Insurance FAQs

Open Season

• When will my Open Season change to the new coverage be effective? View more
  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.
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• I made an Open Season enrollment change. If I have to go to the doctor after January 1, which plan do I contact? View more
  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.
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• 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? View more
  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.
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• 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? View more
  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.
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• My HMO stopped participating in the FEHB Program and now I have no plans where I live. What can I do? View more
  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.
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