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Frequently Asked Questions Insurance

Health

  • No, you do not have to be enrolled in a family plan for the five years before you retire to meet the five-year requirement. As a retiree, you can enroll in a family plan during the Open Season or when an event occurs that permits a change to the family plan.
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    • OPM's Office of Retirement Programs website. The site provides various categories of information including the questions most frequently asked by annuitants and survivor annuitants.
    • During the year, you may request information such as verification of annuity or the value of life insurance as well as make changes to your own retirement account, such as federal and state income tax withholding changes, by calling OPM on the toll-free number 1-888-767-6738, TDD for the hearing impaired 1-800-878-5707, or send email to retire@opm.gov. The automated telephone system is available 24 hours a day, 7 days a week.
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  • Annuitants sometimes need a new copy of “Your Federal Retirement Benefits” to show their retirement income to their mortgage lender, bank, underwriter, state income tax office, or low-income housing provider.  To request a new copy of “Your Federal Retirement Benefits”, or to receive a verification of your annuity, contact OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.  The phone lines are open from 7:30 am to 7:45 pm (Eastern Standard Time). It is a busy phone number so we encourage you to call early in the morning or after 5:00 pm when the phone lines are less busy.
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  • They can apply to suspend their coverage at any time. Annuitants can call OPM's Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Former spouses can get the form from the employing office or retirement system maintaining their enrollment. Eligible individuals must submit a completed suspension form and provide all necessary documentation to show eligibility for TRICARE or CHAMPVA during the period beginning 31 days before and ending 31 days after the date they designate as using TRICARE or CHAMPVA instead of FEHB coverage.
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  • Employee Express is an innovative automated system that Federal employees use to make their personnel and payroll transactions electronically.
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  • No. Employees may not suspend their coverage. However, they can cancel their coverage to use CHAMPVA, TRICARE or TRICARE-for-Life. Employees who do not participate in premium conversion may cancel their enrollment at any time. For employees who participate in premium conversion, eligibility for CHAMPVA or TRICARE is not a qualifying life event that would allow them to cancel their FEHB enrollment. These employees may cancel during any annual FEHB Open Season. If an employee who canceled FEHB coverage to use CHAMPVA, TRICARE or TRICARE-for-Life decides to return to FEHB coverage, the employee can do so during a future Open Season. If the employee loses CHAMPVA, TRICARE or TRICARE-for-Life coverage involuntarily, the employee can immediately reenroll in the FEHB Program.
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  • If you are the surviving spouse and you receive a survivor annuity, you can continue the deceased's Self and Family enrollment for all eligible family members. The enrollment will be changed to your name and premiums withheld from your survivor annuity. If you are the only person eligible for coverage, the enrollment will be changed to Self Only. After the change, the carrier will send you a new identification card.
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  • A qualifying life event (QLE) is a term defined by OPM to describe events deemed acceptable by the IRS that may allow participants in cafeteria plans (including premium conversion) to change their participation election for premium conversion outside of an open season. With two exceptions, the rules for changing FEHB enrollment outside of Open Season do not change. Most of the time, people make changes to their FEHB enrollment on account of and consistent with a qualifying life event. The opportunities for you to enroll or change enrollment described in 5 CFR Part 890, and described in the FEHB Employee Health Benefits Election Form (SF 2809) will continue to be allowed under premium conversion except:
    • you may not cancel your enrollment at any time
    • you may not change from Self and Family to Self Only at any time.
      You will still be allowed to make these changes to your enrollment if the change is on account of and consistent with a qualifying life event. The IRS has additional events that will allow you to change your participation (election) in premium conversion. Read on for more information.
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  • The effective date of the Open Season change is the first day of the first full pay period in January. For annuitants this date will always be January 1.
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  • As a result of health care reform, beginning January 1, 2011, children of Federal enrollees will be covered by their parent’s FEHB Self and Family enrollment until their 26th birthday (plus a 31-day temporary extension of coverage), even if the child previously lost coverage because he/she turned 22.
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