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    Frequently Asked Questions Insurance

    Open Season

    • Monday November 13, 2017 - Monday December 11, 2017.

      Each year, Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December.

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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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    • If you are a current Federal employee, you should contact your Human Resources Office and ask them to find out on what date and carrier report number your enrollment information was forwarded to your new health insurance carrier. With this information, your new carrier will be able to locate your enrollment data and forward ID cards to you.

      If you are an annuitant, call your plan. If they tell you they haven't gotten the paperwork yet from your retirement system, you may contact your retirement system. If you are a Civil Service Retirement System (CSRS) annuitant or a Federal Employees Retirement System (FERS) annuitant, contact OPM at retire@opm.gov.

      Before contacting your retirement system, have your annuity information ready, for instance, your name, civil service annuity number (beginning with CSA or CSF), phone number and address, and information about your plan, such as the carrier enrollment code.

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    • Your new plan is NOT responsible for providing coverage until the effective date of your enrollment change which for most employees is the first day of the first full pay period in January. If you need medical services before the effective date of your Open Season enrollment, you should contact your old plan. Please remember, while the new enrollments are not effective until the first full pay period in January, the new plan benefits are effective January 1. Your old plan, therefore will provide coverage according to the new contract. These expenses will count toward your prior year's deductible.

      If you are an annuitant, you should contact your new plan. Your Open Season enrollment is effective January 1.

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    • By regulation, an employee who does not change the enrollment during the Open Season is considered to have canceled the plan in which enrolled. The cancellation is effective the day before the first day of the first full pay period in January. The plan is responsible for providing coverage only through midnight of that date. If you're not sure of the date, you should contact your Human Resources Office and not the plan for the effective date.

      You should be aware that you are not entitled to a 31-day extension of coverage because the action is considered a cancellation and not a termination. You cannot reenroll in the FEHB Program until the next open season. Also, this is considered a break in coverage. The 5-year requirement to continue your enrollment into retirement will begin when you reenroll in the FEHB Program. If you are within five years of retirement, you will have to work additional time to be eligible to continue your enrollment into retirement.

      If you are an annuitant, you are deemed to have enrolled in the standard option of the Blue Cross and Blue Shield (BCBS) Service Benefit Plan. OPM deems annuitants into the standard option of BCBS by default (and by law) if they do not make a plan selection. If annuitants cancel their FEHB enrollment, they can never reenroll.

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    • You may not be eligible to enroll in an HMO plan but there are ten fee- for-service plans available nationwide to all Federal employees and annuitants. These plans are: APWU Health Plan, Blue Cross and Blue Shield Service Benefit Plan - Standard Option, Blue Cross and Blue Shield Service Benefit Plan - Basic Option, GEHA Benefit Plan - HDHP, Mail Handlers Benefit Plan, Mail Handlers Benefit Plan - HDHP, NALC, SAMBA – High Option, and SAMBA – Standard Option. Please review the brochures of each of these plans to determine which plan best meets your medical needs.

      If Federal enrollees have HMOs in their local areas that do not currently participate in the FEHB Program, we encourage them to ask their HMOs to consider the FEHBP market for their geographic areas. New plan application packages for the FEHB Program are available at www.opm.gov/insure/health/carriers/index.asp. Applications are due to OPM by January 31 of each year for the next contract term.

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    • No.  FEHB law does not permit any exclusions or waiting periods for pre-existing conditions in any plan in the FEHB Program.  This is also true if you change plans after you retire. 
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    • Yes.  Your FEHB plan is considered your primary insurance, even if they have little or no benefits.  Not all FEDVIP plans issue ID cards, but you should let your provider know what coverage you have. 
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    • You may change your FEHB enrollment to self and family to cover your husband during the Federal Benefits Open Season or if you experience a qualifying life event.  One of the qualifying life events would be ifyour spouse loses health insurance.  As mentioned in question #1 above, you should be aware that if you have a self only enrollment, your spouse and/or children would not have any FEHB coverage to continue in the event of your death.

      For FEDVIP, the qualifying life event is if a spouse/eligible family member loses other dental or vision coverage.  Losing one’s job is not a QLE for FEDVIP. 
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    • Maybe, some agencies have their own system where you can make an enrollment change online.  Your human resources office will let you know if your agency will let you make an online enrollment change or if you must complete a Health Benefits Election Form (SF 2809) which is available on our website.  They will let you know how to find and use your online enrollment system.   – If you decide to stay under the same FEHB enrollment, you do not need to do anything. 
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