Federal Employee's CSRS & FERS Federal Civil Service Retirement
& Financial Planning Resources
Federal Employee's Health Benefit's Plan Menu
Open Season ends December 10th. Generally the cost of coverage is
increaaing again this year. Several plans have actually decreased their
premiums.
If you do not make the change during open season, you may not be able to
change health plans until 2014. Don’t let an increased cost in health
insurance be an unfortunate surprise that adversely affects your finances.
Luckily, it is easy to verify the cost of the FEHB insurance for 2013.
For a quick check of the cost changes for FEHB review
OPM's Premium
Rates for the Federal Employees.
In addition, in an effort to be more “green,” paper copies of health plan
brochures will not be automatically mailed to Federal Employees Health
Benefits (FEHB) Program members this open season. This is the first
year of this change.
Federal regulations require an annual Open Season to be held each year from
the Monday of the second full workweek in November through the Monday of the
second full workweek in December. You must submit your Open Season enrollment
change before midnight, Eastern Standard Time, on the last day of Open Season to
be considered timely filed. Open Season enrollment changes take effect the first
day of your first full pay period in January of the following year.
The Federal Employees Health Benefits (FEHB) Program has important
features, including a wide choice of health plans and competitive benefit
packages as well as no
health insurance pre existing conditions limitations or waiting
periods. Now, for 2011, thye have eliminated enrollee cost sharing for
preventive care services, added incentives for tobacco cessation, and, in
accordance with the Affordable Care Act, added coverage for dependents up to
age 26. Premiums will rise an average of 7.2% in 2011.
2013 Open Season (November
12, 2012 through December 10, 2012)
You are now able to manage your FEHB account online. To register
you will need your Annuity Claim Number and they will ask you to enter a
unique user name and password to activate your account. You must
register again for each new open season even though you registered for
the previouos year. I annotated the web
site address, user name, and password in the "Federal Retirement
Benefits" booklet that I received when I first retired for future
reference. Go to
https://retireefehb.opm.gov to register and view your options. This
service allows you to change enrollment, view transaction history, change or
add dependent information, and request health care plan brochures.
The Federal Employees Health Benefits (FEHB) Program helps you and your
family meet your health care needs. Federal employees, retirees and their
survivors enjoy the widest selection of health plans in the country. You can
choose from among Consumer-Driven and High Deductible plans that offer
catastrophic risk protection with higher deductibles, health
savings/reimbursable accounts and lower premiums, or Fee-for-Service (FFS)
plans, and their Preferred Provider Organizations (PPO), or Health Maintenance
Organizations (HMO) if you live (or sometimes if you work) within the area
serviced by the plan.
When you retire your agency will automatically transfer your enrollment to
OPM if you are eligible. To continue your health benefits enrollment into
retirement, you must:
- have retired on an immediate annuity (that is, an annuity which
begins to accrue no later than one month after the date of your final
separation); and
- have been continuously enrolled (or covered as a family member) in
any FEHB Program plan (not necessarily the same plan) for the five years of
service immediately preceding retirement, or if less than five years, for
all service since your first opportunity to enroll.
- Note: Tricare
does count towards the 5-years of coverage requirement
as long as you have FEHB coverage on the date of retirement. The annuitant
and spouse, If the annuitant elects survivor benefits, would continue FEHB
coverage under the annuitant's annuity even if the annuitant predeceases the
spouse. For more information see:
http://www.opm.gov/insure/health/eligibility/index.asp
If you die while a compensationer, your family members can continue your
enrollment if you were enrolled for Self and Family at the time of your death
and at least one of your covered family members receives compensation as a
surviving beneficiary under the Federal Employees' Compensation law.
For your surviving family members to continue your health benefits enrollment
after your death, all of the following requirements must be met:
- You must have been enrolled for Self and Family at the time of your
death; and
- At least one family member must be entitled to an annuity as your
survivor.
All of your survivors who meet the definition of "family member" can continue
their health benefits coverage under your enrollment as long as any one of them
is entitled to a survivor annuity. If the survivor annuitant is the only
eligible family member, the retirement system will automatically change the
enrollment to Self Only. Your surviving spouse should follow up with OPM
to insure this action was taken. If it wasn't, your spouse will be paying
considerably higher Family Option premiums.
Under FERS, your surviving spouse who is entitled to a basic employee death
benefit, or your surviving children whose benefits are offset by Social
Security, may continue your health benefits enrollment by paying premiums
directly to OPM.
If the survivor annuity is not large enough to cover the enrollee share of
the premiums for your plan, your survivors may either change to a lower-cost
plan or option (one in which the enrollee share of the premium is low enough to
be withheld from the annuity) or choose to pay the premiums directly to the
retirement system. Even if your employing office thinks that the survivor
annuity will not cover the enrollee share of the premiums, your retirement
system will transfer in the enrollment. The retirement system will notify your
survivors of their options and take whatever actions they request.
When your surviving spouse will not receive any survivor benefits because
your former spouse has a court-ordered entitlement to a survivor annuity, your
surviving spouse can continue FEHB coverage if you had a Self and Family
enrollment. The retirement system will notify your surviving spouse of his/her
options and take whatever actions are requested.
When the retiree's spouse is not a federal employee they will most likely
need FEHB coverage in retirement. The rules are different for CSRS and FERS
employees and this is a major consideration for federal employees who intend to
retire and leave their spouse other than a full survivors annuity.
Under CSRS your spouse will be eligible for FEHB coverage as long as you
provide them with a survivors annuity. It can be any amount. In my opinion it is
best to provide a survivors annuity large enough to cover FEHB expenses however
it isn't necessary. If you elect a survivors annuity of $3600, enough to cover
many plan costs, your annuity will be reduced by 2.5%.
FERS retirees must elect either 50% or 25% survivors annuity for your spouse
to be eligible for FEHB coverage in retirement after the annuitant's death. The 50% election will cost you
10% of your full annuity and the 25% survivor annuity election will cost you 5%
of your full annuity in retirement.
CLARIFICATION: We
receive a number of questions from site visitors about spousal FEHB
coverage in retirement. A spouse of an annuitant can continue coverage
under the annuitant's FEHB plan after retirement
when an annuitant doesn't elect
a survivor's benefit until the annuitant's death.
After the annuitant's death, the spouse can no longer continue FEHB
coverage since in this case the employee did not elect a spousal
survivor benefit. Reference OPM's "Guide
to Federal Benefits." A federal employee MUST elect
a
minimum survivor's benefit for the spouse to be eligible for FEHB
covered after the annuitant's death.
If you cancel your FEHB enrollment as an annuitant, you won't be able to
reenroll in the FEHB program. There are no exceptions for other employment
insurance. However, there is an exception if you suspend your FEHB
enrollment because you are now covered by a Medicare Advantage plan,
TRICARE, CHAMPVA, Medicaid or similar State-sponsored medical assistance
program, or Peace Corps Volunteer coverage, you can restart your FEHB in the
future.
I changed from an HMO to the Basic Blue Cross plan before retiring. We knew
we would be traveling and that Blue Cross was accepted in most, if not all major
locations nationwide. The change also dramatically reduced our monthly premiums
and our level of service actually improved. We were pleasantly surprised at the
efficiency of their plan and the Basic Option 112 plan is fashioned after an HMO
model from our perspective. We also considered their Standard plan but didn't
feel comfortable with the deductibles and you really don't know what the charges
to you would be until after a procedure was done. The benefit of the
Standard plan is that you can use any service provider even if they aren't a
preferred provider. The Basic plan required you to use preferred providers
and if you do use a non-preferred provider you must pay the bill in most cases
except for emergency care.
Dennis V. Damp, Retired FAA
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