Allowable FEHB Changes You Can Make Outside of Open Season

Limited enrollment adjustments are allowed at other times when a person has a qualifying life event. Although the majority of changes to the Federal Employees Health Benefits (FEHB) program’s enrollment occur during the program’s yearly open season. Registration or an enrollment change is possible due to the following important events: The family situation changes, like getting married, having a child or adopting one, taking in a foster child, getting a divorce, or the death of a spouse or dependent.

A change in employment status occurs in the following way:

  • When an employee returns to work after being absent from their position for more than three days
  • When an employee resumes their regular pay status after having their coverage canceled while they were on leave without pay status
  • When an employee was on break without pay status for more than 365 days
  • When an employee’s pay increases to the point where premiums are withheld
  • When a worker returns to civilian life after serving in the armed forces
  • When an employee changes from a temporary appointment to an appointment that entails continuing employment.

Due to the covered enrollment being terminated, canceled, or converted to self-only status under another federally supported health benefits program, you or a family member lose FEHB or other coverage under another FEHB enrollment. It could be Medicaid or a similar state-sponsored program for the poor. Furthermore, it could be because your membership in the employee organization supporting the FEHB plan terminates or you enrolled in a non-federal health plan.

When one of these occurrences occurs, you may be able to enroll and modify your enrollment. Modifications include switching from self-only to self-plus-one to self-and-family, enrolling in another FEHB plan or option, enrolling in self-only, or canceling your registration. On the other hand, a change to self-only may be made only if the occurrence causes the enrollee to be the final eligible family member under the FEHB enrollment. A cancellation may also be granted if the enrollee can demonstrate that they fulfill the requirement. That is, as a result of the qualifying life event, they and all eligible family members now have other health care coverage.

The SF-2809 form, available at www.opm.gov/forms, includes a table of the allowable adjustments for each case.

Enrolment Cancellation  You may cancel your enrollment at any time. However, you and any family members covered by your enrollment cannot switch to a nongroup plan or enroll in temporary continuation of coverage if you do so. In general, voluntary enrollment cancellation prevents re-registration in the FEHB program. Request that OPM terminate your enrollment. OPM will provide a detailed explanation of how the cancellation may affect your rights.

Suspending Enrollment  You may choose to put your enrollment on hold. Registrations are typically halted because the enrollee wishes to join a Medicare-managed care plan or be covered as a family member. The coverage could be under another person and family FEHB program enrollment.

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Bio:
Mark, a lifelong Tulsan graduated from Westminster College, Fulton, Missouri with a Bachelor of Arts in Accounting. Mark served in the United States Army as a Captain in the 486th Civil Affairs BN. Broken Arrow, Oklahoma and retired in 1996. Mark is married to his high school sweetheart Jenny and has four beautiful children. Mark’s passion for his work, which includes over 20 years in the Financial Industry started as an Oklahoma State Bank Examiner. Mark examined banks throughout Oklahoma gaining a vast knowledge and experience on bank investments, small business and family investments. Mark’s experiences include being formally trained by UBS Wealth Management, a global investment firm where he served as a Financial Consultant specializing in Wealth Management for individuals & families. Mark is a licensed Series 24 and 28 General Securities Principal and an Introducing Broker Dealer Financial Operations Principal. Additionally, Mark is a Series 7 and 66 stockbroker and Investment Advisor focusing on market driven investments for individuals, businesses and their families.

Mark specializes in providing financial knowledge, ideas, and solutions for federal employees, individuals, families and businesses. We serve as your advocate, and assist you in the design and implementation of financial strategies while providing the ideas to maximize your security and wealth. Our goal is to give you maximum control of your financial future. We provide the expertise to help you with personal issues such as: practical tax Ideas, risk management, investment solutions, and estate preservation.

Additionally, we’ve counseled hundreds of employees on their transitions from careers in federal government, and private industry to their next life stage, whether that is retirement or a second career. We specialize in devising strategies that roll your TSP, 401(k), pension plan, to a suitable IRA to meet your objectives.

Disclosure:
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