2021 Federal Employee Program (FEP) Changes
Blue Cross and Blue Shield of Kansas (BCBSKS) will continue to administer the FEP group health plan in Kansas effective January 1, 2021. Service Benefit Plan information can be located on the FEP Website.
The Service Benefit Plan continues to offer three plans:
- Standard Option
- Basic Option
- FEP Blue Focus
Changes to all Service Benefit Plans (Standard, Basic, FEP Blue Focus):
- Some Antiretroviral therapy medications for those at risk of, but who do not have HIV will be covered under preventive benefits. The generic alternative to Truvada will be covered with no member cost-share.
- Some bowel preparation medications will be covered with no member cost-share when used for a preventive colonoscopy screening when obtained at a Preferred Retail Pharmacy.
- Preventive screening for hepatitis C will now include individuals ages 18 and over.
- Preventive chest x-ray was removed as part of the preventive benefits. This service will continue to be covered under the diagnostic benefit, with applicable member cost-share.
- Telemedicine benefit has been added to allow telephone consultations and medical evaluation and management services. Coverage will also include inpatient and facility-billed services. Member cost-share will be applicable for services, except for the first 2 telemedicine visits with Teladoc.
- Formulary adjustments will be implemented including:
- Expanding list of excluded drugs for Standard Option.
- Expanding list of drugs excluded from certain therapeutic classes within the managed formulary for Basic Option.
- Review of closed formulary drugs for FEP Blue Focus.
Changes to Standard/Basic Option only:
- The out-of-pocket cost for tier 4 and 5 specialty drugs increased.
- Benefits for hearing aids up to $2,500 will be allowed once every 5 years.
Changes to Standard Option only:
- Removed reduction of member cost-share associated with Tier 2 and 3 brand-name drugs and Tier 4 and 5 preferred specialty drug copayments for the 31st and subsequent refills.
Changes to Basic Option only:
- Outpatient emergency room facility copayment increased by $50.00 for accidental injury visits.
Changes to FEP Blue Focus only:
- Out-of-pocket (catastrophic) maximums increased to $7,500 for Self Only and $15,000 for Self + One and Self & Family contracts.
- Continuous home hospice care will be reimbursed with no member cost-share when provided by a Preferred provider.
- Screening pregnant members for HIV will be considered a preventive service and reimbursed with no member copayment when provided by a Preferred provider.
If you have any questions regarding this newsletter, please contact your BCBSKS provider consultant.