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Frequently Asked Questions Insurance

Health

  • You can reenroll in the FEHB Program for any reason during a future Open Season. If you are involuntarily disenrolled from TRICARE or CHAMPVA, you are eligible to immediately reenroll in the FEHB Program. Your request to reenroll must be received within the period beginning 31 days before and ending 60 days after your TRICARE or CHAMPVA coverage ends. Otherwise, you must wait until Open Season.
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  • If you do not want to continue your FEHB enrollment, you must notify your employing office in writing that you wish to terminate your coverage. If you do not take action to terminate the coverage, your enrollment will continue for up to 24 months while you are on military duty.
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  • Problems arising from oral discussions are very difficult to settle later because they are impossible to prove or disprove. In contractual situations such as under the FEHB Program, oral statements can never be regarded as official and, so, we state in the brochures that oral statements made by any representative of a carrier cannot modify the benefits described in the brochure.
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  • To qualify for Spouse Equity coverage, submit an application to your former spouse's Human Resources Office (or, if applicable, the former spouse's retirement system) within 60 days after your divorce. To be eligible, you must have been covered as a family member under your spouse's FEHB Program enrollment at least one day during the 18 months prior to divorce and you must have future entitlement to receive a portion of your spouse's retirement annuity or a survivor annuity. Also, if you remarry prior to age 55 you will lose this coverage. If you do not qualify under the Spouse Equity provisions, you may be eligible for coverage under the Temporary Continuation of Coverage provisions. You may also convert to a private policy.
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  • Yes.  Spouses of federal annuitants are covered under a family enrollment in the Federal Employees Health Benefits (FEHB) Program during the divorce process and during a legal separation.  Spouses of annuitants lose eligibility for FEHB coverage when the divorce is final.  Former spouses of annuitants can apply for coverage in the FEHB Program under the Spouse Equity or Temporary Continuation of Coverage provisions of the FEHB law. Former spouses of annuitants must contact the annuitant’s retirement system within 60 days after the divorce to apply.   For more information on divorce after retirement, please visit http://www.opm.gov/insure/health/faq/divorce.asp.
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  • Yes, taxes in 49 states and most localities will be reduced; exceptions include the state of New Jersey and the Commonwealth of Puerto Rico. OPM monitors changes in state and local tax regulations, and provides guidance to your agency as needed. Regardless of where you live, FEHB premiums are not subject to Federal taxes. FICA Taxes If you are covered by the Federal Employees Retirement System (FERS) and participate in premium conversion, FEHB premium deductions will also be excluded from gross pay before Old-Age, Survivors, and Disability Insurance (OASDI) and Medicare taxes are applied. Employer FICA contributions will also be reduced in concert with the decrease in employee withholdings.
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  • There are a number of factors for you to consider if you are employed part-time. Although you will not be eligible for the full government contribution, your entire employee contribution will be pre-tax if you participate in premium conversion. That larger reduction in taxable income might offset the lower government contribution. If you are a part-time reemployed annuitant, we suggest that you consult your agency or a qualified tax advisor to review your individual situation.
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  • If your agency does not pay your premiums, you must pay the employee's share of the premium during the first 12 months of coverage (just as any other employee on leave without pay). You must pay both the employee and government shares, plus an administrative charge of 2 percent of the total premium, for up to 12 additional months that you continue your coverage while on military duty.
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  • If you remarry before age 55, your health benefits enrollment will end on the last day of the month preceding the month in which you remarry. However, if you were married for 30 years or more to the deceased employee or annuitant, your health benefits enrollment will continue. If you are enrolled in Self and Family coverage when your annuity ends, the enrollment will continue for any eligible children as long as one of them is entitled to receive a survivor annuity (but you will not be covered).
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  • We have published a final regulation that allows current FEHB annuitants and former spouses who are eligible for these programs to suspend their FEHB coverage and premium payments. The regulation allows these individuals to reenroll in the FEHB Program during the Open Season, or immediately if they are involuntarily disenrolled from the non-FEHB coverage.
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