FEHB: Enrollment Options Following the Termination of a Plan or Plan Option

January 12, 2016 10:00 AM , Updated November 18, 2016 8:13 AM
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The Office of Personnel Management issued a Benefits Administration Letter today in regards to a final rule issued by the agency on October 28, 2015 amending the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option. The final rule became effective on January 1, 2016.

OPM notes the following in its letter:

When a plan or plan option in the FEHB Program terminates, OPM provides the enrollees of that plan or plan option a time period in which they may elect to enroll in a new plan or plan option. The final rule clarifies the actions that OPM and employing agencies may take when an enrollee fails to make an enrollment election during the time period provided.

In general, the final rule allows OPM and employing agencies to automatically enroll individuals who do not make an enrollment election during the allotted time period into one of the following: in the event of a plan option termination, the lowest cost remaining plan option provided by the same carrier that is not a High Deductible Health Plan (HDHP); or, in the event of a plan termination, into the lowest cost nationwide plan available. The final rule does not alter current standard practice to enroll individuals into the enrollment type (Self Only, Self Plus One, or Self and Family) that the enrollee carried before the plan or plan option terminated. If enrollees learn of a plan or plan option termination and determine that they do not want to continue FEHB coverage, the decision to cancel should be documented in Part F of the Standard Form (SF) 2809.

A copy of the letter is included below.

Federal Employees Health Benefits (FEHB) Program: Enrollment Options Following the Termination of a Plan or…

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Ian Smith is one of the co-founders of FedSmith.com. He enjoys writing about current topics that affect the federal workforce.