Federal Employee Health Benefits: Understanding Open Season

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Federal Employees Health Benefits (FEHB) only has one open enrollment season a year. This is the time you elect the benefits and plans that will affect you and your finances for 12 months. It's vital that you pay attention to the open season dates.

Knowing these dates and who is eligible for coverage gives you the power and opportunity to make sound decisions.

FEHB Open Season

The Office of Personnel Management (OPM) has announced that the 2021 open season for FEHB is from Monday, Nov. 8, 2021, to Monday, Dec. 13, 2021. This enrollment is for the 2022 plan year.

You will have the opportunity at this time to enroll yourself and qualified family members. Eligible family members include:

• Only yourself
• Yourself plus one
• Yourself plus immediate family

There are a few noted exceptions to enrolling outside the open season. For instance, if you have a baby or adopt a child, you will be able to add them. You can add a spouse if you are married outside the open season. These and other exceptions are called Qualifying Life Events (QLE). Check with your agency's HR if you have questions concerning a QLE.

A new hire can also enroll in FEHB if done so within 60 days of initial employment.

Effective Coverage Date for FEHB

Any changes that you make in the ​FEHB 2021 open season​ do not take effect until January 2022. Changes made kick in on the first day of the first full pay period.

If you are a new federal employee, benefits will be effective the first day of the first pay period. You must be in pay status and the agency you work for must receive your enrollment request to trigger the coverage.

Eligibility Requirements of FEHB

Unless holding a position that's excluded by regulation or federal law, all federal employees are eligible to elect FEHB. Those considered eligible employees are:

• Part-time
• Full-time
• Temporary appointments

Other individuals are also eligible for FEHB.

Definition of Family Members

A qualified federal employee's legal spouse, children and dependents are eligible for FEHB. Foster children are also eligible. To be considered an eligible child, they must be:

• Legally adopted child
• Recognized natural child (can be born out of wedlock)
• Stepchildren
• Children of same-sex parents

Children still in school under the age of 26 are also eligible to receive FEHB.

If you are a new federal employee, benefits will be effective the first day of the first pay period.

Federal Retirees Can Choose FEHB

FEHB is also available to federal retirees. They have the choice between Medicare or FEHB when they reach 65. The decision between Medicare and FEHB can only be made once.

Tribal Employers Offer FEHB

Tribal employers can also offer FEHB to their employees. The OPM designates a tribal employer as:

• An Indian tribe
• An urban Indian organization
• A tribal organization

The one caveat is the employer must be consistent and offer FEHB to all employees or none at all.

Non-Federal Health Benefits Enrollment Period

What if you're not a federal employee? When enrolling in health benefits, you still likely have a yearly open enrollment period (OEP). And you must enroll for benefits within that specified enrollment time, or you will not have health benefits the following year.

Some states have a different OEP, but the majority fall on the same dates. For example, the 2021 OEP for private insurance is Monday, ​Nov. 1, 2021, to Saturday, Jan. 15, 2021.​ But if you want your benefits to become effective on ​Jan. 1, 2022, you must be enrolled by Dec. 15, 2021​.

The Department of Health and Human Resources, through the Marketplace, manages the Affordable Care Act. Since Affordable Care insurance is in conjunction with private insurance, it has the same OEP dates. The exception to enrolling during the OEP is if you have a qualifying event.

Health Insurance Benefits

High medical bills can break you financially. It makes good sense to enroll in a health insurance plan. But the opportunity for that only comes once a year. Regardless of if you're a federal employee or work in the private sector, you need to know when the open enrollment period is. Check with your HR and learn not only those dates, but also your eligibility status.