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Healthcare & Insurance Multi-State Plan Program and the
Health Insurance Marketplace

 

Overview

STOP

If you are enrolled in a Federal Employees Health Benefits (FEHB) plan, you should not be enrolled in, or covered by, a Multi-State Plan (MSP Option).

A Multi-State Plan (MSP) option is a high-quality plan offered on the Marketplace, under contract with the U.S. Office of Personnel Management (OPM), the agency that also administers health insurance for Federal employees. OPM negotiates plan benefits, monitors plan performance, and oversees plan compliance with the Affordable Care Act (ACA).

  • We have an External Review process to allow you to appeal to OPM if your claims are denied.
  • MSP options are required to cover Essential Health Benefits, which include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more.
  • OPM has been trusted for 50 years by millions of Federal employees, retirees, and their families to provide high quality FEHB health insurance

For the 2018 plan year, MSP options will be offered throughout the State of Arkansas by Arkansas Blue Cross Blue Shield. Visit HealthCare.gov or CuidadoDeSalud.gov to learn more about the Marketplace. Open enrollment starts November 1, 2017 and ends December 15, 2017, with coverage beginning January 1, 2018.

FAQs

STOP

If you are enrolled in a Federal Employees Health Benefits (FEHB) plan, you should not be enrolled in, or covered by, a Multi-State Plan (MSP Option).

  • The MetLife TCA is a settlement option offered by MetLife for the payment of claims. A MetLife TCA is not a checking, savings, or money market bank account. Since the MetLife TCA is not a bank account, it is not insured by the FDIC or any government agency. Instead, MetLife guarantees the full amount in the MetLife TCA, including all interest earned. MetLife's guarantee is further backed by the beneficiary's respective state guaranty association. Maximum guarantee limits vary from state to state and may change over time. If the beneficiary chooses a MetLife TCA, the relationship is between the beneficiary and MetLife, not with the federal government or any of its agencies. You or your beneficiary can find additional information about state guaranty associations on the National Association of Insurance Commissioners (NAIC) website http://www.naic.org. The MetLife TCA offers a minimum guaranteed annual effective interest rate, meaning that MetLife commits to pay the beneficiary at least that specified rate of interest on the money in the account. The beneficiary begins earning interest the day the MetLife TCA is created. Interest is earned daily, but is not credited until the last day of the month. The interest rate offered on the MetLife TCA may be better or worse than the prevailing market rates. The MetLife TCA is a product offered by MetLife on which the company may make a profit. The beneficiary pays no monthly maintenance fees on a MetLife TCA. The beneficiary has complete control of, and access to, the entire amount of the insurance proceeds. The beneficiary can withdraw the full amount from the MetLife TCA at any time. The information packet the beneficiary receives will include a draft book (similar to a checkbook). At any time and at no cost, the beneficiary can write drafts (similar to checks) from a minimum of $250 up to the full balance of the account. In addition, the beneficiary will receive periodic activity statements, and can designate a beneficiary for the account. If the beneficiary chooses the MetLife TCA settlement option, he or she will receive more detailed information when the account is opened.
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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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  • 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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  • Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide. Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and some medical supplies, which some FEHB plans may not cover or only partially cover (check your plan brochure for details).
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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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  • Premiums are paid on a pre-tax basis (premium conversion) if you are an active employee and your salary is sufficient to make the premium withholding. Pre-tax premiums are not available to annuitants, survivor annuitants or compensationers.
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  • FEHB and FEDVIP are separate programs. While some FEHB plans offer dental or vision benefits as part of their benefit package, only those carriers under contract to OPM are FEDVIP plans. FEDVIP plans offer comprehensive dental and vision benefits. FEDVIP is not part of the FEHB program, and it is different from any supplementary dental and vision product your FEHB plan may offer.
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  • Unfortunately, parents are not eligible family members.
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  • Yes. You can always make changes to your plan during Open Season. In addition, you can make changes if you experience a Qualifying Life Event. For example, if you are currently married and chose a Self Plus One enrollment, in the event you divorce,  you can make a change to Self Only. Alternatively, you can change to Self and Family if you have an eligible child. Other QLEs allow you to make changes as well. You can see a list of all your QLE opportunities on the SF 2809.
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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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Total Count: 976, Number of Pages: 98, Page: 4
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