Here’s What You Need To Know About Federal Employee Health Benefits

The FEHB or the Federal Employees Health Benefits program – covering over 8 million Federal employees, former employees, retirees, family members, as well as former spouses – is the world’s employer-sponsored largest insurance program. There are various plans under the FEHB program like high deductible health plans, consumer-driven health plans, health maintenance organizations, point-of-service, and fee-for-service with a provider organization of one’s choice. The way you choose to receive health coverage and pay for the services varies from one plan to another. The benefits that you receive from each plan are inpatient and outpatient care, mental health and substance abuse care, surgical care, hospital care, prescription drug coverage, obstetrical care, etc. Irrespective of whether you decide to change plans or not, you don’t have to experience waiting periods or any pre-existing condition limitation.

FEHB New Employees

A majority of federal employees can choose their health insurance. Though taking part in FEHB is entirely up to you, you must choose health coverage. In case you are a part-time employee, the contribution of the Government towards the health benefits is allocated according to the amount of part-time work you are required to perform. In case you are appointed temporarily, you can get enrolled under the FEHB program after you have been continuously employed for one year.

If you choose to sign up, you are required to pay a portion of the premium to the employee as well as the Government. You can choose a health insurance plan with the help of some useful resources such as the Health Plan Information Guide, Plan Comparison Tool, Individual Plan Brochures and Premiums, and Description of Plans Available in FEHB. After you sign up for a health plan, you can continue with your enrolment till the time you are eligible for the health program. There is no need to enroll every year. In case you are looking forward to making a change in the health plan, you may have to wait for the Benefits Open Season or a qualifying life event.

Federal Health Benefits Premium Conversion

Post signing up for health insurance, premiums are held back from your salary on a pre-tax basis. This eventually cuts down your income taxes as well as your taxable income. This is what you know as FEHB-PC or Federal Employees Health Benefits Premium Conversion. After you take part in FEHB-PC, you are not allowed to cancel the health insurance coverage or convert it from a family enrollment into a self-only enrollment at any given time. If you want to make these changes, you will have to wait until the Benefits Open Season or a qualifying life event.

Your earnings as you have reported to the Social Security Administration will be lower as you will shell out health insurance premiums with your pre-tax money. As a result, you might get hold of lower Social Security benefits after you decide to retire. If you prefer health insurance premiums being held back on an after-tax basis, you have to sign a PC waiver form choosing not to take part in FEHB-PC at the time of enrolling. After you have waived FEHB-PC as a new employee, you will have the flexibility to elect to participate in FEHB-PC during the Benefits Open Season or the occurrence of a qualifying life event.

Initial Selection Period

If you are a new employee, you can choose the health benefits program within two months from the day you have been appointed. After you fill up SF-2809, the Health Benefits Election Form, you need to submit it within time to your servicing Human Resources office. If somehow you are not able to choose within the stipulated period, you will be counted as someone who has declined health coverage. For the next enrollment opportunity, you will have to wait till the open season arrives or a qualifying event in your life that will make you eligible to enroll. With that being said, whether you are choosing coverage or not, completing and submitting the Health Benefits Election Form is necessary.

Effective Coverage Date

After you choose the health coverage, the process will be effective from the first day of the first pay period. The first pay period will begin after you are in pay status. This implies that the health insurance becomes effective from the start of the pay period that starts rolling after the pay period of your appointment.

Family members considered eligible for enrollment are your spouse (whom you are wedded to under a common law marriage) and kids aged not more than 26.