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Frequently Asked Questions Insurance

FEHB for Federal Civilian Employees who Return from Active Military Duty

  • Yes. The loss of your transitional TRICARE is a Qualifying Life Event and you may request an enrollment change from 31 days before to 60 days after you lose your TRICARE. See Code 1M on Health Benefits Election Form, SF 2809, at www.opm.gov/forms/pdf_fill/sf2809.pdf [848 KB]. Once your agency reinstates your enrollment on the Notice of Change in Health Benefits Enrollment (Standard Form 2810), they should immediately process your request to change your enrollment.
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  • Increases in rates are caused by changes in medical inflation (health care services cost more), demographics (aging population), changes in benefits, technology, and utilization.  The bottom line is that nothing in healthcare costs is declining, and health plans look for a balance between premiums and deductibles and copayments to cover the cost of paying benefits. Under federal law, health plan rates must “reasonably and equitably reflect the cost of the benefits provided.”  OPM’s actuaries scrutinize each health plan’s proposed rates to determine whether the rates comply with this law.    In 2011, overall FEHB premiums will increase an average of 7.3%, less than the increase in 2010, and less than the increase in other major public and private health insurance programs.  For most Self Only enrollees, this means an increase of about $5.53 per bi-weekly pay period.  For most Self and Family enrollees, this means an increase of about $11.45 per bi-weekly pay period.  FEHB Program rates and benefits are based on the cost of providing healthcare and not on any type of cost-of-living calculation. Recently, the cost of providing healthcare has risen faster than the other consumer prices on which the COLA is based.   We are employees and we feel the premium increases, too.  We believe that health plan comparison shopping and smart decision making – using in-network doctors and asking for generic prescriptions – can help offset out-of-pocket expenses.  Employees can also use the FSAFEDS program to help manage these expenses through pre-tax payroll deduction.
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  • If your Certificate of Release or Discharge from Active Duty (DD Form 214) shows your transitional TRICARE eligibility period, bring it to your Human Resources Office to postpone immediate reinstatement of your FEHB. If your DD Form 214 does not show this information, your Human Resources Office must determine the ending date by counting 180 days from midnight of your discharge date.
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  • If you report this by the end of the pay period following the one in which you received your first leave and earnings statement after your return from active duty, your agency may void the Notice of Change in Health Benefits Enrollment (Standard Form 2810) that reinstated your enrollment. You must then sign a Waiver of Immediate Reinstatement of FEHB to postpone your coverage.
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  • Yes. You will need to sign the revocation request at the bottom of the Waiver of Immediate Reinstatement of FEHB form and submit it to your Human Resources Office so that they can resume your coverage immediately.
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  • Following is a summary of the effects of postponing immediate reinstatement of FEHB:
    • You may reinstate your FEHB enrollment at any time within the 180-day TAMP period.
    • If you transfer to another Federal agency, your former Human Resources Office should send the new agency your Waiver of Immediate Reinstatement of FEHB along with your FEHB records, so that your postponement may continue.
    • If you are separating from employment, you can revoke your waiver during your final pay period. Your FEHB would then be reinstated so that you would be eligible for TCC or to convert to an individual policy with your insurance carrier.
    • If you retire during your transitional TRICARE period, you must meet the 5 year/initial opportunity requirement and be covered under FEHB on the day you retire. Your Human Resources Office can help you reinstate your FEHB before you retire.
    • If you die, your waiver terminates and your survivors may continue your FEHB enrollment if they are eligible for a survivor annuity and your postponed enrollment was for Self and Family.
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  • We have advised Federal agencies that you may ask them to postpone reinstatement of your FEHB from the date you are restored to your civilian position until the day after your transitional TRICARE ends, or any date within this timeframe. You should check your leave and earnings statement for that pay period to be sure that your agency reinstated your FEHB and deducted premiums. Contact your Human Resources Office immediately if this has not been done.
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