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While you may count the time you are covered under transitional TRICARE toward meeting the 5 year/initial opportunity requirement to continue your FEHB into retirement, you must be covered under FEHB on the day you retire. If you plan to retire during your transitional TRICARE period, you must reinstate your FEHB before your retirement date. Your Human Resources Office can assist you.
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You must inform your Human Resources Office that you want to revoke your waiver during your final pay period. Your Human Resources Office will then reinstate your FEHB so that you will have an enrollment to continue under TCC or convert. If your leave and earnings statement for your final pay period does not show a withholding for an FEHB premium, contact your Human Resources Office immediately.
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If you die, the Waiver of Immediate Reinstatement of FEHB automatically terminates. If you postponed reinstatement of a Self and Family enrollment, and your survivors are eligible for a survivor annuity, their FEHB coverage will begin the day after your death.
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If you were unable to choose another plan during military service, your Human Resources Office should reinstate your old enrollment code (for enrollment history purposes only), give you an opportunity to change to another plan, and immediately process your change. To avoid any break in coverage, they should make your new enrollment effective on the date they would have reinstated your old enrollment.
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If you cancel your FEHB, you need to be aware of the following consequences that apply to all employees who cancel their FEHB, including:
- You and your dependents are no longer covered under the FEHB Program.
- You may not reenroll in FEHB until you lose your TAMP coverage or have another qualifying life event (QLE) that permits enrollment, or until the next FEHB Open Season. If you reenroll because you lose TAMP coverage, you must do so from 31 days before to 60 days after your TAMP ends, and use Code 1M on Health Benefits Election Form, SF 2809, at www.opm.gov/forms/pdf_fill/sf2809 [848 KB]. Additional QLEs that permit enrollment, for example, a change in family status, are listed on SF 2809. If you have one of these QLEs, you must enroll within the timeframes shown.
- If you transfer to another Federal agency, your cancellation follows you and you may not reenroll until you lose your TAMP coverage or have another QLE that permits enrollment, or until the next FEHB Open Season. See above bullet for details.
- If you separate from your employment, you will not be eligible for temporary continuation of coverage (TCC) because you will not have any FEHB enrollment to continue. Also, you will not have an FEHB enrollment to convert to an individual policy with your former insurance carrier.
- If you retire, you will not have an FEHB enrollment to continue into retirement.
- If you die, you will not have an FEHB family enrollment for your survivors to continue, even if they are eligible for a survivor annuity.
Note: Your agency may ask you to sign a statement stating that you understand these consequences.
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No. Your agency can postpone automatic reinstatement of your FEHB until your transitional TRICARE ends if you sign a Waiver of Immediate Reinstatement of FEHB, which is available through your Human Resources Office.
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Yes. FEHB regulations provide that an employee’s FEHB is automatically reinstated upon return to employment following active duty. An annuitant’s FEHB is automatically reinstated on the day of separation from the uniformed services.
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Your former Human Resources Office should send the new agency your Waiver of Immediate Reinstatement of FEHB along with your FEHB records, so that your postponement may continue. Your new agency should reinstate your FEHB and transfer it in to their payroll office on the date you requested by using the Notice of Change in Health Benefits Enrollment (Standard Form 2810). It is important that you check your leave and earnings statement to be sure that your FEHB is reinstated on the date you requested.
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If you are under premium conversion (see
www.opm.gov/insure/health/faq/premconversion/index.asp), IRS rules govern when you may cancel your FEHB. You may cancel within 60 days of the date you are restored to a civilian position or have another Qualifying Life Event that permits cancellation (see Health Benefits Election Form, SF 2809, at
www.opm.gov/forms/pdf_fill/sf2809.pdf [848 KB]), or during the next FEHB Open Season. If you are not under premium conversion, you may cancel at any time. In either case, you should be aware of the consequences of cancellation as described in the following question.
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The TAMP is the Transitional Assistance Management Program, and it offers transitional TRICARE eligibility to certain separating active duty members and their eligible family members for 180 days. Your Human Resources Office can assist you in determining if you are eligible for transitional TRICARE under the TAMP.
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Yes. The loss of your transitional TRICARE is a Qualifying Life Event and you may request an enrollment change from 31 days before to 60 days after you lose your TRICARE. See Code 1M on Health Benefits Election Form, SF 2809, at
www.opm.gov/forms/pdf_fill/sf2809.pdf [848 KB]. Once your agency reinstates your enrollment on the Notice of Change in Health Benefits Enrollment (Standard Form 2810), they should immediately process your request to change your enrollment.
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If your Certificate of Release or Discharge from Active Duty (DD Form 214) shows your transitional TRICARE eligibility period, bring it to your Human Resources Office to postpone immediate reinstatement of your FEHB. If your DD Form 214 does not show this information, your Human Resources Office must determine the ending date by counting 180 days from midnight of your discharge date.
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Increases in rates are caused by changes in medical inflation (health care services cost more), demographics (aging population), changes in benefits, technology, and utilization. The bottom line is that nothing in healthcare costs is declining, and health plans look for a balance between premiums and deductibles and copayments to cover the cost of paying benefits. Under federal law, health plan rates must “reasonably and equitably reflect the cost of the benefits provided.” OPM’s actuaries scrutinize each health plan’s proposed rates to determine whether the rates comply with this law.
In 2011, overall FEHB premiums will increase an average of 7.3%, less than the increase in 2010, and less than the increase in other major public and private health insurance programs. For most Self Only enrollees, this means an increase of about $5.53 per bi-weekly pay period. For most Self and Family enrollees, this means an increase of about $11.45 per bi-weekly pay period. FEHB Program rates and benefits are based on the cost of providing healthcare and not on any type of cost-of-living calculation. Recently, the cost of providing healthcare has risen faster than the other consumer prices on which the COLA is based.
We are employees and we feel the premium increases, too. We believe that health plan comparison shopping and smart decision making – using in-network doctors and asking for generic prescriptions – can help offset out-of-pocket expenses. Employees can also use the FSAFEDS program to help manage these expenses through pre-tax payroll deduction.
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If you report this by the end of the pay period following the one in which you received your first leave and earnings statement after your return from active duty, your agency may void the Notice of Change in Health Benefits Enrollment (Standard Form 2810) that reinstated your enrollment. You must then sign a Waiver of Immediate Reinstatement of FEHB to postpone your coverage.
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Yes. You will need to sign the revocation request at the bottom of the Waiver of Immediate Reinstatement of FEHB form and submit it to your Human Resources Office so that they can resume your coverage immediately.
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Following is a summary of the effects of postponing immediate reinstatement of FEHB:
- You may reinstate your FEHB enrollment at any time within the 180-day TAMP period.
- If you transfer to another Federal agency, your former Human Resources Office should send the new agency your Waiver of Immediate Reinstatement of FEHB along with your FEHB records, so that your postponement may continue.
- If you are separating from employment, you can revoke your waiver during your final pay period. Your FEHB would then be reinstated so that you would be eligible for TCC or to convert to an individual policy with your insurance carrier.
- If you retire during your transitional TRICARE period, you must meet the 5 year/initial opportunity requirement and be covered under FEHB on the day you retire. Your Human Resources Office can help you reinstate your FEHB before you retire.
- If you die, your waiver terminates and your survivors may continue your FEHB enrollment if they are eligible for a survivor annuity and your postponed enrollment was for Self and Family.
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We have advised Federal agencies that you may ask them to postpone reinstatement of your FEHB from the date you are restored to your civilian position until the day after your transitional TRICARE ends, or any date within this timeframe. You should check your leave and earnings statement for that pay period to be sure that your agency reinstated your FEHB and deducted premiums. Contact your Human Resources Office immediately if this has not been done.
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