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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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The 24-month period begins the day you are separated, furloughed, or placed on leave of absence to serve on military duty. This applies even if part of your military service is covered by paid leave immediately followed by furlough or other leave without pay.
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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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You should contact your Human Resources Office for the appropriate information for employees covered under FEHB who are called to military duty.
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The authority for agencies to pay premiums applies to employees who were called to active duty on or after December 8, 1995, and who meet certain conditions. Agencies may make retroactive payments to qualified employees for premiums paid on or after that date. Ask your Human Resources Office about the policy for your agency.
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If you do not meet these requirements, the authority for you to continue your FEHB comes from the Uniformed Services Employment and Reemployment Rights Act (USERRA) (38 U.S.C. 4317). Public Law 108-454 amended this Act to allow you to continue your FEHB for 24 months if you were called to military duty and elected to continue your health insurance coverage on or after December 10, 2004. If you made your election before December 10, 2004, you are eligible to continue your FEHB for 18 months.
If your FEHB continues under this provision, your agency does not have authority to pay your premiums while you are on military duty. For additional information, see
Benefits Administration Letter 06-401 at BAL 06-401 Federal Employees Health Benefits (FEHB) Program: Extended Coverage for Employees Called to Active Military Duty. [54 KB]
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If you elect to terminate your enrollment before you go on active duty, the termination will be effective on the day you are separated, furloughed, or placed on leave of absence to enter military service. Your employing office must use SF 2810 to terminate your enrollment. This means that you are entitled to a 31-day extension of coverage and if needed, have the right to convert to an individual policy offered by the carrier of your plan.
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Your employing office will notify you of the choices available to you and provide you with a method to make direct premium payments.
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Your agency should contact you or your dependent and give you an opportunity to select another plan. If they were unable to reach you and you learned after the enrollment time frame that your plan discontinued, they must use SF 2810 to reinstate your old enrollment code. This is for enrollment history purposes only, and cannot be sent to your old carrier since the plan is discontinued. Your agency should give you an opportunity to select another plan, and process the change retroactive to the date after your enrollment under your former plan terminated. When selecting another plan, please remember you are responsible for determining if any providers used participate in your new plan's network.
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If your FEHB is retroactively reinstated for 6 additional months, FEHB will become the primary payer and TRICARE the secondary payer during the additional 6 month coverage period. Thus, any payments made by TRICARE during that 6-month period could be reconciled with the FEHB carrier and any benefit adjustments could cause a difference in the amounts that you owe. Factors such as covered vs. non-covered services, network vs. out-of-network providers, deductibles, copayments, coinsurance, Health Maintenance Organization (HMO) geographic considerations, and catastrophic coverage applications may alter your total out-of-pocket expenses. Some additional issues for you to consider are:
- If your FEHB plan covers services that TRICARE does not, having FEHB coverage could work to your advantage.
- If TRICARE covers services that FEHB does not, TRICARE as the secondary payer should not adversely work against you since TRICARE would pay its normal benefits in the absence of benefits from the FEHB carrier.
- If your FEHB plan becomes primary and you used TRICARE providers that were out of your FEHB plan's network, you need to determine if you would be better off with just the TRICARE coverage paying benefits alone or would you be better off having FEHB pay as primary and TRICARE as secondary for the out-of-network services.
- You need to determine if shifting deductibles, copayments, and coinsurance from TRICARE to FEHB as the primary carrier enhances or decreases your overall benefits.
- You need to determine how the geographic restriction of having an HMO Plan as primary payer affects the benefits received for you and your family members and how it affects payment from TRICARE as the secondary payer.
- You need to determine if requesting retroactive FEHB for 6 additional months would enable you to meet your catastrophic protection benefits, thus, potentially enhancing your overall payment receipts.
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