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Frequently Asked Questions Insurance

Open Season

  • 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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  • Your new plan is NOT responsible for providing coverage until the effective date of your enrollment change which for most employees is the first day of the first full pay period in January. If you need medical services before the effective date of your Open Season enrollment, you should contact your old plan. Please remember, while the new enrollments are not effective until the first full pay period in January, the new plan benefits are effective January 1. Your old plan, therefore will provide coverage according to the new contract. These expenses will count toward your prior year's deductible. If you are an annuitant, you should contact your new plan. Your Open Season enrollment is effective January 1.
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  • If you are a current Federal employee, you should contact your Human Resources Office and ask them to find out on what date and carrier report number your enrollment information was forwarded to your new health insurance carrier. With this information, your new carrier will be able to locate your enrollment data and forward ID cards to you. If you are an annuitant, call your plan. If they tell you they haven't gotten the paperwork yet from your retirement system, you may contact your retirement system. If you are a Civil Service Retirement System (CSRS) annuitant or a Federal Employees Retirement System (FERS) annuitant, contact OPM at retire@opm.gov. Before contacting your retirement system, have your annuity information ready, for instance, 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.
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  • By regulation, an employee who does not change the enrollment during the Open Season is considered to have canceled the plan in which enrolled. The cancellation is effective the day before the first day of the first full pay period in January. The plan is responsible for providing coverage only through midnight of that date. If you're not sure of the date, you should contact your Human Resources Office and not the plan for the effective date. You should be aware that you are not entitled to a 31-day extension of coverage because the action is considered a cancellation and not a termination. You cannot reenroll in the FEHB Program until the next open season. Also, this is considered a break in coverage. The 5-year requirement to continue your enrollment into retirement will begin when you reenroll in the FEHB Program. If you are within five years of retirement, you will have to work additional time to be eligible to continue your enrollment into retirement. If you are an annuitant, you are deemed to have enrolled in the standard option of the Blue Cross and Blue Shield (BCBS) Service Benefit Plan. OPM deems annuitants into the standard option of BCBS by default (and by law) if they do not make a plan selection. If annuitants cancel their FEHB enrollment, they can never reenroll.
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  • You may not be eligible to enroll in an HMO plan but there are ten fee- for-service plans available nationwide to all Federal employees and annuitants. These plans are: APWU Health Plan, Blue Cross and Blue Shield Service Benefit Plan - Standard Option, Blue Cross and Blue Shield Service Benefit Plan - Basic Option, GEHA Benefit Plan - HDHP, Mail Handlers Benefit Plan, Mail Handlers Benefit Plan - HDHP, NALC, SAMBA – High Option, and SAMBA – Standard Option. Please review the brochures of each of these plans to determine which plan best meets your medical needs. If Federal enrollees have HMOs in their local areas that do not currently participate in the FEHB Program, we encourage them to ask their HMOs to consider the FEHBP market for their geographic areas. New plan application packages for the FEHB Program are available at www.opm.gov/insure/health/carriers/index.asp. Applications are due to OPM by January 31 of each year for the next contract term.
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  • No. Federal law permits you to choose between two options: a Self Only enrollment or a Self and Family enrollment. Other coverage types such as Self and Spouse, Self and One Child (or two children, three children, etc.), and Self Plus One are not permitted under Federal Employees Health Benefits (FEHB) law.
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  • Each year, Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December.
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  • No.  FEHB law does not permit any exclusions or waiting periods for pre-existing conditions in any plan in the FEHB Program.  This is also true if you change plans after you retire. 
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  • Yes.  Your FEHB plan is considered your primary insurance, even if they have little or no benefits.  Not all FEDVIP plans issue ID cards, but you should let your provider know what coverage you have. 
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  • It is prohibited by IRS law.  This is why we encourage FSAFEDS participants to contribute conservatively, especially in their first year with FSAFEDS.  This is also why FSAFEDS offers a grace period so you can continue to incur eligible expenses until March 15 of the following year, and can continue to file claims until April 30 of that year.  By having 14.5 months to incur expenses and 16 months to file claims, you reduce the risk of forfeiting any contributions at the end of the benefit period.
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