FAQs
When a tribal employer chooses to participate in the Federal Employees Health Benefits
(FEHB) Program, the Initial Enrollment Opportunity occurs. It is the time period for eligible tribal employees to
enroll in the FEHB Program. Please check with your tribal employer to see if they have elected to participate in
FEHB and if they have, when your Initial Enrollment Opportunity occurs.
Tribal employees who are considered common law employees and meet FEHB requirements for
the type of employment are eligible to enroll in FEHB. Check with your tribal employer to see if you are eligible
to enroll.
For details on the common law standard, please see pages two through five of: www.irs.gov/pub/irs-utl/x-26-07.pdf.
Contract employees, tribal retirees, and volunteers are not eligible to enroll in FEHB.
Please contact your tribal employer for the specific date of when your Initial Enrollment Opportunity begins.
Please contact your tribal employer for the specific dates or the specific time period of your Initial Enrollment Opportunity.
It is your opportunity to enroll in an FEHB health plan. You cannot enroll in the FEHB
Program at any other time unless it is during the annual open season (approximately mid-November through
mid-December each year) or if you experience a
Qualifying Life Event.
Two types of plans are available:
- Fee-for Service plans
- Health Maintenance Organizations (HMO)
Both types offer several plan designs and options such as a point-of-service product, high deductible, and
consumer-driven options.
For more information on each type of plan, please visit
http://www.opm.gov/insure/health/tribes/planinfo/index.asp
- You will not have FEHB health insurance coverage.
- You will not be able to enroll in an FEHB health plan until the annual open season (approximately
mid-November through mid-December each year) or if you experience a
Qualifying Life Event.
Please contact your tribal employer for the specific effective date of when your
health insurance coverage will begin. Generally, the effective date of coverage should be the first day of the
month following the end of the Initial Enrollment Opportunity.
Your costs include both your share of premiums and out-of-pocket expenses. Premium
information can be found at [tribal rates page]. You can find information on both premiums and your out-of-pocket
costs in the 2012 FEHB brochures, the 2012 FEHB Guide for Tribal Employees, or on our website at
www.opm.gov/tribalprograms. Tribal employers are expected to
provide an employer contribution to premium that is the same as the Government contribution for Federal employees.
A tribal employer may pay more than the Government contribution amount, but not less.
You can find information on:
The FEHB health plan brochures are available online. Go to
www.opm.gov/insure/health/tribes/planinfo/index.asp.
At the website, you'll see a map of the United States. When you click on a state, three charts will appear
showing all available plans in the state with links to their health plan brochures. Simply find the plan that
interests you and click the link to its brochure.
Several items can help you choose an FEHB plan that best meets your needs:
To compare plan benefits and out-of-pockets costs:
For a full list of resources see the
Initial Enrollment Opportunity
Resources page.
If you need assistance or have a question, contact your human resources office. Your
tribal employer should provide you with contact information.