Retiree explains health coverage



Rosemary Arkoian waited for her turn, but like the silver-haired federal retirees in the crowd around her, she leaned in between others' shoulders or turned her head to the side to listen to Walton Francis dispense his wisdom.

Every year, Arkoian comes to one of two Maryland forums to hear Francis, 63, tell her what to do about her health insurance.

A few years ago, she switched to a cheaper plan based on Francis' advice. Now, Arkoian, 64, a former Russian linguist at the National Security Agency and the widow of a federal employee, is worried that she is showing early signs of osteoporosis. She is not taking medication yet, but when that time comes, should she switch plans?

That's a big decision to place in the hands of a stranger, but thousands of federal workers and retirees in the Washington-Baltimore corridor turn to Francis every year. It is understandable. With 279 choices nationally and an average premium increase of 6.6 percent during this year's open season, people want to know how to save money without giving up important benefits.

Francis started telling people how to do that on his lunch break. It was 1972. He was developing policy for the Department of Health and Human Services. His wife had just given birth to a girl, and he was looking for the best plan for his young family. He started comparing his plan with others and found that he could save $1,000 a year by switching to another one that offered almost identical benefits.

Co-workers at the lunch table so cherished his advice that he decided to write his teachings down and approach a publisher. This year marks the 27th edition of Washington Consumers' Checkbook Guide to Health Plans for Federal Employees, the 142-page health care bible for feds.

"Most people are set in their ways and don't think about what choices are out there," said Francis, who has three government-related master's degrees - one from Yale and two from Harvard. "In the community of federal employees and retirees, there is an excess of conservatism."

At Tuesday's forum in Wheaton, sponsored by U.S. Rep. Chris Van Hollen, a Democrat from the 8th District, retirees one by one held the microphone and asked questions of a three-person panel. Francis fielded almost all of them.

One woman needed five crowns, but she complained that her dental benefits were not adequate. Which plan should she sign up for? One man needed physical therapy, but his insurance did not cover enough of the bill for him to afford it. What should he do? One man switched plans and then began receiving incorrect bills. If he switched again, would the problem get worse?

When Francis did not have an answer off the top of his head, he would thumb through his book and find it, often quoting approximate annual savings to consumers if they took his advice.

His book is loaded with tables. Each year, he has only one month to build them. Insurers do not make the information available until October, and open season starts in November, running until Dec. 12 this year.

"I used to write the book during my annual vacation and on weekends," said Francis, who lives in Virginia and retired from HHS in 1997, where he led the policy division. "I'd lock myself up in my house, and of course, I'd go crazy. But the fun of it is when I get help people."

For Arkoian, a self-described "info-aholic," the advice is indispensable.

Her husband, a Drug Enforcement Administration employee, died in 1992, leaving her to raise their two teenagers.

At a forum a few years back, Francis told the audience that Arkoian's plan was "expensive for what you get." She switched to the "Mail Handlers" benefit plan, which she said that she has been "pretty happy with." But now, with osteoporosis looming, Arkoian wants to know whether she should stick with it.

"Walt said that I wouldn't be making a mistake staying with Mail Handlers, but that I might want to take a look at [the Government Employees Hospital Association] standard" plan, Arkoian said.

Thanks to Francis, Arkoian plans to do her homework.

Here's a sample of Francis' advice, from the Guide to Health Plans for Federal Employees:

"Read your plan's brochure. Do not choose a new plan, or stay in the same plan, without reading at least the sections on `How We Change for 2005' and the `Summary of Benefits.'"

"Elect a survivor annuity for your spouse. If you die and your spouse receives no federal pension, your spouse will lose Federal Employee Health Benefit Plan [FEHBP] coverage forever."

"For retirees, you can keep flexibility only at a high price. The best argument for paying the Medicare Part B premium is to preserve your choices over time, as both the FEHBP and Medicare evolve. However, you will lose hundreds of dollars almost every year for this decision."

The book costs $10.45. Call 202-347-7283 for information on how to order one.

The writer can be reached at or 410-715-2885. Recent back issues can be read at

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