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, dropping an option, or that

it 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

options that remain. If no options remain that 

are not High Deductible Health Plans (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 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/healthcareinsurance/healthcare/planinformation/enroll/#annuitants 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

 Consumer’s Checkbook - 

www.checkbook.org/newhig2/hig.cfm 

* Where can I find the plan brochures?

• Visit www.opm.gov/FEHBbrochures; or

for Tribal employees

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

• 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/healthcare-insurance/tribalemployers/plan-information, 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)1 offers dental and vision

insurance for eligible Federal employees and

retirees. To find more information about dental

insurance, please visit

www.opm.gov/dental. To find more

information about vision insurance, please visit

www.opm.gov/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/openseason; or for Tribal

employees www.opm.gov/healthcareinsurance/tribal-employers/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 carrier directly or your local HR 

office or Tribal employer. 

1

Tribal employees are not eligible for FEDVIP.