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Insurance FAQs Health

  • The employing office has 14 days to notify you of your TCC rights and send you an election form. You must return the election form and a certified copy of your divorce decree within 60 days from your divorce date or 65 days after the date of the employing office notice, whichever is later. Your coverage will be effective the day after your 31-day extension of coverage as a family member ends.
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  • Participation in premium conversion is automatic for eligible employees.
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    • If your tribal employer offers Leave Without Pay (i.e., unpaid leave), then yes, your coverage may continue for up to 365 days.  You must elect to continue or terminate enrollment. 
    • If you continue FEHB enrollment, you may pay premiums directly to the tribal employer or incur a debt to the tribal employer.  The tribal employer must pay premiums to the National Finance Center (NFC).
    • Nonpay status can be continuous or broken by periods of less than 4 months of pay status.
    • If you return to pay status, you must elect to enroll—it’s not automatic—and you have 60 days to enroll after returning.
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  • No. Only employees of agencies that subscribe to Employee Express can use it.
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  • Open Season is the annual time when you can enroll, change, or cancel your FEHB coverage.
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  • If you are not participating in premium conversion, you may elect to reduce your FEHB coverage at any time. As a participant in premium conversion you will be able to reduce FEHB coverage only during an FEHB Open Season or in conjunction with a qualifying life event (QLE). IRS rules govern these non-Open Season opportunities for those who participate in premium conversion.
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  • Yes, if you have family coverage, as long as your child is under age 26. Since you are in an HMO, your child will be covered for services received from Plan providers and for emergency care away from home. Some HMOs offer benefits that are tailored specifically to your situation and others have reciprocal agreements with plans in other areas. Check with your plan.
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  • Transfer-in FEHB Enrollment Under CSRS/FERS, your employing office must transfer-in your FEHB enrollment as of your effective date of participation in premium conversion. Procedures and guidelines pertaining to the transfer of the FEHB enrollment of reemployed annuitants who participate in premium conversion are outlined in Payroll Office Letter P-00-13 [129 KB], FEHB Premium Conversion. Employing Agency Must Contribute Employer Share of Premium Prior to premium conversion, the employer share of the FEHB premium for reemployed annuitants under CSRS/FERS was paid from an OPM appropriation. Effective with premium conversion, your employing office must contribute the employer share of the FEHB premium for all reemployed annuitants that are enrolled in the FEHB as employees. The employer contribution for reemployed annuitants will be remitted to OPM in the same manner as that for other employees. Separation from Active Service Your participation in premium conversion ends on the last day of the last pay period as an employee. When you separate from active service, your FEHB enrollment must be transferred back from your employing agency to OPM or the appropriate retirement system.
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  • Premium conversion does not affect your EITC. The EITC is based on Total Earned Income (TEI), which includes both taxable and nontaxable earned income. Taxable earned income includes money earned as wages, salaries and tips while nontaxable earned income includes salary deferrals and reductions. Premium conversion falls under the category of nontaxable earned income because salary is reduced by an amount equal to a health insurance premium payment and a health insurance premium is then paid with these pre-tax dollars. The EITC amount is unaffected by premium conversion because premium conversion shifts health insurance premium payments from taxable to nontaxable earned income, both of which are included in the TEI when calculating the EITC.
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  • Your information is as secure as using an ATM. Your using a combination of SSN, PIN, and agency-specific information makes it secure.
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  • Mary J. is a single parent with one child who will turn age 26 at the end of March. She wants to maintain her Self and Family coverage until that time. The loss of an eligible child is a QLE, and changing her coverage from Self and Family to Self Only is on account of and consistent with that QLE. At the end of March, Mary changes her coverage to Self Only. Michael M., a federal employee, has Self Only coverage and so does his wife, who is employed in the private sector. In June, she gives birth to their first child. Michael wants to cancel his FEHB coverage, saying that his wife has picked up family coverage that includes him and their new child. Michael's request is on account of and consistent with his QLE. Monique K. begins an approved period of leave without pay (LWOP) to attend school. She elects to keep her FEHB coverage, and incur an obligation to her employing agency. She may not change her FEHB coverage, but may change her premium conversion election. Agencies must determine acceptable documentation for a qualifying life event (QLE). Acceptable documentation includes birth and death certificates, marriage licenses, divorce papers, etc. When your QLE is one where documentation is not readily available the IRS has indicated that your certification of coverage under another health plan is sufficient.
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  • You do not need to change the enrollment. New eligible family members are automatically covered by your Self and Family coverage. However, you should let your plan know about the addition right away so they can adjust their records.
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  • It is your opportunity to enroll in an FEHB health plan. You cannot enroll in the FEHB Program at any other time unless it is during the annual open season (approximately mid-November through mid-December each year) or if you experience a Qualifying Life Event.
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  • January 1st of the following calendar year.
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  • Look at the FEHB brochure for the plan that interests you. Brochures are on the OPM website at www.opm.gov/insure. You can also ask the health benefits officer in your Human Resources Office for help. When you know the plan you want to enroll in, you can make the change in Employee Express. You'll need the 3-character enrollment code for the plan.
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Total Count: 482, Number of Pages: 33, Page: 20
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