Experienced-Rated Carrier and Service Organization Audit Guide	As directed in Audit Guide	Exp-rated	As directed in Audit Guide	Trust Funds Group/ Wynn (melanese.wynn@opm.gov)
Community-rated financial reports package (currently, only your annual CPA report is required)	Annual	Comm-rated	90 days after carrier's FY	Trust Funds Group/ Wynn (melanese.wynn@opm.gov)
Other Financial Reports
C1 - Annual Incurred Report (12 months incurred paid through 18 months)	Annual	FFS	July 31	Ofc of Actuaries (actuary@opm.gov)
C2 - Number of Procedures and Number Receiving Benefits	Annual	FFS	July 31	Ofc of Actuaries (actuary@opm.gov)
Triangle Table	Quarterly	FFS and Experience Rated HMOs	15 days after end of quarter	Ofc of Actuaries (actuary@opm.gov)
Loca Draw down	Quarterly	FFS and Experience Rated HMOs	15 days after end of quarter	Ofc of Actuaries (actuary@opm.gov)
Other Submissions
Service charge request (Plans are not required to request a service charge)	Annual	Exp-rated	As directed	Health Insurance Specialist
Special contingency reserve request	When applicable	Exp-rated	As directed	Health Insurance Specialist
Pilot Projects
Small Business Subcontracting Plan	Annual	6 pilot project carriers	Jun 15	Health Insurance Specialist
Subcontracting Report for Individual Contracts (SF 294)	Semi-annual	6 pilot project carriers	Apr 30 and Oct 30	Health Insurance Specialist
Summary Subcontract Report (SF 295)	Annual	6 pilot project carriers	Oct 30	Health Insurance Specialist
Premium Payment
TFS Form 3881 B Payment Information Form	At approval	All	As directed	Trust Funds Group/Wynn (melanese.wynn@opm.gov)
Change of Financial Institution	When applicable	All	As directed	Trust Funds Group/Wynn (melanese.wynn@opm.gov)
Rate Related
Rate Proposal (includes several tables and reports)	Annual	All; by Rate type	May 31	Ofc of Actuaries (actuary@opm.gov)
Rate Reconciliation Request (includes several tables and reports)	Annual	C-rated	April 30	Ofc of Actuaries (actuary@opm.gov)

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• Directory of Headquarters Level Agency Benefits Officers
• Tests and Procedures Identified in the Choosing Wisely Campaign
• Guiding Principles for FEHB Carriers
• Carrier Handbook
• Benefits Administration Letters
• Tribal Benefits Administration Letters
• Indian Tribes Reference Materials
• Medicare
• Title 5, United States Code, Chapter 89 - Health Insurance
• FEHB Regulations - Part 890 of CFR Title 5
• Federal Acquisition Regulation (FAR)
• OPM Federal Employees Health Benefits Acquisition Regulation (FEHBAR)
• FEHB Enrollment Through Tribal Employees
• FedScope
• Federal Employees Health Benefits Program Call Letter

Performance Assessment

• FAQs on Carrier Letter 2014-19 FEHB Health Plan Performance Assessment
• FAQs Carrier Letter 2014-28 Additional Information on the Performance Areas for the FEHB Plan Performance Assessment
• FAQS Measures and Framework Design
• Reporting HEDIS Metrics to the National Committee Quality for Assurance (NCQA) 

Health Information Technology References

Health & Human Services

• Office of the National Coordinator for Health Information Technology (ONCHIT)
• National Health Information Infrastructure (NHII) Home Page
• CMS DOQ-IT Project
• CMS QIO Program (Quality Improvement Organizations)
• The Health Information Technology Leadership Panel: Final Report (Press Release)
• The Health Information Technology Leadership Panel: Final Report

Executive Branch/Congressionally Appointed Commission

• Certification Commission for HIT

Regional Health Organizations (focusing on the States with which HHS-AHRQ has contracts on HIT demos)

• Indiana Health Information Exchange
• Utah Health Information Network
• Blue Cross $50 Million for Massachusetts HIT 
• Information on Rhode Island HIT efforts

Technology Groups

• Health Information and Management Systems Society
• HL-7 (Health Level 7) Home Page
• Webgroup for Electronic Data Interchange (WEDI) Health Data

• 2022-01 Health Matters Newsletter - Telehealth
• 2022-02 Health Matters Newsletter - Adult Immunization Status

Federal Employees Health Benefit (FEHB) Program Plan Performance Assessment

The Office of Personnel Management’s (OPM) goal is to improve the health of the populations we serve, ensure the delivery of high quality consumer focused health care, and provide Federal employees and retirees with affordable insurance benefits. We evaluate FEHB Carriers on key parameters of clinical quality, customer service, resource use, and contract oversight.

Many aspects of our performance assessment framework rely on measures from the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS). Scoring measures against national benchmarks help OPM recognize top performing health insurance carriers in the program, inform enrollee choice, and link objective performance to profit.

FEHB Carriers are encouraged to join the National Committee for Quality Assurance's Digital Measurement Community to learn about the implementation of digital performance measures. FEHB Carriers may also find the Health Care Payment Learning and Action Network, managed by the Department of Health and Human Services, as a source of proven value-based payment models utilized among commercial carriers. OPM also encourages FEHB Carriers to join the PPA Best Practices Workgroup. Details can be found in Carrier Letter 2017-10, "Plan Performance Assessment Best Practices Workgroup." Carriers interested in joining the FEHB Program should carefully review materials listed under the subject areas on this page.

Below are links to more FEHB Plan Performance Assessment Information: