This manual provides standardized guidance for employing offices, carriers, and employees on how to interpret and act on Significant Events during the annual Federal Benefits Open Season. For terms and definitions, please see the FEHB Handbook.

List of all FEHB/PSHB Significant Events Tables

A. Plans Leaving, Reducing, or Terminating Coverage

Table A1 - Plans Leaving the FEHB/PSHB Program
Table A2 - Plans Leaving the FEHB/PSHB Program That Will Continue to Participate in the PSHB Program or the FEHB Program
Table A3 - Plans Reducing Service Areas and Terminating Enrollment Codes
Table A4 - Plans Reducing Service Areas Without Terminating Enrollment Codes
Table A5 - Plans Terminating Options and Enrollment Codes

B. Plan and Enrollment Code Consolidation

Table B1 - Enrollment Code Mergers With Terminating Enrollment Codes
Table B2 - Contract Consolidations

Other FEHB/PSHB Tables of Significant Plan Changes

C. New Plan, Options, and Enrollment Codes

Table C1 - New Plans Entering the FEHB/PSHB Program
Table C2 - Plans Adding New Options and Enrollment Codes

D. Service Area Expansions and Changes

Table D1 - Service Area Expansions Without New Enrollment Codes
Table D2 - Service Area Expansions Adding New Enrollment Codes
Table D3 - Service Area Changes - Count/Zip Code Changes Due to USPS Boundary Changes
Table D4 - Service Area Name Changes

E. Plan and Option Name Changes

Table E1 - Plans Changing the Names of Existing Plan Options
Table E2 - Plans Changing Names

F. Enrollment Eligibility Changes

Table F1 - Closed Plans Changing Enrollment Criteria for Newly Eligible Enrollees

FEDVIP - Significant Plan Change Events

Table 1 - Plan Leaving the FEDVIP
Table 2 - New Plans Joining the FEDVIP

Federal Employees Health Benefits (FEHB) Program and Postal Service Health Benefits (PSHB) Program

A. Plans Leaving, Reducing, or Terminating Coverage

Table A1 - Plans Leaving the FEHB/PSHB Program and
Table A2 - Plans Leaving the FEHB/PSHB Program That Will Continue to Participate in Either the PSHB Program or the FEHB Program

If a carrier elects not to renew either its FEHB or its PSHB contract for the upcoming plan year, all active enrollment codes under that plan are discontinued effective at the end of the contract year. Enrollees in terminating plans must enroll in a new FEHB or PSHB plan during Open Season or they will be automatically enrolled in a plan option determined by OPM, per 5 CFR 890.301(n). The carrier may elect not to renew its plan contract in one Program but continue to offer plans in the other Program (FEHB or PSHB).

Employing Office Instructions

• Notify employees enrolled in the terminating FEHB/PSHB plans. Advise employees if they do not choose a new plan, per 5 CFR 890.301(n) they will automatically be enrolled in a plan option determined by OPM. See Benefit Administration Letter (BAL) 16-202, Enrollment Options Following the Termination of a Plan or Plan Option for additional information on how to automatically enroll individuals who do not make an enrollment election during the allotted time period.
• Distribute copies of the tables to affected employees with your employing office’s notice about Open Season along with copies of FastFacts - What to Do When Your Health Plan is Terminating Coverage in Your Area or Leaving the FEHB/PSHB Program.
• Follow up with employees in these plans.

Carrier Instructions

• Notify enrollees advising them their plan will not continue in the FEHB/PSHB Program for the upcoming year and if they do not choose a new plan, per 5 CFR 890.301(n), they will automatically be enrolled in a plan option determined by OPM.
• Continue processing claims and providing benefits under the current contract until the contract end date.

Enrollee Instructions

• Enrollee in plans leaving the FEHB/PSHB Program must select a new FEHB/PSHB plan during Open Season. Employees who do not make an election will be automatically enrolled in a plan option determined by OPM, per 5 CFR 890.301(n).
• New Coverage: For FEHB, enrollees’ coverage under their new health plan will be effective the first day of the pay period beginning on or after January 1. For PSHB, the effective date of coverage is January 1.
• Continued Coverage: Enrollees' coverage under their current plan will remain in effect until the new plan becomes effective.

Table A3 - Plans Reducing Service Areas and Terminating Enrollment Codes

Enrollees in terminating plans must make a positive election into another FEHB/PSHB plan during Open Season or they will be automatically enrolled in a plan option determined by OPM, per 5 CFR 890.301(n).

Employee Office Instructions

• You must notify employees enrolled in the terminating FEHB/PSHB plans.
• Advise employees that if they do not choose new plans, they will be automatically enrolled in a plan option determined by OPM, per 5 CFR 890.301(n). Distribute copies of the tables to affected employees with your employing office’s notice about Open Season along with copies of FastFacts - What to Do When Your Health Plan is Terminating Coverage in Your Area or Leaving the FEHB/PSHB Program.
• Follow up with employees in these plans.

Carrier Instructions

• Plan Notification: Carriers have been instructed to notify enrollees that they must select new plans for the upcoming benefit year, or they will be automatically enrolled in a plan option determined by OPM per 5 CFR 890.301(n).

Enrollee Instructions

• Employees who live or work where there is a service area reduction with terminating enrollment codes must enroll in a new FEHB/PSHB plan during Open Season. If they do not enroll in a new plan, they will be automatically enrolled in a plan option determined by OPM per 5 CFR 890.301(n).
• New Coverage: For FEHB, enrollees’ coverage under their new health plan will be effective the first day of the pay period beginning on or after January 1. For PSHB, the effective date of coverage is January 1.
• Enrollees’ coverage under their current plan will remain in effect until the new plan becomes effective.

Table A4 - Plan Reducing Service Areas Without Terminating Enrollment Codes

Enrollees in affected areas who do not select a new health plan during Open Season will only have access to emergency services in their area. They will have to travel to their plan’s remaining service area to obtain medical care in order to receive full benefits from the plan.

Employing Office Instructions

• Notify employees enrolled in the FEHB/PSHB plans listed to select a new FEHB/PSHB plan if they live or work in a service area that is being terminated.
• Advise your employees if they do not choose a new plan, they will only be covered for emergency services where they live or work and they will have to travel to their plan’s remaining service area to receive full benefits in the upcoming benefit year.
• Distribute copies of the tables to employees along with your employing office’s notice about Open Season and copies of FastFacts - What to Do When Your Health Plan is Terminating Coverage in Your Area or Leaving the FEHB/PSHB Program.
• Follow up with employees in these plans and remind them to select a new plan.

Carrier Instructions

• Plan Notification: Carriers have been instructed to notify enrollees that their respective plan service areas are being terminated. If enrollees do not choose another FEHB/PSHB plan, the enrollees will only be covered for emergency services where they live or work and they will have to travel to their plan’s remaining service area to receive full benefits in the upcoming benefit year.

Enrollee Instructions

• Employees who are enrolled in plans that are reducing service in the area where they live or work should elect a new FEHB/PSHB plan for the upcoming benefit year.
• If an employee does not choose a new FEHB/PSHB plan, they will only be covered for emergency services where they live or work and will have to travel to their plan’s remaining service area to receive full benefits.

Table A5 - Plans Terminating Options and Enrollment Codes

Enrollees in the plan’s terminating option will be automatically enrolled into the plan’s remaining non-High Deductible Health Plan (HDHP) option if no new plan is selected by the enrollee. If only an HDHP remains, enrollees will be automatically enrolled in a plan option determined by OPM per 5 CFR 890.301(n).

Employing Office Instructions

• Advise your employees who are enrolled in the plan option that is terminating that if they do not choose a new health plan, they will be automatically enrolled into the plan’s non-HDHP option as specified in the table.
• Distribute copies of the tables to employees along with your employing office’s notice about Open Season and copies of FastFacts - What to Do When Your Health Plan is Terminating Coverage in Your Area or Leaving the FEHB/PSHB Program.
• Follow up with affected employees and remind them that if they do not choose a new health plan, they will be automatically enrolled into the plan’s option specified in the table.

Carrier Instructions

• Plan Notification: Carriers have been instructed to notify FEHB/PSHB enrollees that their current plan option is being terminated.

Enrollee Instructions

• Employees in a plan terminating an option may choose a new health plan during Open Season or they may remain with their current plan. If an employee does not choose a new plan, their FEHB/PSHB plan will enroll the employee into the plan’s option specified in the table. If only an HDHP remains, enrollees will be automatically enrolled in a plan option determined by OPM per 5 CFR 890.301(n).
• New Coverage: For FEHB, enrollees’ coverage under their new health plan will be effective the first day of the pay period beginning on or after January 1. For PSHB, the effective date of coverage is January 1.

B. Plan and Enrollment Code Consolidation

Table B1 - Enrollment Code Mergers With Terminating Enrollment Codes

Employing Office Instructions

• Ensure enrollees are automatically moved into the remaining FEHB/PSHB codes unless the enrollees select another FEHB/PSHB plan during Open Season.
• Distribute copies of the tables to employees with your employing office’s notice about Open Season.

Enrollee Instructions

• Employees in a plan whose enrollment code is merging with another will be automatically moved into their FEHB/PSHB plan’s new enrollment code, unless they change health plans during Open Season.
• New Coverage: For FEHB, enrollees’ coverage under their new health plan will be effective the first day of the pay period beginning on or after January 1. For PSHB, the effective date of coverage is January 1.
• Continued Coverage: Enrollees’ coverage under their current plan will remain in effect until the new plan becomes effective.

Table B2 - Contract Consolidations

Employing Office Instructions

• Follow the instructions outlined in the table for implementation guidance, subject to change based on plan consolidation.

Enrollee Instructions

• No action required. There will be no change to their enrollment code.
• New Coverage: For FEHB, enrollees’ coverage under their new health plan will be effective the first day of the pay period beginning on or after January 1. For PSHB, the effective date of coverage is January 1.

Other FEHB/PSHB Tables of Significant Plan Changes

Information pertaining to the following tables can be found in the Significant Plan Tables. 

Include the information below when you count the number of eligible employees and place your order for brochures. Plan contact information is available on our website.

C. New Plan, Options, and Enrollment Codes

Table C1 - New Plans Entering the FEHB/PSHB Program

Table C2 - Plans Adding New Options and Enrollment Codes

D. Service Area Expansions and Changes

Table D1 - Service Area Expansions Without New Enrollment Codes

Table D2 - Service Area Expansions Adding New Enrollment Codes

Table D3 - Service Area Changes - County/Zip Code Changes Due to USPS Boundary Changes

Table D4 - Service Area Name Changes

E. Plan and Option Name Changes

Table E1 - Plans Changing the Names of Existing Plan Options

Table E2 - Plans Changing Names

F. Enrollment Eligibility Changes

Table F1 - Closed Plans Changing Enrollment Criteria for Newly Eligible Enrollees

FEDVIP - Significant Plan Change Events

Table 1 - Plan Leaving the FEDVIP

A dental or vision carrier may exit FEDVIP at the end of a plan year. When a carrier leaves the program, enrollees in that plan must take action to ensure continued coverage for the next year.

Employing Office Instructions

• Provide employees with the appropriate FEDVIP Open Season notice and include information about any carriers leaving the program.
• Notify affected enrollees that they must choose a new plan during Open Season to ensure uninterrupted coverage.

Plan / BENEFEDS Instructions

• The terminating FEDVIP carrier will notify its enrollees regarding the need to enroll in a new plan for the next plan year.
• BENEFEDS will send mail and email notifications to impacted enrollees before and during Open Season reminding them to enroll in a new plan to ensure uninterrupted FEDVIP coverage.

Enrollee Instructions

• Employees enrolled in a terminating FEDVIP plan must select a new plan during Open Season in order to maintain coverage for the upcoming plan year.
• New coverage under the selected plan will take effect on January 1 of the following year.
• Coverage under the terminating plan will continue through December 31 and will end when the new plan becomes effective.

Table 2 - New Plans Joining the FEDVIP

Each year, new dental or vision carriers may join FEDVIP. When a new carrier enters the program, employees and retirees gain additional plan options to consider during Open Season.

Employing Office Instructions

• Include information about newly added FEDVIP carriers in Open Season communications.
• Ensure employees are aware of all available dental and vision options, including new carriers, to support informed decision-making.

Plan / BENEFEDS Instructions

• Newly added FEDVIP carriers will provide information on their benefits, premiums, and networks to assist employees in comparing options.
• BENEFEDS will update the plan comparison tools and issue notices during Open Season to help enrollees review new plan offerings.

Enrollee Instructions

• New FEDVIP carriers and plan options will be available for selection during Open Season.
• Employees and annuitants may choose to enroll in one of the newly added plans, enroll in a different plan, or keep their current coverage.
• Coverage elected during Open Season becomes effective January 1 of the following plan year.