Civil Service 

Retirement 

System 

Federal Employees’ 

Group Life 

Insurance Program 

Federal Employees 

Health Benefits 

Program 

Federal Employees 

Retirement 

System 

Federal 

 Long Term 

Care Insurance 

Program 

United States 

Office of 

Personnel Management 

The Federal Government’s Human Resources Agency

Retirement and Insurance Service 

Benefits Administration Letter 

Number: 01-406 Date: November 1, 2001 

Subject: 2001 Federal Employees Health Benefits (FEHB) Program Open Season: 

Conducting the Open Season

GENERAL 

 

FEHB Guides 

The FEHB Plans were accredited by the Joint Commission on Accreditation of Healthcare 

Organizations (JCAHO), the National Committee for Quality Assurance (NCQA), and/or the 

American Accreditation Healthcare Commission (URAC). This year, in the “Accredited” column 

of the FEHB Guide, we have replaced the Checkmark ( ) with a number rating system. An 

accreditation by NCQA would be denoted by N1, N2, N3, N4, or N6, an accreditation by JCAHO 

would be denoted by J1, J2, J3, J5 or J6, and URAC is denoted by U1. A lower number means 

that the plan is a better-accredited plan. Full accreditation details are available on our web site at 

www.opm.gov/insure. 

FEHB WEB SITE 

Visitors to our web site will find it informative and easy to use. You can link to most of our 

topics directly from the front home page. All FEHB Guides and plan brochures will be available 

for downloading. We are encouraging you and your employees to use the FEHB Website during 

the 2001 Open Season. You may download the 2002 FEHB Guides, Plan brochures, SF 2809, as 

well as all open season Benefits Administration Letters (BAL) from this site. 

You may also find the “FEHB Facts” booklet on the web site, which offers information on the 

FEHB Program, how to enroll, eligibility issues, and much more. 

Visit the web site at www.opm.gov/insure for the most up to date information. 
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COUNSELING Agencies are responsible for counseling employees who ask for 

EMPLOYEES help on health benefits matters. Counseling should be limited to 

answering questions about the FEHB Program including questions 

on premium conversion and the application of the FEHB law and 

regulations to particular circumstances. 

 FEHB Guides provide summary information that is designed to 

help employees narrow their choices of health plans, not to make 

final decisions. You should refer employees to the actual plan 

brochures for specific information vital to making an informed 

decision. 

You should try to answer employees’ benefit questions by referring 

them to the brochure of the plan in question. If the answers cannot 

be found in the brochure, instruct the employee to contact the 

health plan directly. Do not refer employees to the plans if their 

questions concern subjects other than benefits. Answering 

questions about FEHB enrollment rules, such as which dependents 

are eligible for coverage and when coverage begins and ends, is the 

responsibility of the agencies, not the health plans. If you do not 

know the answer, contact your agency’s headquarters insurance 

officer. 

PLAN TERMINATIONS In BAL 01-402, we notified you of the names of plans that are 

dropping out of the FEHB Program, or that are dropping a service 

area with a separate enrollment code, at the end of 2001. We 

strongly recommend that you distribute the list of terminating plans 

and enrollment codes to all employees so they can check to see 

whether their plan or enrollment code will continue to be valid in 

2002. 

 An employee whose plan or enrollment code will not participate in 

the Program next year must enroll in another plan to continue 

FEHB coverage in 2002. You should monitor employees who are 

covered by these terminating plans/codes and follow up with those 

who have not submitted a change of enrollment before the end of 

open season. 

PLAN MERGERS BAL 01-402 also informed you of plans that are merging with 

other plans at the end of 2001. Enrollees of the merging plans will 

be transferred automatically to the surviving plan, but they may 

find that their new plan has very different benefits than they were 

accustomed to. Employees in plans that merge should read their 

2002 brochures carefully. 
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STANDARD FORM (SF) This form is available as a screen-fillable Adobe Acrobat 

2809 PDF file on the FEHB Web site. Using the free downloadable 

Adobe Acrobat reader, employees may complete the form on the 

screen and then print it out already completed. Note, however, that 

if you are using the free Acrobat reader software you cannot save 

the form with the information that is typed in it on the screen. You 

need the commercial Adobe Acrobat program in order to save the 

form with the data. 

ANNUITANT Some annuitants who retire from your agency may contact you 

INQUIRIES asking for a SF 2809. 

 CSRS and FERS - The Office of Personnel Management (OPM) 

does not use the SF 2809 to register open season changes for Civil 

Service Retirement System (CSRS) or Federal Employees 

Retirement System (FERS) annuitants. These annuitants should be 

directed to call our toll-free service, Open Season Express. 

Instructions for using Open Season Express are included in the 

open season package sent to each enrolled CSRS and FERS 

annuitant before open season. If an annuitant loses or does not 

receive the package, they can get one by calling our Retirement 

Information Office at 1-88-US-OPM-RET (1-888-767 6738). 

The hearing-impaired who have access to a TDD machine may call 

our toll-free Retirement Information Office TDD number at 1-800-

878-5707. 

Annuitants should always provide their CSA/CSF retirement claim 

number and/or their Social Security Number when communicating 

with OPM for any reason. 

  Other retirement systems - These annuitants should contact 

their retirement system for the proper registration form. 

  OWCP - Former employees receiving benefits from the Office of 

Workers' Compensation should contact the OWCP office that 

maintains their FEHB records. 

CARRIER ACCESS 

 Health Fairs We strongly encourage agencies to hold open season health fairs or 

to permit representatives of FEHB carriers to address groups of 

employees on their plans' benefits, methods of obtaining services, 

and similar matters. 
4

 We encourage agencies to stagger health fairs, beginning prior to 

the actual start of open season, since the number of carrier 

representatives knowledgeable about the benefit provisions and 

claims procedures of the plans they represent is often limited. 

 When holding health fairs, remember: 

  The purpose of the fair is to inform, not promote. You should 

discourage carriers from distributing trinkets, holding raffles, or 

engaging in similar activities that divert attention from the primary 

goal. 

  Carrier representatives are expected to confine their presentations 

to benefit provisions and claims procedures of the FEHB plan they 

represent. Questions that do not pertain to benefits or claims 

should be referred to agency insurance officials. 

 

Other Companies You may be contacted by insurance companies that do not 

participate in the FEHB Program, but wish to sell dental insurance 

or other types of "supplemental" policies to Federal employees. 

These companies sometimes send marketing material to you and 

ask that you distribute it. They may ask to be invited to the 

agency's health fairs or even show up at health fairs uninvited. 

 We strongly discourage you from assisting in the marketing efforts 

of these companies, including companies FEHB carriers may have 

contracted with for particular benefits. You should limit access to 

your premises to health plans that actually participate in the FEHB 

Program; i.e., those plans listed in the FEHB Guide. 

Note: Due to the recent events of September 11, 2001, we realize that agencies are enforcing 

strict security procedures. When inviting carriers to your premises for health fairs, please 

ensure that you have alerted them in advance of the security procedures to expect. 

OPEN SEASON CHANGES 

Permissible Actions The following changes in registration may be made during open 

season: 

 

  An eligible employee who is not enrolled may elect to enroll in 

FEHB. 

  An eligible employee who elects to enroll in FEHB may also 

elect to participate or waive participation in premium conversion. 
5

  An enrollee may change from one plan or option to another, from 

self only to self and family, or make any combination of these 

changes. 

  An enrollee who currently participates in premium conversion 

may waive participation or if they had previously waived premium 

conversion, may elect to begin participation. 

 New enrollments and enrollment changes for permissible reasons 

other than the open season can be made, as usual, between 

November 12 and December 10, 2001. These changes, however, 

may have different effective dates than open season changes, and 

should not be mistakenly identified as such. 

 Whether an employee is enrolling or changing enrollment based on 

open season or some other qualifying event, it is important that the 

correct event number be noted on the SF 2809, so that the correct 

effective date will be assigned. 

Timely Registration You must receive an open season change on the SF 2809 no later 

than close of business on December 10, 2001, to be considered 

timely filed. 

The Employee Express contractor (OPM Macon, GA) must receive 

changes via Employee Express no later than midnight on 

December 10. 

Belated Registration You have the authority to accept late registrations if you determine 

that an employee was unable to submit a SF 2809 on time due to 

circumstances beyond the employee's control. While we normally 

encourage you to make limited use of this authority, we 

recommend that you take a liberal view in cases where an 

employee's plan is terminating its FEHB participation. 

If you decide to accept an employee's late registration, write 

"Belated open season enrollment/change" in the "Remarks" section 

of the SF 2809. You must attach to copy 1 of the SF 2809 the 

employee's statement explaining why they could not register on 

time, or add your own note if the reason was an agency problem. 

If you decide that the delay in filing is not due to a cause beyond 

the employee's control, do not accept the employee's late request. 

You must notify the employee in writing that you are not 
6

approving the late enrollment. You should give the reason for your 

denial and include a statement of the employee's right to request 

reconsideration within 30 days after the date of your notice. 

Effective Dates From not enrolled to enrolled - Effective the first day of the first 

pay period which begins on or after January 1, 2002, and which 

follows a pay period in any part of which the employee was in pay 

status. The enrollment of a new employee who happens to register 

for the first time during open season is effective the same as for all 

new employees; i.e., the first day of the first pay period after the 

employing office receives the SF 2809. 

 

Enrollment change - Effective the first day of the first pay period 

which begins on or after January 1, 2002, regardless of whether or 

not the employee was in pay status during the preceding pay 

period. 

Premium Conversion Change in Election - Effective the first day 

of the first pay period which begins on or after January 1, 2002. 

Belated open season action - Effective retroactive to the first day 

of the first pay period, which begins on or after January 1, 2002. 

This effective date is the same as that of an open season change 

filed on time. If the belated change is from not enrolled to 

enrolled, the requirement of having been in pay status during the 

preceding pay period must also be met. 

Belated premium conversion elections are allowed, however, 

the effective date of these elections are not retroactive. 

Cancellation - Effective the last day of the pay period in which the 

employing office receives the SF 2809. The effective date is 

therefore different from the effective date of actions related to open 

season. 

Outside of open season, enrollees who participate in premium 

conversion may only cancel their FEHB coverage due to a 

qualifying life event. Enrollees who waived participation in 

premium conversion may cancel their health insurance at any time 

without waiting for a qualifying life event or an open season. 

Cancellation Agencies should be sure to counsel employees about the 

consequences of canceling their enrollment. 
7

Remember that an employee must have been covered under the 

FEHB Program continuously for the five years of service 

immediately before retirement or, if less than five years, for all 

periods of service during which he/she was eligible for FEHB 

coverage in order to continue FEHB coverage after retirement. 

 If an employee is canceling his/her enrollment in order to be 

picked up as a family member by a spouse's open season 

enrollment, be sure to coordinate the effective date of the 

cancellation with the effective date of the spouse's enrollment to 

prevent a break in coverage. 

AGENCY ACTIONS 

Prompt Processing It is important that you process open season enrollments and 

enrollment changes promptly. Payroll offices should process 

enrollee and carrier copies of SF 2809 daily. 

  You must notify gaining carriers of new enrollments so 

they can complete the paperwork necessary to provide 

coverage for the employee and covered family members 

and issue identification cards to the new enrollees. 

  You must notify losing carriers as soon as possible of 

enrollment terminations so they do not guarantee or provide 

benefits to ineligible employees or family members. 

Verification of Employee Employees become concerned when they do not receive their 

 Coverage identification cards from a new plan within a short time after the 

end of open season. If an employee asks you about this, you 

should contact the payroll office to determine when the carrier was 

notified of the change. If more than three weeks have passed since 

the payroll office sent the SF 2809 to the carrier, contact the carrier 

to determine the reason for the delay and relay the employee's 

request for identification cards. 

An employee may need verification of coverage under his/her plan 

before the carrier processes the enrollment or enrollment change. 

You should verify that the employee is covered under the plan and 

inform the requesting party (e.g., carrier, doctor, hospital) of the 

effective date of the coverage. You should also remind employees 

that their copy of the SF 2809 is acceptable as proof of enrollment 

until they receive their identification cards from the plan. 
8

Employees who make open season changes electronically via 

Employee Express and who do not receive new identification cards 

by the effective date of the change may obtain a letter confirming 

their coverage by calling the Employee Express Help Desk at 912-

757-3030, or by requesting your help. 

Reconciliation Requests You will receive requests from carriers to reconcile their 

enrollment records after open season is completed. These requests 

must receive the highest priority. The reconciliation process is 

critical to ensure that carriers receive the proper premium payments 

and that enrollees are properly reflected on plans' records. 

 

 Abby L. Block 

 Assistant Director 

 for Insurance Programs