Selling health benefits to the federal government: pricing guidelines and pitfalls

Approximately 300 health plans contract with the Office of Personnel Management (OPM) to provide health care services to federal employees and their families under the Federal Employees Health Benefits Program. Total enrollment in this program is approximately 10 million persons, making it by far the largest employer health plan in the United States. However, the federal government insists on getting the "best price." This article explores the uncertainties and pitfalls that a health plan faces when it contracts with OPM and does not offer the best price.