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Insurance FAQs

  • If you do not want to continue your FEHB enrollment, you must notify your employing office in writing that you wish to terminate your coverage. If you do not take action to terminate the coverage, your enrollment will continue for up to 24 months while you are on military duty.
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  • No, FEDVIP is completely separate from your private plan. You will not be able to transfer the amount of time you spent in your private plan to your FEDVIP Plan.
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  • Generally, your coverage continues for 36 months from the date of your divorce or annulment, as long as you pay your premiums on time. After your TCC enrollment ends:
    • you get a 31-day extension of coverage, and
    • you may convert to an individual contract offered by your health benefits plan,
    unless you lose coverage because you canceled your enrollment or didn't pay your premiums.
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  • Increasing life insurance:  FEGLI life insurance open seasons are extremely rare and none are currently scheduled.  Your agency and OPM's website will announce when there is a life insurance open season coming up.  The most recent FEGLI open seasons were held in 2004 and 1999. Outside of an open season, eligible employees can enroll or increase their coverage by taking a physical exam or with a Qualifying Life Event. For more information about the physical exam, please see SF 2822. FEGLI life events are marriage, divorce, death of spouse, or acquisition of an eligible child.  With a life event, you can enroll or increase coverage in Basic, Option A, up to five multiples of Option B, and/or up to five multiples of Option C.  You must submit an SF 2817 to your human resources office within 60 days after the life event. Reducing or cancelling life insurance: You can reduce or cancel your FEGLI life insurance at any time, without waiting for an open season.   If you are an employee, submit an SF 2817 to your human resources office, signing only for the coverage you want to keep.   If you are retired, there is no form; you must write a signed letter to OPM's Retirement Office stating clearly the reduction or cancellation you want to make.  Be sure to include your signature, annuity number (CSA/CSF) or social security number, and your phone number.  Send the letter to:
    • Office of Personnel Management 
    • Retirement Operations Center 
    • P.O. Box 45 
    • Boyers, PA 16017-0045
    Please note that you cannot enroll, increase coverage, or restore cancelled coverage after you have retired. Changing beneficiaries: You can change beneficiaries at any time, without waiting for an open season.  Submit an SF 2823 to your human resources office, or to OPM's Retirement Office if you have retired.  The address for OPM's Retirement Office is on page 3 of the form.
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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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  • FedFlex, The Federal Flexible Benefits Plan , is the name of OPM's cafeteria plan. In order to offer pre-tax benefits, OPM was required to create a plan document in accordance with IRS regulations that outlines the benefits and employee choices under that plan.
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  • Information about the new TRICARE-For-Life program can be obtained by calling 1-888-DOD LIFE (1-888-363-5433) or by going to the TRICARE website at www.tricare.osd.mil.
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  • Dental plans provide a comprehensive range of services, including the following:
    • Class A (Basic) services, which include oral examinations, prophylaxis, diagnostic evaluations, sealants and x-rays.
    • Class B (Intermediate) services, which include restorative procedures such as fillings, prefabricated stainless steel crowns, periodontal scaling, tooth extractions, and denture adjustments.
    • Class C (Major) services, which include endodontic services such as root canals, periodontal services such as gingivectomy, major restorative services such as crowns, oral surgery, bridges and prosthodontic services such as complete dentures.
    • Class D (Orthodontic) services with up to a 24-month waiting period.
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  • You are eligible for Medicare if you are age 65 or over. Also, certain disabled persons and persons with permanent kidney failure (or End Stage Renal Disease) are eligible. You are entitled to Part A without having to pay premiums if you or your spouse worked for at least 10 years in Medicare-covered employment. (You automatically qualify if you were a Federal employee on January 1, 1983.) If you donï't automatically qualify for Part A, and you are age 65 or older, you may be able to buy it; contact the Social Security Administration. You must pay premiums for Part B coverage, which are withheld from your monthly Social Security payment or your annuity. You must be enrolled in both Medicare Parts A and B before you can enroll in Part C. You must be enrolled in either Part A or Part B before you can enroll in Part D. The cost of any additional premium will vary depending on the Part C or Part D plan that you select.
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  • Problems arising from oral discussions are very difficult to settle later because they are impossible to prove or disprove. In contractual situations such as under the FEHB Program, oral statements can never be regarded as official and, so, we state in the brochures that oral statements made by any representative of a carrier cannot modify the benefits described in the brochure.
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  • No, by law there is no Government contribution to the premiums.
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  • You can submit a court order if you are an employee, an annuitant, a former spouse, the former spouse's attorney or anyone else.
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  • There are a number of factors for you to consider if you are employed part-time. Although you will not be eligible for the full government contribution, your entire employee contribution will be pre-tax if you participate in premium conversion. That larger reduction in taxable income might offset the lower government contribution. If you are a part-time reemployed annuitant, we suggest that you consult your agency or a qualified tax advisor to review your individual situation.
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  • Yes, taxes in 49 states and most localities will be reduced; exceptions include the state of New Jersey and the Commonwealth of Puerto Rico. OPM monitors changes in state and local tax regulations, and provides guidance to your agency as needed. Regardless of where you live, FEHB premiums are not subject to Federal taxes. FICA Taxes If you are covered by the Federal Employees Retirement System (FERS) and participate in premium conversion, FEHB premium deductions will also be excluded from gross pay before Old-Age, Survivors, and Disability Insurance (OASDI) and Medicare taxes are applied. Employer FICA contributions will also be reduced in concert with the decrease in employee withholdings.
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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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  • Each year OPM releases the new health insurance rates about a month prior to the FEHB Open Season. The FEHB Open Season runs from the second Monday in November through the Second Monday in December. The new rates are generally released by mid-October at http://www.opm.gov/insure/health/rates/index.asp.
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  • Yes, if you experience one of the following Qualifying Life Events: You are enrolled in a FEHB Health Maintenance Organization (HMO) and you (or a covered family member) move or become employed outside the geographic area from which your FEHB carrier accepts enrollments; (or, if already outside this area, you move further from this area); You lose coverage due to discontinuance in whole or part of your FEHB plan; You experience a change in your family status. (Family status changes include marriage, legal separation, divorce, death of spouse or dependent, loss of coverage by your last dependent child.)
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  • Under CSRS offset, your Social Security benefits would be slightly reduced, but your CSRS Offset benefits would be increased by almost the same amount. Participating in premium conversion is most likely a benefit to you.
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  • While you may count the time you are covered under transitional TRICARE toward meeting the 5 year/initial opportunity requirement to continue your FEHB into retirement, you must be covered under FEHB on the day you retire. If you plan to retire during your transitional TRICARE period, you must reinstate your FEHB before your retirement date. Your Human Resources Office can assist you.
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  • No. The only way to continue coverage into retirement is to meet the five year/all opportunity rule. You cannot "buy" the years you are missing.
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Total Count: 817, Number of Pages: 41, Page: 5
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