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Frequently Asked Questions Insurance

FEHB for Federal Civilian Employees who Perform Active Military Duty

  • Your agency should contact you or your dependent and give you an opportunity to select another plan. If they were unable to reach you and you learned after the enrollment time frame that your plan discontinued, they must use SF 2810 to reinstate your old enrollment code. This is for enrollment history purposes only, and cannot be sent to your old carrier since the plan is discontinued. Your agency should give you an opportunity to select another plan, and process the change retroactive to the date after your enrollment under your former plan terminated. When selecting another plan, please remember you are responsible for determining if any providers used participate in your new plan's network.
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  • No. The termination is not considered a break in the continuous enrollment necessary for continuing FEHB coverage during retirement. If you decide not to continue your coverage, your enrollment is terminated, not canceled. To avoid a gap in your coverage after you return to work, you must reinstate your enrollment on or before the last day of your TRICARE coverage. See our questions and answers on Return from Military Service.
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  • Yes, FEHB law (5 U.S.C. 8906(e)(3)) gives agencies the authority to pay your premiums if you meet certain conditions. You must:

    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.

    Although the law gives your agency the authority to pay your premiums if you meet these conditions, your agency must decide to implement this authority. Ask your Human Resources Office about the policy for your agency.

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  • If your FEHB is retroactively reinstated for 6 additional months, FEHB will become the primary payer and TRICARE the secondary payer during the additional 6 month coverage period. Thus, any payments made by TRICARE during that 6-month period could be reconciled with the FEHB carrier and any benefit adjustments could cause a difference in the amounts that you owe. Factors such as covered vs. non-covered services, network vs. out-of-network providers, deductibles, copayments, coinsurance, Health Maintenance Organization (HMO) geographic considerations, and catastrophic coverage applications may alter your total out-of-pocket expenses. Some additional issues for you to consider are:

    • If your FEHB plan covers services that TRICARE does not, having FEHB coverage could work to your advantage.
    • If TRICARE covers services that FEHB does not, TRICARE as the secondary payer should not adversely work against you since TRICARE would pay its normal benefits in the absence of benefits from the FEHB carrier.
    • If your FEHB plan becomes primary and you used TRICARE providers that were out of your FEHB plan's network, you need to determine if you would be better off with just the TRICARE coverage paying benefits alone or would you be better off having FEHB pay as primary and TRICARE as secondary for the out-of-network services.
    • You need to determine if shifting deductibles, copayments, and coinsurance from TRICARE to FEHB as the primary carrier enhances or decreases your overall benefits.
    • You need to determine how the geographic restriction of having an HMO Plan as primary payer affects the benefits received for you and your family members and how it affects payment from TRICARE as the secondary payer.
    • You need to determine if requesting retroactive FEHB for 6 additional months would enable you to meet your catastrophic protection benefits, thus, potentially enhancing your overall payment receipts.
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  • FEHB law (5 U.S.C. 8905a) permits you to continue your FEHB enrollment for up to 24 months if you were called to active duty on or after September 14, 2001, and meet certain requirements. You must:

    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.
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  • It depends.  If your daughter is your only eligible family member and she acquires TRICARE, you may change your FEHB enrollment to self only based on this qualifying life event.  But if you must maintain a self and family enrollment to cover other family members, you may not remove your daughter from your enrollment.  FEHB will coordinate benefits with TRICARE.
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