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 

change your plan during Open Season. 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/retire/pubs/bals or 

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

* What do I do now that I know my 

enrollment is affected? You will 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 an employee 

and you do not change plans, you will not 

have coverage in the new plan year. If you 

are a retiree, 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 an employee and 

you do not change plans, you will not have 

coverage in the new plan year. If you are a 

retiree, 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 or urgent care services 

in the new plan year. You would need to 

travel to the plan’s remaining service area to 

receive benefits for other eligible medical 

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 an employee, use 

your agency’s online self-service system 

such as Employee Express, MyPay, Employee 

Personal Page, EBIS, etc. If you need 
additional help, please contact your HR office 

for details. 

If you are a Civil Service Retirement System 

(CSRS) or Federal Employees Retirement 

System (FERS) retiree, you should 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.

asp#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 

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 2012 effective dates for most 

enrollees. 

Non-Postal Employees Jan. 1

Postal Employees Jan. 14

Retirees Jan. 1

Office of Workers’ 

Compensation (OWCP) 

Jan. 15

* 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/plans

earch 

 Health Plan Brochures 

www.opm.gov/FEHBbrochures 

 Guide to Federal Benefits - 

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

es/index

 PlanSmartChoice -

www.plansmartchoice.com/registration.aspx 

 Consumer’s Checkbook - 

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

employees only)

* Where can I find the plan brochures? 

 Visit www.opm.gov/FEHBbrochures 

 Call the plan directly 

 Contact your HR office 

* 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 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) 

offers 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 will 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

and www.opm.gov/insure/openseason. The 

Open Season website will be updated with 

information in late October.