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Frequently Asked Questions Insurance

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  • I am going to retire soon. What are the requirements to continue health benefits into retirement? View more
    A. In order for you to continue your health benefits enrollment into retirement, you must: (1) be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement; and (2) have been continuously enrolled (or covered as a family member) in any Federal Employees Health Benefits (FEHB) Program plan(s) (not necessarily the same plan) for the five years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person's FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.
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  • Where can Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS) annuitants get answers to other questions about retirement benefits? View more
    • OPM's Office of Retirement Programs website. The site provides various categories of information including the questions most frequently asked by annuitants and survivor annuitants.
    • During the year, you may request information such as verification of annuity or the value of life insurance as well as make changes to your own retirement account, such as federal and state income tax withholding changes, by calling OPM on the toll-free number 1-888-767-6738, TDD for the hearing impaired 1-800-878-5707, or send email to retire@opm.gov. The automated telephone system is available 24 hours a day, 7 days a week.
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  • When is the first opportunity to change my enrollment to Self Plus One? View more
    You will be able to select a Self Plus One enrollment beginning in the 2015 Open Season.  After Open Season, you will have an opportunity to change your enrollment upon experiencing a Qualifying Life Event (QLE).
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  • Why would someone waive premium conversion? What are the disadvantages? View more

    For a small number of individuals it may make sense to waive premium conversion. There are two items to consider in making a decision to waive participation and they are:

    Flexibility

    Under IRS rules, you may reduce coverage (cancel, or change from Self and Family to Self Only) only during an Open Season or at the time of a qualifying life event.

    Social Security

    Paying your premiums with pre-tax money reduces your earnings reported to the Social Security Administration. When you begin to collect Social Security (normally this occurs at age 65), you may receive a slightly lower Social Security benefit. The extent of the impact will vary depending upon the retirement system you participate in, your salary compared with the Social Security wage base ($87,000 in 2003) and the number of years until you retire.

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  • How will OPM verify that I am eligible to carry FEHB into retirement? View more
    Your Human Resources Office will compile your health benefits records and forward them to OPM along with your retirement application and other records. OPM will review your health benefits records to determine if you are eligible to continue your FEHB enrollment into retirement. If you are eligible, OPM will process a transfer-in action and forward you a copy of this action for your records.
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  • Can actively working civil service employees suspend their FEHB coverage to use CHAMPVA, TRICARE or TRICARE-for-Life? View more
    No. Employees may not suspend their coverage. However, they can cancel their coverage to use CHAMPVA, TRICARE or TRICARE-for-Life. Employees who do not participate in premium conversion may cancel their enrollment at any time. For employees who participate in premium conversion, eligibility for CHAMPVA or TRICARE is not a qualifying life event that would allow them to cancel their FEHB enrollment. These employees may cancel during any annual FEHB Open Season.

    If an employee who canceled FEHB coverage to use CHAMPVA, TRICARE or TRICARE-for-Life decides to return to FEHB coverage, the employee can do so during a future Open Season. If the employee loses CHAMPVA, TRICARE or TRICARE-for-Life coverage involuntarily, the employee can immediately reenroll in the FEHB Program.

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  • What is Employee Express? View more
    Employee Express is an innovative automated system that Federal employees use to make their personnel and payroll transactions electronically.
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  • What do Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS) retirees have to do to change health insurance coverage? View more
    During the annual Open Season, OPM sends Open Season material to all those enrolled in the FEHBP plus those who have suspended their enrollments to enroll in a Medicare-sponsored plan approved by the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA) and to enroll in TRICARE.
    • OPM provides Open Season Express, an operator supported toll-free telephone service for retirees to call to request brochures, health benefits satisfaction surveys, and make enrollment changes using telephone technology. The phone number is 1 (800) 332-9798.
    • OPM also provides an interactive Open Season website at retireefehb.opm.gov/.
    • There are other events that allow retirees or their survivors to make enrollment changes -- such as a move out of the service area of an HMO, enrollment in Medicare, or a change in marital status. These events are given in the FEHB Handbook. During the year, annuitants should call OPM on the toll-free number 1-888-767-6738, TDD for the hearing impaired 1-800-878-5707, or send email to retire@opm.gov. Annuitants in the Washington DC local calling area should dial (202) 606-0500, or (202) 606-0551 for the hearing impaired.
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  • Will Federal employees on LWOP to work for a union be eligible for premium conversion? View more
    If the union agrees to adopt our plan, premium conversion may apply to Federal employees on LWOP to work for a union.
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  • When will my Open Season change to the new coverage be effective? View more
    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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