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Frequently Asked Questions Insurance

General

  • FEHB will be the primary payor.  As stated in the Primary Payor Chart in Section 9, Coordinating Benefits with Medicare and Other Coverage, of the FEHB plan brochures, the rule regarding reemployed annuitants is that FEHB pays first if the reemployed annuitant is employed in a position that conveys FEHB eligibility (including DC Health Link).  Though Members of Congress and designated congressional staff are now enrolled in DC Health Link plans, and not OPM-contracted FEHB plans, per OPM regulations, these DC Health Link plans are considered to be included under the “FEHB umbrella.”  Therefore, the same FEHB rules for who is primary payor for other Federal reemployed annuitants apply to Members of Congress and designated congressional staff. It is important to note that a reemployed annuitant can terminate Medicare Part B enrollment if the reemployed annuitant is in a position that conveys FEHB (including DC Health Link) eligibility.  The reemployed annuitant should contact his/her local Social Security Office to inform them that he/she now has health insurance as an active employee.  The reemployed annuitant is entitled to a Special Enrollment Period (SEP) to reenroll in Medicare Part B once he/she retires again.  
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  • Affordable Care Act, Section 1312, defines congressional staff as all full-time and part-time employees employed by the official office of a Member of Congress. Therefore, staff who do not work for the official office of a Member will remain eligible for OPM-contracted FEHB plan coverage.
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