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Insurance FAQs

FEHB for Federal Civilian Employees who Perform Active Military Duty

  • What if I decide I do not want to continue my FEHB coverage while I'm on military duty? View more
    If you do not want to continue your FEHB enrollment, you must notify your employing office in writing that you wish to terminate your coverage. If you do not take action to terminate the coverage, your enrollment will continue for up to 24 months while you are on military duty.
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  • When does the 24-month period begin? View more
    The 24-month period begins the day you are separated, furloughed, or placed on leave of absence to serve on military duty. This applies even if part of your military service is covered by paid leave immediately followed by furlough or other leave without pay.
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  • If my agency does not pay my FEHB premiums, what amount am I responsible for? View more
    If your agency does not pay your premiums, you must pay the employee's share of the premium during the first 12 months of coverage (just as any other employee on leave without pay). You must pay both the employee and government shares, plus an administrative charge of 2 percent of the total premium, for up to 12 additional months that you continue your coverage while on military duty.
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  • I am enrolled in an FEHB plan and just received orders to report for military duty. What should I do? View more
    You should contact your Human Resources Office for the appropriate information for employees covered under FEHB who are called to military duty.
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  • How do I make premium payments while I am on military duty? View more
    Your employing office will notify you of the choices available to you and provide you with a method to make direct premium payments.
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  • What happens if my orders do not show that I am called to active duty in support of a contingency operation, or I do not meet all the requirements of FEHB law for my agency to pay my premiums? View more
    If you do not meet these requirements, the authority for you to continue your FEHB comes from the Uniformed Services Employment and Reemployment Rights Act (USERRA) (38 U.S.C. 4317). Public Law 108-454 amended this Act to allow you to continue your FEHB for 24 months if you were called to military duty and elected to continue your health insurance coverage on or after December 10, 2004. If you made your election before December 10, 2004, you are eligible to continue your FEHB for 18 months. If your FEHB continues under this provision, your agency does not have authority to pay your premiums while you are on military duty. For additional information, see Benefits Administration Letter 06-401 at BAL 06-401 Federal Employees Health Benefits (FEHB) Program: Extended Coverage for Employees Called to Active Military Duty. [54 KB]
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  • If I elect to terminate my FEHB enrollment, when will the termination be effective? View more
    If you elect to terminate your enrollment before you go on active duty, the termination will be effective on the day you are separated, furloughed, or placed on leave of absence to enter military service. Your employing office must use SF 2810 to terminate your enrollment. This means that you are entitled to a 31-day extension of coverage and if needed, have the right to convert to an individual policy offered by the carrier of your plan.
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  • I have returned from active duty. May I receive a refund for the premiums I've paid? View more
    The authority for agencies to pay premiums applies to employees who were called to active duty on or after December 8, 1995, and who meet certain conditions. Agencies may make retroactive payments to qualified employees for premiums paid on or after that date. Ask your Human Resources Office about the policy for your agency.
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  • Can I continue coverage beyond the 24-month period? View more
    No. There is no provision of law that allows for coverage to continue beyond 24 months during your military duty. However, at the end of the 24 months, you have a 31-day extension of coverage and the right to convert to an individual policy offered by the carrier of your plan. You are not required to provide evidence of insurability for this private coverage. There is no provision in FEHB law that allows for Temporary Continuation of Coverage (TCC) after the 24 months of coverage.
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  • If I decide to terminate my coverage, will it be considered a break in coverage for meeting the requirements for continuing my FEHB after I retire? View more
    No. The termination is not considered a break in the continuous enrollment necessary for continuing FEHB coverage during retirement. If you decide not to continue your coverage, your enrollment is terminated, not canceled. To avoid a gap in your coverage after you return to work, you must reinstate your enrollment on or before the last day of your TRICARE coverage. See our questions and answers on Return from Military Service.
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  • Why doesn’t FEHB offer a Self Plus One option for annuitants or employees? View more
    FEHB law does not permit the Program to offer a Self Plus One category.  Pursuant to section 8905 of title 5, United States Code, “An employee [or annuitant] may enroll in an approved health benefits plan under section 8903 or 8903(a) of this title either as an individual or for self and family.”  The law does not allow a Self Plus One option.  Congress would need to change the law to permit this type of enrollment plan. OPM’s Office of Actuaries has done cost and premium projections on the impact of changing from a two-tiered structure to a multi-tiered structure in the current FEHB Program.  While it might not be readily apparent, because a large number of older two-person families participate in the FEHB Program, the cost of providing health insurance for this older two person group is often nearly twice as high as it is to cover younger members with large families.  The self plus one premium would be based on the health cost of this group.  For this reason, it is not clear that adding additional enrollment options to the FEHB Program would result in any significant benefit to those who ask for the change.  In fact, they might be worse off. The objective of a group insurance policy like FEHB is to promote the beneficial aspects of risk-sharing.  The Program shares the risk among a large group of enrollees, from those who are sick and high-risk to those who are healthy and low-risk.  By spreading the risk, FEHB enrollees as a whole can get better coverage and lower premiums.  We believe that balancing charges across large demographic groups provides the best value, stability, and equity over the life of program enrollment opportunities.
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  • My FEHB enrollment terminated after 18 months. What factors should I consider in deciding if I should request the 6 additional months of FEHB coverage allowed by current law? View more
    If your FEHB is retroactively reinstated for 6 additional months, FEHB will become the primary payer and TRICARE the secondary payer during the additional 6 month coverage period. Thus, any payments made by TRICARE during that 6-month period could be reconciled with the FEHB carrier and any benefit adjustments could cause a difference in the amounts that you owe. Factors such as covered vs. non-covered services, network vs. out-of-network providers, deductibles, copayments, coinsurance, Health Maintenance Organization (HMO) geographic considerations, and catastrophic coverage applications may alter your total out-of-pocket expenses. Some additional issues for you to consider are:
    • If your FEHB plan covers services that TRICARE does not, having FEHB coverage could work to your advantage.
    • If TRICARE covers services that FEHB does not, TRICARE as the secondary payer should not adversely work against you since TRICARE would pay its normal benefits in the absence of benefits from the FEHB carrier.
    • If your FEHB plan becomes primary and you used TRICARE providers that were out of your FEHB plan's network, you need to determine if you would be better off with just the TRICARE coverage paying benefits alone or would you be better off having FEHB pay as primary and TRICARE as secondary for the out-of-network services.
    • You need to determine if shifting deductibles, copayments, and coinsurance from TRICARE to FEHB as the primary carrier enhances or decreases your overall benefits.
    • You need to determine how the geographic restriction of having an HMO Plan as primary payer affects the benefits received for you and your family members and how it affects payment from TRICARE as the secondary payer.
    • You need to determine if requesting retroactive FEHB for 6 additional months would enable you to meet your catastrophic protection benefits, thus, potentially enhancing your overall payment receipts.
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  • I have heard that my agency may pay my premiums while I am on active duty. Is this true? View more
    Yes, FEHB law (5 U.S.C. 8906(e)(3)) gives agencies the authority to pay your premiums if you meet certain conditions. You must:
    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.
    Although the law gives your agency the authority to pay your premiums if you meet these conditions, your agency must decide to implement this authority. Ask your Human Resources Office about the policy for your agency.
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  • What happens if my plan leaves the FEHB program while I am on military duty? View more
    Your agency should contact you or your dependent and give you an opportunity to select another plan. If they were unable to reach you and you learned after the enrollment time frame that your plan discontinued, they must use SF 2810 to reinstate your old enrollment code. This is for enrollment history purposes only, and cannot be sent to your old carrier since the plan is discontinued. Your agency should give you an opportunity to select another plan, and process the change retroactive to the date after your enrollment under your former plan terminated. When selecting another plan, please remember you are responsible for determining if any providers used participate in your new plan's network.
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  • What issues should I consider in making my decision to continue or terminate my FEHB enrollment? View more
    Your FEHB enrollment will continue unless you elect to have it terminate. You should also consider:
    • Any family members covered under your enrollment
    • Payment of your premiums
    Note: If your enrollment continues and you participate in premium conversion, you may not cancel your enrollment at any time. If you think you might want to stop your FEHB at some time during your military service, you should consider waiving premium conversion at this time.
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  • How long will my FEHB coverage continue while I'm on active duty? View more
    FEHB law (5 U.S.C. 8905a) permits you to continue your FEHB enrollment for up to 24 months if you were called to active duty on or after September 14, 2001, and meet certain requirements. You must:
    1. be enrolled in an FEHB plan;
    2. be a member of a reserve component of the armed forces;
    3. be called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 U.S.C.);
    4. be placed on leave without pay or separated from service to perform active duty; and
    5. serve on active duty for a period of more than 30 consecutive days.
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Total Count: 16, Number of Pages: 0, Page: 1

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