Posted on Friday, 17th October 2014 by

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Open Season for Federal Employees Health Benefits (FEHB) is just around the corner. Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December. This year Open Season is November 10, 2014 – December 8, 2014.

Federal retirees and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees. In order to carry your FEHB coverage into retirement, you must be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement) and must have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person’s FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.

Below are some frequently asked questions regarding FEHB for retirees.

What are the FEHB enrollment types? Self only and self and family. (Note: OPM plans to implement the self-plus-one option effective January 1, 2016)

What do Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS) retirees have to do to change health insurance coverage?
During the annual Open Season, OPM sends Open Season material to all those enrolled in the FEHB plus those who have suspended their enrollments to enroll in a Medicare-sponsored plan approved by the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA) and to enroll in TRICARE. The package will include an explanation of benefit changes for the next year and your new premium rate, but will exclude the health plan brochure.

  • OPM provides Open Season Express, an operator supported toll-free telephone service for retirees to call to request brochures, health benefits satisfaction surveys, and make enrollment changes using telephone technology. The phone number is 1 (800) 332-9798. (The line will be open in early November.)
  • OPM also provides information on their healthcare insurance plan information website. (As of 10/16/2014, the site still has 2014 plan information.)

When will my Open Season change to the new coverage be effective?

The effective date of the Open Season change for annuitants is always January 1.

I am retired but my spouse is a current Federal employee. I have carried our FEHB enrollment for the past several years. If I cancel my FEHB enrollment to be covered by my spouse’s FEHB enrollment, will I be able to enroll in a Self Only enrollment in the future?

Yes, you will be able to reenroll in the future because you are canceling your enrollment to be covered by another FEHB enrollment.

I am retired but my spouse is not. I want to drop out of the FEHB Program for a year or two because my spouse has good free coverage from her employer for the both of us. Will there be any penalty?

Normally, such a cancellation would be permanent. Annuitants cannot re-enroll in the program except under very limited circumstances, such as to enroll in a Medicare-sponsored health plan or TRICARE. Do not drop out of the program unless you are sure of being able to re-enroll.

I want to change my FEHB enrollment to an HMO but I don’t live or work in the Plan’s area as required by that particular plan’s brochure. Why can’t I enroll in it?

Most health maintenance organizations (HMO) restrict enrollment to an area where its doctors and hospitals are accessible. Although some HMOs do not have restrictions on where you live or work, please recognize that if you later find it is inconvenient to get to a plan provider, you may have to wait until the next Open Season to change plans.

How can I find out the amount of my FEHB premium?

The premiums for the FEHB plan you are currently enrolled in are in the brochure you will receive from your plan during the annual Federal Benefits Open Season. In addition, you can check OPM’s site for 2015 FEHB Premiums. The U.S. Office of Personnel Management (OPM) has announced the average premium rate for people covered by the Federal Employees Health Benefits (FEHB) Program will increase by 3.2 percent in 2015. That percentage is lower than last year’s increase of 3.7 percent. The average premium increase for the Federal Employees Dental and Vision Insurance Program (FEDVIP) will be 1.7 percent for dental coverage and average premiums for vision benefits will increase by 1.5 percent.

I made an Open Season enrollment change. If I have to go to the doctor after January 1, which plan do I contact?

As a retiree, your new plan becomes effective on January 1.

I am an annuitant. I changed my health insurance in Open Season and have not received an identification card even though it is late January. What can I do?

First, call your plan. If they tell you they haven’t received the paperwork yet, you may contact OPM at 1-888-767-6738 or retire@opm.gov. Before contacting OPM, have your annuity information ready: your name, civil service annuity number (beginning with CSA or CSF), phone number and address, and information about your plan, such as the carrier enrollment code.

My retirement annuity keeps deducting for my old health plan even though I’m not enrolled anymore. How can I get the deductions to stop?

To verify your current health benefits plan, contact OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.The phone lines are open from 7:30 am to 5:30 pm (Eastern Standard Time). It is a busy phone number.

I am a survivor annuitant. Can I change my FEHB plan?
Yes, you can request an enrollment change during the Open Season.

What is the Federal Employees Dental and Vision Insurance Program (FEDVIP)?

The Federal Employee Dental and Vision Benefits Enhancement Act of 2004 authorizes OPM to establish arrangements under which supplemental dental and vision benefits are made available to Federal and U.S. Postal Service employees, retirees, and their eligible family members, and the law gives OPM broad contracting authority to leverage the purchasing power of Federal enrollees to provide comprehensive benefits with competitive premiums.

How do the FEDVIP plans differ from the dental and vision benefits FEHB plans provide as part of the FEHB benefits package?

FEHB and FEDVIP are separate programs. While some FEHB plans offer dental or vision benefits as part of their benefit package, only those carriers under contract to OPM are FEDVIP plans. FEDVIP plans offer comprehensive dental and vision benefits. FEDVIP is not part of the FEHB program, and it is different from any supplementary dental and vision product your FEHB plan may offer.

Update on the Self Plus One option

The effective date for the new Self Plus One enrollment type will be January 1, 2016. Therefore, the annual Open Season beginning on November 9, 2015 will include the Self Plus One enrollment type in the available enrollment choices. Unfortunately, this option won’t be available for another year. The Self Plus One enrollment type will cover the enrollee and one eligible family member.

For more information on FEHB and the various plans, visit OPM’s FEHB site and Federal Retirement Net ’s site at http://www.federalretirement.net/fehb.htm .

Learn more about your benefitsemployment, and financial planning issues on our site and visit our Blog frequently at http://fedretire.net to read all forum articles.

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The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and financial information are subject to change. To ensure the accuracy of this information, contact relevant parties and ask them to review your official personnel file and circumstances concerning this issue. Retirees can contact the OPM retirement center. Our article is not intended nor should it be considered investment advice and our articles and replies are time sensitive. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

 

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