The head of each agency must designate a person to serve as the headquarters benefits officer (Benefits Officer) for the agency. The agency head must notify OPM in writing of the designee's name or any change in the designation. The Benefits Officer is OPM's contact for agencywide insurance matters.
Agency heads can send their notification to Office of Personnel Management, Retirement and Insurance Service, Agency Services Division, P.O. Box 57, Washington DC 20044 or fax the notification to 202-606-1108.
The head of each agency must arrange for the designation of employees at the employing office level. This person will be responsible for explaining the FEHB Program to employees and other eligible persons. He/she will determine individual eligibility for enrollment, effective dates of health benefits actions, and other related matters.
An agency may also delegate responsibility for counseling and advising employees and maintaining records to decentralized local operating offices or field installations or provide the services in some other way.
Each agency has a responsibility to provide health insurance information and counseling to its employees. Agencies must become especially familiar with the participation requirements for continuing FEHB coverage into retirement and make this information available to employees, especially those considering retirement. OPM encourages agencies to develop counseling programs that meet the needs of their own employees. While these services must be provided, agencies are using many different approaches. Specific information on resources within your agency should be available to you at your work site.
Authorized agency insurance officials should develop contacts with carrier representatives to assist their employees. These contacts must be limited to agency personnel who have FEHB Program responsibilities and to those employees enrolled in the carrier's plan, except during an Open Season. An agency may allow carrier representatives on agency premises to help enrollees with claim or service problems.
A carrier representative may give information only about the plan's benefit provisions and claim procedures. Carrier representatives must be qualified to explain and assist with problems involving the plan's benefit structure and claims procedures and they must confine themselves to these matters. If you have any other questions, such as questions on the law, the regulations, or the FEHB Program in general, you should ask authorized agency insurance officials.
Carrier representatives may address groups of employees during Open Seasons about their plan's benefits structure, methods of obtaining services, and similar matters. An agency may allow the use of its facilities or services for the distribution of OPM-authorized, carrier-supplied information on health benefits plans. An agency must treat employee organization carriers in accordance with current policies on labor-management relations in the Federal service, found in chapter 71 of title 5, United States Code.
Distribution of materials is limited to official brochures and other carrier-supplied information on a health insurance plan that the carrier certifies are in compliance with OPM's supplemental literature guidelines.
Employing office questions concerning the FEHB Program must be directed to the headquarters Benefits Officer. This person may refer questions to OPM's Insurance Policy and Information Division. Questions about the benefits or claims procedure of a specific plan should be directed to a local office of that plan.
Agencies also are responsible for:
Each carrier is responsible for:
Your plan carrier will mail your identification cards directly to you. You will receive a new identification card if you change the type of enrollment within your plan or if your name changes. You will not receive a new identification card if you retire or change payroll or employing offices without changing your enrollment.
If you want a duplicate identification card, you must request the card from your carrier. Include in the request your date of birth, social security number, and any additional identifying number the plan may use. This number can usually be found on your current identification card.
Some carriers provide claim kits as a convenient way for you to maintain claims expense records. Generally, carriers issue the kits to their enrollees at the same time they issue identification cards. Employing offices wanting information copies of these kits may obtain them from the nearest office of the plan.
Your responsibilities include:
If you are a current employee, a former employee or family member covered under temporary continuation of coverage (TCC), a compensationer, or a former spouse of a current employee, you must direct questions about the FEHB Program to your servicing employing office. If you are an annuitant or a former spouse whose divorce occurred after the enrollee left Federal service, you can direct your questions to OPM's Retirement Information Office at 1-88USOPMRET (1-888-767-6738) or (202) 606-0500 from the metropolitan Washington area, or you can write to OPM's Retirement Operations Center, P.O. Box 45, Boyers, PA 16017-0045.
Questions from agency personnel offices and field installations must be directed to the agency headquarters Benefits Officer.
Designated headquarters Benefits Officers can direct their questions to OPM, Retirement and Insurance Service, Office of Insurance Programs, Insurance Policy and Information Division, Washington, DC 20415. Questions also may be sent through the e-mail address on the OPM web site.
Our customers include Federal employees and retirees, or their survisors, who are eligible to enroll in the FEHB Program. This is our commitment to our health benefits customers:
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