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, is dropping an option, or is

no longer providing services in your area. You 

can contact your Human Resources (HR) office 

with additional questions.

* 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 or during the time period set by 

OPM. 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, annuitant, or Tribal employee and

you do not change plans, you will be 

automatically enrolled into the lowest-cost 

nationwide plan option available as designated 

by OPM. 

* 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, annuitant, or

Tribal employee and you do not change 

plans, you will be automatically enrolled into 

the lowest-cost nationwide plan option 

available as determined by OPM. 

* My plan is reducing its service area

where I live/work but 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 a remaining 

option or to another plan? You will be

automatically enrolled into one of the plan’s

remaining options. If no options remain, or 

the remaining option is a High Deductible 

Health Plan (HDHP), you will be automatically 

enrolled into the lowest cost nationwide plan 

option as indicated by OPM. 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 your plan terminates. 

* How do I change my enrollment to

another plan? If you are a Federal employee,

you may be able to 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. 

Outside of Open Season contact the Retirement 

Office through email at retire@opm.gov or by 

phone at 1-888-767-6738.
If you receive an annuity from another

retirement system, please visit

www.opm.gov/healthcareinsurance/healthcare/enrollment/ for

information on how to change your

enrollment.

* When does my old plan or option stop 

providing coverage and my new plan or 

option begin? Your old plan will continue to

provide benefits until the plan you’ve elected

during Open Season or during the time 

period provided by OPM becomes effective. 

There will be no gaps in coverage

* 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.

* 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/fehbcompare

 Health Plan Brochures - 

www.opm.gov/FEHBbrochures; or for Tribal

employees www.opm.gov/healthcareinsurance/tribal-employers/planinformation/plans/. 

* Where can I find the plan brochures?

• Visit www.opm.gov/FEHBbrochures; or

for Tribal employees

https://www.opm.gov/healthcareinsurance/tribal-employers/planinformation/plans/. 

• Call the plan directly

• Contact your HR office or Tribal

Employer

* How do I find out if my doctor is in a 

health plan’s network? You can find

provider directories at 

www.opm.gov/FEHBbrochures or; for Tribal

employees www.opm.gov/healthcareinsurance/tribal-employers/planinformation/plans/ or call your plan, or 

contact your provider.

* 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/openseason; or for Tribal

employees www.opm.gov/healthcareinsurance/open-season. The Open Season

website will be updated with information by

early November.

* Who can I contact with additional 

questions? 

If you have additional questions, you can 

contact your plan directly or your local HR

office or Tribal employer. 

1

Tribal employees are not eligible for FEDVIP.