What to Expect for the 2023 Federal Benefits Open Season

This year’s federal benefits open season runs from Nov. 13 through Dec. 11, 2023. During this period, federal employees have the opportunity to enroll in the Federal Employee Health Benefits (FEHB) program, change their current FEHB program health plan or health plan options, change enrollment type or cancel enrollment in the FEHB program.

Federal retirees can also do each of the aforementioned actions, with the exception of enrolling in the FEHB program. Those federal retirees who were previously enrolled in the FEHB program, either as an employee or as a retiree, but who disenrolled cannot re-enroll in the FEHB program.

SEE ALSO:  2024 FEHB Plan Comparison Tools, Brochures, Premium Rates

This column discusses the FEHB program and what employees and retirees need to be aware of with respect to their participation in the FEHB program.

The health insurance plans offered through the FEHB program are not alike. The benefits open season is a time in which employees and retirees exercise their right of choice. By making the right choices, employees and retirees can have access to health care services that they and eligible family members need and can afford.

Items to Be Aware with the FEHB Program

1. There are many health insurance plans under the FEHB program to meet employee and retiree needs.

2. An employee must be enrolled in the FEHB program for the five years of service ending on the effective date the employee retires from federal service.

3. There are no waiting periods and no pre-existing conditions limitations under the FEHB program, even if an employee or a retiree were to change their health plans.

What Actions Can Be Performed During the FEHB Program Open Season?

During the FEHB program open season employees and retirees can do the following:

• Enroll or re-enroll in the FEHB program (employees only).

Those federal employees who did not enroll in the FEHB program when they were initially hired can enroll in the program during the open season. Employees who were previously enrolled in the program but who disenrolled can re-enroll.

• Suspend their existing FEHB program enrollment.

Those employees and retirees who are currently enrolled in the FEHB program can suspend their enrollment. Suspending one’s enrollment does not mean that an employee or retiree is canceling their enrollment.

Suspending enrollment means that an employee or retiree is leaving the FEHB program temporarily in order to enroll in either:

(a) Tri-Care; or

(b) A private Medicare Advantage plan.

• Change existing health insurance plans within the FEHB program.

There are hundreds of health insurance plans available within the FEHB program including:

(1) Fee-for-Service;

(2) Preferred Provider Organization;

(3) Point-of-Service;

(4) Health Maintenance Organization;

(5) Consumer Driven High Deductible; and

(6) High Deductible Health Plan associated with a health saving account.

Employees and retirees can change the plan they were enrolled in during 2023 to a new plan during 2024.

• Change plan options.

Employees and retirees can make changes to the coverage options they have selected for their plan. For example, they can switch from low deductible to high deductible, or from “standard” to “basic” coverage.

• Change enrollment type.

There are three types of enrollments available in the FEHB program:

(1) Self only;

(2) Self plus one (eligible family member – a spouse or a child under the age of 26); and

(3) Self and family – multiple family members.

• Cancel FEHB program enrollment. Canceling coverage means that an employee or a retiree is dropping out of the FEHB program.

Note that an employee who cancels his or her FEHB program enrollment can re-enroll in the FEHB program during a future open season. Or, in some situations, as a result of a life event. However, a federal retiree who drops out of the FEHB program cannot re-enroll, even due to a life event.

What Happens if An Employee or a Retiree Takes No Action During Open Season?

An employee or a retiree who makes no changes with regard to their FEHB program enrollment during the 2024 open season will keep the same FEHB program health plan type of coverage and type of enrollment for 2024 as they had during 2023.

Where Do Employees and Retirees Get Information about FEHB Program Health Plans in Their Geographic Area?

Employees and retirees should visit the OPM website to get more information about FEHB health plans available in the geographic area that they live.

How Does an Employee or a Retiree Make a Change to His or Her FEHB Program Enrollment During Open Season?

An employee or a retiree who needs to make changes to his or her enrollment during open season should visit the OPM.gov website for instructions on how to make changes.

What is the Effective Date of FEHB Program Enrollment or Health Insurance Plan Change?

The effective date of an employee’s enrollment change made during the open season (Nov. 13 – Dec 11, 2023) is the first day of the 2024 leave year. The 2024 leave year begins at most federal agencies on January 14, 2024. This means that employees who made changes to their FEHB program health insurance coverage during the open season will have these changes taking effect on January 14, 2024.

However, the January 14,2024 effective date assumes an employee is in pay status in the pay period ending January 13,2024 (pay period 27 of leave year 2023). At most federal agencies pay period 27 of leave year 2023 will be from December 31,2023 through January 13, 2024.

If an employee is not in pay status during pay period 27 of leave year 2023 and returns to pay status effective January 14, 2024, then the effective date of enrollment for changes or new enrollment made during the open season will be January 28, 2024. This is the start of the second pay period for leave year 2024.

For retirees who made changes to their FEHB program enrollment during the open season, the changes will become effective on January 1, 2024.