FEHB Changes Are Permitted Outside of Open Season for Certain Reasons

Most FEHB Program enrollment changes occur during the yearly Open Season. However, some changes are permitted at other times when a person has a “qualifying life event.” Significant occurrences that allow enrollment changes include:

  1. A change in one’s family situation, such as a divorce, legal separation, the arrival of a child, the adoption of a foster child, or the passing of a spouse or other dependent,
  2. A change in employment status occurs:
  • when you return to work after an absence of more than three days,
  • when your coverage expires due to a leave of absence lasting more than 365 days,
  • when you get a pay rise large enough for premiums to be withheld,
  • when you are reinstated to the workforce after serving in the uniformed services, or
  • when you transition from a temporary appointment to one that involves more responsibility.

You or your family member can lose FEHB or any other coverage in the following cases:

  • when under another FEHB Program due to the coverage’s enrollment being terminated, canceled, or changed to Self Only coverage;
  • under another federally sponsored health benefits program;
  • under Medicaid or another similar state-sponsored program for the needy;
  • due to the termination of your membership in the employee organization that sponsors the FEHB plan; or
  • under a non-federal health plan.

You can enroll, modify your enrollment to a different FEHB plan, change your enrollment to Self Only, cancel your enrollment, or change your enrollment between Self Only, Self Plus One, and Self and Family.

However, a “Self Only” change can happen if the enrollee becomes the final eligible family member covered by the FEHB membership due to the event. A cancellation is only permitted if the enrollee can demonstrate that they and any eligible family members now have access to other healthcare coverage due to the qualifying life event.

The SF-2809 form, available at www.opm.gov/forms, contains a table listing the permitted adjustments for each circumstance.

Enrollment Cancellation

You may have your enrollment voluntarily terminated at any time. But if you do, neither you nor any family members covered by your enrollment will be allowed to enroll in a short-term continuation of coverage or switch to a non-group plan. The FEHB Program generally prohibits re-registration after a voluntary cancellation of enrollment. If you ask OPM to revoke your enrollment, OPM will fully explain how this would affect your legal rights.

Enrollment Suspension 

You might choose to put your enrollment on hold. Enrollments are typically halted because the enrollee wants to enroll in a Medicare-managed care plan or become a family member of someone else enrolled in the Self and Family FEHB Program.

FEHB Open Enrollment Season 2022

The start dates for FEHB Open Season 2022 are Monday, November 14, to Monday, December 12, 2022. For the FEHB Program and the FEDVIP, federal employees can enroll, change plans or plan options, modify the type of enrollment, or cancel enrollment. It’s also a chance to enroll in the FSAFEDS Program again or for the first time.

It’s vital to remember that the FLTCIP and the FEGLI do not take part in the yearly Open Season.

Federal employees should seek assistance from their local human resources office if they have any questions about the Federal Benefits Open Season or their benefits in general.

Options of FEHB in the Open Season

  • Enroll
  • Changes your plan
  • Changes to the plan
  • Change to a different enrollment type (to Self Only, Self Plus One, or Self and Family)
  • Stop the coverage

What if I don’t do anything?

Your current coverage will continue automatically. If you are happy with your FEHB plan as it is now, there is nothing you need to do. If your plan has stopped providing coverage in your area or is no longer participating in the FEHB Program, you must switch policies.

What do I need to know?

As soon as it becomes available, OPM will upload information about plans offered in your area to www.opm.gov/openseason. This will happen at the beginning of November, according to OPM.

How can I change something?

For more, go to www.opm.gov/healthcare-insurance/healthcare/enrollment/.

When do the changes come into effect?

The changes come into effect on the first day and first pay period that starts on or after January 1, 2023, following a pay period in which you (if an employee) are in pay status for a part of that pay period.

Contact Information:
Email: tcarmack@hotmail.com
Phone: 6232511574

Bio:
Todd Carmack grew up in Dubuque, Iowa, where he learned the concepts of hard work and the value of a dollar. Todd spent years in Boy Scouts and achieved the honor of Eagle Scout. Todd graduated from Iowa State University, moved to Chicago, spent a few years managing restaurants, and started working in financial services and insurance, helping families prepare for the high cost of college for their children. After spending years in the insurance industry, Todd moved to Arizona and started working with Federal Employees, offing education and options on their benefits. Becoming a Financial Advisor / Fiduciary can help people properly plan for the future. Todd also enjoys cooking and traveling in his free time.

Disclosure:
Investment advisory services are offered through BWM Advisory, LLC (BWM). BWM is registered as an Investment Advisor located in Scottsdale, Arizona, and only conducts business in states where it is properly licensed, notice has been filed, or is excluded from notice filing requirements. This information is not a complete analysis of the topic(s) discussed, is general in nature, and is not personalized investment advice. Nothing in this article is intended to be investment advice. There are risks involved with investing which may include (but are not limited to) market fluctuations and possible loss of principal value. Carefully consider the risks and possible consequences involved prior to making any investment decision. You should consult a professional tax or investment advisor regarding tax and investment implications before taking any investment actions or implementing any investment strategies.

Free Retirement Benefits Analysis

Federal Retirement benefits are complex. Not having all of the right answers can cost you thousands of dollars a year in lost retirement income. Don’t risk going it alone. Request your complimentary benefit analysis today. Get more from your benefits.

I want more

I grew up in Dubuque, Iowa, where I learned the concepts of hard work and the value of a dollar. I spent years in Boy Scouts and achieved the honor of Eagle Scout. I graduated from Iowa State University and moved to Chicago and spent a few years managing restaurants. I then started working in financial services and insurance helping families prepare for the high cost of college for their children. After spending years in the insurance industry, I moved to Arizona and started working with Federal Employees offing education and options on their benefits. I became a Financial Advisor / Fiduciary to further help people properly plan for the future. I enjoy cooking and traveling in my free time.

Federal Employee, Federal Employee Benefits, Federal Employee Retirement, Retirement, Todd Carmack 0

Is it Prudent to Wait Until 70 to Claim Social Security Benefits? Let’s Look at the Statistics

It is rational to wait until age 70 to receive Social Security benefits; your monthly payments would be 35% greater...

READ MORE
Federal Employee, Federal Employee Benefits, Federal Employee Retirement, Retirement, Todd Carmack 0

Roller coaster vs. merry-go-round TSP investors

If you have been a Thrift Savings Plan (TSP) investor for a time, you're aware that the C, S, and...

READ MORE
Federal Employee, Federal Employee Benefits, Federal Employee Retirement, Retirement, Todd Carmack 0

FEHB Changes Are Permitted Outside of Open Season for Certain Reasons

Most FEHB Program enrollment changes occur during the yearly Open Season. However, some changes are permitted at other times when...

READ MORE
Federal Employee, Federal Employee Benefits, Federal Employee Retirement, Retirement, Todd Carmack 0

How Medicare Works When You Aren’t Retired

Many retirees find it difficult to afford healthcare due to rising costs. A report showed that healthcare costs were higher...

READ MORE