This week I’m starting a series that covers the two most-used insurance programs for federal employees and retirees, the Federal Employees Health Benefits Program (FEHB) and the Federal Employees Group Life Insurance Program (FEGLI). In each case I’ll describe the program as it applies federal employees. I’ll follow that with a description of how it applies to retirees.
Who can enroll?
The FEHB program is open to nearly all federal and postal employees. Your first opportunity to enroll is within 60 days from the either the date on which you are hired or the date on which you first become eligible. You also can enroll during the annual open season as described below; this year it will run November 9-December 14.
Are there any special conditions that need to be met?
No. Coverage is provided without your having to get a physical examination. And there aren’t any waiting periods before you can receive benefits.
How much does it cost?
The premium cost is split between you and the government, with the government providing the lion’s share—on average, about 70 percent. Premiums are lower for Postal Service employees because of union agreements that have them shouldering even less of the cost. However, that subsidy ends when they retire. Then they pay the same amount as other employees and retirees.
Range of plan choices
Because there are nearly 250 organizations providing benefits, you can pick a plan or level of coverage that meets your needs and your pocket book. While most plans are offered by health maintenance organizations (HMOs), others are fee-for-service plans, many of which are open to anyone. Others are proved by employee organizations, which usually require that you be a member of that organization.
When you enroll in the FEHB program, you have three choices: Self-Only, which provides benefits for you alone; Self Plus One, which provides benefits for you and one eligible family member; and Self and Family, which provides benefits to you and all eligible family members.
The term “eligible family member” means your spouse, including a common law marriage spouse recognized in the state where you live, and children under age 26. In the latter case, an exception is made if the child is incapable of self support because of a mental or physical disability that began before age 26.
Anyone enrolled in the FEHB program can change plans or options during the annual Open Season. And anyone who hasn’t enrolled can enroll at the same time.
Under certain circumstances, you can also enroll or change plans or options when a “qualified life event” occurs, for example a change in family status such as marriage or the birth of a child.
ask.FEDweek.com: FEHB – Federal Employee Health Benefits