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Frequently Asked Questions Insurance

Life

  • No. FEGLI life insurance open seasons are extremely rare.  Outside of an open season, eligible employees can enroll in FEGLI by taking a physical exam or with a Qualifying Life Event.

    The form to request FEGLI by taking a physical exam is available the SF 2822.  The form is completed partly by you, partly by your agency, and partly by your healthcare provider.  If OFEGLI approves your request, you are automatically enrolled in Basic. If you want Optional insurance as well as Basic, you can enroll in Option A and/or Option B within 60 days from the date of OFEGLI's approval. You cannot enroll in Option C by getting a physical.

    With a FEGLI Qualifying Life Event, you can enroll in FEGLI Basic, Option A, up to five multiples of Option B, and/or up to five multiples of Option C.  Qualifying Life Events are marriage, divorce, death of spouse, or acquisition of an eligible child. To enroll or increase your FEGLI coverage based on a life event, submit an SF 2817 to your human resources office within 60 days after the life event.

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  • This means that the person (a designated beneficiary or person entitled under the order of precedence) advised OFEGLI, in writing, that he/she does not want the money he/she is entitled to receive. A disclaimer by default means that the person doesn't ever file a claim form to claim the benefits.

    If someone entitled to benefits disclaims them, he/she cannot tell OFEGLI who should get the disclaimed benefits. Rather, OFEGLI must treat those benefits as if the person disclaiming had died before the Insured. If the person disclaiming was a designated beneficiary, OFEGLI would pay the disclaimed share equally to the remaining beneficiaries. If there are no remaining beneficiaries or the person disclaiming was not a designated beneficiary, OFEGLI will pay the proceeds according to the next step in the order of precedence.

    Perhaps a few examples will help.

    Mary designated John and Susan for 50% each. Mary dies. John disclaims his share. It does not matter that John wanted his mother, Laura, to receive the benefits. OFEGLI will pay 100% to Susan.

    Here's another example.

    Raul is single, childless, and did not designate a beneficiary. Raul dies. His parents are entitled to the benefits based on the order of precedence. His father disclaims his share of the benefits. OFEGLI will pay 100% to his mother.

    And here's a final example.

    Cyndi is married with one child. She did not designate a beneficiary. Cyndi dies. Her husband is entitled to the benefits based on the order of precedence. He disclaims the benefits. OFEGLI moves to the next step in the order of precedence and pays 100% to Cyndi's child.
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  • Yes. OFEGLI can pay FEGLI benefits to a funeral home if that's what the person entitled to the money wants to happen. Funeral homes have the form to do this.
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  • No. Option C coverage only provides coverage for your spouse and eligible children. Mothers, fathers, brothers, sisters and other family members are not covered under Option C. There are no exceptions to this, regardless of the health status of your family member and whether he or she qualifies as your dependent.
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  • No. The only way to continue coverage into retirement is to meet the five year/all opportunity rule. You cannot "buy" the years you are missing.
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  • When you return to work after a break in service of less than 180 days, your human resources office will automatically enroll you in the same coverage that you had before you left your prior position. You will have to qualify to elect other coverage (Open Season, physical exam or life event).

    When you return to work after a break in service of 180 days or more, your human resources office will automatically enroll you in Basic and the same Optional insurance that you had in your prior position. You will have this coverage the first day you are in pay and duty status. Any previous waiver of insurance is automatically cancelled. Unless you file a new waiver, Basic insurance becomes effective your first day in pay and duty status in a position in which you are eligible for coverage.

    You may elect more insurance (if you don't already have the maximum) within 31 days of returning to service in an eligible position, regardless of the coverage you had during previous employment. If you do not make a new election, you will automatically get back whatever Optional insurance you had immediately before your separation. Any coverage that you had previously waived will be waived again.

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  • Yes, and this works differently than when a survivor disclaims benefits. You can name someone as a beneficiary and someone else if that first person disclaims the benefits. It's a form of contingent beneficiary. As the insured, you CAN specify who should receive the disclaimed benefits (the beneficiary cannot specify who should receive disclaimed benefits).

    For example, you could word your designation like this:

    Mary Jones, 100%, unless she disclaims. 
    Otherwise to Johnson Wallace, 100%.
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  • If you disagree with the plan’s decision on your claim, the Federal Employees Health Benefits (FEHB) Program provides for an appeal process.  Check your plans FEHB brochure to see if the service is covered, limited, or excluded.


    Review and follow the directions in the disputed claims section (Section 8) of the brochure. This section will tell you how to ask the plan to reconsider your claim. You must explain why (in terms of the applicable brochure coverage provisions) you feel the services should be covered.

    If the plan again denies the claim, read the plan's decision letter carefully. Then, check your plan's brochure again. If you still disagree with the plan's decision, the disputed claims section of the brochure will tell you how to write to the U.S. Office of Personnel Management to ask us to review the claim.

     


    If you have a complaint that is not related to a disputed claim, email your complaint to FEHB@opm.gov.


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  • To inquire about how much coverage you have under the Federal Employees Group Life Insurance (FEGLI) Program, contact OPM's Retirement Office by emailing retire@opm.gov or calling 1-888-767-6738. 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. You will need to provide your retirement claim number (CSA) or Social Security Number.

     

    Please note: For privacy reasons, the response to an email request for information on FEGLI coverage will be mailed to the address on file with the OPM Retirement Office. It will not be sent back via email.

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  • You can submit a court order if you are an employee, an annuitant, a former spouse, the former spouse's attorney or anyone else.
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