Federal Benefits

FastFacts 

What to do When Your Health Plan is 

Terminating Coverage in Your Area or 

Leaving the Federal Employees Health 

Benefits (FEHB) Program.

There are four ways your plan’s 

enrollment can be affected. Each may 

require a different response, so be sure to 

identify your situation. 

1. Plan leaves FEHB Program entirely;

2. Plan reduces its service area and 

eliminates its enrollment code;

3. Plan reduces its service area and keeps 

its enrollment code; or

4. Plan drops an option.

* How will I know if my enrollment is 

affected? You will receive a letter from your 

plan stating that it is no longer participating in 

the FEHB Program or that it is no longer 

providing services in your area. You can 

contact your Human Resources (HR) office or 

refer to the Federal Benefits Open Season: 

FEDVIP and FEHB Program Significant Plan 

Changes at 

www.opm.gov/insure/health/reference/hr.asp

* What do I do now that I know my 

enrollment is affected? You may need to 

change your enrollment to another plan during 

Open Season. Follow the instructions in the 

letter you received from your plan. 

* My plan is leaving the FEHB Program 

entirely. What happens if I don’t change 

to another plan? If you are a Federal 

employee or Tribal employee and you do not 

change plans, you will not have coverage in 

the new plan year. If you are a Federal 

annuitant, you will be automatically enrolled in 

the Blue Cross Blue Shield Service Benefit Plan 

Standard Option.

* My plan is reducing its service area AND 

eliminating my enrollment code. What 

happens if I don’t change to another plan? 

If you are a Federal employee or Tribal 

employee and you do not change plans, you 

will not have coverage in the new plan year. If 

you are a Federal annuitant, you will be 

automatically enrolled in the Blue Cross Blue 

Shield Service Benefit Plan Standard Option.

* My plan is reducing its service area AND 

keeping my enrollment code. What 

happens if I don’t change to another plan?

You will only have coverage in your area for 

emergency care services in the new plan year. 

You must travel to the plan’s remaining service 

area to receive full coverage for your care.

* My plan is eliminating my option. What 

happens if I don’t change to another plan? 

You will be automatically enrolled into one of 

the plan’s options that remain. Please refer to 

the letter you received from your plan for more 

information. 

* If my High Deductible Health Plan 

(HDHP) is terminating coverage in my 

service area or is leaving the FEHB 

Program, what happens to my Health 

Savings Account (HSA) or my Health 

Reimbursement Arrangement (HRA)? If 

you wish to continue contributing to your HSA, 

you must enroll in another HDHP. If you do not 

enroll in another HDHP, you can withdraw 

money from your HSA for qualified medical 

expenses. You should check Internal Revenue 

Service (IRS) guidance on use of HSA dollars 

for non-qualified medical expenses. You should 

work directly with your fiduciary to make 

decisions regarding your HSA.

 

Unless you use your HRA credits, they will be 

forfeited once the plan you’ve elected becomes 

effective.

 

* How do I change my enrollment to 

another plan? If you are a Federal employee, 

use your agency’s online self-service system 

such as Employee Express, MyPay, Employee 

Personal Page, EBIS, etc. If you need 

additional help, contact your HR office.

If you are a Tribal employee, contact your 

Tribal Employer.

If you are a Civil Service Retirement System 

(CSRS) or Federal Employees Retirement 

System (FERS) retiree, call Open Season 

Express at 1.800.332.9798 or access Open 

Season Online at https://retireeFEHB.opm.gov.

If you receive an annuity from another 

retirement system, please visit 

www.opm.gov/insure/health/planinfo/enroll.as
p#annuitants for information on how to change 

your enrollment. 

* When does my old plan stop providing 

coverage? The plan will continue to provide 

benefits until the plan you’ve elected during 

Open Season becomes effective.

What are my rights if I’m pregnant or I 

have a chronic or disabling condition?

Under the Patients’ Bill of Rights, enrollees who 

are seeing a specialist for a chronic or disabling 

condition or who are in the second or third 

trimester of a pregnancy have a right to 

continued treatment for up to 90 days of care 

(or treatment through the end of post-partum 

care) following notice that a health plan is 

leaving the FEHB Program. 

* When does the health plan I’ve elected 

during Open Season start providing 

coverage? Your coverage begins on the first 

day of the first full pay period in the next 

contract year. For example, below shows the

2013 effective dates for most enrollees.

Non-Postal Federal Employees Jan. 13

Postal Employees Jan. 12

Retirees and Tribal Employees Jan. 1

Office of Workers’ 

Compensation (OWCP) 

Jan. 13

* How can I compare the different health 

plans available to me? There are several 

resources available to help you compare plans. 

 Compare Health Plans -

www.opm.gov/insure/health/search/plansea

rch.aspx 

 Health Plan Brochureswww.opm.gov/FEHBbrochures; or for Tribal 

employees 

www.opm.gov/insure/health/tribes/planinfo

/index.asp

 Guide to Federal Benefits -

www.opm.gov/insure/health/planinfo/guide

s/index ;or for Tribal employees 

www.opm.gov/insure/health/tribes/2012tri

beguide.pdf

 PlanSmartChoice -

www.plansmartchoice.com/registration.aspx

 Consumer’s Checkbook -

www.checkbook.org/newhig2/hig.cfm (for

Federal employees only)

* Where can I find the plan brochures?

 Visit www.opm.gov/FEHBbrochures; or for 

Tribal employees 

www.opm.gov/insure/health/tribes/planinfo/

index.asp

 Call the plan directly

 Contact your HR office or Tribal Employer

* How do I find out if my doctor is part of 

the health plan? You can find provider 

directories at www.opm.gov/FEHBbrochures or; 

for Tribal employees

www.opm.gov/insure/health/tribes/planinfo/ind

ex.asp, or call your plan, or contact your 

provider. 

* I have a supplemental dental plan 

offered through my old FEHB plan. What 

happens to that coverage? Since your plan 

is terminating coverage, any supplemental 

dental and/or vision coverage that you have 

through your plan will also terminate. The 

Federal Employees Dental and Vision Insurance 

Program (FEDVIP)1offers dental and vision 

insurance for eligible Federal employees and 

retirees. To find more information about 

dental insurance, please visit 

www.opm.gov/insure/dental. To find more 

information about vision insurance, please visit 

www.opm.gov/insure/vision. If you are 

currently enrolled in FEDVIP, your FEHB plan’s 

termination will not affect your FEDVIP 

enrollment.

* I have other supplemental coverage 

through my old FEHB plan. What happens 

to that coverage? Since your plan is 

terminating coverage, any supplemental 

coverage that you have through your plan may 

also terminate. Please contact your plan for 

more information about your supplemental 

coverage.

Where can I go for more information on 

Open Season?

Visit www.opm.gov/insure/openseason; or for 

Tribal employees

www.opm.gov/insure/health/tribes/tribalopens

eason for tribal employees. The Open Season 

website will be updated with information in late 

October.

 

1

Tribal employees are not eligible for FEDVIP.