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Insurance FAQs Health

Tribal Insurance Benefits

  • The QLE determines which action(s) may be taken:                                                                                                                   
    • Enroll in a plan in the FEHB Program, if not already enrolled
    • Cancel FEHB enrollment
    • Change type of enrollment (Self Only vs. Self and Family)
    • Change from one plan or option to another
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  • No.  However, you will have a free 31-day extension of coverage.  You are also eligible for Temporary Continuation of Coverage (TCC).  TCC is a feature of the FEHB Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends.  Former tribal employees are eligible for up to 18 months of TCC and to convert to an individual policy with the health plan in which you are enrolled.  The former tribal employee is responsible for the total premium in addition to an administrative fee.
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  • You can enroll in FEHB during the Initial Enrollment Opportunity, when you become a new or newly eligible employee, the annual Open Season, and if you experience a qualifying life event (QLE) that allows you to enroll.
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  • Generally, the effective date of coverage should be the first day of the month following the end of the Initial Enrollment Opportunity.  Please contact your tribal employer for the specific effective date of when your health insurance coverage will begin. 
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  • Your enrollment is generally effective the first day of the first pay period that begins after your enrollment request is received by your Tribal Benefits Officer and that follows a pay period during any part of which you were in pay status.
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  • The Affordable Care Act  states that: (1) urban Indian organizations carrying out programs under Title V of the Indian Health Care Improvement Act and (2) Indian tribes or tribal organizations carrying out programs under the Indian Self-Determination and Education Assistance Act are entitled to purchase coverage, rights, and benefits of the FEHB program for their tribal employees.   OPM uses the term “tribal employer” to refer to Indian tribes, tribal organizations, and urban Indian organizations.
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    • Nationwide Fee for Service (FFS) plan with a Preferred Provider Organization (PPO) (overseas coverage available)
    • Health Maintenance Organization (HMO)
    • Consumer Driven Health Plan (CDHP)
    • High-deductible Health Plan (HDHP) with an HSA or HRA
    For more information please on plan types please review: http://www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-types/  
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Total Count: 37, Number of Pages: 3, Page: 3
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