Benefit Questions

Open Season runs each year from the second Monday in November through the second Monday in December. You can enroll, change plans/options, or cancel FEHB (Federal Employees Health Benefits), FEDVIP (Federal Employees Dental and Vision Insurance Program), and FSAFEDS (Flexible Spending Accounts for Federal Employees) elections with no qualifying event required. FEHB changes go through the employee self-service platform/agency system; FEDVIP through BENEFEDS; FSAFEDS requires annual re-enrollment. Changes take effect the first pay period of the new year.

Resources: opm.gov/healthcare-insurance/open-season; benefeds.gov; fsafeds.gov

A QLE—marriage, divorce, birth/adoption, a family member gaining/losing coverage, etc.—lets you change FEHB, FEDVIP, FSAFEDS, and FEGLI (Federal Employees' Group Life Insurance) elections outside Open Season. FEHB allows changes from 31 days before to 60 days after the event; FEDVIP and FSAFEDS also use a 60-day window. Missing the window generally means waiting for Open Season.

Resources: opm.gov/healthcare-insurance/life-events

Each federal job announcement includes a Marriage is a QLE. You may change from Self Only to Self Plus One or Self and Family from 31 days before to 60 days after the date of marriage. Submit via your agency system or SF-2809 with your marriage certificate.

Resources: opm.gov/healthcare-insurance/life-events; Form SF-2809

Birth/adoption is a QLE with a 60-day window to change enrollment. A newborn is covered from birth under Self and Family, but you must submit the change and documentation within the window. Also review FEGLI, FSAFEDS dependent care, and beneficiaries.

Resources: opm.gov/healthcare-insurance/life-events; Form SF-2809; fsafeds.gov

Yes, if you retire on an immediate annuity and have been continuously enrolled in FEHB for 5 years immediately before retirement (or since your first opportunity). Coverage and government contribution continue at active-employee rates.

Resources: opm.gov/healthcare-insurance/healthcare

First update your name with the Social Security Administration. Then submit a Processing request with your new SSA card/court document; HR processes a name-change SF-50, and update TSP, FEHB, beneficiary forms, and PIV card separately.

Resources: ssa.gov; Processing ticket form; badge/PIV office

Yes. A former spouse is not eligible as of the divorce date; continuing coverage can create a debt. Change your enrollment within 60 days. Your ex-spouse may qualify for Temporary Continuation of Coverage (up to 36 months) or Spouse Equity coverage, at their own expense.

Resources: opm.gov/healthcare-insurance/life-events; Form SF-2809

FEDVIP enrollment is handled entirely through BENEFEDS, not your agency. Enroll during Open Season or within 60 days of a qualifying event (including new hire). Premiums are deducted automatically.

Resources: benefeds.gov; 1-877-888-3337

FEGLI open seasons are rare, but you can increase coverage within 60 days of a life event, or anytime with satisfactory medical evidence (SF-2822). You can reduce or cancel coverage at any time.

Resources: opm.gov/healthcare-insurance/life-insurance; Forms SF-2817, SF-2822

FEHB coverage ends at the end of the pay period in which they turn 26 (with limited exceptions). They may qualify for Temporary Continuation of Coverage for up to 36 months or seek marketplace/employer coverage.

Resources: opm.gov/healthcare-insurance/life-events; healthcare.gov

Enroll at fsafeds.gov during Open Season or within 60 days of a qualifying event (before October 1). FSAFEDS does not carry over automatically—you must re-enroll each year. Health care FSAs allow limited carryover; dependent care FSAs do not.

Resources: Resources: fsafeds.gov; 1-877-372-3337

While actively employed, FEHB remains primary and you can generally delay Medicare Part B without penalty. After retirement, Medicare becomes primary and FEHB secondary. Review your specific plan's Medicare coordination section before deciding on Part B.

Resources: opm.gov/healthcare-insurance/medicare; medicare.gov; ssa.gov

Use OPM's plan comparison tool to compare premiums, deductibles, and coverage, and review each plan's official brochure (the binding statement of benefits). Check provider network status, prescription coverage, and total cost—not just premium.

Resources: opm.gov/healthcare-insurance/healthcare/plan-information

Common reasons include missing itemized documentation, services outside the benefit period, or IRS-ineligible expenses. Log in to fsafeds.gov to view the denial reason, resubmit, or file an appeal—HR cannot overturn FSAFEDS decisions.

Resources: fsafeds.gov; IRS Publication 502

Each program has its own form: FEGLI uses SF-2823, unpaid compensation uses SF-1152, FERS contributions use SF-3102, and Thrift Savings Plan (TSP) designations are made online at tsp.gov. Review after any marriage, divorce, birth, or death.

Resources: https://www.opm.gov/healthcare-insurance/healthcare/reference-materials/premium-conversion/

Each program has its own form: FEGLI uses SF-2823, unpaid compensation uses SF-1152, FERS contributions use SF-3102, and Thrift Savings Plan (TSP) designations are made online at tsp.gov. Review after any marriage, divorce, birth, or death.

Resources: opm.gov/forms; tsp.gov

FEHB continues up to 365 days (you must pay premiums or incur a debt). FEGLI continues 12 months free. TSP contributions stop, and extended LWOP can affect retirement service credit and WIGI timing.

Resources: opm.gov/healthcare-insurance; opm.gov/policy-data-oversight/pay-leave

Submit your resignation/retirement in writing, complete the agency clearance process, and review the exit checklist covering lump-sum annual leave, FEHB/FEGLI continuation options, TSP, and final LES/W-2 address.

Resources: opm.gov/healthcare-insurance