Insurance FAQs

The employing office bills you for each pay period (generally each month) you are covered.

Yes, if you are eligible for this TRICARE program, you can suspend your FEHB coverage.

No. Accidental death and dismemberment coverage ends when your employment ends. You cannot carry this coverage into retirement.

Each year OPM releases the new health insurance rates about a month prior to the FEHB Open Season. The FEHB Open Season runs from the second Monday in November through the Second Monday in December. The new rates are generally released by mid-October at http://www.opm.gov/insure/health/rates/index.asp.

No. The only way to continue coverage into retirement is to meet the five year/all opportunity rule. You cannot "buy" the years you are missing.

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.

For dental benefits, there is a waiting period for orthodontia services of up to 24 months, for all but one dental plan. Your eligible dependent must be enrolled in the same dental plan/option over the duration of the waiting period to receive orthodontia services. There are no waiting periods for any other dental services or any vision services.

Yes, taxes in 49 states and most localities will be reduced; exceptions include the state of New Jersey and the Commonwealth of Puerto Rico. OPM monitors changes in state and local tax regulations, and provides guidance to your agency as needed. Regardless of where you live, FEHB premiums are not subject to Federal taxes. FICA Taxes If you are covered by the Federal Employees Retirement System (FERS) and participate in premium conversion, FEHB premium deductions will also be excluded from gross pay before Old-Age, Survivors, and Disability Insurance (OASDI) and Medicare taxes are applied. Employer FICA contributions will also be reduced in concert with the decrease in employee withholdings.

Generally, your coverage continues for 36 months from the date of your divorce or annulment, as long as you pay your premiums on time. After your TCC enrollment ends:

• you get a 31-day extension of coverage, and
• you may convert to an individual contract offered by your health benefits plan,

unless you lose coverage because you canceled your enrollment or didn't pay your premiums.

The following dental plans are available in specific regions:

• Humana/CompBenefits is available in Alabama, Arizona, Arkansas, California, Colorado, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, parts of Maryland, Missouri, Mississippi, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, and West Virginia.
• Group Health, Inc. is available in all of New York, Northern New Jersey (counties of Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex, and Union), Connecticut (counties of Fairfield, Litchfield, New Haven), Pennsylvania (counties of Pike and Monroe).
• Triple-S Salud, Inc. is available in Puerto Rico.

Under CSRS offset, your Social Security benefits would be slightly reduced, but your CSRS Offset benefits would be increased by almost the same amount. Participating in premium conversion is most likely a benefit to you.

No.

Call the OPM-Macon Help Desk at 478-757-3030, choose the PIN option, and request a new PIN. The Help Desk will mail your new PIN the next day. Since the Help Desk will mail your new PIN to the address your agency has on file, make sure that your Human Resources Office has your current address. We suggest you change your PIN to something easy to remember and be sure to keep your PIN in a safe place. You won't be able to use Employee Express until you get your new PIN.

You can't cancel a change. You can, however, make another change, using Employee Express. You can change most discretionary personnel and payroll transactions such as direct deposit, Federal and state tax withholdings, savings bonds, etc. at any time. Changes to FEHB and TSP are generally limited to Open Season. During FEHB Open Season, you may change your enrollment and/or waive or begin participation in premium conversion at any time up until the last day of Open Season. Employee Express will process only the last transaction.

As a result of health care reform, beginning January 1, 2011, children of Federal enrollees will be covered by their parent’s FEHB Self and Family enrollment until their 26th birthday (plus a 31-day temporary extension of coverage), even if the child previously lost coverage because he/she turned 22.

Annuitants sometimes need a new copy of “Your Federal Retirement Benefits” to show their retirement income to their mortgage lender, bank, underwriter, state income tax office, or low-income housing provider.  To request a new copy of “Your Federal Retirement Benefits”, or to receive a verification of your annuity, contact OPM’s Retirement Office at 1-888-767-6738 or retire@opm.gov.  The phone lines are open from 7:30 am to 7:45 pm (Eastern Standard Time). It is a busy phone number so we encourage you to call early in the morning or after 5:00 pm when the phone lines are less busy.

We have published a final regulation that allows current FEHB annuitants and former spouses who are eligible for these programs to suspend their FEHB coverage and premium payments. The regulation allows these individuals to reenroll in the FEHB Program during the Open Season, or immediately if they are involuntarily disenrolled from the non-FEHB coverage.

The date of the court order itself is not relevant. But the date the agency or retirement system (as applicable) received the court order is relevant. If someone submitted a court order before July 22, 1998, it is not valid and the Office of Federal Employees' Group Life Insurance (OFEGLI) cannot honor it.

To qualify for Spouse Equity coverage, submit an application to your former spouse's Human Resources Office (or, if applicable, the former spouse's retirement system) within 60 days after your divorce. To be eligible, you must have been covered as a family member under your spouse's FEHB Program enrollment at least one day during the 18 months prior to divorce and you must have future entitlement to receive a portion of your spouse's retirement annuity or a survivor annuity. Also, if you remarry prior to age 55 you will lose this coverage. If you do not qualify under the Spouse Equity provisions, you may be eligible for coverage under the Temporary Continuation of Coverage provisions. You may also convert to a private policy.