By Reg Jones
Q. I would appreciate a clarification of eligibility for Federal Employees Health Benefits under postponed retirement. I selected a postponed retirement and have recently begun receiving benefits. I may, at some point, want to sign up for FEHB as a FERS retiree. In my situation, in my last government position (as an appointee), I had continuous coverage under my wife’s FEHB as a part of a family plan. Since I left the government position, I have continued to be covered under my wife’s FEHB family plan. As I understand it, postponed retirees who were enrolled at the time they left government can re-enroll once they start benefits. In my case: Am I eligible for benefits even though I was not enrolled myself but was covered under my wife’s plan? Given that I am still covered under my wife’s plan, can I, if it makes sense, enroll myself in an FEHB plan?
A. Yes, but only if your wife switches to self-only at the same time during an open season or if she passes on before you while you are still covered by her self and family enrollment.
Q. I will be a CSRS retiree soon enrolled on my younger wife’s FEHB family plan. Does it make sense for me to enroll in Medicare part B being on her plan? Will her premiums be affected if I do?
A. Her premiums won’t be affected one way or the other. Whether you should enroll in Medicare Part B is up to you to decide based on your current and projected health needs. Just remember this: If you don’t enroll in Part B and later decide that you want to do that, the cost of those premiums will be 10 percent higher for each full 12-month period you could have enrolled in Part B and didn’t.
March 13th, 2013 | Uncategorized
Q. Since the employee pays the full premium for FEHBP vision or dental benefits, is there any reason to enroll in the program if I have coverage under my spouse’s employer-covered program? For example, are you required to enroll in vision or dental five years before retiring to maintain the premium rate in retirement? Can I join the vision or dental program after retirement if I have post-retirement health care benefits? Also, will the premium rate remain constant after retirement?
A. If you retire on an immediate annuity, you can enroll at any time. You don’t have to be covered by the Federal Employees Health Benefits program to do so. If you are asking if the premiums for retirees differ from those for employees, the answer is no.
March 13th, 2013 | Uncategorized
Q. I have a couple of questions about insurance plan comparisons for single and family options in retirement.
For health insurance in retirement, when or should we change to two self-only plans or stay with the self and family plan in retirement? Are there any major considerations in selecting two single plans or the family plan? My wife and I, no other dependents, are CSRS retirees. We are covered by my self and family BCBS Standard 105 plan.
I have been reading the plan brochure but cannot create a logical comparison of when, or if, to go with two single plans versus the family plan option.
I know each single plan would have its own deductible per year for that persons plan.
Do you know of any way to compare and determine if the choice of two single plans would be better than staying with the family option? The annual difference in premiums is $710.40 for two singles versus the family plan under the BCBS Standard 105 Plan.
For several years after retirement, I worked at a company that offered three BCBS plan options: “Single” “1 Plus” and “Family” plans. The “1 Plus” premium fell between the “Single” and the “Family” premiums, but the government has not negotiated that option yet for retirees benefit.
A. Your question has no single answer. As the saying goes, “It all depends.” You’ve done a good job of identifying the differences between self and family coverage and two single enrollments.
Now you and your spouse have to make the decision.
As for OPM not having negotiated an option for retiree benefits, it can’t. Only a change in the law would allow it to do that, and no one on the Hill or in any administration has shown an interest in doing that.
Whether making such a change would reduce or increase the cost of retiree coverage is unclear. What is clear is that fragmenting the risk pool is rarely a good idea.
March 12th, 2013 | Uncategorized
Q. I married a woman whose ex-husband who is a retired federal employee.
He had their son covered under his health plan. I am a retired federal employee also, and when I covered their son (my stepson) under my plan, I got a notice that a dependent can’t be covered by two federal health plans.
If this is true, what law/policy covers this prohibition?
A. Yes, it is true. See 5 U.S. Code Section 890.302(a)(1), which states, in part: “No employee, former employee, annuitant, child or former spouse may enroll or be covered as a family member if he or she is covered under another person’s self and family enrollment in the FEHB program.”
March 12th, 2013 | Uncategorized
Q. I have had my wife and family on my Retirement Health Insurance plan the last three years. Recently, my wife has had a full-time job with benefits. If I change from family to self and she quits her full-time job, can my family go back to the retirement health plan?
A. Yes, under Code 2G of OPM’s Table of Permissible Changes in FEHB Enrollment for Annuitants and Compensationers.
March 8th, 2013 | Uncategorized
Q. I have been a CSRS retiree for six years. I am getting remarried shortly. I want to ensure my Federal Employees Health Benefits continue to be available to my spouse after my death. I understand I have two years from date of marriage to elect a survivor annuity. May I select either a full survivor benefit or a reduced survivor benefit and still retain the FEHB from my surviving spouse? If reduced is an option, how much can it be reduced and still retain the FEHB?
A. Because you are a CSRS retiree, with your spouse’s written and notarized consent, you can elect any amount from $1 a year on up. If the amount of your survivor spouse’s annuity isn’t sufficient to pay the premiums, he or she can pay them directly to the Office of Personnel Management.
March 6th, 2013 | Uncategorized
Q. I’m 53 with 27 years and 10 months. I could get six months of military service for Army Reserve full-time training credit. I’m in a term position. If I’m given a reduction in force, what are my options? Can I defer my retirement until my minimum retirement age of 56? If so, would I lose my health and insurance benefits? If I’m RIF’ed and do not defer, does that means I lost health benefits?
A. If you receive a RIF notice, you have two choices. You can either sit tight and see if you are going to be separated, or you can take early retirement. If you are going to be involuntarily separated, you can still retire. Whether your retirement was voluntary or involuntary, the age penalty would be waived. Therefore, there wouldn’t be any point in retiring and postponing the receipt of your annuity to a later date. As for your Federal Employees Health Benefits coverage, as long as you were enrolled in the program before the RIF was announced, you could carry it into retirement.
Q. I am 59 years old and covered under Federal Employees Health Benefits as the spouse of a CSRS annuitant. Due to a covered disability, I have been receiving Social Security Disability Benefits for the past 18 months and was just advised that I will be eligible for Medicare Parts A and B in June. If I decline Part B and decide to take it later, will I be subject to the Medicare Premium penalty?
March 6th, 2013 | Uncategorized
Q. I have been on my wife’s health plan for the past 14 years. Her job is through the county, not the federal government. The plan is one of the ones offered by FEHBP.
To have my own health plan after retirement, do I need to enroll in the same plan under FEHBP for five years? Or is my membership in my wife’s plan sufficient for me to get my own health coverage after retirement?
A. No, membership in your wife’s plan is not sufficient. You would have to be enrolled in an FEHB plan for the five consecutive years before you retire to carry that coverage into retirement.
Q. I am retired with Blue Cross/Blue Shield and will be signing up for Medicare Part A soon to avoid penalties for Part B and Part D. Does my BC/BS meet the “creditable plan” requirement to avoid penalties? I have been told “yes and no” on the phone by Medicare. If I sign up for an HMO with a lower cost, will I meet “creditable plan” standards if I drop Federal Employees Health Benefits? Can I re-sign up for BC/BS later if I don’t like the coverage?
A. The “creditable plan” feature you’re referring to only applies to those who are currently employed or are covered by a family member who is employed. It doesn’t apply to retirees, regardless of the plan they are in.
If you drop your FEHB coverage, you can’t re-enroll in it unless you return to work for the government in a position that allows you to be covered by the FEHB program.
Q. I am a FERS employee. I will be drawing my reservist retirement June 27 at 60 years old. Can I drop my Federal Employees Health Benefits for Tricare? Can you give me details about this how long will it take, if this has to be done at open season and the grace period on the policy?
A. You can get an FEHB suspension form by calling the Office of Personnel Management’s Retirement Information Office at 1-888-767-6738. They may be able to tell you how long it takes.
March 4th, 2013 | Uncategorized
Q. I will retire early next year. For purposes of state Medicaid, I need to know, as a retired CSRS employee, whether or not I would receive a monthly annuity receipt in the mail even though I chose direct deposit. If so, would this receipt show the paid monthly health care premium (FEHB) and the amount taken out?
A. No, you won’t receive a monthly annuity receipt in the mail regardless of whether you use direct deposit or have the check mailed to your home. To find out what your monthly premiums are, you’ll have to go to www.opm.gov/healthcare-insurance/healthcare, click on Plan information, then click on Premiums.
March 1st, 2013 | Uncategorized
Q. I am a 51-year-old FERS employee whose minimum retirement age is 56. I will have over 30 years of service when I reach the minimum retirement age. A couple of years ago, I went under my wife’s health plan. We incorrectly assumed that she needed five years to become vested and that we could just stay under her plan when we retired (as with FERS). However, she is a Non-Appropriated Funds Defense Department employee and would need 15 years.
I am picking up my Federal Employees Health Benefits insurance again so that I will have five years under the plan when I reach the MRA. If I were to retire at 56, my understanding is that I can (a) begin receiving a reduced annuity immediately or (b) defer receiving my annuity until I reach 62. I was told that if I begin immediately receiving a reduced annuity, I can keep my FEHB and still benefit from the government contribution.
What happens if I defer the annuity until I am 62? Will I need to pay the whole premium, plus 2 percent, for the years between 56 and 62? My wife will likely work until I am 62, so could I go under her health insurance between 56 and 62 and then pick up my FEHB again when I begin collecting my annuity? Under either of those scenarios, could I change my coverage from self-only to self and family to add my wife to my coverage when I am 62?
A. I think you are suffering from a misunderstanding, which I hope to clear up. If you will have 30 years of service when you reach your MRA, you could retire on an immediate unreduced annuity. And you would also be entitled to the special retirement supplement, which approximates the Social Security benefit you earned while a FERS employee. If you had five years of continuous enrollment in the FEHB, you could carry that coverage into retirement and, unless you are a Postal Service employee, the premiums you’d pay as a retiree would be the same as those you have been paying as an employee.
Q. On Jan. 18, there was question about which is primary between these two programs, and the answer ended with “whether you keep both [Federal Employees Health Benefits] and Tricare is something you’ll have to decide.” How do you decide? Where can I find a clear, side-by-side comparison of my FEHB (BC/BS standard in my case) and Tricare for Life — one that is not comparing apples to oranges? I have been told I don’t really need FEHB because TFL is “very comprehensive,” but how can I find out exactly what, if anything, FEHB would cover that TFL wouldn’t. P.S. I’m in excellent health and am also covered by Medicare Parts A and B.
A. Unfortunately, no one has made such a comparison, nor is it likely that anyone will. While Tricare and Medicare A and B are monolithic, with their benefits spelled out in detail, there are around 200 plans in the FEHB program. And what they cover varies, not only in the services covered but in the level of reimbursement, co-payments and deductibles. If you want to make such a comparison, you can do so by carefully reviewing what your own FEHB plan provides with what Tricare does.
In closing, you mentioned that others have told you that you don’t need the FEHB coverage because Tricare is very comprehensive. While I don’t know if that’s true, I’ve been told the same by other former members of the military who made the decision to suspend their FEHB coverage and were happy with the decision. Whether you’d be happy if you did the same is something I can’t predict.
Q. I am enrolled in Medicare Part A and B. I also have Tricare for Life and Federal Employees Health Benefits (Blue Cross/Blue Shield). My doctor has opted out of Medicare and wants $5,000 for a hip replacement. Will FEHB pay his fee?
A. The only way to find out how much of your doctor’s fee your FEHB plan will pay is to ask them.
Q. You have stated that to calculate the high-3, OPM will consider only salaries from which the government has deducted retirement contributions.
For which items will they not deduct the contributions? Social Security taxes? Medicare taxes? Medical, dental and vision insurance payments? Thrift plan payments?
I think it is fraud when everywhere it is stated “average of three highest salaries” and the actual amount is way low. Nobody told me that’s how it is calculated.
I was a title 38 physician and have retired under FERS, but I also have CSRS component.
A. First, let’s clear the deck. There isn’t any fraud. A high-3 is based on an employee’s highest three consecutive years of average basic pay, not salary. Second, basic pay is the amount you receive before any deductions are taken out for Social Security, Medicare, medical, dental and vision insurance, the TSP, etc.
February 25th, 2013 | Uncategorized
Q. I am anticipating retiring Jan. 3 after almost 40 years of continuous service for the Veterans Affairs Department. I recall, many years ago, retirees electing withdrawal of their cumulative contributions to the retirement fund and receiving a minimum penalty in their annuity. I am unable to find anything online relating to this option and my human resources people say they’ve never heard of it. When did we lose this option?
On that subject, my earnings and leave do not reflect the total amount that I have contributed to the retirement fund, but only the amount contributed since conversion to the Defense Finance and Accounting Services. I’m told “they never figured out a way to convert the figures from the old system.” Other than searching through my attic for old E&L records, and adding the two figures, where can I find the amount of my total contribution?
Also, I’ve read where under Obamacare, congressmen and their staffs will no longer be under Federal Employees Health Benefits after January 2014 and will have to go under a state program. Is there any plan to move federal employees and retirees also?
A. You are referring to the alternative form of annuity. When it became law in 1986, it allowed a retiree to receive a tax-free payment of his contributions to the retirement system and accept a reduced annuity.
However, Public Law 103-66 eliminated this lump-sum option for everyone other than those employees who have a life expectancy of less than two years and who are not retiring on disability.
When you retire, the Office of Personnel Management will provide you with the exact amount of money you have contributed to the retirement fund. I’m not aware of any way you could get that figure now.
Finally, there is no plan to move federal employees to a state program or anywhere else, for that matter.
Q. When I turn 65, I can enroll in Medicare Parts A and B. The other parts do not interest me. At this time, I am enrolled in a Federal Employees Health Benefits plan. I am a veteran who is 60 percent disabled, and the Veterans Affairs Department covers my medical needs at 100 percent plus meds if I use its facility. At age 65, I would like to suspend my FEHB plan and use Medicare Parts A and B plus my VA. Can I suspend my FEHB under this situation?
A. No, you can’t.
February 22nd, 2013 | Uncategorized
Q. I enrolled in Federal Employees Health Benefits on April 26, 1987. Resigned March 21, 1992. Temporary appointment Aug. 26, 2001, to Oct. 19, 2002. Re-enrolled Nov. 3, 2002. Resigned Sept. 27, 2008. Temporary appointment, not eligible to enroll Dec. 7, 2008, to July 3, 2010. Re-enrolled July 18, 2010, until present. Had COBRA between enrollments. My human resources department says I should be able to continue health benefits into retirement if I work through June 20. I am planning on retiring in December. I know the Office of Personnel Management has the final say but wanted to know if this response sounds correct.
A. To be eligible to carry your FEHB coverage into retirement, you need to have five consecutive years of coverage. Those periods don’t have to be continuous. They can be broken by times when you weren’t a federal employee or when you weren’t eligible to enroll in the program. What’s important is that you be covered each time when you left and re-enrolled immediately each time that you were eligible to enroll. You need to recheck your employment records to be sure that you met the requirements and that the total time you were covered adds up to at least five years.