United States 

Office of 

Personnel Management 

The Federal Government’s Human Resources Agency

Benefits Administration Letter

Number: 15-404 Date: October 15, 2015 

Subject: 2015 Federal Benefits Open Season: FSAFEDS and FEHB Program 

Significant Plan Changes 

This Benefits Administration Letter (BAL) is the fourth in our series of 2015 Federal 

Benefits Open Season BALs for the Federal Flexible Spending Account Program 

(FSAFEDS), the Federal Employees Dental and Vision Insurance Program (FEDVIP) and 

the Federal Employees Health Benefits (FEHB) Program. This BAL provides 

information on significant plan changes for FSAFEDS, FEDVIP, and the FEHB Program

for 2016. 

This year’s Federal Benefits Open Season will run from Monday, November 9 through 

Monday, December 14, 2015.

SELF PLUS ONE FOR FEHB

As a result of the Bipartisan Budget Act of 2013, the Self Plus One enrollment type will 

be available beginning in January 2016. The first opportunity to enroll in Self Plus One 

will be during the annual Federal Benefits Open Season, which runs from Monday, 

November 9, 2015 through Monday, December 14, 2015. 

Self Plus One is a new enrollment type in the FEHB Program that allows enrollees to 

cover themselves and one eligible family member they designate to be covered. Family 

member eligibility for a Self Plus One enrollment is the same as for a Self and Family 

enrollment. A family member eligible to be covered under a Self Plus One enrollment 

includes either a spouse OR a child under age 26. A child age 26 or over who is deemed 

incapable of self-support because of a mental or physical disability that existed before age 

26 is also an eligible family member. 

Additional information on the new Self Plus One enrollment type is available at 

https://www.opm.gov/healthcare-insurance/special-initiatives/self-plus-one/.

GUIDE TO FEDERAL BENEFITS

OPM is no longer producing the Guide to Federal Benefits (Guide) beginning with the 

2016 benefit year. This will include both the printed and online versions of the Guide. 
2

We have determined that it is no longer cost effective to produce the Guide, and due to 

the implementation of the Going Green Initiative in 2010, an increasing number of 

agencies are turning toward online resources for information about the federal benefits 

programs instead of ordering printed copies of the Guide. 

Also, almost all of the information printed in the Guide is already on our federal benefits 

programs’ website, www.opm.gov/healthcare-insurance, such as: 

 Specific plan information on the Federal Employees Health Benefits (FEHB) 

Program and the Federal Employees Dental and Vision Insurance Program 

(FEDVIP); 

 Premium charts; and 

 Information on eligibility and how to enroll in or apply for all of the federal 

benefits programs, including the Federal Employees’ Group Life Insurance 

Program (FEGLI), Federal Flexible Spending Account Program (FSAFEDS), and 

the Federal Long Term Care Insurance Program (FLTCIP). 

OPM will create additional online materials, such as FastFacts and premium charts for 

Temporary Continuation of Coverage (TCC) enrollees and former spouses enrolled under 

Spouse Equity. We will also display quality healthcare scores on the FEHB Program 

website. 

FSAFEDS 

Health care and limited expense flexible spending accounts (FSAs) no longer have a 

grace period; instead, qualifying participants will be able to carry over up to $500 of 

unused funds to the next plan year. To be eligible for carryover, participants must have 

enrolled during Open Season or as a new hire during the year and must meet the 

following requirements: 

 Be actively employed by a FSAFEDS-participating agency and contributing to 

your FSA account through December 31; and 

 Re-enroll for the next Benefit Period. If you do not re-enroll, you forfeit your right 

to a carryover account. 

Dependent care FSAs will continue to have a grace period each year and cannot carry 

over funds from one year to the next. 

FEDVIP 

There are no 2016 FEDVIP significant changes.

FEHB PROGRAM 

The remainder of this letter provides important information on the significant changes 
3

affecting certain plans in the FEHB Program for the upcoming Open Season. The first 

attachment to this BAL identifies the FEHB plans and their corresponding significant 

changes. Some of these events will require action on the part of agencies and enrollees. 

Please note there are plans leaving the FEHB Program at the end of 2015 or reducing 

their service areas and terminating their enrollment codes. Since employees in these 

terminating plans and service area reductions must enroll in a new plan during Open 

Season if they wish to continue health insurance coverage in 2016, please distribute this 

list throughout your agencies. It is your responsibility to monitor employees who are 

covered by these terminating plans or service area reductions and follow up with those 

who have not submitted an enrollment change before the end of Open Season. Enrollees 

in the terminating plans and enrollment codes who do not change their health plan by 

enrolling in another FEHB plan during Open Season will not have health benefits for 

2016. 

TIP: Distribute the attached list of significant FEHB plan changes to all employees so 

they can check to see if their plan or service area will continue to participate in the FEHB 

Program in 2016. 

Table 1: Plans Leaving the FEHB Program 

Table 2: FEHB Plan Reducing Service Areas and Terminating Enrollment Codes 

What Must Employees Do? 

 Employees in terminating plans (Table 1) or service area reductions with 

terminating enrollment codes (Table 2) must enroll in a new health plan during 

Open Season if they want coverage. If they do not enroll in a new plan, they will 

not have FEHB coverage in 2016.

 New Coverage: Coverage under an enrollee’s new health plan will be effective 

the first day of the pay period beginning on or after January 1, 2016; for most 

employees this will be Sunday, January 10, 2016. Enrollees will remain 

covered and receive the 2015 benefits of the old plan until coverage under the new 

plan becomes effective.

What Must You Do? 

 You must notify employees enrolled in the plans listed in Tables 1 and 2 to select 

new plans. Advise your employees if they do not choose new plans, they will not 

have FEHB coverage in 2016. 

 Distribute copies of this list to employees with your agency’s notice about Open 

Season along with copies of the second attachment, FastFacts: What to do When 

Your Health Plan is Terminating Coverage in Your Area or Leaving the Federal 

Employees Health Benefits (FEHB) Program. 

 Follow up with employees in these plans and remind them to select new plans.

 Belated changes: Some employees still might not receive instructions to change 
4

plans during Open Season. We encourage you to be liberal in accepting belated 

Open Season changes from employees enrolled in terminating plans or plans with 

service area reductions and terminating enrollment codes.

What Will Health Plans Do? 

Plan Notification: The plans in Tables 1 and 2 have been instructed to notify enrollees 

of the need to select new plans for 2016; however, because some plans’ enrollment and 

address lists may not be up-to-date, we encourage you to accept belated changes. 

Table 3: FEHB Plans Reducing Service Areas without Terminating Enrollment 

Codes 

What Must Employees Do? 

Employees in the service areas being terminated should elect a new health plan for 2016; 

however, employees who do not choose a new health plan will only have emergency 

services where they live and will have to travel to their plan’s remaining service area to 

receive full benefits.

What Must You Do? 

 You must notify employees enrolled in the plans listed in Table 3 to select a new 

plan. Advise your employees if they do not choose a new plan, they will only 

have emergency services where they live and they will have to travel to their 

plan’s remaining service area to receive full benefits in 2016. 

 Distribute copies of this list to employees with your agency’s notice about Open 

Season along with copies of the second attachment, FastFacts: What to do When 

Your Health Plan is Terminating Coverage in Your Area or Leaving the Federal 

Employees Health Benefits (FEHB) Program.

 Follow up with employees in these plans and remind them to select a new plan.

 Belated changes: Some employees still might not receive instructions to change 

plans during Open Season. We encourage you to be liberal in accepting belated 

Open Season changes from employees enrolled in the plan reducing its service 

area.

What Will Health Plans Do? 

Plan Notification: The plans in Table 3 have been instructed to notify enrollees that 

their respective service areas are being terminated. If enrollees do not choose another 

health plan, the enrollees will only have emergency services where they live and they will 

have to travel to their plan’s remaining service area to receive full benefits in 2016. 

However, because a plan’s enrollment and address lists may not be up-to-date, we 

encourage you to accept belated changes. 

Table 4: FEHB Plan Terminating Option and Enrollment Codes 
5

What Must Employees Do? 

 Employees in the plan dropping an option (Table 4) may choose a new health 

plan during Open Season or remain with their current plan and be switched 

automatically into the plan’s remaining option specified in Table 4. 

 New Coverage: Coverage under an enrollee’s new health plan or option will be

effective the first day of the pay period beginning on or after January 1, 2016; for 

most employees this will be Sunday, January 10, 2016. Enrollees will remain 

covered and receive the 2015 benefits of the old plan or option until coverage 

under the new plan becomes effective.

What Must You Do? 

 Advise your employees who are enrolled in the plan that is dropping an option 

(Table 4) that if they do not choose a new health plan, they will be automatically 

transferred into the plan’s remaining option as specified in Table 4.

 Distribute copies of this list to employees with your agency’s notice about Open 

Season.

 Follow up with employees in the plan and remind them that if they do not choose 

a new health plan, they will be automatically transferred into the plan’s remaining 

option specified in Table 4.

 Belated changes: Some employees still might not receive instructions regarding 

their plan dropping an option. We encourage you to be liberal in accepting 

belated Open Season changes from employees enrolled in the plan dropping an 

option listed in Table 4.

What Will the Health Plan Do? 

 Plan Notification: The plan in Table 4 has been instructed to notify enrollees 

that their current plan option is being discontinued and that if they do not change 

to another plan during Open Season, they will be switched automatically into one 

of the plan’s remaining options specified in Table 4.

Table 5: FEHB Plan Contract and Enrollment Code Merger with Terminating 

Enrollment Codes 

What Must You Do? 

 Advise your employees who are enrolled in the plan that is merging into another 

plan that if they do not choose a new health plan, they will be automatically 

transferred into the new plan and enrollment code as specified in Table 5.

 Distribute copies of this list to employees with your agency’s notice about Open 

Season.

 Follow up with employees in the plan and remind them that if they do not choose 

a new health plan, they will be automatically transferred into the new plan 

andenrollment code as specified in Table 5.
6

 Belated changes: Some employees still might not receive instructions regarding 

their plan dropping an option. We encourage you to be liberal in accepting 

belated Open Season changes from employees enrolled in the plan dropping an 

option listed in Table 5.

What Will the Health Plan Do? 

 Plan Notification: The plans in Table 5 have been instructed to notify enrollees 

that their current plan option is being discontinued and that if they do not change 

to another plan during Open Season, they will be switched automatically into one 

of the new plans as specified in Table 5.

Table 6: Enrollment Code Merging Into a Different FEHB Plan 

Table 7: Service Area Movement to Another Existing Enrollment Code 

Table 8: New Plans Entering the FEHB Program 

Table 9: FEHB Plans Adding New Options and Enrollment Codes 

Table 10: Service Area Expansions without New Enrollment Codes

Table 11: FEHB Plan Name Change 

What Must You Do? 

You must include the merged plan, moved service area, new plans, the plans with new 

options, and the plans with expanded service areas (Tables 6-11) when you count the 

number of eligible employees and place your order for brochures. 

SUMMARY OF BENEFITS AND COVERAGE - REMINDER 

As a result of the Affordable Care Act, FEHB plans have been providing a summary 

document on their websites which details information about health plan benefits and 

coverage. The summary document is also available on our website at 

www.opm.gov/healthcare-insurance/healthcare/plan-information/summary-of-benefits.

In order to help FEHB enrollees better understand their coverage and allow them to easily 

compare different plans and plan options, the Summary of Benefits and Coverage (SBC) 

document includes information on the following: 

 Cost - deductibles, copayments, coinsurance, and out-of-pocket limits 

 Coverage - covered services, examples of covered services and excluded services 

 Rights - rights to continue coverage as well as grievance and appeal rights 

 A statement that coverage under the plan qualifies as “minimum essential 

coverage”

 A statement that the health coverage of the plan does meet the minimum value 

standard for the benefits the plan provides 
7

The SBC will continue to have a disclaimer indicating that the plan brochure remains the 

official statement of benefits. 

Plans will continue to provide information in their Open Season materials to their 

enrollees about where to find their SBC on their website as well as how to obtain a paper 

copy of the SBC. The plans may also have their SBC available at health fairs. 

CONCLUSION 

Again, this year’s Federal Benefits Open Season will run from Monday, November 9

through Monday, December 14, 2015. 

We encourage you and your employees to visit our website at www.opm.gov/openseason

for the most up-to-date information. Please note that 2016 Plan information will be 

posted on our website by the first week of November. 

We look forward to working with you to ensure Federal employees have a successful 

Open Season. 

Sincerely,

John O’Brien

Director 

Healthcare and Insurance 

Attachments