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FEHB Enrollment With Military Service

Federal employees who elect to serve in the military can continue their FEHB coverage during their service. Entry into Military Service For 30 days or Less If you enter one of the uniformed services for 30 days or less, your FEHB enrollment will continue without change. Withholdings and Government contributions will also continue, as long as you are in pay status or until your military orders are changed so that your period of duty is more than 30 days. Entry into Military Service For More Than 30 Days If you enter...

HMOs in the FEHB Program

Two types of plans participate in the FEHB Program: fee-for-service plans and health maintenance organizations (HMOs). Health Maintenance Organizations Health Maintenance Organizations (HMOs) provide or arrange for comprehensive health care services on a prepaid basis through designated plan physicians, hospitals, and other providers in particular locations. Each HMO sets a geographic area for which health care services will be available, called its service area. This area is described in the plan’s brochure. You may join...

Fee-for-Service Plans in the FEHB Program

Two types of plans participate in the FEHB Program: fee-for-service plans and health maintenance organizations (HMOs) Fee-for-Service Plans These plans reimburse you or your health care provider for the cost of covered services. You may choose your own physician, hospital, and other health care providers. Most fee-for-service plans have preferred provider (PPO) arrangements. If you receive services from a preferred provider, you usually have lower out-of-pocket expenses (i.e., a smaller copayment and/or a reduced or waived...

New OPM Rule Could Prevent FEHB Coverage Gap

The Office of Personnel Management has proposed a new rule that would prevent a gap in coverage for employees who fail to enroll in a new health plan when employees' previous Federal Employees Health Benefits plans or options terminate. While OPM already provides enrollees of defunct plans or options a period in which they may elect to enroll in a new one, the proposed rule lays out actions OPM and agencies may take if an enrollee fails to do so within the allotted time period. Under current regulation, an employee's FEHB...

What To Do if Your FEHB Plan Is Discontinued

You may change to another plan when you are enrolled in a plan that is discontinued in whole or in part. You may enroll in the new plan for either Self Only or Self and Family coverage. If your plan is discontinued at the end of a contract year, you must change your enrollment during Open Season unless OPM establishes a different time. Normally, a plan that terminates its participation in the FEHB Program will terminate as of December 31 of a given year. The plan will continue to provide benefits until the new coverage...

FEHB Deduction Errors for Current Federal Employees

Payroll offices must adjust errors in withholdings and contributions on a subsequent payroll and must include the adjustments in a subsequent withholdings and contributions report. Your employing office must ensure that your individual payroll record shows not only the regular (current) deductions for health benefits withholdings, but also the adjustments. Where annual appropriations are involved and the fiscal year changes between the processing of the erroneous withholdings and/or contributions and the processing...

Coordinating Federal Employee Healthcare Benefits with Medicare

If you or a covered family member is entitled to benefits from a source other than your FEHB plan, such as Medicare, those benefits will need to be “coordinated.” “Coordination of benefits” means that when you are covered by more than one type of insurance that covers the same health care expenses, one pays its benefits in full as the primary payer and the others pay a reduced benefit as a secondary or third payer. When the primary payer doesn’t cover a particular service but the secondary...

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