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Insurance FAQs

  • 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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  • 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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  • Federal and U.S. Postal Service employees eligible for FEHB coverage (whether or not enrolled) and annuitants/survivor annuitants/compensationers (regardless of FEHB eligibility) are eligible to enroll.
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  • Yes. The amount of your FEGLI automatically increases when your salary goes up, whenever your annual pay is increased by an amount sufficient to raise the pay to the next $1,000 bracket.
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  • A. Yes, you will be able to reenroll in the future because you are canceling your enrollment to be covered by another FEHB enrollment.
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  • For a small number of individuals it may make sense to waive premium conversion. There are two items to consider in making a decision to waive participation and they are: Flexibility Under IRS rules, you may reduce coverage (cancel, or change from Self and Family to Self Only) only during an Open Season or at the time of a qualifying life event. Social Security Paying your premiums with pre-tax money reduces your earnings reported to the Social Security Administration. When you begin to collect Social Security (normally this occurs at age 65), you may receive a slightly lower Social Security benefit. The extent of the impact will vary depending upon the retirement system you participate in, your salary compared with the Social Security wage base ($87,000 in 2003) and the number of years until you retire.
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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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  • A. In order for you to continue your health benefits enrollment into retirement, you must: (1) be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement; and (2) have been continuously enrolled (or covered as a family member) in any Federal Employees Health Benefits (FEHB) Program plan(s) (not necessarily the same plan) for the five years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person's FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.
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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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  • No. Employees may not suspend their coverage. However, they can cancel their coverage to use CHAMPVA, TRICARE or TRICARE-for-Life. Employees who do not participate in premium conversion may cancel their enrollment at any time. For employees who participate in premium conversion, eligibility for CHAMPVA or TRICARE is not a qualifying life event that would allow them to cancel their FEHB enrollment. These employees may cancel during any annual FEHB Open Season. If an employee who canceled FEHB coverage to use CHAMPVA, TRICARE or TRICARE-for-Life decides to return to FEHB coverage, the employee can do so during a future Open Season. If the employee loses CHAMPVA, TRICARE or TRICARE-for-Life coverage involuntarily, the employee can immediately reenroll in the FEHB Program.
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  • A Living Benefit payment is a lump sum payment to those who are terminally ill and have a documented medical prognosis showing a life expectancy of no more than nine months. You are eligible to elect a Living Benefit if you are an employee, annuitant, or compensationer and you are enrolled in the FEGLI Program. Employees can choose a full or partial (a multiple of $1,000) Living Benefit. Annuitants and compensationers can elect only a full Living Benefit. A Living Benefit is equal to the Basic Life insurance amount, plus any extra benefit for persons under age 45, that would be in effect nine months after the date of the Office of Federal Employees' Group Life Insurance (OFEGLI) receives a completed claim for Living Benefits form. If you have assigned your life insurance, you cannot elect a Living Benefit. Living Benefit payments are reduced by a nominal amount (4.9%) to make up for lost earnings to the Life Insurance Fund because of the early payment of benefits. The election of Living Benefits has no effect on the amount of any Optional life insurance. You will continue to pay premiums for any Optional insurance you have. You must contact OFEGLI at 1-800-633-4542 to obtain the form to elect Living Benefits (Form FE-8). This form is not available from your human resources office or the Office of Personnel Management (OPM).
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  • The effective date of the Open Season change is the first day of the first full pay period in January. For annuitants this date will always be January 1.
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  • No, your FEDVIP enrollment will not count towards the 5-year enrollment requirement for carrying FEHB coverage into retirement.
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  • When children reach age 26, they are eligible to enroll in Temporary Continuation of Coverage (TCC) or convert to an individual policy.  It is the responsibility of you or your child to know when he/she is no longer eligible for coverage and to apply for TCC or a conversion policy in a timely manner. Your employing office is not obligated to inform you of your child’s eligibility for TCC and conversion rights when he/she is no longer eligible for coverage. TCC: If a child loses coverage under your enrollment because he/she reaches age 26, he/she is eligible for TCC. You must contact your Human Resources Office within 60 days of your child’s 26th birthday to inform them that your child is turning age 26.  Your Human Resources Office will give you information about enrolling your child in TCC or converting your child to an individual policy.  Your child has 60 days to request enrollment for TCC from the later of (1) his/her 26th birthday or (2) the date of the TCC notice from the Human Resources Office. For more information about TCC, please review the TCC coverage pamphlet at www.opm.gov/insure/health/eligibility/tcc. Conversion: If a child loses coverage under your enrollment because he/she reaches age 26, he/she is entitled to convert to an individual policy offered by the carrier of your plan. Your child is not required to provide evidence of insurability.  To apply for conversion, you or your child must make a written request to the carrier of your plan.  You or your child must apply for conversion within 31 days after his/her 26th birthday.  For more information about conversion, please visit http://www.opm.gov/insure/health/reference/handbook/FEHB15.asp#31.
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  • Read about FEDVIP Qualifying Life Events.
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  • When you retire, you are entitled to the full government contribution.
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  • No, unlike FEHB, employees may not opt out of premium conversion for FEDVIP. If employees do not wish to have premium conversion for FEDVIP, they should not enroll.
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Total Count: 980, Number of Pages: 49, Page: 3
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