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Insurance FAQs

Disputed Claims

  • Yes, it is true. As part of the Basic life insurance, employees who are under age 45 get an Extra Benefit at no additional cost. The Extra Benefit doubles the amount of the life insurance payable if you are age 35 or younger. Beginning on your 36th birthday, the Extra Benefit decreases 10% each year until, at age 45, there is no Extra Benefit.
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  • 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.
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  • You must apply for Temporary Continuation of Coverage (TCC) with your agency Human Resources Office within 60 days from the date you separate from Federal service. TCC coverage becomes effective the day after the qualifying event. After your 31-day extension of your group coverage ends, you pay the full premium (the enrollee and Government contribution) plus a 2 percent administrative fee. For more information, contact your agency's Human Resources Office and review the TCC pamplet at www.opm.gov/insure/health/eligibility/tcc.
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  • 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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  • You can read the FEGLI Program Booklet for Federal Employees or for Postal employees) and review the FEGLI Handbook. Information on current premiums is available here. The FEGLI Calculator can help you figure out your coverage and premiums. Contact your human resources office if you have additional questions.
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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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  • 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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  • Please report it here: https://apps.opm.gov/retire/death/death.cfm.  If you are unable to use the website, you can report it by contacting OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.  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.
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  • 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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  • The Judiciary Branch, U.S. Postal Service, and some smaller Executive Branch agencies with independent compensation-setting authority, have already implemented their own FEHB premium conversion plans; the employees of these entities will not participate in our premium conversion plan. At the present time, annuitants and compensationers whose FEHB premiums are deducted from annuities and benefits are not eligible to participate in premium conversion. There are special rules for reemployed annuitants; see below.
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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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  • No, you will pay the same premium as you paid while you were an employee. However, annuitants are paid on a monthly basis so you will pay them at the monthly rate. You may see an increase if you are employed by an agency, such as the Post Office, that contributes additional money towards the total premium. Retirees receive the same government contribution as most Federal employees.
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    • 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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  • President George W. Bush signed The Federal Employee Dental and Vision Benefits Enhancement Act of 2004 into law on December 23, 2004. The Act authorizes OPM to establish arrangements under which supplemental dental and vision benefits are made available to Federal and U.S. Postal Service employees, retirees, and their eligible family members, and the law gives OPM broad contracting authority to leverage the purchasing power of Federal enrollees to provide comprehensive benefits with competitive premiums.
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  • Family members eligible for coverage under your Self and Family enrollment are your spouse (including a valid common law marriage) and children under age 26, including legally adopted children, stepchildren, and recognized natural (born out of wedlock) children.  Foster children are included if they live with you in a regular parent-child relationship. A child age 26 or over who is incapable of self support because of a mental or physical disability that existed before age 26 is also an eligible family member. Your employing office will look at the child’s relationship to you as the enrollee to determine whether the child is a covered family member. You cannot cover other relatives, such as your mother, even if they are otherwise considered your dependents. An employee’s agency makes enrollment eligibility decisions in accordance with the law and regulations.  Ask your Human Resources Office for help in deciding whether your circumstances meet the requirements.
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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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  • 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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  • 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, you do not have to be enrolled in a family plan for the five years before you retire to meet the five-year requirement. As a retiree, you can enroll in a family plan during the Open Season or when an event occurs that permits a change to the family plan.
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  • Employee Express is an innovative automated system that Federal employees use to make their personnel and payroll transactions electronically.
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Total Count: 712, Number of Pages: 36, Page: 2
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