Frequently Asked Questions Insurance

You must request a waiver of the five-year requirement from OPM. The steps you must take are given in the FEHB Handbook at Waiver of 5-Year Enrollment Requirement - Waiver of 5-Year Enrollment Requirement.

If your agency has buyout authority, you may not need to write to the OPM. If you think you might qualify for a waiver of the 5-year coverage requirement, contact your Human Resources Office for information. If you meet the requirements, your agency will attach a memorandum to your retirement application stating that you meet the requirements for waiver by the OPM.

You need to complete the SF 2809 if you change your enrollment from Self and Family to Self Only or vice versa.

For example, if you have Self and Family coverage and you plan to keep Self and Family coverage, you do not need to complete any forms. You must let the health plan know the date of the divorce so that your ex-spouse can be removed from your enrollment. If you have Self and Family coverage and you now plan on enrolling in Self Only coverage, you must notify your Human Resources Office. You will have to complete an SF 2809.

Yes, you may change your FEHB enrollment to any available plan or option at any time beginning 30 days before you become eligible for Medicare. You may use this enrollment change opportunity only once. You may also change your enrollment during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status).

 
The requirements for continuing your FEGLI life insurance into retirement are explained in the FEGLI Handbook.

If you meet the requirements, you must choose what will happen to your Basic when you turn 65 or retire, whichever is later.  Your choices are:

• 75% Reduction: your Basic coverage reduces 2% each month until it reaches 25% of its pre-reduction amount.  Your Basic is free (no premium) once the reductions begin and remains free until your death.

• 50% Reduction: your Basic coverage reduces 1% each month until it reaches 50% of its pre-reduction amount.  There is an extra premium for this choice that you will continue to pay until you die, switch to 75% reduction, or cancel Basic.

• No Reduction: your Basic coverage does not reduce.  You maintain the same amount of Basic coverage you had when you stopped being enrolled as an employee.  There is a larger extra premium for this choice that you will continue to pay until you die, switch to 75% Reduction, or cancel Basic.

If you select 75% or 50%, the reduction begins the second month after your 65th birthday, or the second month after you retire, whichever is later.

To see the different premiums for the different choices, visit Premiums for Annuitants.

To make your choice, submit SF 2818 to your human resources office shortly before you retire. If you do not turn in the form, you will be defaulted to 75% Reduction.

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.

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.

Spouse equity is a provision of the law that allows the former spouse of a Federal employee or annuitant to enroll in FEHB if he or she meets certain requirements.

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.