I HAVE QUESTIONS ABOUT FEHB
Do pre-existing condition exclusions apply? No, they do not. Persons enrolling in the FEHB Program are not subject to pre-existing condition exclusions. Is TCC (Temporary Continuation of Coverage) similar to COBRA? Yes it is. COBRA is offered to individuals in the private sector. However, like COBRA, TCC may offer certain individuals and their family coverage […]
WHO IS ELIGIBLE TO PARTICIPATE IN FEHB
Title 5 of the U. S. Code, Chapter 89 governs the Federal Employees Health Benefits Program (FEHBP). The Office of Personnel Management (OPM) formerly, the Civil Service Commission, has statutory oversight for the Program including the authority to contract with qualified carriers. The Federal government is the largest employer in the United States making the […]
DO ALL FEDS HAVE ACCESS TO ALL HEALTH PLANS
There are probably more than 256 different plan choices within the Federal Employees Health Benefit (FEHB) Program, but every Federal employee cannot participate in every plan. The plans may be available based on the region or jurisdiction you live in. Most Federal workers will have a choice of at least 10 to 20 plans to choose […]
SELF-PLUS ONE ENROLLMENT
It is nearly here – an enrollment type that fits you. Not every employee needs Self only or Self and Family. The world is changing and there are many family types and categories that describe what we need in health care and so many other venues of our lives. Many organizations outside of the Federal […]
THE ANNUAL CALL FOR BENEFIT AND RATE PROPOSALS
Calling all Federal employees active and retired. This is where you can make a real difference. Each year the Office of Personnel Management sends out a Call Letter to Carriers who desire to apply or reapply to provide services to the largest workforce in the world via the Federal Employees Health Benefit (FEHB) Program. The […]
WHAT CARRIERS QUALIFY TO PARTICIPATE IN FEHB
The Office of Personnel Management (OPM) has a strict set of standards that allow carriers to participate in the Federal Employees Health Benefits (FEHB) Program. The Office of Personnel Management is invested in making the best health care decisions available to ensure the health and safety of the Federal workforce, their families and retirees. As such […]
SIMILARLY-SIZED SUBSCRIBER GROUPS (SSSGs)
SSSGs are defined as a comprehensive medical plan’s two employer groups that as of the date specified by the Office of Personnel Management in the rate instructions have a subscriber enrollment closest to the FEHB subscriber enrollment and use any rating method other than retrospective experience rating and meet the criteria specified in the rate […]
MEDICAL LOSS RATIO
There are often words and phrases tossed about when we hear talk of benefits and other things that matter to us we don’t completely understand. Medical Loss Ratio is one of those items very important in understanding overall our Federal Employees Health Benefits (FEHB) Plan. According to the Centers for Medicare and Medicaid Services (CMS), […]
NEWSLETTER WEEKLY-ARE FEDS LOSING THEIR BENEFITS
Are Federal employees losing their health care benefits? Not really, FEHB is still in place. However, some of the Health Plans currently offered to Federal employees will not be around in 2015.  The Office of Personnel Management (OPM) has announced that 5 health insurance plans are dropping out of the Federal Employees Health Benefits Program […]
WHAT ABOUT PHASED RETIREMENT
Federal employees who qualify and are approved by their agencies may begin submitting applications to participate in Phase Retirement in November. Who actually can participate in Phased Retirement is really agency driven. It might be another few months before there is enough data available to gauge interest in the program. Many HR professionals in the […]
