How to continue coverage in an FEHB Plan?
How to continue coverage with the local Blue Cross Blue Shield Plan?
What is the difference between Standard Option and Basic Option?
Does the Service Benefit Plan offer dental benefits?
What is Temporary Continuation of Coverage (TCC) and what are the requirements to enroll under the TCC provisions of the Federal Employees Health Benefits (FEHB) law?
When is Open Season?
Where can I call to get benefit information about the Service Benefit Plan?
Does Standard Option or Basic Option provide coverage if I am overseas?
How to continue coverage in an FEHB Plan?
Temporary Continuation of Coverage (TCC) allows former employees to continue their healthcare coverage for up to 18 months and eligible family members to continue their healthcare coverage for up to 36 months. Members enrolling in TCC are responsible for both the employee and employer share of the premium, plus an additional 2% administrative fee.
TCC is available to:
- Employees and/or their eligible family members when the employee separates from Federal service, except an involuntary separation due to gross misconduct
- A change in circumstance that causes an individual to become ineligible to be considered a dependent (e.g., divorce or annulment from employee, unmarried children who reach 22, or children under 22 who marry)
Spouse Equity allows certain former spouses of civil service employees, former employees and annuitants to continue coverage. Unlike TCC, there is no time limit on the length of enrollment. Coverage remains in effect as long as the former spouse is eligible. Former spouses are responsible for both the employee and employer share of the premium with no administrative fee.
Spouse Equity is available to:
- Former spouses who do not remarry before age 55
- Former spouses who were enrolled as a dependent any time during the 18 months preceding the divorce
- Former spouse currently receives, or has future title to receive a portion of the annuity payable to the employee upon retirement
To verify eligibility and enroll, members electing TCC or Spouse Equity must contact their or the employee's employing agency (or OPM for annuitants).
How to continue coverage with the local Blue Cross Blue Shield Plan?
Conversion coverage allows any employee, annuitant or family member to continue non-FEHB coverage with the local Blue Cross Blue Shield Plan. Unlike TCC or Spouse Equity, any member whose FEHB coverage has terminated for any reason is eligible. Coverage remains in effect as long as the policy is in force.
Members who do not qualify for or decide not to enroll in TCC or Spouse Equity are eligible for conversion. Members whose TCC or Spouse Equity coverage ends may also apply for conversion coverage offered by the terminated member's local Blue Cross Blue Shield Plan.
Benefits and rates for conversion coverage will differ from those under the FEHB Program. Benefits which may have been provided under the FEHB coverage are not guaranteed and do not in any way affect the benefits available to the member under conversion coverage. However, the local Blue Cross and Blue Shield Plan will not ask you questions about your health and will not impose a waiting period for pre-existing conditions.
For more information on conversion coverage offered by your local Blue Cross Blue Shield Plan, please contact the customer service number on the back of your BlueCross BlueShield Federal Employee Program identification card.
What is the difference between Standard Option and Basic Option?
While both Options offer comprehensive benefits for you and your family, they are structured differently to complement different healthcare needs. Under Basic Option, you use Preferred providers to provide all the medical care you and your family need, and there is no deductible. Standard Option provides benefits regardless of whether you use a Preferred or Non-participating provider; however, your out-of-pocket expenses will probably be lower if you choose a Preferred provider. For more information about the differences between the two Options, please visit the Compare Benefits section of this Web site or consult the Service Benefit Plan brochure.
Whether you decide to enroll in Standard Option or Basic Option, please be sure to use the appropriate enrollment code:
| Self | Self and Family | |
|---|---|---|
| Standard Option | 104 | 105 |
| Basic Option | 111 | 112 |
Does the Service Benefit Plan offer dental benefits?
Yes. Both Standard Option and Basic Option offer some level of dental benefits. Basic Option provides preventive dental care while Standard Option provides additional routine services. Additional information is available in the Basic Option Dental Benefits and Standard Option Dental Benefits sections of this Web site or consult the Service Benefit Plan brochure for more details.
What is Temporary Continuation of Coverage (TCC) and what are the requirements to enroll under the TCC provisions of the Federal Employees Health Benefits Program (FEHBP) law?
Temporary Continuation of Coverage (TCC) is available to:
- Employees who lose their FEHBP coverage because they leave their federal jobs; except in involuntary separations due to misconducts
- Children who lose their FEHBP family member status because they become age 22 or marry
- Former spouses who lose their FEHBP family member status because of divorce or annulment
TCC allows former employees to continue their healthcare coverage for up to 18 months and former family members (children and former spouses) to continue healthcare coverage for up to 36 months. TCC enrollees must pay the full premium for the plan they select (that is, both the employee and Government shares of the premium) plus a 2 percent administrative charge. For more specific information about TCC, please contact your employing office's health benefits officer.
When is Open Season?
The US Office of Personnel Management (OPM) holds Open Season each year from the Monday of the second full workweek in November through the Monday of the second full workweek in December. Your Open Season election generally will take effect the following January. Please contact your employing office's health benefits officer for additional information.
Where can I call to get benefit information about the Service Benefit Plan?
During Open Season, you may call our Open Season Information Center at 1.800.411.BLUE. You may also contact your local Blue Cross Blue Shield Plan year-round for information about the Service Benefit Plan. To locate the contact information for your Local Plan, please visit the Contact Us section of this Web site. For current members, you can also find the phone number on the back of your identification card.
Does Standard Option or Basic Option provide coverage if I am overseas?
Yes, the Service Benefit Plan provides overseas coverage for you and your covered family members through our 24-hour Worldwide Assistance Center. Please keep in mind that many overseas providers require payment upfront and there will be differences regarding coverage and reimbursement between coverage under Standard Option and Basic Option. For more information, please visit the Standard Option and Basic Option Overseas Benefits sections of this Web site or consult the Service Benefit Plan brochure.