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Frequently Asked Questions Insurance

Health

  • Yes, if you are eligible for this TRICARE program, you can suspend your FEHB coverage.
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  • When you retire, you are entitled to the full government contribution.
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  • Yes. There are a few things an employee should consider. First, to be eligible to continue FEHB coverage after retirement, a retiring employee must be enrolled or covered under the FEHB Program for the five years of service immediately before retirement, or, if less than five years, for all service since the first opportunity to enroll. Employees can count their coverage under TRICARE toward meeting this requirement. However, the employee must be enrolled in an FEHB health plan on the date of retirement to continue coverage.

    Second, if the employee dies when the cancellation is in effect, any surviving spouse will not be eligible to continue FEHB health benefits coverage.

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  • A. Yes, you will be able to reenroll in the future because you are canceling your enrollment to be covered by another FEHB enrollment.
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  • When children reach age 26, they are eligible to enroll in Temporary Continuation of Coverage (TCC) or convert to an individual policy.  It is the responsibility of you or your child to know when he/she is no longer eligible for coverage and to apply for TCC or a conversion policy in a timely manner. Your employing office is not obligated to inform you of your child’s eligibility for TCC and conversion rights when he/she is no longer eligible for coverage.

    TCC:

    If a child loses coverage under your enrollment because he/she reaches age 26, he/she is eligible for TCC. You must contact your Human Resources Office within 60 days of your child’s 26th birthday to inform them that your child is turning age 26.  Your Human Resources Office will give you information about enrolling your child in TCC or converting your child to an individual policy.  Your child has 60 days to request enrollment for TCC from the later of (1) his/her 26th birthday or (2) the date of the TCC notice from the Human Resources Office. For more information about TCC, please review the TCC coverage pamphlet at www.opm.gov/insure/health/eligibility/tcc.

    Conversion:

    If a child loses coverage under your enrollment because he/she reaches age 26, he/she is entitled to convert to an individual policy offered by the carrier of your plan. Your child is not required to provide evidence of insurability.  To apply for conversion, you or your child must make a written request to the carrier of your plan.  You or your child must apply for conversion within 31 days after his/her 26th birthday.  For more information about conversion, please visit http://www.opm.gov/insure/health/reference/handbook/FEHB15.asp#31.

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  • The employing office bills you for each pay period (generally each month) you are covered.
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  • You can change most "discretionary" personnel and payroll transactions, including your:
    • Financial allotments
    • Savings bonds
    • Health benefits
    • Thrift Savings Plan (TSP)
    • Direct deposit
    • Federal and state tax withholdings
    • Your home address
    • Combined Federal Campaign (CFC)
    • Your Employee Express PIN
    • New! -- You can also get a copy of your Leave and Earnings Statement for the current pay period and two previous pay periods.

    (You can't change your life insurance on Employee Express.)

    Contact your Human Resources Office to find out what other services your agency may provide through Employee Express.

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  • You should obtain, complete and return a waiver/election form to your employing office. You may waive participation in premium conversion (or elect to participate, if you previously waived) during the annual FEHB Open Season. Also, you may have the opportunity to waive participation in premium conversion if you've experienced a Qualifying life event (QLE). Refer to the QLE section for more information.

    FEHB Open Season

    During the FEHB Open Season, you will have an opportunity to elect or waive your participation in premium conversion. An Open Season election to participate or waive participation in premium conversion must be received by your employing agency no later than the last day of the Open Season to be considered timely filed. The effective date of your election will be the same as the effective date of an FEHB enrollment election: the first payroll period that begins on or after January 1st. If your agency accepts and processes a late Open Season enrollment election, it must also accept a late election to participate or waive participation in premium conversion.

    Because elections begin with pay periods, when you change participation in premium conversion (begin or waive participation) during the FEHB Open Season, there will likely be at least one payroll paid date in the subsequent calendar year in which your FEHB deductions reflect the previous election.

    Example

    Mark G. had previously waived participation in premium conversion. He opted to participate again in premium conversion during the November 2002 Open Season. Mr. G. is paid on a biweekly basis, with the following payroll periods:

    Payroll Begin Date End Date Pay Date Pre-Tax/ After-tax 01 12/15/02 12/28/02 1/8/03 after-tax 02 12/29/02 1/11/03 1/22/03 after-tax 03 1/12/03 1/25/03 2/5/03 pre-tax

    Mr. Marks' payroll office would treat his FEHB deductions on an after-tax basis through the end of payroll period 02.

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  • If the documentation showing your eligibility for TRICARE is received within the period beginning 31 days before and ending 31 days after the date you designate as the day you want to use TRICARE or CHAMPVA instead of FEHB coverage, the suspension becomes effective at the end of the day before the day you designated. Otherwise, the suspension becomes effective at the end of the month in which we receive your documentation.
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  • Contact your ex-spouse's agency Human Resources Office (or retirement system, if applicable) for information on how to enroll. You will need to document your eligibility. You will be required to submit a certified copy of the court order to the US Office of Personnel Management, Court Ordered Benefits Branch, P.O. Box 17, Washington DC 20044-0017. This office will review the court order to determine if you qualify to enroll. The Court Ordered Benefits Branch will issue a letter notifying you of their findings. Since it may take a few months for this notification to be sent, you should contact your former spouse's Human Resources Office and request to enroll in TCC. The notification from the Court Ordered Benefits Branch will provide instructions on enrolling under the Spouse Equity provisions of the law.
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