Q. Where can I find the Guide to Federal Benefits that lists the premiums for TCC?
A. You can find the Guide that list premiums for TCC at this link. www.opm.gov/insure/health/planinfo/guides/index.asp The Guide for TCC is RI 70-5.
Q. When I enroll in TCC, how will I pay my premiums?
A. The employing office bills you for each pay period (generally each month) you are covered.
Q. Do I have to pay for the thirty-one day temporary extension of coverage?
A. No. When you lose FEHB coverage other than by cancellation (including cancellation by nonpayment of premiums) you have a 31-day temporary extension of coverage, at no cost. This coverage is provided in the same enrollment category so you may convert to an individual contract with your current health benefits plan. Please review the Temporary Continuation of Coverage (TCC) pamphlet. www.opm.gov/insure/health/eligibility/tcc
Q. What is Temporary Continuation of Coverage (TCC) and what are the requirements to enroll under the Temporary Continuation of Coverage provisions of the FEHB law?
A. Temporary Continuation of Coverage (TCC) is available to: (1) employees who lose their FEHB Program coverage because they leave their Federal jobs, (2) children who lose their FEHB Program family member status because they reach age 26, and (3) former spouses who lose their FEHB Program family member status because of divorce or annulment. TCC allows former employees to continue their FEHB Program coverage for up to 18 months, and former family members (children and former spouses) to continue FEHB Program coverage for up to 36 months. For more information about TCC, please review the TCC pamphlet at www.opm.gov/insure/health/eligibility/tcc/index.asp.
Q. I am resigning from my Federal job, how do I enroll for TCC?
A. You must apply for Temporary Continuation of Coverage (TCC) with your agency Human Resources Office within 60 days from the date you separate from Federal service. TCC coverage becomes effective the day after the qualifying event. After your 31-day extension of your group coverage ends, you pay the full premium (the enrollee and Government contribution) plus a 2 percent administrative fee. For more information, contact your agency's Human Resources Office and review the TCC pamplet at www.opm.gov/insure/health/eligibility/tcc.
Q. Can my children get coverage when they reach age 26?
A. When children reach age 26, they are eligible to enroll in Temporary
Continuation of Coverage (TCC). You need to contact your Human Resources Office and
inform them that your child is turning age 26. It is not their responsibility to notify you. They will give you information about enrolling your child for TCC.
You have 60 days from the 26th birthday to notify your Human Resources
Office your child turned 26. Your child has 60 days from the later of (1)
the 26nd birthday or (2) the date of the TCC notice from the Human Resources Office to request enrollment for TCC. For more information about TCC, please review the TCC coverage pamphlet at www.opm.gov/insure/health/eligibility/tcc.
Q. What is the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and does it apply to persons with FEHBP coverage?
A. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a Federal law that provides far-reaching health insurance reforms and medical privacy protections for all Americans. Title I of HIPAA offers important, though limited, Federal protections that improve the availability and continuity of health coverage for workers and their families. Under certain conditions, this law guarantees the availability of new health coverage with no exclusions for pre-existing conditions for individuals who lose employment-based health coverage due to changes in employment or family status. The Departments of the Treasury, Labor, and Health and Human Services are jointly responsible for Federal rules concerning health insurance portability and accessibility requirements. However, since HIPAA gives enforcement authority to the individual states and allows states to impose more generous protections than those under HIPAA, a key source of information for individuals is your State Insurance Commissioner.
Q. Where can I get help to determine if I may be eligible for HIPAA health coverage protection?
A. The Centers for Medicare and Medicaid Services in the Department of Health and Human Services, offers two resources to help answer questions about HIPAA health insurance protections and individual eligibility. HIPAA OnLine is an interactive tool that provides information about HIPAA rights and protections based on the user's responses to questions about personal health coverage and life events. There is also a booklet entitled Protecting Your Health Insurance Coverage (see "publications" link on website). Both resources are available on the Internet at www.cms.hhs.gov/HIPAAGenInfo/. Single copies of the booklet are also available on request from 1-800-MEDICARE (1-800-633-4227), or TTY/TDD, at 1-877-486-2048.
HIPAA OnLine also has direct links to Federal and State contacts for
information about health coverage protections under HIPAA.
An Internal Revenue Service publication entitled Deciding Whether to Elect
COBRA Health Care Continuation Coverage After the Enactment of HIPAA is
available on the IRS website at www.irs.gov/newsroom/. As explained in OPM pamphlet RI 79-27, Temporary Continuation of Coverage (TCC) under the FEHB Program (p.1), Federal employees must exhaust any TCC eligibility (which corresponds to COBRA provisions for private sector employees) as one condition for guaranteed access to individual health coverage under HIPAA.
Q. When I leave the FEHB Program, I understand I will receive a certification of my group coverage that I can use to get new coverage with my private industry employer. Will my agency or my plan certify my insurance coverage?
A. We require FEHB carriers to issue certifications of prior coverage to enrollees. They issue certifications automatically whenever coverage terminates, whether it is termination of regular coverage, TCC coverage, or Spouse Equity coverage. If the plan does not certify your coverage, you should write to them and ask them to send you certification of coverage.