Fedweek

OPM has sent guidance to agencies on a policy under which federal employees will be protected from inadvertently losing FEHB coverage if their plan drops out, drops a level of coverage, or restricts its coverage areas. Such changes are announced in advance of the annual fall open season so that affected enrollees can make a new choice for the upcoming year. Under the new policy, enrollees who don’t elect new coverage during the open season will be switched to the same type of enrollment in their plan’s remaining option, if available, or to the lowest-cost national plan if not. Previously, a similar policy applied to retirees but not to active employees. Meanwhile, OPM has proposed setting a definite time limit, three years, for filing court claims disputing an eligibility decision under the FEGLI life insurance program. In cases of disputes over eligibility or a change in coverage, the current policy requires an appeal first to the employing agency for active employees or to OPM for retirees; it provides for an appeal from there into federal court, but does not set a time limit for such suits. Under the proposed rules in the January 12 Federal Register, such a case could be brought no later than the end of the third year after the final administrative decision. The cases have to be brought against the FEGLI insurance company, not against the government.