UPDATE

Federal Employees Dental and Vision Insurance Program

Coverage under the Federal Employees Dental and Vision Insurance Program (FEDVIP) was effective on December 31, 2006.

Plan Updates

The Office of Personnel Management (OPM) has issued the following FEDVIP updates:

MetLife Dental

MetLife's new, streamlined process for coordinating benefits became effective on February 5, 2007. MetLife coordinates benefits according to the FEDVIP law, which requires the Federal Employee Health Benefits (FEHB) plan to pay first. MetLife's new process minimizes the administrative burden for enrollees. When an enrollee receives services from a MetLife provider, the following steps will occur:

1. The MetLife dental provider files a claim for services with MetLife.

2. MetLife reviews the claim for FEHB information and checks to see if the FEHB plan pays dental benefits.

a. If the FEHB plan does not pay dental benefits, MetLife processes the claim and pays the benefits due to the enrollee.

b. If the FEHB plan pays dental benefits, MetLife sends the claim to the FEHB provider for payment and then pays the claim based on the plan allowance.

3. MetLife sends an explanation of benefits to the enrollee and the dental provider for information purposes. The MetLife enrollee does not have to contact his or her FEHB plan to pay the claim or obtain an FEHB explanation of benefits.

MetLife enrollees are strongly encouraged to provide their FEHB information at the point of service and to review and update their FEHB information at www.BENEFEDS.com if it was not previously provided or has changed since the initial FEDVIP enrollment. Otherwise, payment of claims will be delayed.

BCBS Vision Plan

The FEP BlueVision network is separate from the medical network available under the FEHB Blue Cross and Blue Shield Service Benefit Plan. FEP BlueVision provides a network that includes optometrists, ophthalmologists, and optical retailers - and the network is getting bigger every day. Over 600 providers were recently added, many due to nominations made by enrollees.

To find or nominate a provider:

1. Go to http://www.fepblue.org.

2. Click on Enter Site at the bottom of the page.

3. Under the word "Welcome" click on the link: Click to Look at What's New in 2007 FEP BlueVision. A pop- up window will appear.

4. Click the Continue button to be transferred to the FEP BlueVision Web site.

a. To find a provider, scroll down and click on Find a Provider.

b. To nominate a provider, scroll down and click on New Provider Nomination.

General FEDVIP Information

FEDVIP plans are required to coordinate benefits with FEHB carriers. Under the law, FEDVIP coverage is secondary to dental or vision benefits covered by the FEHB Program. The purpose of coordinating the benefits available through each plan is to give enrollees the opportunity to obtain payment for as much as possible of their out-of-pocket dental and/or vision expenses.

Key points in the coordination of benefits:

• Most FEDVIP enrollees have medical coverage through the FEHB program, and most FEHB plans provide some dental and/or vision benefits.

• The FEDVIP carrier is responsible for coordinating benefits, not the FEHB plan nor the enrollee.

• Enrollees are asked to do the following (1) provide their FEHB information on www.BENEFEDS.com when they enroll in FEDVIP (so that BENEFEDS can inform the FEDVIP carrier); (2) give their FEHB information to their dental or vision services provider; (3) update FEHB enrollment information on www.BENEFEDS.com whenever it changes. Otherwise, payment of claims will be delayed.

• The process for coordinating benefits will vary by carrier; however, in all cases the dental or vision provider must submit claims directly to the FEDVIP carrier. The carrier will coordinate benefits processing using one of the following methods:

1. Pay the benefit first; then pursue payment from the FEHB plan (if applicable).

2. Submit the claim to the FEHB plan first; then pay benefits based on any remaining balance.

3. Pay the claim based on the estimated amount that the FEHB plan will pay based on the plan's usual and customary charges or plan allowance; then make adjustments later, if necessary.

Updates to Demographic Information

Updates to demographic information (names, addresses, etc.) should be made through BENEFEDS by the enrollee. Enrollees may update information by calling BENEFEDS at 877-888-3337 or TTY 877-889-5680 or via the Web at www.BENEFEDS.com. Updates made by enrollees are automatically transferred to the dental and vision carriers by BENEFEDS on a daily basis.

Cancellations, Changes, and Enrollments

Enrollees may cancel their enrollment in FEDVIP only during FEDVIP Open Season.

Enrollees may change their enrollment or enroll in FEDVIP if they experience a qualifying life event (QLE). FEDVIP offers fewer QLEs than the FEHB Program, but includes QLEs such as losing other dental or vision coverage and returning to pay status from active military duty. For more detailed information on FEDVIP QLEs, contact BENEFEDS.

Paper forms are no longer accepted for enrollment in FEDVIP. However, the paper forms submitted during FEDVIP Open Season have been processed by BENEFEDS.

Newly hired and newly eligible employees have 60 days from their eligibility date to enroll in FEDVIP through BENEFEDS at 877-888-3337, TTY 877-889-5680, or via the Internet at www.BENEFEDS.com.

Where to Call with Questions

For questions about providers, networks, benefits, claims, and the process for coordinating benefits, contact your individual FEDVIP plan.

For questions about enrollment (including new employee enrollment and belated FEDVIP Open Season enrollments), changes to existing enrollments, QLEs, and premium deductions, contact BENEFEDS.

— Compensation,
Human Resources, 2-15-07