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Insurance FAQs Health

Tribal Insurance Benefits

  • Generally, the effective date of coverage should be the first day of the month following the end of the Initial Enrollment Opportunity.  Please contact your tribal employer for the specific effective date of when your health insurance coverage will begin. 
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  • Each year,  Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December. This year Open Season is November 09, 2015 - December 14, 2015
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  • Your enrollment is generally effective the first day of the first pay period that begins after your enrollment request is received by your Tribal Benefits Officer and that follows a pay period during any part of which you were in pay status.
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  • The Affordable Care Act  states that: (1) urban Indian organizations carrying out programs under Title V of the Indian Health Care Improvement Act and (2) Indian tribes or tribal organizations carrying out programs under the Indian Self-Determination and Education Assistance Act are entitled to purchase coverage, rights, and benefits of the FEHB program for their tribal employees.   OPM uses the term “tribal employer” to refer to Indian tribes, tribal organizations, and urban Indian organizations.
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    • Nationwide Fee for Service (FFS) plan with a Preferred Provider Organization (PPO) (overseas coverage available)
    • Health Maintenance Organization (HMO)
    • Consumer Driven Health Plan (CDHP)
    • High-deductible Health Plan (HDHP) with an HSA or HRA
    For more information please on plan types please review: http://www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-types/  
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  • The QLE determines which action(s) may be taken:                                                                                                                   
    • Enroll in a plan in the FEHB Program, if not already enrolled
    • Cancel FEHB enrollment
    • Change type of enrollment (Self Only, Self Plus One or . Self and Family)
    • Switch a covered family member under a Self Plus One enrollment
    • Change from one plan or option to another
     
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  • Open Season runs from Monday of the first full Federal pay period in November to the Monday of the first full Federal pay period in December. During this period, you may  enroll, change, or cancel your FEHB coverage.
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Total Count: 37, Number of Pages: 3, Page: 3
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