Federal Employees Health Benefits (FEHB) Program Open Season 2015
The Federal Employees’ Health Benefits (FEHB) Program’s annual Open Season begins Monday, November 9, 2015 and continues through Monday, December 14, 2015. During this period, if you are eligible for government benefits, you may enroll, change plans or options, change between self-only, self and family, or self plus one, cancel your enrollments, and/or change your premium conversion option. After Open Season, these options will only be available under limited situations. Open Season requests will be effective Sunday, January 10, 2016.
See the Benefits Calendar of Events for additional information.
Who is Eligible?
If you are on a permanent Federal civilian appointment or on one of the following appointments you are eligible to enroll or change enrollment: Employees working on a temporary appointment for at least 90 days; employees on a seasonal schedule who will be working a schedule of less than six months per year, but at least 90 day; and intermittent employees who are expected to work at least 130 hours per month or more for at least 90 days. If you have questions, please contact your Benefits Contact.
Note: IRTA, Visiting Fellows, Special Volunteers or others covered under health insurance offered through the Foundation for Advanced Education in the Sciences (FAES ) are not covered under this open season. Also, if you are a member of the PHS Commissioned Corp you are not covered under this program.
I am Eligible. What Should I Do?
If you are satisfied with your current plan, review the 2016 on-line Guide to Federal Benefits and premium rates to make certain you want to continue with your plan. Updates to the Guide will be made the first week of November. If you are still satisfied, do nothing. Your coverage will continue and any adjustments will take place automatically on January 10, 2016.
If you would like to start, stop or change your enrollment, review the information on the available plans and options to see what plan will best meet your needs. You MUST request an open season election through myPay (available 24 hours a day, 7 days per week). We strongly recommend that after you submit your open season request, you click on the option that provides confirmation of your request.
To access myPay , you will need your Login and Password. If you have forgotten your Login or Password, click the "Forgot Your Login ID?" or "Forgot or Need a Password?" link on the left side of the myPay screen. Using this method, your Password can be e-mailed to you if you pre-registered your e-mail address, or it can be mailed to your current home address of record within 7 to 10 business days. A second option for requesting a Password is to send a fax to 216-367-3549. You will need to include in your request your name, SSN, a daytime phone number, a copy of your NIH ID Card, and you must sign the fax. Upon receiving your fax, the Defense Finance & Accounting Service (DFAS) will reset your Password using a temporary Password. Your temporary Password will be 8 numbers, the last 4 numbers of your SSN twice. You will not receive a notice from DFAS that your Password has been reset. Simply wait at least two business days before logging into myPay to use your temporary Password. Upon logging in, you will be prompted to reset your Password. Information pertaining to establishing an acceptable Login and Password can be obtained at myPay FAQs .
If you encounter problems with your Login and/or Password or technical issues using myPay , contact the DFAS Centralized Customer Support Unit toll-free at 1-888-332-7411. This support line is available Monday through Friday, 7:00 A.M. to 6:30 P.M. Eastern Standard Time.
When Will My Open Season Change Occur?
Enrollments or changes in enrollments requested during open season, as well as new premium rates, will become effective January 10, 2016. These will be reflected in your salary check and on your January 29, 2016 Leave and Earnings Statement. Please review this statement carefully and report any problems to your timekeeper or your Benefits Contact.
Where Can I Find FEHB Guides and Brochures?
Guides and brochures will be available for view and printing from OPM's web site in the near future.
Need Help Deciding?
The Consumer Checkbook is an interactive tool that can help in comparing the Federal health plans. This site will provide you with instructions on accessing and using the tool.
The Office of Personnel Management also has an interactive on-line tool to help you compare available plans. The tool will give you a chance to compare costs and benefits among the plans available to you. The tool will be updated soon to include the 2016 information.
What Is Premium Conversion?
Premium conversion is the ability to pay your health insurance premium with pre-tax dollars. All eligible employees are automatically covered under premium conversion. During the annual open season, you have the option to change your decision. You do not need to do anything unless you want to change your earlier decision. Premium conversion does limit your ability to cancel FEHB or to change your coverage from family to self-only.
Significant Changes in 2016
There is one significant changes to the FEHB program that employees should pay special attention to:
- There is a new “self plus one” enrollment type. Elections made during the Open Season will be effective on January 10, 2016. NIH will not automatically change enrollments for individuals enrolled in “Self and Family” with only one covered family member. If you wish to change, you must elect the new enrollment type during the Open Season at https://mypay.dfas.mil/mypay.aspx .
New Plans Entering the FEHB Program
- UnitedHealthcare Insurance Company, Choice Plan, High (LR1, LR2, LR3) Will cover entire District of Columbia
- UnitedHealthcare Insurance Company, Choice Plan, High (LR1, LR2, LR3) Will cover entire state of Maryland
- UnitedHealthcare Insurance Company, Choice Plan, High (LR1, LR2, LR3) Will cover Northern Virginia
- Optima Health Plan, High (PG1, PG2, PG3) Will cover Hampton Roads Region
Service Area Expansions without new Enrollment Codes
- Aetna Open Access, High/Basic (JN1, JN2, JN3, JN4, JN5, JN6) Maryland Counties of Allegany, Caroline Dorchester, Garrett, Somerset and Worcester
- Aetna Open Access, High (YE1, YE2, YE3) Pennsylvania Counties of Cameron, Clearfield, Crawford, Elk, Forest, McKean, Potter, Warren
- Aetna Open Access, High/Basic (JN1, JN2, JN3, JN4, JN5, JN6) Virginia counties of Greene, Madison, Orange, and Rappahannock
Plans Leaving the FEHB Program
Enrollees in the terminating FEHB plans who do not change their health plan by enrolling in another FEHB plan during Open Season will not have health benefits for 2016.
- Piedmont Community Health Plan (2C1, 2C2) Virginia Lynchburg Area
- The Health Plan of the Upper Ohio Valley, Inc. (U41, U42) 55 counties in West Virginia
TRICARE (Formally CHAMPUS) Coverage and FEHB
If you have TRICARE coverage and are now a civilian Federal employee not enrolled in the FEHB, you should be aware that TRICARE coverage terminates when you become eligible for Medicare (usually age 65). You may wish to enroll in an FEHB plan during the Open Season before you retire as a civilian Federal employee so that you may continue the FEHB coverage into retirement. TRICARE coverage counts towards meeting the requirements of having FEHB coverage for the last 5 years of Federal service prior to retirement. You should also be aware that if you become age 65 while you are still employed, event number 1M on the Table of Permissible Changes allows you to enroll in FEHB when you lose your TRICARE coverage.
- Note: Effective October 1, 2001, military retirees may elect to enroll in TRICARE-for-Life provided they enroll in Medicare Part B. For more information call 1-888-DOD-LIFE or visit the TRICARE web site
Customer Satisfaction Survey
The US Office of Personnel Management has arranged to have a customer satisfaction survey completed in which enrollee's can rate their health plans in a variety of areas. The results of the survey are in the FEHB Guide .
Temporary Continuation of Coverage (TCC)
You should be aware that if you leave Federal employment, you might be eligible for Temporary Continuation of Coverage (TCC). TCC can continue your enrollment for up to 18 months. TCC is also available for up to 36 months for your dependents who lose eligibility as family members under your enrollment. This includes spouses who lose coverage due to a divorce and children who lose coverage because they reach age 26. TCC enrollees must pay the total premium (without a Government contribution) plus a 2% charge for administrative expenses.
TCC enrollments must be requested within 60 days of the event that causes the loss of coverage (i.e. date of separation, date of divorce, or child's 26th birthday). Please notify your Benefits Contact for further information concerning TCC.
Federal Long Term Care Insurance Program (FLTCIP)
FEHB plans do not cover long-term care. However, you can protect yourself against the high cost of long term care by applying to the Federal Long Term Care Insurance Program (FLTCIP). FLTCIP helps pay for costs of care if you need help with activities of daily living or you have a severe cognitive impairment, such as Alzheimer's disease. Care can be received at home, an adult day care center, a hospice, an assisted living facility, or a nursing home. Qualified relatives are also eligible to apply for coverage. This includes your current spouse, adult children, parents, parents-in-law, and stepparents.
Unlike other benefit programs, you must take action. Applications can be obtained on the FLTCIP website or by calling 1-800-582-3337 (TTY: 1-800-843-3557). You may apply for enrollment at any time. There are no open season requirements.