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Insurance FAQs

Health

    • OPM's Office of Retirement Programs website. The site provides various categories of information including the questions most frequently asked by annuitants and survivor annuitants.
    • During the year, you may request information such as verification of annuity or the value of life insurance as well as make changes to your own retirement account, such as federal and state income tax withholding changes, by calling OPM on the toll-free number 1-888-767-6738, TDD for the hearing impaired 1-800-878-5707, or send email to retire@opm.gov. The automated telephone system is available 24 hours a day, 7 days a week.
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  • During the annual FEHB Open Season, you may enroll, cancel an enrollment, change plans or options, and waive or begin participation in premium conversion. If you waived participation in premium conversion, you can change from self- and-family enrollment to a Self Only enrollment or cancel your enrollment at any time. You can make other changes during Open Season or due to certain events. Your Human Resources Office can give you more information about these events.
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  • No, you do not have to be enrolled in a family plan for the five years before you retire to meet the five-year requirement. As a retiree, you can enroll in a family plan during the Open Season or when an event occurs that permits a change to the family plan.
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  • They can apply to suspend their coverage at any time. Annuitants can call OPM's Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Former spouses can get the form from the employing office or retirement system maintaining their enrollment. Eligible individuals must submit a completed suspension form and provide all necessary documentation to show eligibility for TRICARE or CHAMPVA during the period beginning 31 days before and ending 31 days after the date they designate as using TRICARE or CHAMPVA instead of FEHB coverage.
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  • Annuitants sometimes need a new copy of “Your Federal Retirement Benefits” to show their retirement income to their mortgage lender, bank, underwriter, state income tax office, or low-income housing provider.  To request a new copy of “Your Federal Retirement Benefits”, or to receive a verification of your annuity, contact OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.  The phone lines are open from 7:30 am to 7:45 pm (Eastern Standard Time). It is a busy phone number so we encourage you to call early in the morning or after 5:00 pm when the phone lines are less busy.
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  • Employee Express is an innovative automated system that Federal employees use to make their personnel and payroll transactions electronically.
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  • A qualifying life event (QLE) is a term defined by OPM to describe events deemed acceptable by the IRS that may allow participants in cafeteria plans (including premium conversion) to change their participation election for premium conversion outside of an open season. With two exceptions, the rules for changing FEHB enrollment outside of Open Season do not change. Most of the time, people make changes to their FEHB enrollment on account of and consistent with a qualifying life event. The opportunities for you to enroll or change enrollment described in 5 CFR Part 890, and described in the FEHB Employee Health Benefits Election Form (SF 2809) will continue to be allowed under premium conversion except:
    • you may not cancel your enrollment at any time
    • you may not change from Self and Family to Self Only at any time.
      You will still be allowed to make these changes to your enrollment if the change is on account of and consistent with a qualifying life event. The IRS has additional events that will allow you to change your participation (election) in premium conversion. Read on for more information.
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  • No. Employees may not suspend their coverage. However, they can cancel their coverage to use CHAMPVA, TRICARE or TRICARE-for-Life. Employees who do not participate in premium conversion may cancel their enrollment at any time. For employees who participate in premium conversion, eligibility for CHAMPVA or TRICARE is not a qualifying life event that would allow them to cancel their FEHB enrollment. These employees may cancel during any annual FEHB Open Season. If an employee who canceled FEHB coverage to use CHAMPVA, TRICARE or TRICARE-for-Life decides to return to FEHB coverage, the employee can do so during a future Open Season. If the employee loses CHAMPVA, TRICARE or TRICARE-for-Life coverage involuntarily, the employee can immediately reenroll in the FEHB Program.
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  • If you are the surviving spouse and you receive a survivor annuity, you can continue the deceased's Self and Family enrollment for all eligible family members. The enrollment will be changed to your name and premiums withheld from your survivor annuity. If you are the only person eligible for coverage, the enrollment will be changed to Self Only. After the change, the carrier will send you a new identification card.
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  • You must apply within 60 days of:
    • the date your marriage ended, or
    • the date the employing office notified you that your qualifying court order (or your former spouse's election) entitled you to coverage, whichever is later.
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  • As a result of health care reform, beginning January 1, 2011, children of Federal enrollees will be covered by their parent’s FEHB Self and Family enrollment until their 26th birthday (plus a 31-day temporary extension of coverage), even if the child previously lost coverage because he/she turned 22.
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  • You must request a waiver of the five-year requirement from OPM. The steps you must take are given in the FEHB Handbook at Waiver of 5-Year Enrollment Requirement - Waiver of 5-Year Enrollment Requirement. If your agency has buyout authority, you may not need to write to the OPM. If you think you might qualify for a waiver of the 5-year coverage requirement, contact your Human Resources Office for information. If you meet the requirements, your agency will attach a memorandum to your retirement application stating that you meet the requirements for waiver by the OPM.
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  • During the annual Open Season, OPM sends Open Season material to all those enrolled in the FEHBP plus those who have suspended their enrollments to enroll in a Medicare-sponsored plan approved by the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA) and to enroll in TRICARE.
    • OPM provides Open Season Express, an operator supported toll-free telephone service for retirees to call to request brochures, health benefits satisfaction surveys, and make enrollment changes using telephone technology. The phone number is 1 (800) 332-9798.
    • OPM also provides an interactive Open Season website at retireefehb.opm.gov/.
    • There are other events that allow retirees or their survivors to make enrollment changes -- such as a move out of the service area of an HMO, enrollment in Medicare, or a change in marital status. These events are given in the FEHB Handbook. During the year, annuitants should call OPM on the toll-free number 1-888-767-6738, TDD for the hearing impaired 1-800-878-5707, or send email to retire@opm.gov. Annuitants in the Washington DC local calling area should dial (202) 606-0500, or (202) 606-0551 for the hearing impaired.
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  • When you retire, you are entitled to the full government contribution.
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  • Yes, if you are eligible for this TRICARE program, you can suspend your FEHB coverage.
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  • 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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  • You can change most "discretionary" personnel and payroll transactions, including your:
    • Financial allotments
    • Savings bonds
    • Health benefits
    • Thrift Savings Plan (TSP)
    • Direct deposit
    • Federal and state tax withholdings
    • Your home address
    • Combined Federal Campaign (CFC)
    • Your Employee Express PIN
    • New! -- You can also get a copy of your Leave and Earnings Statement for the current pay period and two previous pay periods.
    (You can't change your life insurance on Employee Express.) Contact your Human Resources Office to find out what other services your agency may provide through Employee Express.
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  • If the documentation showing your eligibility for TRICARE is received within the period beginning 31 days before and ending 31 days after the date you designate as the day you want to use TRICARE or CHAMPVA instead of FEHB coverage, the suspension becomes effective at the end of the day before the day you designated. Otherwise, the suspension becomes effective at the end of the month in which we receive your documentation.
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  • The employing office bills you for each pay period (generally each month) you are covered.
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  • You should obtain, complete and return a waiver/election form to your employing office. You may waive participation in premium conversion (or elect to participate, if you previously waived) during the annual FEHB Open Season. Also, you may have the opportunity to waive participation in premium conversion if you've experienced a Qualifying life event (QLE). Refer to the QLE section for more information. FEHB Open Season During the FEHB Open Season, you will have an opportunity to elect or waive your participation in premium conversion. An Open Season election to participate or waive participation in premium conversion must be received by your employing agency no later than the last day of the Open Season to be considered timely filed. The effective date of your election will be the same as the effective date of an FEHB enrollment election: the first payroll period that begins on or after January 1st. If your agency accepts and processes a late Open Season enrollment election, it must also accept a late election to participate or waive participation in premium conversion. Because elections begin with pay periods, when you change participation in premium conversion (begin or waive participation) during the FEHB Open Season, there will likely be at least one payroll paid date in the subsequent calendar year in which your FEHB deductions reflect the previous election. Example Mark G. had previously waived participation in premium conversion. He opted to participate again in premium conversion during the November 2002 Open Season. Mr. G. is paid on a biweekly basis, with the following payroll periods: Payroll Begin Date End Date Pay Date Pre-Tax/ After-tax 01 12/15/02 12/28/02 1/8/03 after-tax 02 12/29/02 1/11/03 1/22/03 after-tax 03 1/12/03 1/25/03 2/5/03 pre-tax Mr. Marks' payroll office would treat his FEHB deductions on an after-tax basis through the end of payroll period 02.
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Total Count: 482, Number of Pages: 25, Page: 2
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