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As a new/newly eligible or rehired employee, you have 60 days from the effective date of your appointment, rehire, or reinstatement in which to complete an election either to enroll in a plan or not to enroll. If you do not make an election, you are considered to have declined coverage.
If you are transferring, you are not normally eligible to change your benefits elections. However, if you moved from a post of duty overseas to one in the United States, or reverse, or if your transfer moved you out of the servicing area of your Health Maintenance Organization (HMO) plan, you may elect a new health plan within 60 days of your transfer effective date.
The Office of Personnel Management (OPM) provides an annual Open Season for the following Federal benefit programs:
- Federal Employees Health Benefits (FEHB) Program
- Federal Employees Dental and Vision Program (FEDVIP), and
- Federal Flexible Spending Account Program (FSA)
Generally the OPM will announce the open season period beginning the Monday of the second full workweek in November through the Monday of the second full workweek in December.
During the open season, eligible employees may make any of the following four benefit choices:
- Enroll in or change an existing enrollment in a health insurance plan under the Federal Employees Health Benefits (FEHB) Program.
- Sign up for a flexible spending account for health or dependent care under the Federal Flexible Spending Account Program (FSA) at https://www.fsafeds.com/fsafeds/index.asp or by contacting a FSAFEDS Benefits Counselor. Enrollments in FSAFEDS cannot be cancelled or changed after their effective date, unless the employee experiences a qualified status change (QSC). FSA enrollments also do not carry over from year to year; employees must make a positive enrollment each calendar year.
- Enroll in or change an existing enrollment in a dental plan under the Federal Employees Dental and Vision Insurance Program (FEDVIP) at https://www.benefeds.com/.
- Enroll in or change an existing enrollment in a vision plan under the Federal Employees Dental and Vision Insurance Program (FEDVIP) at https://www.benefeds.com/.
Open Season elections generally will take effect the following January.
You may also be eligible to make a change to your enrollment, eligible to enroll, cancel your enrollment, or change from one plan or option in conjunction with a qualifying life event.
A qualifying life event (QLE) is a term defined by OPM to describe events, such as marriage, divorce, or birth of a child to change their participation election outside of an open season.
The rules for changing FEHB enrollment outside of Open Season do not change. OPM has developed the Life Cycle Events that may occur during or after your Federal career. It is divided into three sections and can be found at http://www.opm.gov/insure/lifeevents/index.asp.
Change in Pay/Employment Status
Leave Without Pay (LWOP)
Generally, employees are eligible to continue health insurance coverage for up to 365 days in a leave without pay status; however, employees must pay the employee’s share of premiums. Upon entering a leave without pay status, employees must elect whether to terminate their health insurance enrollment or continue the enrollment and either pay the premiums for every pay period that your enrollment continues or incur a debt. Employees should receive an election notice at the time they enter leave without pay. If you fail to respond to the election notice within the specified timeframe, the health insurance enrollment will automatically terminate. Enrollment will terminate at the end of the pay period which includes the 365th day in consecutive leave without pay status. Employees will have a 31-day extension of coverage and conversion rights.
Employees entering into a leave without pay status are advised to contact the DLA Benefits Team as soon as you are aware you will be entering into a leave without pay status to ensure you receive proper notification of your election opportunity and to ensure there is no miscommunication regarding your intent for continued coverage.
NOTE: This does not apply to DoDEA Educators placed in a non-pay status for summer recess; however, educators requesting LWOP for other reasons must elect whether they wish to terminate or continue their health insurance enrollment in accordance with the LWOP regulatory requirements.
Active Duty Military
Employees who are covered by the Federal Employees Health Benefits Program (FEHB) and are either separated or placed in a LWOP status to perform military service may continue to be covered by FEHB for up to 18 months (if placed on active duty for more than 30 days), unless the employee elects in writing to have the enrollment terminated.
Many agencies, including the Department of Defense, are paying the employee's health benefits premium share, in addition to the employer's health benefits premium share for covered employees ordered to active duty in support of a contingency operation.
Employees should contact their local servicing Human Resources Office or the DLA Benefits Team immediately to obtain information and guidance pertaining to FEHB election options if called to active duty military.
Additional information may also be obtained from the OPM website.