We answer your Open Season questions

The end of Open Season is just around the corner and Federal News Radio has got your back. Send us your Open Season questions and we'll do our best to answer th...

The end of Open Season is just around the corner, but Federal News Radio has got your back.

We asked readers to send us their questions. Our Federal Employee Health Benefits Plan experts did their best to answer them below.


How many times can I make a change during Open Season?

If I make preliminary decisions today and enter the data, for example, to Self+one, can I change that up until Dec 14 if I change my mind? — Dan Twomey 

ANSWER: Employees are free to make as many changes as they want during Open Season, says OPM. But the last election is the one that becomes effective.

When can I make changes for next year’s TSP deduction?

When can you make changes for next years TSP (and catchup) deduction? Last year the catch up was made on/around first part of December. — David Yasler

ANSWER: You can make a catchup contribution through a payroll deduction at any time, according to a factsheet from the Federal Retirement Thrift Investment Board. The contribution will become effective during the first full pay period after your election is received by your agency or service. You’ll need to file the election annually, as the election is only valid through the calendar year in which you made it.

[Follow up email from David Yasler: Defense Finance and Accounting Services said make the changes in the second week of December (I did mine last year 9 Dec 2014). Twenty-six pay periods this next year (2015/27 pay periods)  and if you put it in during the early part of open season it could affect the current year’s contributions (TSP & Catchup); if you make a catchup (over 50+) you must make a declaration every year (not automatic).

Which plans cover prescription drug costs overseas when you retire?

Which plan(s) cover prescription drug costs if you retire overseas? How does it work? — Matthew Murguia

ANSWER: Many of the plans cover prescription drug costs. It’s probably a good idea to get a copy of The Checkbook Guide to Health Plans for Federal Employees by Walt Francis to compare the different plans. If you’re still a federal employee, your agency likely has online access to that book.

Once you’ve selected a plan, check to see if its mail order pharmacy will send prescription drugs overseas. You might also be able to file a claim for drugs you purchase overseas, provided the physician is licensed in the U.S. and the drugs, by U.S. law, require a prescription. OPM has some online tips for overseas coverage.

When can I remove children from my family plan?

My son joined the Navy, my daughter is a new federal employee. Neither is 26 yet. I cannot remove them from my family plan — I’ve been told that’s how the law is written. I’ve been told my choice is to change plans — but not to another family plan because by law all under 26 family members will be included. Self plus one with the same company (Aetna) has a higher premium.
how is it that the law that protects our children up to 26 also prevents them from being independent adults? Have I misunderstood? marcher castell

ANSWER: It appears your reading of the law is correct. However, now that your son is a member of the military service, his eligibility status has changed. Even though he’s under 26, you can take him off of your health plan and he can receive his own coverage through the military’s health plan. See: Change in Family Status.

I’m having trouble contacting OPM, what’s up?

I am a retired federal law enforcement officer. I attempted to change to self plus one, but need
to double check to see that the change went through. I have been unable to contact OPM by
phone due to their poor planning and understaffing for the call volume. I can not get back into
the web site, as it no longer accepts my password. I have requested a new password, but have not received one. How do I contact OPM in order to verify that my change to self plus one went through? I have very little confidence in OPM, since they seem incapable of making it easy to reach them. —Mark Sias

ANSWER: Be patient and be persistent.

Federal News Radio reported earlier this month that the Employee Express online portal, which is hosted by OPM, was frustrating federal employees with a sluggish system. That was caused in large part by the agency’s cybersecurity updates, but it certainly didn’t help that more people than usual were attempting to access the portal. That in turn pushed people to call OPM’s help desk and overload the hotline.

OPM admitted the help desk volume “increased significantly and users were experiencing very long wait times.”

The agency is working to smooth out wrinkles — including temporarily extending its help desk hours.

The Office of Personnel Management’s special Open Season number is 800-332-9798 or visit OPM’s premiums site. Federal employees facing these problems should turn to their Human Resources office for answers.

What if I’m happy with my current plan?

If I’m satisfied with my current health plan, do I need to do anything during open enrollment or will it automatically renew? — Mike Shafer

ANSWER: If you do not want to change your present insurance coverage, you don’t have to do anything — unless your plan no longer participates in the FEHB program. Your current coverage will continue automatically.

When is the time to add/make a change to my options?

My wife covers the family (me included) through her plan at work. I have MHBP Value Self only currently and it’s been in place for 5 years. Can I add self + one, dental and/or vision family options at any time (< 5 years from retirement or after retirement)? Does having the most basic insurance option available for > 5 years allow me to add/upgrade to any self/family option now? — Earl Meyers

ANSWER: As long as your wife is also not a federal employee (except for a few circumstances you cannot be covered under two federal health plans), you may add those options but must do so during Open Season. At least while you are still an active employee, you only have that window to make changes — barring a qualifying life event. Open Season is the time when you are encouraged to shop around and make changes, so even if you are on the most basic plan, you still have time to switch to a self-plus-one or self-plus-family. Remember for retirement benefits, your wife would not be entitled to anything if you were to pass away without adding her to your plan.

When should I sign up for Medicare Part B?

As a retiree should I sign up for Medicare part B and self plus one FED insurance? — Ralph Kleinfelter

ANSWER: Federal health insurance expert Walton Francis advised that you are not legally required to sign up for Part B, but if you don’t sign up when you turn 65 (unless you are still working and covered by employer insurance) there is a penalty of paying an extra 10 percent in Part B premium for every year you delayed. Certainly take a look at self-plus-one, because you are likely to save more because you are not paying for the cost of a family premium. But as an annuitant there is not as much of a rush to make that choice before the Dec. 15 deadline. Annuitants are allowed to decrease enrollment at any time. This means that if you have a self and family enrollment and you decide you would like to change to a self-plus-one enrollment, you may do so throughout the year.

Can I be enrolled under two insurance plans?

In previous years, my wife and two kids were under my Federal Health Plan. For 2016, I want to switch Health Plans and cover just myself this year. In 2016, I want all of us to be covered under my wife’s health plan which is way better than any Federal Health Plan. My wife is NOT a federal employee. Am I allowed to be doubled cover under two health plans? I am only keeping my plan because I plan on retiring in the next three years. — Roy Morledge

ANSWER: Yes. For now you might consider enrolling in one of the cheapest plans. Consider it “insurance so you can get insurance.”  But it’s also important to remember for those under a self-only enrollment, if you were to die without enrolling your partner, your partner would lose FEHBP forever. Some households do have two federal employees, and in that case, OPM warns you may not be covered under two plans at the same time, except in certain circumstances.

Does Self Plus One affect five-year requirement?

I have over 33 years in with IRS & I know we have to maintain the same Insurance for the five years before we retire to be able to keep the insurance after retirement. If I change to Self Plus One instead of family this year, is that considered a change in insurance and would have to work another five years with Self Plus One to be able to retain our health insurance that we have had since the creation of water? — Ronald Dowling

ANSWER: “No, you do not have to be enrolled in Self Plus One for the five years before you retire to meet the five-year requirement,” according to OPM. “You need to be enrolled in FEHB for five years before you retire, or for the entire time for which you were eligible to be enrolled, and retire on an immediate annuity to be eligible to continue coverage into retirement.”


Where can I find the audio of your interview with Walt Francis?

Senior Correspondent Mike Causey hosted a Nov. 18 interview with federal benefits expert Walton Francis on Your Turn. Francis is author of Checkbook Guide to Health Plans for Federal Employees.

Click here to listen to the full interview.

Read an archive of our online chat with Francis by clicking here.

How can I enroll in Self Plus One?

If you are an annuitant, you need to contact the Retirement Office before Open Season closes on Dec. 14. The Office of Personnel Management has all the contact information here.

Active employees need to contact their human resources office to sign up for Self Plus One. If the HR office can’t help you, contact the benefits officer at your headquarters. A list of Benefits Officers maintained by OPM can be found here.

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