FEHB. Health Benefits Coverage for Noncareer Employees

Transcription

1 FEHB Health Beefits Coverage for Nocareer Employees Notice 426 September 2005

2 The Federal Employees Health Beefits (FEHB) Program permits certai ocareer (temporary) employees to obtai health isurace, if they meet certai eligibility requiremets. Who is eligible for ocareer FEHB coverage? If you are a ocareer employee, you are eligible to eroll i the FEHB Program if you meet all of the followig requiremets: 1. Complete 1 year of curret cotiuous employmet without a break i service of more tha 5 days. (If you are a casual or trasitioal employee, you do ot meet the 1-year requiremet; therefore, you are ot eligible for ocareer FEHB coverage.) 2. Have a predetermied, regular scheduled tour of duty. 3. Ear eough to have the full cost of the health isurace premium withheld from your biweekly pay. How are eligibility criteria defied? Curret meas begiig the day you apply ad coutig back 1 full year (365 caledar days). Cotiuous meas employmet with o break i service of more tha 5 days. A break i service occurs whe you are off Postal Service rolls. Leave without pay is ot cosidered a break i service. Days o which a part-time employee is ot scheduled to work are ot cosidered a break i service. Regular tour of duty meas a work schedule that is prescribed i advace (with cosistet hours each pay period) ad is expected to cotiue for at least 6 moths. Sufficiet earigs meas that i each pay period you must ear eough to cover all of your madatory deductios i additio to your health isurace premium. As a eligible, ocareer employee, you are expected to maitai sufficiet earigs for at least 6 moths. Madatory deductios will be withheld from your gross pay before health isurace premiums are withheld, i the followig order: (1) FICA (Social

3 Security); (2) Medicare; (3) federal, state, ad local icome taxes; ad (4) ivolutary deductios. Total health isurace premium meas the full cost of the group health isurace premium. The Postal Service does ot cotribute toward the cost of health isurace for ocareer employees. Who pays the premiums? You are expected to pay the total cost of your health isurace premiums, which must be withheld from your earigs. The Postal Service will ot pay ay portio of the premium cost. If you do ot ear eough i ay oe pay period to allow for withholdig of your health isurace premium, the upaid premium is withheld i the ext pay period. However, if you do t ear eough i the secod pay period, you may lose coverage. Whe two adjustmets for isufficiet earigs have bee made, you will receive a ivoice (Form 1903-DZ, Ivoice ad Statemet) for the total amout due. You must pay the total amout billed withi 30 days of the ivoice date, or your FEHB erollmet will be termiated retroactive to the date the iitial upaid health isurace premium was due. This meas that you ot your health isurace pla will be resposible for payig for ay medical services received after the due date of the first missed premium paymet. If you lose coverage for opaymet of premiums, you caot reew your erollmet util (1) the ext ope seaso, or (2) the FEHB program offers aother opportuity to eroll. What is the time limit for electio? If you are eligible ad wish to eroll, you must submit your FEHB electio to your persoel office withi 31 days after the first day you become eligible. If you do ot eroll whe you first become eligible, you will have a opportuity to eroll durig the ext regularly scheduled health beefits ope seaso or you have a qualifyig life evet that permits erollmet.

4 As a iterested, eligible employee, how do I eroll for coverage? Obtai FEHB Booklet RI 70-8PS, Erollmet Iformatio Guide ad Pla Compariso Chart for Certai Temporary Employees, from your persoel office. It cotais detailed iformatio about erollmet, total premium rates, ad the major features of each participatig pla. Review the booklet, idividual pla brochures, ad other iformatio that may help you to choose a health isurace pla. To register for FEHB health isurace coverage, you must complete a PostalEASE FEHB Worksheet (located i FEHB Booklet RI-70-8PS). Eroll i PostalEASE by followig the directios o the worksheet. Premium paymets for ocareer employees are automatically withheld o a after-tax basis. If you wish to have your premiums withheld with pre-tax moey, see the sectio titled Pre-Tax Paymet of Premium Cotributios i FEHB Booklet RI 70-8PS for guidelies. What is the effective date of my coverage? The effective date of a erollmet, outside a regular FEHB Health Beefits Ope Seaso, is the first day of the pay period that begis 1. After your persoel office receives your completed registratio forms; ad 2. Follows a pay period durig which you were i a pay status of ay legth. Whe may I chage erollmet? You may chage erollmet durig the FEHB Ope Seaso, or whe a qualifyig life evet occurs that allows you to chage erollmet. Your erollmet may be chaged from Self ad Family to Self Oly at ay time. Family members who lose coverage because you chage to Self Oly are etitled to a 31-day extesio of coverage for coversio to a idividual (ogroup) cotract.

5 How ca my erollmet be termiated? Your erollmet will ed if you leave the Postal Service, cacel your erollmet, or fail to pay health isurace premiums withi 30 days of the date of a ivoice statig the total amout due. Nopaymet of health isurace premiums is cosidered to be a volutary cacellatio of erollmet. Whe I leave the Postal Service, ca I cotiue my coverage? Yes. You ad members of your family who lose coverage other tha by cacellatio (icludig cacellatio by opaymet of premiums) have a 31-day period of exteded coverage, at o cost, for the purpose of covertig to a idividual (ogroup) cotract with your health beefits pla. This applies whether or ot you have the right to elect Temporary Cotiuatio of Coverage (TCC). Also, whe you separate from the Postal Service, you may be able to elect TCC of health beefits for up to 18 moths. Childre of employees erolled i FEHB who lose their status as family members, ad certai former spouses of employees erolled i FEHB, may be able to elect TCC for up to 36 moths. Notice 423, FEHB Temporary Cotiuatio of Coverage, provides iformatio cocerig TCC ad is available from your persoel office. If you elect TCC istead of the coversio policy, you will have aother 31-day period of exteded coverage (at o cost) ad aother opportuity to covert to a idividual (ogroup) cotract whe the TCC eds for ay reaso other tha cacellatio. If I am coverted to career status, how will that affect my erollmet? Your coversio to career status is cosidered to be a evet that permits you to cotiue the same coverage or to chage plas, optios, or types of erollmet.

6 If I am coverted to career status ad the retire, will it affect my eligibility for health coverage i retiremet if I have ot elected coverage as a ocareer employee? A prior decisio ot to eroll i the FEHB Program uder the temporary provisios will ot affect future eligibility to qualify for FEHB coverage durig retiremet. Geerally, a employee caot cotiue FEHB coverage ito retiremet uless the employee has bee erolled sice the first opportuity, or for the 5 years of service immediately before retiremet. However, the opportuity to eroll i the FEHB Program as a temporary (ocareer) employee is ot cosidered the first opportuity for purposes of determiig eligibility for postretiremet FEHB coverage. Where ca I obtai more iformatio? Persoel offices ca provide additioal iformatio cocerig ocareer FEHB coverage. HEADQUARTERS COMPENSATION US POSTAL SERVICE 475 L ENFANT PLAZA SW RM 9670 WASHINGTON DC Notice 426 September 2005 PSN UNITED STATES POSTAL SERVICE