FEHB Plan Brochures
Plan brochures are both necessary and sufficient to determine what benefits each plan covers, or does not cover. In some cases a plan does not mention a service at all in its brochure, but has assured us that its claims manual (which is not available to employees) says the service is covered. You cannot fully rely on this, however, since OPM has stated that the brochure "is the only official description of the benefits provided by each plan. Do not rely on statements not contained in the brochure. Study the brochures carefully." We agree, and endorse OPM efforts to assure that brochures are consistently and clearly written. Indeed, compared to most public and private insurance, the FEHB brochures are models of clarity. They are particularly well designed to facilitate comparisons among plans by consumers.
Unfortunately, health plan brochures have mushroomed in length. In 1990 the average national plan had a brochure 29 pages in length; by ten years later the average grew to 77 pages. For local plans, brochures grew over the same period from 16 to 65 pages, on average. Some of the increase represents increased clarity through "plain English," some is due to increased complexity in plan benefits, and some is due to unnecessary detail. Nonetheless, downloading brochures as PDF files either from guidetohealthplans.org or from opm.gov is easily accomplished, and vital to final plan selection.