The Workplace of Personnel Administration (OPM) introduced vital modifications for some FEHB plans in 2025. Federal workers and retirees ought to concentrate on these modifications previous to the Federal Advantages Open Season which runs via Dec. 9, 2024 .
“There are plans leaving the FEHB program on the finish of 2024,” the Workplace of Personnel Administration wrote in a letter. “Staff in these terminating plans should enroll in a brand new plan throughout Open Season or they are going to be enrolled in GEHA Indemnity Profit Plan Elevate (the bottom value nationwide plan choice for 2025 as decided by OPM).”
SEE ALSO: 2025 FEHB Plan Comparison Tool
OPM Listing of 2025 FEHB Plan Adjustments
To view the record of 2025 FEHB plan modifications, go here (9-page PDF obtain).
OPM additionally supplied a frequently asked questions fact sheet concerning the modifications (see beneath):
What to do When Your Well being Plan is Terminating Protection in Your Space or Leaving the Federal Staff Well being Advantages (FEHB) Program.
There are 4 methods your FEHB plan enrollment could also be affected. Every state of affairs could require a distinct response, so you’ll want to determine your scenario.
Commercial
1. Plan leaves FEHB Program completely.
2. Plan reduces its service space and eliminates its enrollment code.
3. Plan reduces its service space and retains its enrollment code.
4. Plan eliminates an choice (equivalent to Normal or Excessive).
Inquiries to Take into account:
How will I do know if my enrollment is affected?
It’s best to have acquired a letter out of your plan stating that it’s not taking part within the FEHB Program, that it’s not offering protection in your space (and is eliminating or protecting the enrollment code), or that it’s eliminating an choice. See Benefits Administration Letter: Significant Plan Changes. You’ll be able to contact your Human Sources (HR) workplace with extra questions. (Observe: the record from OPM of plan modifications will be downloaded here).
What ought to I do if my enrollment is affected?
You might want to vary your enrollment to a different plan throughout Open Season, or through the time interval set by OPM.
My plan is leaving the FEHB Program completely. What occurs if I don’t change to a different plan?
As a Federal worker, annuitant, or Tribal worker, in case your plan is leaving the FEHB Program and you don’t change your enrollment, your using company will enroll you within the lowest-cost
nationwide plan choice as decided by OPM. Comply with the directions within the letter you obtain out of your plan or contact your HR workplace. See our Open Season website for added data.
My plan is lowering its service space and eliminating my enrollment code. What occurs if I don’t change to a different plan?
In case you are a Federal worker, annuitant, or Tribal worker and you don’t change plans, you may be mechanically enrolled into the lowest-cost nationwide plan choice accessible as decided by OPM.
My plan is lowering its service space the place I stay or work however protecting my enrollment code. What occurs if I don’t change to a different plan?
You’ll solely have protection in your space for emergency care providers within the new plan 12 months. It’s essential to journey to the plan’s remaining service space to obtain full protection on your care.
My plan is eliminating my choice. What occurs if I don’t change to a remaining choice or to a different plan?
You may be mechanically enrolled into one of many plan’s choices that stay. If solely a Excessive Deductible Well being Plan (HDHP) stays, you may be mechanically enrolled into the bottom value nationwide plan choice as indicated by OPM. Please check with the letter you acquired out of your plan for extra data or contact your Human Sources workplace.
If my Excessive Deductible Well being Plan (HDHP) is terminating protection in my service space or is leaving the FEHB Program, what occurs to my Well being Financial savings Account (HSA) or my Well being Reimbursement Association (HRA)?
For those who want to proceed contributing to your HSA, you will need to enroll in one other HDHP. If you don’t enroll in one other HDHP, you aren’t eligible to contribute to your HSA, however you could request withdrawals for certified medical bills. It’s best to test Inside Income Service (IRS) steerage on use of HSA {dollars} for non-qualified medical bills. It’s best to contact your plan’s HSA fiduciary earlier than making selections concerning your HSA.
Except you utilize your HRA credit, they are going to be forfeited as soon as the plan you’ve elected turns into efficient.
How do I alter my enrollment to a different plan?
In case you are a Federal worker, use your company’s on-line self-service system equivalent to Worker Specific, MyPay, Worker Private Web page, EBIS, and so forth. For those who want extra assist, contact your HR workplace.
In case you are a Tribal worker, contact your Tribal Employer.
In case you are a Civil Service Retirement System (CSRS) or Federal Staff Retirement System (FERS) retiree, name Open Season Specific at 1.800.332.9798 or entry Open Season Online.
For those who obtain an annuity from one other retirement system, please learn extra about health benefits after retirement.
When does my present plan or choice cease offering protection and my new plan or choice start?
Your present plan will proceed to supply advantages till the efficient date of the plan you’ve elected throughout Open Season or through the time interval supplied by OPM. There might be no gaps in protection. Open Season enrollment modifications take impact the primary day of your first full pay interval in January of the next 12 months.
What are my rights if I’m pregnant or I’ve a continual or disabling situation?
Beneath the Patients’ Bill of Rights, enrollees who’re seeing a specialist for a continual or disabling situation or who’re within the second or third trimester of a being pregnant have a proper to continued therapy for as much as 90 days of care (or therapy via the top of post-partum care) following discover {that a} well being plan is leaving the FEHB Program.
How can I evaluate the totally different well being plans accessible to me?
There are a number of assets accessible that will help you evaluate plans:
Use the FEHB Plan Comparison Tool
Seek the advice of Consumer’s Checkbook
Assessment and evaluate accessible Well being Plan Brochures
The place can I discover Well being Plan Brochures and Data?
Federal employees and annuitants
How do I discover out if my physician is a part of the well being plan?
Entry to supplier directories can be found on our plan information tool.
Alternatively, you’ll be able to name the plan immediately, contact your HR workplace, or Tribal Employer.
I’ve supplemental protection (i.e. dental) supplied via my present FEHB plan. What occurs to that protection?
Since your plan is terminating protection within the service space or leaving the FEHB Program, any supplemental dental and/or imaginative and prescient protection that you’ve got via your FEHB plan may also terminate. The Federal Staff Dental and Imaginative and prescient Insurance coverage Program (FEDVIP) presents dental and imaginative and prescient insurance coverage for eligible Federal workers and retirees. Tribal workers aren’t eligible for FEDVIP. For extra data, please read more about dental and vision insurances.
The place can I’m going for extra data on Open Season?
Federal workers can go to OPM’s Open Season Page
Tribal workers can go to OPM Tribal Employees Open Season Page
The Open Season web site will present up to date data by early November.
Who can I contact with extra questions?
If in case you have extra questions, you’ll be able to contact your provider immediately or your native HR workplace or Tribal employer.
