http://www.myfederalretirement.com

FEHB Open Season:
Important Frequently Asked Questions for Federal Retirees (and Those Soon-to-Retire)

In early November (prior to the href="http://www.myfederalretirement.com/public/709.cfm">Open Season), your

current Federal Employee Health Benefits (FEHB) plan provider will send you

a brochure, and your retirement office will send you instructions for ordering

brochures and making FEHB Open Season changes.

It is very important that you keep your address up to date to ensure that you

receive your Open Season materials each year. If you move, be sure to let

your retirement office know your new address. Any address request sent to the

Office of Personnel Management (OPM) must have your CSA or CSF claim number so

that OPM can identify you.

If you decide not to change your enrollment, do not respond

to the Open Season material. Your coverage under your current health plan

continues automatically.

Cancellation

You may voluntarily cancel your enrollment at any time. If you cancel, you

will not be entitled to a 31-day extension of coverage for conversion to a

non-group (private) policy and neither you nor your family members will be

entitled to a temporary continuation of coverage (TCC). Once your cancellation

takes effect, you will not be able to enroll again as a retiree unless you have

been continuously covered as a family member under another enrollment in the

FEHB since the date of your cancellation, and you lose the coverage because the

enrollment ends or the enrollee changes from self and family to self only.

Suspension

You may suspend your FEHB enrollment for any of the following reasons:

  • to enroll in a Medicare Advantage plan (these are Health Maintenance

    Organizations or Fee-for-Service plans approved by the Centers for Medicare and

    Medicaid Services);

  • because you are eligible under Medicaid or a similar state-sponsored program

    of medical assistance for the needy; or

  • because you have coverage under Peace Corps, TRICARE, TRICARE For Life, or

    CHAMPVA military program.

For more information on how to suspend your FEHB enrollment, contact your

retirement office or go to href="http://www.opm.gov/retire">http://www.opm.gov/retire. Time limitations

and other restrictions apply. For instance, you must submit eligibility

documentation that you are suspending FEHB to enroll in one of the other

programs listed in case you wish to re-enroll in the FEHB Program at a later

time.

If you have suspended FEHB coverage for one of the eligible programs (and

submitted the required documentation) but now want to enroll in the FEHB Program

again, you may enroll during Open Season. You may re-enroll outside Open Season

only if you move out of the Medicare Advantage plan's service area, or you

involuntarily lose coverage under one of the eligible programs. If you cancel

your coverage from one of those eligible programs for any reason, you cannot

re-enroll in FEHB until Open Season.

Coordination of FEHB benefits with Medicare or other

coverage

If the original Medicare Plan is your primary payer, which is generally the

case if you have Medicare and are not working, check the plan brochure to see if

the plan waives some of its FEHB cost-sharing (e.g., deductibles, coinsurance,

or copayments.

If you are interested in an HMO plan, some FEHB HMOs also offer Medicare

Advantage plans. Information on coordinating benefits with other coverage,

original Medicare or Medicare Advantage is available in Section 9 of the plan

brochures.

face="arial, helvetica, sans-serif">FREQUENTLY ASKED

QUESTIONS

What do I need in order to suspend my FEHB enrollment because I am

enrolled in a Medicare Advantage Health plan?

You must request and complete a Health Benefits Cancellation/Suspension form,

RI 799. You must provide documentation of your enrollment in a Medicare

Advantage health plan. An example of a Medicare Advantage health plan is "Secure

Horizons" or "Kaiser Permanente Senior Advantage." A copy of your Medicare card

alone will not allow you to suspend your FEHB enrollment.

As a retiree, am I entitled to the FEHB pretax premiums (premium

conversion)?

No, the IRS regulation allowing pretax premiums only applies to employees.

However, if you are reemployed in a position that conveys FEHB coverage, you can

participate in premium conversion by having your agency deduct your FEHB

premiums on a pretax basis. This is normally automatic unless you waive

participation in the premium conversion program. If you are employed by a

Federal agency and in receipt of a survivor annuity, you should contact your

employing personnel office, if you would like to transfer your FEHB enrollment

from your annuity to your employing agency and participate in premium

conversion.

I am eligible for Medicare. Can I change from one plan or option to

another at any time?

Yes, you may change plans at any time beginning on the 30th day before

becoming eligible for Medicare to anytime thereafter. However, this is a onetime

event. Medicare A & B eligibility is not an event that permits you to

suspend your enrollment in the FEHB.

I am receiving a survivor annuity based on my deceased spouse's

Federal service. I remarried after age 55. Can I add my new spouse to my current

FEHB plan?

No. While your annuity can continue if you remarry after age 55, or if you

were married to the deceased Federal retiree/employee for at least 30 years, you

cannot cover your new spouse on the enrollment. Only eligible family members of

the deceased are entitled to benefits under the FEHB program.

What do I need to do in order to suspend my FEHB enrollment because I

have Tricare, Tricare for Life, Peace Corps or CHAMPVA?

You must request and complete a Health Benefits Cancellation/Suspension

Confirmation form, RI 799. If you are a Tricare/Tricare for Life enrollee, you

must provide a copy of your Uniformed Services Identification (ID) card and, if

over age 65, a copy of your Medicare card showing Parts A and B along with the

completed Health Benefits Cancellation/Suspension Confirmation form. If you are

a CHAMPVA enrollee, you must provide a copy of your CHAMPVA Authorization card

(Acard) along with the completed Health Benefits Cancellation/Suspension form.

If you are a Peace Corps volunteer, you must provide evidence of your enrollment

along with the completed Health Benefits Cancellation/Suspension form.

For more information, go to:  href="http://www.opm.gov/retire">http://www.opm.gov/retire

Source:  RI 70-09 

11/09

Copyright © 2007-2012 My Federal Retirement. All Rights Reserved. Reproduction without permission prohibited.