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Frequently Asked Questions Insurance

Life

  • No. Accidental death and dismemberment coverage ends when your employment ends. You cannot carry this coverage into retirement.
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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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  • When your life insurance terminates, except when you stop it voluntarily by cancellation, the coverage automatically continues for 31 days after the terminating date. You do not pay any premiums during these 31 days.
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  • No. You may be eligible to obtain insurance as a reemployed annuitant, but you will have to pay the same rates as any other employee for such insurance. Your agency will give you more information when you are reemployed.
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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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  • 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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  • 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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  • The MetLife TCA is a settlement option offered by MetLife for the payment of claims. A MetLife TCA is not a checking, savings, or money market bank account. Since the MetLife TCA is not a bank account, it is not insured by the FDIC or any government agency. Instead, MetLife guarantees the full amount in the MetLife TCA, including all interest earned. MetLife's guarantee is further backed by the beneficiary's respective state guaranty association. Maximum guarantee limits vary from state to state and may change over time. If the beneficiary chooses a MetLife TCA, the relationship is between the beneficiary and MetLife, not with the federal government or any of its agencies. You or your beneficiary can find additional information about state guaranty associations on the National Association of Insurance Commissioners (NAIC) website http://www.naic.org.

    The MetLife TCA offers a minimum guaranteed annual effective interest rate, meaning that MetLife commits to pay the beneficiary at least that specified rate of interest on the money in the account. The beneficiary begins earning interest the day the MetLife TCA is created. Interest is earned daily, but is not credited until the last day of the month. The interest rate offered on the MetLife TCA may be better or worse than the prevailing market rates. The MetLife TCA is a product offered by MetLife on which the company may make a profit. The beneficiary pays no monthly maintenance fees on a MetLife TCA.

    The beneficiary has complete control of, and access to, the entire amount of the insurance proceeds. The beneficiary can withdraw the full amount from the MetLife TCA at any time. The information packet the beneficiary receives will include a draft book (similar to a checkbook). At any time and at no cost, the beneficiary can write drafts (similar to checks) from a minimum of $250 up to the full balance of the account. In addition, the beneficiary will receive periodic activity statements, and can designate a beneficiary for the account. If the beneficiary chooses the MetLife TCA settlement option, he or she will receive more detailed information when the account is opened.
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