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Insurance FAQs

  • No, this is a voluntary dental and vision program available to eligible Federal and USPS employees, retirees, and their eligible family members who want comprehensive dental and vision benefits.
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  • A court order for permanent custody is acceptable as proof of dependency, but is not necessarily required. However, a court order for temporary custody or a Power of Attorney is not acceptable proof for health benefits enrollment. Other acceptable proof of foster child status are:
    • evidence that the child has been included as a dependent on your tax returns for previous years;
    • canceled checks, money orders, or receipts for periodic payments received from you for or on behalf of the child;
    • evidence of goods or services which show regular or substantial contributions of considerable value; and
    • sworn affidavits from people unrelated to you that the child lives in your home.
    The employing office will ultimately make the final decision as to what proof is acceptable in an individual case.
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  • If you are a retiree, you can cancel or reduce your FEGLI life insurance at any time. There is no form; you must mail a signed letter to OPM's Retirement Office at: U.S. Office of Personnel Management Retirement Operations Center P.O. Box 45 Boyers, PA 16017-0045 The Letter must state:
  • Your full name
  • Your address
  • Your retirement claim number (CSA) or Social Security Number (SSN)
  • Exactly what coverage you want to cancel or reduce (Basic, Option a, Option B and/or Option C)
  • You must hand sign the letter
  • You should also note that you understand you cannot increase or reinstate your coverage after this change is made.
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  • Yes. If you meet the five-year requirement when your reemployment terminates, you will be able to continue your Option B. An example of this may help you to understand. Gabriela had Basic since she was first employed with the Federal Government and Option B, two multiples, since March 1991. She retired in June 1993. She was not able to continue her Option B. She was reemployed as a reemployed annuitant in June 1996. She elected Option B, two multiples as an employee. She worked until December 1999. She is now eligible to continue her Option B, 2 multiples, into retirement because she has had it for the five years of service immediately preceding her separation in 1999.
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  • The formulary for your health plan provides a list of medications that a team of health care specialists have approved. Your doctor will write a prescription based on your medical needs, but the formulary provides him with recommendations from the pharmacist and physician team. An effective formulary system provides a medication safety feature. When drugs and administration methods are systematically included (or deleted) in a controlled drug formulary, there are a number of benefits. For instance, each new drug added undergoes a peer review process that uncovers any safety concerns with the drug. Also, when drugs are systematically added to the formulary, there is adequate time to educate the staff before the drug is used. An organized formulary also ensures that the number and variety of drugs is kept to an effective minimum. There are approximately 13,000 prescription drugs on the market today and several drugs can often be used to treat the same condition. A formulary, based on safety and cost considerations, helps to limit the drugs recommended by your plan's health care professionals.
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  • The legal age or age of adulthood for the FEGLI Program is 18, unless the state in which the minor lives has established a lower age of adulthood. In that case, the legal age is the lower age.
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  • Yes, you can submit your FEDVIP co-payments/deductibles as eligible expenses against your FSA account. However, FEDVIP insurance premiums are not reimbursable under an FSA.
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  • Medicare has two new provisions: Part C (Medicare Advantage) and Part D (Medicare Prescription Drug Coverage). Part C: You can enroll in a Medicare Advantage plan to get your Medicare benefits. Medicare Advantage is the term used to describe the various private health plan choices available to Medicare beneficiaries. Part D: There is a monthly premium for Part D coverage. Most Federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits Program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage. Still, you may want to be aware of the benefits Medicare is offering, so you can help others make informed decisions. If you have limited savings and a low income, you may be eligible for Medicare's Low-Income Benefits. For people with limited income and resources, extra help in paying for a Medicare prescription drug plan is available. Information regarding this program is available through the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
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  • No, you are not required to contact BENEFEDS. However, you can speed up the process by contacting BENEFEDS.
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  • First, have your doctor contact the plan to discuss the situation. You and your doctor can provide your plan with information to support your contention that the surgery should be authorized, such as medical records that indicate the need for the surgery, and ask your plan to reconsider its decision. If the plan reconsiders its decision but continues to uphold its denial, and after considering the plan's rationale you still disagree, consult the disputed claims section of your plan's brochure for specific information on how to write to the Office of Personnel Management to ask us to review the claim.
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  • Only Basic insurance is available for a Living Benefit. The Office of Federal Employees' Group Life Insurance cannot pay Optional insurance as a Living Benefit. A Living Benefit election has no effect on your Optional insurance. Your Optional insurance will not change and you will continue to pay your Optional insurance premiums.
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  • The time limit for notification is 60 days from your divorce or annulment. Either you or your former spouse must notify the employing office in writing that you want TCC. If your former spouse is retired, notify the retirement system.
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  • Be careful. Such a cancellation would be permanent. Annuitants cannot re-enroll in the program except under very limited circumstances, such as to enroll in a Medicare-sponsored health plan, as described below, or TRICARE. Another exception is if your spouse is also a Federal employee and you cancel to be covered by your spouse's FEHB plan. Further, neither you nor your family members would be eligible for continued coverage nor would you be able to convert your coverage to a private non-group policy. Do not drop out of the program unless you are sure of being able to re-enroll.
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  • Each situation varies; however, the two plans will coordinate benefits to lower your out-of-pocket costs.
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  • If you elect to terminate your enrollment before you go on active duty, the termination will be effective on the day you are separated, furloughed, or placed on leave of absence to enter military service. Your employing office must use SF 2810 to terminate your enrollment. This means that you are entitled to a 31-day extension of coverage and if needed, have the right to convert to an individual policy offered by the carrier of your plan.
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  • Yes. You should still send a copy of the court order to your Human Resources Office to review and make a determination if any action is required. They will file the copy in your OPF and flag it so that they know a court order relating to health benefits has been filed. If your children aren't listed as family members on the SF 2809, they will send a copy of the court order to your FEHB plan.
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  • You can find the Guide to Federal Benefits (RI 70-5) that lists the premiums for TCC at http://www.opm.gov/insure/health/planinfo/guides/index.asp.
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  • No, your FEHB plan is separate from the dental and vision insurance program. You may enroll in any dental or vision plan (assuming you live in the service area, if it is a regional plan).
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  • Portability is a provision in Public Law 105-311, the Federal Employees Life Insurance Improvement Act, which was enacted October 30, 1998. It applies only to FEGLI Option B insurance, which provides coverage in multiples of 1 to 5 times an employee's annual salary. Employees that met certain requirements were eligible to continue Option B insurance following separation from Government service. The portability provision was a three-year demonstration project. It expired April 24, 2002, and is no longer available. Your agency should not give any employees a Portability Notice or other portability information. For more detailed information refer to¬†Benefits Administration Letter 02-206 of April 26, 2002[119 KB].
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  • Not all screens are accessible by all employees or available at all agencies. For example, if you participate in premium conversion, you may not change from Self and Family to Self Only or cancel your FEHB enrollment at any time. Therefore, this menu option will not appear. You may still be able to change your enrollment if you have experienced a qualifying life event, or QLE. If you don't find the change option on your menu, see your Human Resources Office.
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  • Total Count: 976, Number of Pages: 49, Page: 8
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