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FEHB Open Season Clarifications

Posted By Dennis Damp On In ANNUITIES / ELIGIBILITY,BENEFITS / INSURANCE,FINANCE / TIP,RETIREMENT CONCERNS,SOCIAL SECURITY / MEDICARE,SURVIVOR INFORMATION | Comments Disabled
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The 2016 plan brochures [2] are now available online at OPM.  I ordered 6 plan brochures through OPM’s FEHB Open Season Online [3] service on Monday. I requested hard copies so I can sit down and review them offline. You can also view them online. This year has generated many more questions due to the new Self Plus One option and the fact that health care costs are generally increasing while our annuities are decreasing due to inflation and no 2016 COLA. Even with escalating costs our FEHB Health Care Program [4] is still an excellent benefit.

A number of plans are dropping out of the program in 2016. You will have to select another plan if your plan is withdrawing from the FEHB program. Some Restricted Fee for Service plans, only open only to specific individuals, are not included in the 2016 guide. If you are enrolled in a restricted plan review the plan brochures for benefit and premium information.

It was brought to my attention that on page two of this year’s Open Season Benefits Guide it states that your spouse can continue coverage after the annuitant dies only if you have self and family coverage. The brochure states “While you can cover your spouse on a family enrollment during your lifetime, in the event of your death, your spouse may continue enrollment in the FEHB Program as your survivor only if you are enrolled in self and family coverage at the time of death, and you elected to provide a survivor benefit for your spouse.”

I called OPM and talked with Donna Douglas, an OPM customer service representative. She stated that the brochure needs to be updated and your spouse will be covered if you are enrolled in either a family plan or in the self plus one option when the annuitant dies and the spouse will automatically be switched to the self only option under your current plan.

Nicholas, another newsletter reader stated that he couldn’t find where he could pay his FEHB plan premiums directly because next year his annuity will not be enough to continue premium deductions. He didn’t want to switch to a lower cost plan. According to OPM, “if your monthly annuity payment is less than the monthly premium for the plan you want, you may pay your premium directly. You can request information on electing this payment option through Open Season Online or Open Season Express”.

Couples now enrolled in a family option are not automatically changed to the Self Plus One option. You must elect this new option if desired and make the change during open season. My previous articles titled FEHB Self Plus One – A Major Disappointment [5], and FEHB Cost Savings and our New 2016 Leave Chart [6] provide additional information for the new Self Plus One option.

Many of your questions will be answered in this year’s Open Season Health Benefit Guide that you will receive shortly or you can download a copy at https://retireefehb.opm.gov/Annuitant/ [7] after you register. I downloaded my copy earlier this week.

Request a Retirement Benefits Summary & Analysis [8]. Includes projected annuity payments, income verses expenses, FEGLI, and TSP projections.

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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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