Q. When is Open Season?
A. Each year, Open Season runs from the Monday of the second full workweek in November through the Monday of the second full workweek in December. This year, Open Season runs from November 10, 2008 through December 8, 2008.
Q. When will my Open Season change to the new coverage be effective?
A. The effective date of the Open Season change is the first day of the first full pay period in January. For annuitants this date will always be January 1.
Q. I changed my health insurance during the Open Season and haven't received an identification card from my new plan and it is now after the effective date of the new enrollment. What can I do?
A. If you are a current Federal employee, you should contact your Human Resources Office and ask them to find out on what date and carrier report number your enrollment information was forwarded to your new health insurance carrier. With this information, your new carrier will be able to locate your enrollment data and forward ID cards to you.
If you are an annuitant, call your plan. If they tell you they haven't
gotten the paperwork yet from your retirement system, you may contact
your retirement system. If you are a Civil Service Retirement System
(CSRS) annuitant or a Federal Employees Retirement System (FERS)
annuitant, contact OPM at retire@opm.gov.
Before contacting your retirement system, have your annuity information ready,
for instance, your name, civil service annuity number (beginning with CSA or
CSF), phone number and address, and information about your plan, such as the
carrier enrollment code.
Q. My plan decided to stop participating in the FEHB Program for the next contract year. What happens if I don't make an enrollment change during the Open Season because I want to be covered by my spouse's private health insurance plan?
A. By regulation, an employee who does not change the enrollment during the Open Season is considered to have canceled the plan in which enrolled. The cancellation is effective the day before the first day of the first full pay period in January. The plan is responsible for providing coverage only through midnight of that date. If you're not sure of the date, you should contact your Human Resources Office and not the plan for the effective date.
You should be aware that you are not entitled to a 31-day extension of
coverage because the action is considered a cancellation and not a
termination. You cannot reenroll in the FEHB Program until the next open
season. Also, this is considered a break in coverage. The 5-year
requirement to continue your enrollment into retirement will begin when
you reenroll in the FEHB Program. If you are within five years of
retirement, you will have to work additional time to be eligible to continue
your enrollment into retirement.
If you are an annuitant, you are deemed to have enrolled in the standard
option of the Blue Cross and Blue Shield (BCBS) Service Benefit Plan. OPM
deems annuitants into the standard option of BCBS by default (and by law) if they do not make a plan selection.
If annuitants cancel their FEHB enrollment, they can never reenroll.
Q. I made an Open Season enrollment change. If I have to go to the
doctor after January 1, which plan do I contact?
A. Your new plan is NOT responsible for providing coverage until the effective date of your enrollment change which for most employees is the first day of the first full pay period in January. If you need medical services before the
effective date of your Open Season enrollment, you should contact your
old plan. Please remember, while the new enrollments are not effective until the first full pay period in January, the new plan benefits are effective January 1. Your old plan, therefore will provide coverage according to the new
contract. These expenses will count toward your prior year's deductible.
If you are an annuitant, you should contact your new plan. Your Open Season enrollment is effective January 1.
Q. My HMO stopped participating in the FEHB Program and now I have
no plans where I live. What can I do?
A. You may not be eligible to enroll in an HMO plan but there are ten fee- for-service plans available nationwide to all Federal employees and annuitants. These plans are: APWU Health Plan, Blue Cross and Blue Shield Service Benefit Plan - Standard Option, Blue Cross and Blue Shield Service Benefit Plan - Basic Option, GEHA Benefit Plan - HDHP, Mail Handlers Benefit Plan, Mail Handlers Benefit Plan - HDHP, NALC, SAMBA High Option, and SAMBA Standard Option. Please review the brochures of each of these plans to determine which plan best meets your medical needs.
If Federal enrollees have HMOs in their local areas that do not currently participate in the FEHB Program, we encourage them to ask their HMOs to consider the FEHBP market for their geographic areas. New plan application packages for the FEHB Program are available at www.opm.gov/insure/health/carriers/index.asp. Applications are due to OPM by January 31 of each year for the next contract term.