OPM Looking to Modernize FEHB Enrollment

EHR

The Office of Personnel and Management (OPM) released a request for information on January 30 looking for vendors to help it implement a “one-stop shop” portal for comparing and enrolling in Federal Employees Health Benefits (FEHB) plans. The RFI is open for questions until February 15, and open for responses until March 11.

The portal would cover current Federal employees, retirees, and family members. With an estimated four million enrollees, one million enrollment transactions annually, and premiums exceeding $54 billion, creating a centralized hub would be no small task. However, the need to modernize is clear.

“While overall program administration is centralized at OPM, the enrollment process, enrollment reconciliation, and most customer service functions are decentralized across the Federal Government and beyond. This has resulted in processes that do not deliver a modern enrollment experience for enrollees, and adds unnecessary and costly administrative burden on agencies and carriers,” OPM notes in the RFI.

As part of the solution, OPM is looking for capabilities in:

  • Enrollment support;
  • Decision support;
  • Enrollment processing;
  • Enrollment reconciliation;
  • Premium reconciliation; and
  • Data warehousing and reporting.

“The CEP [Central Enrollment Program] will be the authoritative source for program-wide FEHB enrollment data, and provide real-time enrollment and premium transaction information to all employing agencies and participating FEHB health insurance carriers,” OPM notes.

In its questions for vendors, OPM asks if they have a solution that can use artificial intelligence to support customers, provide for multi-factor authentication, and provide real-time data validation.

On the data warehousing side, OPM asks about compliance with a variety of regulations, including FedRAMP, FISMA, and NIST guidelines. OPM is also looking to see if vendors can apply artificial intelligence to identify patterns, provide a dashboard view to authorized users of historical information, and export visualizations.

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