FEHB Subsidies May Apply to Some Enrollees

Most FEHB plans, excluding high-deductible health plans, are considered qualified employer-sponsored health insurance coverage under Public Law 111-03, the Children’s Health Insurance Program (CHIP) Reauthorization Act of 2009, OPM has said in guidance to agencies. That law allows states to subsidize health insurance premium payments for certain children of low-income families who have access to qualified employer-sponsored health insurance coverage. Therefore, FEHB-eligible enrollees who meet the criteria for child health assistance are eligible to receive state premium subsidy assistance payments to help them pay for the FEHB plan premiums, OPM said. An eligible enrollee who loses coverage under the FEHB or another group health plan, including loss of eligibility or assistance under Medicaid or CHIP, may enroll or change enrollment from self only to self and family from 31 days before to 60 days after the date of loss of coverage. Eligible employees also may enroll or change enrollment from self only to self and family if the employee or an eligible family member becomes eligible for assistance under a Medicaid plan or a state CHIP. Employees may make these enrollment changes regardless of whether they are covered under premium conversion.