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Frequently Asked Questions Insurance

  • Your spouse is eligible for coverage while you are in the process of getting divorced and even while you are legally separated. Your spouse loses eligibility for coverage as a family member when your divorce is final. Your spouse can apply for coverage in the FEHB Program under the Spouse Equity or Temporary Continuation of Coverage provisions of the FEHB law. Your spouse should contact your HR office to apply.
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  • During the first 12 months of LWOP, your FEGLI coverage continues. If you die during the first 12 months, OFEGLI uses the salary at the time of death to compute the benefit. For example:

    Stan had Basic insurance only. He went on LWOP February 1, 2003. His salary at that time was $18,449. In September 2003, he got a within-grade increasing his salary to $20,849.00. He died November 15, 2003. Since he died during the first 12 months of LWOP, life insurance is payable. The basic salary used to compute the benefit is $20,849.00.
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  • Eligible individuals will be able to enroll during the annual Open Season or after a Qualifying Life Event (QLE) that permits enrollment outside of Open Season.

    You must enroll through BENEFEDS at www.BENEFEDS.com. Those without access to a computer can enroll by telephone at 1-877-888-FEDS (3337), TTY 1-877-889-5680. Should you have any enrollment questions, please contact BENEFEDS at www.BENEFEDS.com or 1-877-888-FEDS (3337), TTY 1-877-889-5680.

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  • During the annual FEHB Open Season, you may enroll, cancel an enrollment, change plans or options, and waive or begin participation in premium conversion.

    If you waived participation in premium conversion, you can change from self- and-family enrollment to a Self Only enrollment or cancel your enrollment at any time. You can make other changes during Open Season or due to certain events. Your Human Resources Office can give you more information about these events.

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  • Once Medicare becomes the primary payer, you may find that a lower cost FEHB plan is adequate for your needs, especially if you are currently enrolled in a plan's high option. Also, some plans waive deductibles, coinsurance, and copayments when Medicare is primary.
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  • Dental plans provide a comprehensive range of services, including the following:

    • Class A (Basic) services, which include oral examinations, prophylaxis, diagnostic evaluations, sealants and x-rays.
    • Class B (Intermediate) services, which include restorative procedures such as fillings, prefabricated stainless steel crowns, periodontal scaling, tooth extractions, and denture adjustments.
    • Class C (Major) services, which include endodontic services such as root canals, periodontal services such as gingivectomy, major restorative services such as crowns, oral surgery, bridges and prosthodontic services such as complete dentures.
    • Class D (Orthodontic) services with up to a 24-month waiting period.
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  • Unfortunately, parents are not eligible family members.
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  • They can apply to suspend their coverage at any time. Annuitants can call OPM's Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Former spouses can get the form from the employing office or retirement system maintaining their enrollment. Eligible individuals must submit a completed suspension form and provide all necessary documentation to show eligibility for TRICARE or CHAMPVA during the period beginning 31 days before and ending 31 days after the date they designate as using TRICARE or CHAMPVA instead of FEHB coverage.
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  • No, retiree pay premiums on a post tax basis.
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  • If you provide documentation to your retirement system that you are suspending your FEHB coverage to enroll in a Medicare Advantage plan, you may reenroll in FEHB if you later lose or cancel your Medicare Advantage plan coverage. However, you must wait until the next Open Season to reenroll in FEHB, unless you involuntarily lose your coverage under the Medicare Advantage plan (including because the plan is discontinued or because you move outside its service area). In this case, you may reenroll from 31 days before to 60 days after you lose the Medicare Advantage plan coverage, and your reenrollment in FEHB will be effective the day after the Medicare Advantage plan coverage ends (or ended).
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