FEHB clarifications and open enrollment

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Topic Author
david3213
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Joined: Mon Apr 29, 2019 1:35 pm

FEHB clarifications and open enrollment

Post by david3213 » Mon Oct 07, 2019 4:56 pm

I'm currently trying to decide if I should enroll in FEHB via my wife (a federal employee) or with my company. The two key differences are that my company plan is about $800 cheaper per year than GEHA (either standard or HDHP) and that my company has a much lower out of pocket maximum ($3450 for a family compared with $10,000 for GEHA HDHP). Coinsurance for my corporate plan is about 20% for most procedures. For GEHA HDHP coinsurance is 5% (after deductible). We were on my corporate plan this year and hit the out of pocket maximum and likely will next year (my wife and son both see an acupuncturist so the costs add up).

Right now, my quick mental calculations suggest that (mainly due to the much lower out of pocket limit), my corporate plan makes much more sense than the GEHA HDHP. The only thing that would potentially push us over to FEHB is the ability to continue coverage into retirement. I was reading the FEHB/FERS websites and it appears that we have to be enrolled for 5 years continuously up to the date my wife retires from government service AND retire on an immediate annuity. It looks like this would be age 60 for my wife (since she would have had 20 years of service by that point). Based on this, it sounds like we don't have to worry about ensuring we enroll in FEHB until around the time my wife is 54/55 (to ensure 5 years of continuous coverage). Does this sound correct?

delamer
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Re: FEHB clarifications and open enrollment

Post by delamer » Mon Oct 07, 2019 5:05 pm

Our family was on my husband’s company’s (private sector) plan until I was about 6 years out from retirement at my federal job.

Then we switched over to FEHB in order to ensure we could continue it in retirement.

So yes, your plan would work fine. Just remember that FEHB coverage starts at the beginning of the year. So if your wife wants to retire in, for example, June 2030, then you should start FEHB coverage in January 2025.

Tdubs
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Re: FEHB clarifications and open enrollment

Post by Tdubs » Mon Oct 07, 2019 10:17 pm

Has your wife looked at the CareFirst HDHP? Lower OOP max than GEHA HDHP. Checkbook shows it is less costly than GEHA. Also has better dental coverage.

I'm in GEHA now and can say the 5 percent after deductible is nice.

Topic Author
david3213
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Joined: Mon Apr 29, 2019 1:35 pm

Re: FEHB clarifications and open enrollment

Post by david3213 » Tue Oct 08, 2019 8:39 am

Tdubs wrote:
Mon Oct 07, 2019 10:17 pm
Has your wife looked at the CareFirst HDHP? Lower OOP max than GEHA HDHP. Checkbook shows it is less costly than GEHA. Also has better dental coverage.
Doesn't look like it's an option in my area. I'm also partial to GEHA since it's nonprofit.

Topic Author
david3213
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Re: FEHB clarifications and open enrollment

Post by david3213 » Tue Oct 08, 2019 8:41 am

delamer wrote:
Mon Oct 07, 2019 5:05 pm
Our family was on my husband’s company’s (private sector) plan until I was about 6 years out from retirement at my federal job.

Then we switched over to FEHB in order to ensure we could continue it in retirement.

So yes, your plan would work fine. Just remember that FEHB coverage starts at the beginning of the year. So if your wife wants to retire in, for example, June 2030, then you should start FEHB coverage in January 2025.
Thanks! To confirm, there's no way we could retire early and still continue FEHB coverage? For example, if we decided to retire at 55, that would mean my wife was not eligible for an immediate annuity and, therefore, could not continue FEHB coverage? Could we fill in the gap using other plans and then re-enroll in FEHB coverage when she becomes eligible for the annuity at 60 (assuming that's possible)?

delamer
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Joined: Tue Feb 08, 2011 6:13 pm

Re: FEHB clarifications and open enrollment

Post by delamer » Tue Oct 08, 2019 10:22 am

david3213 wrote:
Tue Oct 08, 2019 8:41 am
delamer wrote:
Mon Oct 07, 2019 5:05 pm
Our family was on my husband’s company’s (private sector) plan until I was about 6 years out from retirement at my federal job.

Then we switched over to FEHB in order to ensure we could continue it in retirement.

So yes, your plan would work fine. Just remember that FEHB coverage starts at the beginning of the year. So if your wife wants to retire in, for example, June 2030, then you should start FEHB coverage in January 2025.
Thanks! To confirm, there's no way we could retire early and still continue FEHB coverage? For example, if we decided to retire at 55, that would mean my wife was not eligible for an immediate annuity and, therefore, could not continue FEHB coverage? Could we fill in the gap using other plans and then re-enroll in FEHB coverage when she becomes eligible for the annuity at 60 (assuming that's possible)?
I think there is a provision for deferring your annuity and enrolling in FEHB again once you start the annuity. And there is temporary continuation of coverage available that is similar to COBRA if you leave service.

Check the OPM website, as I am no expert.

totesmagotes
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Re: FEHB clarifications and open enrollment

Post by totesmagotes » Tue Oct 08, 2019 2:02 pm

delamer wrote:
Tue Oct 08, 2019 10:22 am
david3213 wrote:
Tue Oct 08, 2019 8:41 am
delamer wrote:
Mon Oct 07, 2019 5:05 pm
Our family was on my husband’s company’s (private sector) plan until I was about 6 years out from retirement at my federal job.

Then we switched over to FEHB in order to ensure we could continue it in retirement.

So yes, your plan would work fine. Just remember that FEHB coverage starts at the beginning of the year. So if your wife wants to retire in, for example, June 2030, then you should start FEHB coverage in January 2025.
Thanks! To confirm, there's no way we could retire early and still continue FEHB coverage? For example, if we decided to retire at 55, that would mean my wife was not eligible for an immediate annuity and, therefore, could not continue FEHB coverage? Could we fill in the gap using other plans and then re-enroll in FEHB coverage when she becomes eligible for the annuity at 60 (assuming that's possible)?
I think there is a provision for deferring your annuity and enrolling in FEHB again once you start the annuity. And there is temporary continuation of coverage available that is similar to COBRA if you leave service.

Check the OPM website, as I am no expert.
I'm not sure either. However, this is from a FAQ on the OPM site:
"I am going to retire soon. What are the requirements to continue health benefits into retirement?
To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan (not necessarily the same plan) for the five years of service immediately preceding retirement, or if less than five years, for all service since your first opportunity to enroll."

"Are retirees receiving a deferred annuity eligible?
No."

However, from a pamphlet on a deferred annuity (Page 3 at https://www.opm.gov/retirement-services ... 92-19a.pdf):
"Health Benefits, Life Insurance and Federal Dental and Vision Program Coverage
If you separated from Federal service after reaching the Minimum Retirement Age with at least 10 years of service, but postponed the commencing date of your annuity to reduce or avoid the age reduction, you are eligible to reenroll in the Federal Employees Health Benefits Program and the Federal Employees' Group Life Insurance Program, if you participated in the program for the 5 years of service immediately before you separated from Federal service or continually for your earliest opportunity. You are also eligible to reenroll in the Federal Dental and Vision Program if you were enrolled when you separated from Federal Service.

If you separated from Federal service with at least 10 years of service before reaching the Minimum Retirement Age or if you separated from Federal service with at least 5, but less than 10 years of service, and are now applying for a deferred annuity, you are not eligible to continue any health benefits, life insurance, or Federal Dental and Vision coverage you had while employed."

rich126
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Re: FEHB clarifications and open enrollment

Post by rich126 » Tue Oct 08, 2019 2:25 pm

There are a few exceptions.

Once you reach minimum retirement age (MRA), have had 5 years of continuous health insurance via FEHB, and have at least 10 years of service, you can take a postponed retirement. In that case everything gets "suspended" and when you turn 62 (60 if you had 20 years of service) you get your pension w/o penalty, your health insurance and life insurance.

Also if you left the government after 10 years (or some other time frame) with health insurance for the last 5 years and then return to the government, say at 59, you can then retire at 62 and keep the health insurance.

But a deferred retirement gives up your health insurance (i.e., leaving the government without reaching MRA and not returning).

Government health insurance isn't the cheapest and for a family of 2, it is expensive. Although being able to have it at 60 or whenever you retire is pretty valuable IMO.

delamer
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Re: FEHB clarifications and open enrollment

Post by delamer » Tue Oct 08, 2019 3:40 pm

rich126 wrote:
Tue Oct 08, 2019 2:25 pm
There are a few exceptions.

Once you reach minimum retirement age (MRA), have had 5 years of continuous health insurance via FEHB, and have at least 10 years of service, you can take a postponed retirement. In that case everything gets "suspended" and when you turn 62 (60 if you had 20 years of service) you get your pension w/o penalty, your health insurance and life insurance.

Also if you left the government after 10 years (or some other time frame) with health insurance for the last 5 years and then return to the government, say at 59, you can then retire at 62 and keep the health insurance.

But a deferred retirement gives up your health insurance (i.e., leaving the government without reaching MRA and not returning).

Government health insurance isn't the cheapest and for a family of 2, it is expensive. Although being able to have it at 60 or whenever you retire is pretty valuable IMO.
The employee portion of the premium for retirees is about $275 a month in 2019 for GEHA standard coverage.

Hardly expensive.

rich126
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Re: FEHB clarifications and open enrollment

Post by rich126 » Tue Oct 08, 2019 4:45 pm

delamer wrote:
Tue Oct 08, 2019 3:40 pm
rich126 wrote:
Tue Oct 08, 2019 2:25 pm
There are a few exceptions.

Once you reach minimum retirement age (MRA), have had 5 years of continuous health insurance via FEHB, and have at least 10 years of service, you can take a postponed retirement. In that case everything gets "suspended" and when you turn 62 (60 if you had 20 years of service) you get your pension w/o penalty, your health insurance and life insurance.

Also if you left the government after 10 years (or some other time frame) with health insurance for the last 5 years and then return to the government, say at 59, you can then retire at 62 and keep the health insurance.

But a deferred retirement gives up your health insurance (i.e., leaving the government without reaching MRA and not returning).

Government health insurance isn't the cheapest and for a family of 2, it is expensive. Although being able to have it at 60 or whenever you retire is pretty valuable IMO.
The employee portion of the premium for retirees is about $275 a month in 2019 for GEHA standard coverage.

Hardly expensive.
The cost for a family of two is basically the same as if you have kids. For example BCBS biweekly premium for just yourself is 76, for a couple it is 179 and for a family 191.

I recently left and while I don't have BCBS I certainly pay less and so far prescriptions and the like have been cheaper.

Glancing at the 2020 monthly premium for GEHA, the price for self+one is more than double than the price for yourself. Seems strange.

delamer
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Re: FEHB clarifications and open enrollment

Post by delamer » Tue Oct 08, 2019 6:19 pm

rich126 wrote:
Tue Oct 08, 2019 4:45 pm
delamer wrote:
Tue Oct 08, 2019 3:40 pm
rich126 wrote:
Tue Oct 08, 2019 2:25 pm
There are a few exceptions.

Once you reach minimum retirement age (MRA), have had 5 years of continuous health insurance via FEHB, and have at least 10 years of service, you can take a postponed retirement. In that case everything gets "suspended" and when you turn 62 (60 if you had 20 years of service) you get your pension w/o penalty, your health insurance and life insurance.

Also if you left the government after 10 years (or some other time frame) with health insurance for the last 5 years and then return to the government, say at 59, you can then retire at 62 and keep the health insurance.

But a deferred retirement gives up your health insurance (i.e., leaving the government without reaching MRA and not returning).

Government health insurance isn't the cheapest and for a family of 2, it is expensive. Although being able to have it at 60 or whenever you retire is pretty valuable IMO.
The employee portion of the premium for retirees is about $275 a month in 2019 for GEHA standard coverage.

Hardly expensive.
The cost for a family of two is basically the same as if you have kids. For example BCBS biweekly premium for just yourself is 76, for a couple it is 179 and for a family 191.

I recently left and while I don't have BCBS I certainly pay less and so far prescriptions and the like have been cheaper.

Glancing at the 2020 monthly premium for GEHA, the price for self+one is more than double than the price for yourself. Seems strange.
Even if your coverage costs less now, that doesn’t mean that FEHB plans are expensive.

And, of course, there is a wide range of premiums within FEHB. So choosing wisely is important. Two-thirds of FEHB enrollees are one of the BCBS plans. The next highest enrollment has less than 10%.

See Figure 1 here: https://www.gao.gov/assets/690/687595.pdf

Topic Author
david3213
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Re: FEHB clarifications and open enrollment

Post by david3213 » Wed Oct 09, 2019 10:53 pm

rich126 wrote:
Tue Oct 08, 2019 2:25 pm
Government health insurance isn't the cheapest and for a family of 2, it is expensive. Although being able to have it at 60 or whenever you retire is pretty valuable IMO.
I haven't priced out what health care is available for retirees so I'm not sure how important it is to have access to FEHB. It does seem valuable to have the option to continue FEHB into retirement. That's many years away though, so it seems that I should be safe picking my "megacorp" plan rather than my wife's FEHB options, at least for next year.

Topic Author
david3213
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Joined: Mon Apr 29, 2019 1:35 pm

Re: FEHB clarifications and open enrollment

Post by david3213 » Wed Oct 09, 2019 10:54 pm

totesmagotes wrote:
Tue Oct 08, 2019 2:02 pm
I'm not sure either. However, this is from a FAQ on the OPM site:
"I am going to retire soon. What are the requirements to continue health benefits into retirement?
To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan (not necessarily the same plan) for the five years of service immediately preceding retirement, or if less than five years, for all service since your first opportunity to enroll."
Yes, that's my basic understanding. But, as you point out below, it gets a bit confusing.
However, from a pamphlet on a deferred annuity (Page 3 at https://www.opm.gov/retirement-services ... 92-19a.pdf):
"Health Benefits, Life Insurance and Federal Dental and Vision Program Coverage
If you separated from Federal service after reaching the Minimum Retirement Age with at least 10 years of service, but postponed the commencing date of your annuity to reduce or avoid the age reduction, you are eligible to reenroll in the Federal Employees Health Benefits Program and the Federal Employees' Group Life Insurance Program, if you participated in the program for the 5 years of service immediately before you separated from Federal service or continually for your earliest opportunity. You are also eligible to reenroll in the Federal Dental and Vision Program if you were enrolled when you separated from Federal Service.

If you separated from Federal service with at least 10 years of service before reaching the Minimum Retirement Age or if you separated from Federal service with at least 5, but less than 10 years of service, and are now applying for a deferred annuity, you are not eligible to continue any health benefits, life insurance, or Federal Dental and Vision coverage you had while employed."
I will have to have my wife discuss this with her HR rep or OPM.

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Jerry55
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Re: FEHB clarifications and open enrollment

Post by Jerry55 » Wed Oct 09, 2019 11:32 pm

rich126 wrote:
Tue Oct 08, 2019 4:45 pm

The cost for a family of two is basically the same as if you have kids. For example BCBS biweekly premium for just yourself is 76, for a couple it is 179 and for a family 191.

I recently left and while I don't have BCBS I certainly pay less and so far prescriptions and the like have been cheaper.

Glancing at the 2020 monthly premium for GEHA, the price for self+one is more than double than the price for yourself. Seems strange.

I retired in 2012 as a CSRS employee. There are two BCBS plans, one being low option and the other, Standard (more expensive)

I live in IL, and BCBS is a Federal plan, available nationwide. I can certainly assure you that, in 2018, my monthly premiums (Self Only) was $245, and it went down in 2019 to $243 monthly. I just was advised that the 2020 monthly premium for BCBS Standard option is now approx. $253.30 / month, Self Only.
That's on the Federal Insurance website that I just saw 2 days ago.

It's the 2nd, 3rd and 4th line down. "Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option"

https://www.opm.gov/healthcare-insuranc ... non-postal
Retired CSRS on 12/19/2012 @ age 57 w/39 years | Good Bye Tension, Hello Pension !!!

rich126
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Re: FEHB clarifications and open enrollment

Post by rich126 » Thu Oct 10, 2019 9:40 am

Jerry55 wrote:
Wed Oct 09, 2019 11:32 pm
rich126 wrote:
Tue Oct 08, 2019 4:45 pm

The cost for a family of two is basically the same as if you have kids. For example BCBS biweekly premium for just yourself is 76, for a couple it is 179 and for a family 191.

I recently left and while I don't have BCBS I certainly pay less and so far prescriptions and the like have been cheaper.

Glancing at the 2020 monthly premium for GEHA, the price for self+one is more than double than the price for yourself. Seems strange.

I retired in 2012 as a CSRS employee. There are two BCBS plans, one being low option and the other, Standard (more expensive)

I live in IL, and BCBS is a Federal plan, available nationwide. I can certainly assure you that, in 2018, my monthly premiums (Self Only) was $245, and it went down in 2019 to $243 monthly. I just was advised that the 2020 monthly premium for BCBS Standard option is now approx. $253.30 / month, Self Only.
That's on the Federal Insurance website that I just saw 2 days ago.

It's the 2nd, 3rd and 4th line down. "Nationwide Blue Cross and Blue Shield Service Benefit Plan Standard Option"

https://www.opm.gov/healthcare-insuranc ... non-postal
Basically $500 per month for a couple. That sounds like a lot to me but it may be a bargain. I'll definitely be using it when I turn 60 as I was one who qualified via the postponed retirement route. Currently I pay $39 biweekly or $84 monthly but I am glad I have the option to get health insurance at 60. And as I mentioned above, I certainly think it is valuable to have. I just think the pricing seems strange when a couple is paying almost the same amount as a family of 3,4,5, etc.

jerryk68
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Re: FEHB clarifications and open enrollment

Post by jerryk68 » Thu Oct 10, 2019 6:41 pm

We have BC/BS Basic plus one which went from $369 this year to $386.99 a month next year plus we purchased Medicare at $135.50 each per month. We like Basic because it reimburses some of our Medicare premiums from $600 each this year to $800 (total $1600) next year which results in us having no additional cash outlay for coinsurance, co-pay or deductibles. Since Medicare is primary and BC/BS secondary it offers Medicare/BC/BS Basic customers a prescription mail order service which is fantastic because we usually receive the drugs the next day. I get two (90 day) generic drugs at $5 each plus a tier 2 drug (eliquis) at $100. Very satisfied with Basic with Medicare and I would recommend it. Your mileage may vary.

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Info_Hound
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Re: FEHB clarifications and open enrollment

Post by Info_Hound » Fri Oct 11, 2019 11:48 am

Jerry55 thanks for the link to the rates page. I was waiting for info and your post was exactly what I was looking for.

I have several changes I need to make insurance wise now that I am also covered by Medicare. Looks like (for once) my health insurance will be cheaper in 2020 than 2019.

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