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Frequently Asked Questions Insurance

  • When you enroll in a Medicare Advantage plan, you may not need FEHB coverage because the Medicare Advantage plan will provide you with many of the same benefits. You should review the Medicare Advantage Plan benefits carefully before making a decision to suspend or cancel FEHB coverage. You should contact your retirement system to discuss suspension and reenrollment.
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  • If you are a retiree, you can cancel or reduce your FEGLI life insurance at any time. There is no form; you must mail a signed letter to OPM's Retirement Office at: U.S. Office of Personnel Management Retirement Operations Center P.O. Box 45 Boyers, PA 16017-0045 The cancellation or reduction must be in writing and have an original signature by the insured retiree.  Be sure to include your retirement claim number (CSA) or Social Security Number (SSN) and specify what action you want taken.  Please note that you cannot increase your coverage after retirement or reinstate coverage that you cancel.
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  • Yes, you may change your FEHB enrollment to any available plan or option at any time beginning 30 days before you become eligible for Medicare. You may use this enrollment change opportunity only once. You may also change your enrollment during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status).
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  • You need to complete the SF 2809 if you change your enrollment from Self and Family to Self Only or vice versa. For example, if you have Self and Family coverage and you plan to keep Self and Family coverage, you do not need to complete any forms. You must let the health plan know the date of the divorce so that your ex-spouse can be removed from your enrollment. If you have Self and Family coverage and you now plan on enrolling in Self Only coverage, you must notify your Human Resources Office. You will have to complete an SF 2809.
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  • The Office of Federal Employees' Group Life Insurance (OFEGLI) is an administrative unit of Metropolitan Life Insurance Company that pays claims for the Federal Employees' Group Life Insurance (FEGLI) Program. If OFEGLI is paying the beneficiary less than $5,000, the beneficiary will receive a check. If OFEGLI is paying the beneficiary $5,000 or more, the beneficiary will have a choice of two ways to receive the payment.
    • A check
    • A MetLife Total Control Account or (TCA), an interest bearing account set up in the beneficiary's name, with Metropolitan Life Insurance Company (MetLife)
    If the beneficiary is receiving $5,000 or more and does not make a decision on how to receive payment, a MetLife Total Control Account will be set up in the beneficiary' s name. For more information, see the FEGLI Handbook chapter on claims.
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  • You can reach the Help desk by phone at 478-757-3030 or email at EEXHELP@opm.gov. When you email the Help Desk, be sure to include this information in your message:
    • Your full name
    • Your agency's name
    • Your phone number
    • A brief description of your problem
    Do NOT include your SSN or PIN in your email.
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  • To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan (not necessarily the same plan) for the five years of service immediately preceding retirement, or if less than five years, for all service since your first opportunity to enroll.
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  • Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide. Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and some medical supplies, which some FEHB plans may not cover or only partially cover (check your plan brochure for details).
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  • Your life insurance coverage continues for up to 12 months in a LWOP or nonpay status. You do not have to pay any premiums while you are on LWOP unless you are receiving benefits from the Department of Labor, Office of Workers' Compensation Programs. The life insurance ends at the end of the 12 months with a 31-day extension of coverage and a right to convert to an individual policy.
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  • During the first 12 months of LWOP, your FEGLI coverage continues. If you die during the first 12 months, OFEGLI uses the salary at the time of death to compute the benefit. For example:
    Stan had Basic insurance only. He went on LWOP February 1, 2003. His salary at that time was $18,449. In September 2003, he got a within-grade increasing his salary to $20,849.00. He died November 15, 2003. Since he died during the first 12 months of LWOP, life insurance is payable. The basic salary used to compute the benefit is $20,849.00.
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