Federal Employees Health Benefits
ELDER CARE – IS ON THE RISE by Dianna Tafazoli
ELDER CARE – IS ON THE RISE
As the Federal workforce ages there is more and more of a focus on Elder Care. We are witnessing the first generation of children who are retiring and their parents are still alive. It is almost like two sets of senior citizens but at different times and of course with different needs. But what it really means is that as Federal employees retire they are saddled with the responsibility of taking care of their elderly parents and family members. Americans are living longer today because the nation as a whole is more in tune to addressing and managing their health. More and more Americans also have access to health care through employer-sponsored insurance, state-sponsored programs and the country’s effort to bring quality health care to all Americans.
It seems that there is always a catch-22. We live longer and then because we are living longer we generally experience health conditions that come as result of aging and then we need someone to take care of us when we cannot do for ourselves – Elder Care. The Federal Government has a number of workplace flexibilities in place intended to assist Federal workers in taking care of the new array of problems encountered by an aging society.
Policies on flexibilities put in place by the Federal Government allow workers time off to provide care to elderly parents and other family members. The Office of Personnel Management has provided a handbook to educate employees and provide assistance to those employees who are providing elder care to family members. Federal employees do a tremendous job in providing a vast array of services to the American public. In order to keep the workforce ready to uphold their public responsibilities, it is imperative that the Federal government lends its workers a helping hand when it comes to caring for the needs of their own families.
P. S. Always Remember to Share What You Know.
Dianna Tafazoli
Unions Seek to Prevent Fed Employees Health Benefits Premium Hike
A few days ago, the U.S. Office of Personnel Management (OPM) today announced premiums for the 2016 Federal Employees Health Benefits (FEHB) Program will rise by an average of 6.4 percent.
OPM is offering a new Self Plus One enrollment type in the FEHB Program that will provide coverage for an enrollee and one designated eligible family member. All FEHB plans will offer a Self Only, Self Plus One, and Self and Family enrollment type beginning in 2016.
On average, enrollees with Self Only coverage will pay $5.50 more each pay period; enrollees with Self and Family coverage will pay $19.61 more per pay period. Those who opt for Self Plus One coverage will pay $8.92 more per pay period than they previously paid for Self and Family coverage. The Government contributes approximately 70 percent of the total cost of a plan’s premium.
“I am pleased that OPM has implemented the new Self Plus One choice for the 2016 plan year. This will give enrollees an opportunity to select coverage just for themselves and their spouse or child,” said OPM Acting Director Beth Cobert.
Federal employee unions including NARFE and NTEU were obviously not as pleased as Director Cobert at the hike in premiums for the health benefits program.
NTEU Seeks Congressional Action to Prevent FEHB Premium Hike
The National Treasury Employees Union (NTEU) issued a statement noting that this 6.4 percent increase in premiums further underscores the need for Congress to act on cost-saving prescription drug contracting and benefit management reforms for FEHB.
OPM attributed the higher rate of increase in large part to increased prescription drug utilization.
“NTEU views prescription drug reforms as an essential way to better control drug spending in FEHBP, which would reduce costs for federal employees and retirees,” NTEU National President Tony Reardon said. “FEHBP enrollees are paying more than they should.”
Specifically, what the NTEU is asking for is support for Rep. Stephen Lynch’s (D-Mass.) legislation—H.R. 2175. The bill would provide OPM with enhanced oversight and contracting authority to ensure that FEHB participants are receiving the best possible drug prices.
The bill also requires that Pharmacy Benefit Managers (PBMs) operate as middlemen to negotiate prescription drug prices with drug companies and pharmacies on behalf of individual FEHB plans, and return any rebates, incentives, and other price discounts obtained from drug manufacturers to FEHB.
An Economically Changing World
The world is changing. As Federal and Postal employees we face more economic challenges today than the majority of the current workforce has ever witnessed. The hardships of the Great Depression, we either read about in textbooks or heard stories from parents and grandparents, but hardly a reality for baby boomers and beyond.
Over the past several years, the reality of our finances and the turbulence of a global economy is a constant conversation at the average Federal and Postal employee’s families dinner tables. Yet, our responsibility, regardless if we are CSRS or FERS, to do what is necessary to face a retirement future with readiness, still remains. I remember parents saying, “Save for a rainy day.” The economic uncertainty of our times requires that we save for a tsunami. The cost of maintaining our standard of living is much higher today than it was for our parents.
In addition, economically, conditions have created differing and varying levels of responsibility for Federal and Postal retirees. Retirement incomes are increasingly being shared to support other family members, including adult children who are either unemployed or under-employed. Providing support to family members is what we do as Americans until they can get on their feet.
Because our plates are fuller than ever before in recent times, planning for a long life after retirement must be approached with care and a deliberate commitment to live well below our means. We can no longer economically live at our means and certainly not above our means, but below them in order to have a cushion of economic longevity. Remember, economically, the goal is to have your resources outlast you.
The technical aspects of the federal and postal employees’ retirement system from FEHB, Medicare, to FEGLI and your TSP are difficult to understand and much more difficult to master. There are such a vast number of technical pieces of the federal retirement system it seems to justify the use and consultation of both your HR office or a qualified retirement benefit expert.
Use PSRetirement.com’s easy access for more information on your TSP Account and Login information.
P. S. Always Remember to Share What You Know.
Suspending My FEHB
What Happens If I drop of suspend my FEHB – Can I Ever Get it Back?
That’s a good question and one that is extremely valuable in planning for a comfortable and secure retirement. When you get the information needed to make informed decisions you can ensure that you will retire well.
If you drop or suspend your FEHB under certain circumstances you can re-enroll? It is always a good idea to talk to your human resources office before you consider taking action to drop or suspend your FEHB.
It should be noted that you cannot enroll in FEHB after you retire if you were not enrolled in the plan at retirement and met the FEHB qualifying criteria. A situation when suspending or dropping your FEHB may be appropriate, is when an employee marries or is married to another federal employee with FEHB coverage. Both spouses having FEHB does not constitute double coverage, as you cannot be covered under two FEHB plans simultaneously. However, each person can decide to carry self only or a family plan can be considered. Whatever the choice, it is always a good idea to weigh the financial burden of the choice made and talking with your chosen financial planner may help with your analysis.
Regardless of your CSRS or FERS eligibility, if you are considering dropping or suspending your FEHB coverage you need to give a very good amount of time and energy to understanding what the impacts may be to you and your family. Although the cost of the FEHB premium changes annually, unlike FEGLI which gets terribly expensive as a person ages, FEHB remains cost competitive in the market with the average employee paying only about 25% of the cost. Having information and discussing options with a professional who is an expert in your benefits and your human resources office will help you make the best decision to retire well.
P. S. Always Remember to Share What You Know.
FEHB and Medicare
What do FEHB and Medicare have to do with the other?
Americans are living longer and that means going forward we will have an unprecedented number of seniors making up the American population. Unfortunately, as the population ages, we will have a greater need for medical treatment and services – more visits to the doctor and more hospitalizations associated with aging.
The significant aging population also speaks to a decrease in income and earning capacity among that group due to retirement. As income declines, a balance will only be achieved by realizing a decline in expenses.
One of the greatest increases we face as an aging population is medical costs. One way of keeping your money in your pocket is by making sure your health care needs are covered. It is undeniable that health care will become one of the largest outlays of financial resources as we age.
FEHB will not pay for all our health care needs and neither will Medicare, but having them both should place us in a safe spot. For instance, one of the luxuries of retiring is traveling to other countries for many retirees. If you become ill and need emergency treatment while on travel, your FEHB will cover you, but not Medicare. It is very important to find out exactly what services are covered under your plan, be it FEHB, Medicare or a Medicare Advantage Plan.
Being a federal employee puts you in a very good position as you evaluate your future health care needs. Having the benefit of your FEHB and Medicare just might be one of the safest ways to protect your physical and financial health so that you can retire well.
P. S. Always Remember to Share What You Know.
FEHB – The Decision is Yours
What You Decide to do With Your FEHB at Retirement is Your Decision…..
The best gift one human being can give to another is the gift of knowledge and information. As you get closer and closer to retirement, you may come across a myriad of discussions about whether you should keep your FEHB when you become eligible for Medicare or whether you should suspend your FEHB or wave goodbye to it. Give your friends, your colleagues, and even give yourself, the knowledge you need to make the best FEHB and Medicare decisions.
I am sure every report you read will have some pretty good sounding reasons as to what you should do with FEHB at retirement. Their arguments might be so convincing that you find it hard to resist their opinion about the very important business of your life and your Medicare or FEHB coverage.
Don’t shy away from reading and listening because you can always pick up some good tips, but remember to educate yourself on the facts – a very key ingredient to ensuring that you retire well. Get a good handle on what your health care goals are for retirement and beyond and whether FEHB fits within those plans. Speak to a professional who is an expert in your benefits and determine how you want to reach those goals and what is the best fit for what you and your family need. As you analyze the business of your life – it becomes urgently important to distinguish between what is required for you to survive and what is simply a matter of what is pleasing.
There is a vast difference between need and want the decision will boil down to what you can afford. That difference will become more and more vivid as you paint a picture, as only you can, of what you want that picture to represent for you and retiring well and your health should be something that you don’t skimp on. Gather, analyze, evaluate all the information on FEHB that you can, along with all of the resources available to you so that you can make an informed decision that has the flexibility to land you in the place that fits your retirement needs to retire well..
P. S. Always Remember to Share What You Know.
FEHB who is a dependent
Who is considered a family member eligible as a dependent for coverage under my FEHB benefits?
That is a million dollar question that requires a million dollar answer. The definition of family member is rather broad for federal employees eligible to participate in the Federal Employees Health Benefits program. Below are a list of who is considered a family member for eligibility coverage provisions as a dependent under individual and family enrollment:
• Children Under Age 26
• Legally Adopted Childreny
• Spouse
• Spouse (Valid Common Law Marriage)
• Recognized natural children( Those born out of wedlock)
• Stepchildren
• Foster Children (Living in a Parent-Child Relationship)
• Children Age 26 and over ((Mental or physical disability before age 26)
and incapable of self-support.
The above list provides the information needed for you to determine who qualifies as a family member dependent and what benefits are available to them as a result of your federal employment. If you are unclear about the determination of a relationship between you and a dependent, your human resources office can work with you to establish who meets the relationship criteria to qualify for coverage as a family member.
P. S. Always Remember to Share What You Know.
Medicare eligibility and participation is important when you are considering your FEHB
Postal FEHB – www.LiteBlue.usps.gov
FEHB and Surviving Spouses
If I pass away, will my spouse be able to retain FEHB coverage?
Surviving spouses are able to keep FEHB coverage and pay the same competitive costs as active employees as long as eligibility criteria is met. Meeting the 5 year requirement can be achieved in a number of ways: the time you are covered as a family member under another’s enrollment (in this case, under the federal spouses enrollment) and the time you are covered under Tricare for Uniformed Services personnel covered under FEHB at the time of retirement.
Your spouse, including former spouses under certain conditions, may be eligible to participate in a benefits plan under FEHB. It is good planning to understand eligibility requirements to continue FEHB coverage for you, your spouse or former spouse, and available benefits to your survivors in the event of death.
Take the opportunity to discuss your package of benefits and how they work with your family members so together you can organize questions you need an answer to and present them to your human resources office. Planning now eliminates the stress of not knowing in the future. Retiring well means gettting your questions answered so both you and your family members will be well informed and protected.
Additional Information on FEHB
Strong Consideration Should be Given to Holding On to your FEHB in retirement.
Many Federal and Postal retirees will have a critical decision to make about their Health Benefits moving into retirement and whether or not they should transport their FEHB coverage. If your spouse has a health care plan outside of government and you have FEHB, in conjunction with you potential Medicare elections, you should careful analysis should be exercised to determine what fits best into your plan to retire well.
There will never be a plan or plans that pay 200% coverage, but having your FEHB and Medicare upon reaching the qualifying age of 65 could guarantee your health care security. Medicare will only pay about 80% of your health care expenses and FEHB will cover the rest. However, once you become qualified for Medicare, and you are retired, Medicare will become the primary coverage with FEHB being secondary in most instances.
If you are still working when you reach age 65 and qualify for Medicare, your FEHB will remain the primary. It should also be noted that there are many services that standard Medicare does not cover and some, even, that FEHB does not cover. A careful examination of what services are covered under both FEHB and Medicare is critical to determine the best health benefit fit for you and your family.
When you become eligible for Medicare, it is very wise to look at the important benefits your FEHB offers, particularly when compared to Medicare’s prescription drug coverage. The drug prescription coverage offered via FEHB is second to none. Therefore, even when you become eligible for Medicare, don’t forget to consider holding on to your FEHB so that retiring well will be a part of your plan to live well in retirement.
P. S. Always Remember to Share What You Know.
Special Provisions and Open Season
Special Provisions & Open Season for Federal and Postal Retirees
FERS and CSRS eligible employees have the opportunity to enroll or make special provisions to their FEHB, Dental and Vision coverage (FEDVIP) along with making the Flexible Spending Account elections (FSAFEDS) that best their families. However, during open season retirees may change their enrollment via phone or in writing.
Although changes to your health plan are made during Open Season, whether you are FERS or CSRS, certain qualifying events such as change in family status, change in employment or loss of your FEHB coverage, allow changes to be made at the time the event happens.
Open season runs from the Monday of the second full work week in November through the Monday of the second full work week in December. Employees have a menu of plans to choose from that are also available to retirees. Retirees should always take the opportunity to explore what benefit options are available to them in retirement.
If you’re interested in more information on your Federal and Postal Retirement please read this.
P.S. Always Remember to Share What You Know.
Transporting FEHB
Transporting FEHB
What Could Prevent You From Carrying your FEHB coverage into Retirement?
There might be some other conditions that prevent you from carrying your FEHB into retirement. If something happens that prevents you from carrying your FEHB into retirement, your coverage will still be active for 31 days at no cost to you. When that time expires, you either must drop the FEHB coverage, continue for a period of time or convert to an individual policy.
There is also a Temporary Continuation of Coverage (TCC), known as COBRA, which allows you to carry your coverage for 18 months. You must, however, pay your cost, the agency cost and the 2% administrative fee, totaling 102%.
There are so many changes that have taken place around Federal Employee Health Benefits (FEHB) that individuals who find there are circumstances that might prevent them from transporting FEHB into retirement, now have a number of choices to secure health coverage.
Military or Uniformed Services retirees may elect to cancel their FEHB during open season and opt for ChampVA Tricare or Tricare-For-Life These plans cover Medicare’s coinsurance, deductible and prescription drugs very much like the FEHB plan.
Be sure to check to see what your plan covers and if it allows transporting FEHB, opting always to choose the plan that offers the best benefit to you and your family.
P. S. Always Remember to Share What You Know.
You can always learn more about how FEHB and Medicare work together
Military – Tricare and FEHB
Tricare and FEHB
Federal and Postal employees must meet the 5 year enrollment requirement in order to take my FEHB into retirement. However, if you don’t have the required time, you may use your Military Tricare time to qualify for FEHB.
Military personnel enrolled in Tricare (regulated by the Department of Defense (DOD) is a health care program that serves Uniformed Service members, retirees and their families around the world) are able to count that Tricare time towards the required five year provision for FEHB as long as they are enrolled in an FEHB covered health plan at retirement.
As a federal employee you do not have to worry about filling out an application to keep your health benefits when your retire. When your retirement becomes effective, your coverage will automatically transfer to the Office of Personnel Management (OPM) where they will process your retirement papers and take care of you as a retiree. Your agency will no longer be responsible for you.
If, however, you decide that you don’t want to take your FEHB into retirement, you will need to include in your retirement package a fully completed SF 2809 (Benefits Registration Form) cancelling your coverage.
FEHB access for Postal employees HERE
P. S. Always Remember to Share What You Know.
About FEHB (Transporting your FEHB)
Can I Take My FEHB into Retirement?
Federal employees represent the largest workforce in the world. They also have some of the best benefits on the market with very competitive rates. The federal workforce is so large making it easy for the federal government, acting as representative agent, to negotiate rates that work in the best interest of the federal workforce and their families. Buying in large quantities can drive down costs making the rate for premiums paid by employees for health insurance some of the most competitive you will find.
The Federal Employees Health Benefit program (FEHB) is open to all employees who wish to participate. Employees can choose from a number of different health plans that fit their personal and family needs. As federal employees you get to take your health insurance into retirement if you have met the requirement of being enrolled in FEHB five years or from the earliest opportunity to enroll prior to retirement.
Although, as a retiree you get to enjoy the same low premium benefits in retirement, instead of paying those premiums bi-weekly, they will be deducted once per month from your Annuity. You also have the same opportunity to participate in open season just as you did while working.
It does not matter how often you change plans, as long as you meet the five year or first opportunity to enroll requirement, you can transport your FEHB into retirement.
Social Security is also a key component for eligible Federal and Postal employees
Postal employees can access their FEHB accounts HERE
How do your Medicare elections fit with your FEHB elections?
P.S. Always Remember to Share What You Know.
Medicare Part D
Medicare Part D
Medicare Part D is an option that you may want to consider as you become eligible. Medicare Part D eligibility is based on the standard eligiblity factors associated with Medicare but the Medicare Part D coverage has more expansive benefits for those recipients who have larger prescription drug costs.
Medicare Part D was;
- Implemented in 2006 as a voluntary prescription benefit.
- Premiums averaged approximately $32 per month with a $250 deductible for Medicare Part D plans.
- Is a cost-sharing benefit, with Medicare paying 75 to 95 percent based on drug costs.
- Individuals with lower incomes may be exempt from the cost-sharing and instead pay small co-pays per prescription.
- Managed by private health insurance companies for a monthly premium.
- Open to everyone on Medicare without income consideration.
- Generally includes low co-payments or co-insurance for brand and generic prescription drugs.
- Can be chosen as a stand-alone drug plan or it may be a part of your Medicare Advantage Plan.
- There are many plans available, comparison shopping is a wise choice to find the proper fit for your budget.
P. S. Always Remember to Share What You Know.
Because of the unique health benefits that Federal and Postal employees receive in retirement you may wish to consider some additional reading on your FEHB coverage.
If you are a Postal employee click HERE for your LiteBlue account
