Affordable Care Act

What to know about how the Affordable Care Act affects your Federal Employees Health Benefits Plan.

While the Affordable Care Act expanded access to insurance for millions of Americans and broadened health insurance benefits, federal employees covered by the Blue Cross and Blue Shield Service Benefit Plan (or any other FEHB insurer) saw only a few changes.

Service Benefit Plan coverage, prescription coverage, and Medicare coverage have not been reduced or restricted as a result of the Affordable Care Act.

Here are some changes you should be aware of:

Free Preventive Health Services

Under the ACA, health plans must cover an array of preventive health services (such as vaccines and screenings) at no cost to you when delivered by a Preferred provider. The Service Benefit Plan’s broad coverage of preventive services complies with ACA requirements. 

Read the Blue Cross and Blue Shield Service Benefit Plan brochure to review preventive benefits.

Coverage for Dependents Under 26

If you have children who are covered under your Self Plus One or Self and Family plan, they can now stay on the plan up to age 26—whether they are single or married. Coverage does not extend to a child’s spouse or children. 

The young adult does not need to live with you, be financially dependent, or be a student.

At age 26, the young adult may continue coverage with a Self Only plan for up to 18 months. He or she must pay the entire premium, plus two percent for administrative costs.

Unmarried dependents who were disabled before age 26 can continue to be covered under their parent’s Self Plus One or Self and Family plan after they turn 26.

Reporting Coverage to the IRS

The Affordable Care Act requires you and your dependents to have minimum essential health insurance coverage or pay a penalty with your federal tax return. 

By March 2, 2018 we will send you IRS Form 1095-B to assist with your federal income tax return. This form verifies that you and your dependents had minimum essential health coverage during the tax year. While the information on this form may assist in preparing your federal income tax return, it is not required. You can prepare and file your return using other information about your health insurance. You do not attach the form to your tax return and do not have to wait for the form to file your federal income tax return.

For accurate reporting, we need the name, address, and Tax Identification Number (or TIN; typically the Social Security Number) for each person covered under your policy.

To verify or change the information we have on record, log into MyBlue® or call the customer service number on the back of your member ID card during regular business hours. We will never call you asking for your TIN/SSN.

Further information can be found here on the IRS website.

Members of Congress

As of 2014, Members of Congress and designated congressional staff can no longer be covered under an FEHB plan and must obtain health insurance through the Health Insurance Marketplace (Exchange). For more information, visit opm.gov