Federal Employees Health Benefits Program Health Care Coverage

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Frequently Asked Questions

UPDATED: JANUARY 23, 2013

Q: When am I eligible to enroll?

A: You are eligible to enroll when you are deployed. 

Q: When will my FEHB election be effective?

A: Elections will become effective on the first day of the first pay period that begins after the date OCCHCO receives an appropriate request to enroll.  When OCCHCO receives the election form verification of deployment and the effective date will be established.

Q: When will I receive my enrollment cards?

A: Enrollments cards will be received from the plan you elected approximately 6 weeks after the effective date of enrollment.

Q: What happens if I have to go to the doctor before I receive my enrollment cards?

A: You will need to pay out-of-pocket and once you have received your enrollment cards you may submit a request for reimbursement through the plan you enrolled in.

Q: What happens if I need a prescription filled before I receive my enrollment cards?

A: You will need to pay out-of-pocket and once you have received your enrollment cards you may submit a request for reimbursement through the plan you enrolled in.

Q: When will my insurance terminate?

A: Your FEHB will terminate the last day of the pay period in which you are deactivated/demobilized.  You will have a 31-day extension of coverage (at no cost to you) during which time you may convert to a private policy with the plan you were enrolled in.  You will be responsible for paying all costs for that policy.

Q: What is the difference between a Fee for Service (FFS) and a Health Maintenance Organization (HMO)?

A FFS plan provides flexibility in using medical providers of your choice.  You may choose medical providers who have contracted with the health plan to offer discounted charges.  You may also choose medical providers who do not contract with the plan, but you will pay more of the cost.  FFS plans will cover you and your eligible family member throughout the United States and some may cover you overseas.

A: A HMO provides care through a network of physicians and hospitals in particular geographic or service areas.  HMO’s coordinate the health care service you receive and free you from completing paperwork or being billed for covered services.  Your eligibility to enroll in an HMO is determined by where you live not work.  Medical care from a provider not in the plan’s network is not covered unless its emergency care or your plan has an arrangement with another plan.

Q: Where do I go to get information on the health insurance plans available and what they cover?

A: http://www.opm.gov/insure/health/planinfo/index.asp

Q: Where do I get the form to enroll in the Federal Employee Health Insurance Program?

A: Health Benefits Election Form (SF-2809)

Q: Where do I send my form once I have completed it and signed it?

A: Once you have completed and signed the SF 2809 send to FEMA-HC-Reservists-Benefits@fema.dhs.gov or fax your enrollment to 540-504-2144 ATTN: Reservist Benefits.

Q: Am I eligible to enroll in the Dental and/or Vision (FEDVIP) program or the Flexible Spending Account (FSA)?

A: No


FAQs - December 14, 2012

Q: Are FEMA Reservists eligible to apply for benefits under the Federal Employees Health Benefits Program (FEHBP)?

A: The Office of Personnel Management (OPM) recently approved FEMA’s request to provide Federal Employees Health Benefits (FEHB) to intermittent employees engaged in emergency response functions.  FEMA is still in the process of implementing the newly approved FEHB program.  We expect that by early 2013, we will be ready to open the new program to Reservists.

Q: How soon will Reservists be eligible to apply for benefits under the Federal Employees Health Benefits Program (FEHBP)?

A: Next year, FEMA will provide all Reservists with the opportunity to enroll in a health benefits plan under FEHB each time they enter pay status, such as during deployments.  Once enrolled, Reservists will be able to maintain coverage while they remain in pay status and will receive a 31-day extension of coverage after entering non-pay status. 

Q: What prompted this change to allow Reservists to be eligible for health benefits and who makes decisions on eligibility?

A: FEMA leadership has been committed to exploring options for providing health benefits for our Reservists and has been working with OPM for a change in the regulations.  OPM has broad authority to prescribe the conditions under which employees are eligible to enroll in the FEHB program.  OPM may also include or exclude employees on the basis of the nature and type of their employment. 

In November 2012, OPM published a final interim rule to allow agencies to apply to OPM for FEHB for intermittent employees engaged in emergency response.  Almost immediately after OPM’s announcement, FEMA applied to make Reservists eligible and OPM approved the request.

Intermittent emergency response employees often work in conditions that may expose them to various environmental hazards.  In light of the need for agencies to attract and bring emergency workers on board quickly and in recognition of the hazardous conditions those employees often face, OPM has concluded that its current policy of categorically excluding intermittent employees from FEHBP coverage is no longer in the public interest and should be changed.

Q: How can I find out more information about how to apply for benefits?

A: Over the next few weeks, we will continue to communicate through e-mail, on the FEMA Intranet, and in the FEMA Weekly about our progress toward implementing the new program and how to apply for FEHB benefits.

 

Last Updated: 
07/24/2014 - 16:00
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