Social Security Survivor Benefits After Death: A Federal Employee Case Study

The Federal Employees Health Benefits (FEHB) Program provides one of the largest employer-sponsored health insurance offerings in the nation. Each year, FEHB Open Season gives you and other federal employees and retirees the opportunity to make important choices about your health coverage for the coming year. Knowing the Open Season rules can help you make confident, well-informed decisions about your health benefits.

What Is FEHB Open Season?

FEHB Open Season is a set period each year when employees and retirees can enroll in, make changes to, or cancel their FEHB health insurance coverage. Open Season is an annual event tied to the benefits cycle for federal workers. This window is your designated chance to review your options and adjust your coverage as needed, outside of certain life events.

Why Does Open Season Matter?

Your participation in FEHB Open Season allows you to reassess your health insurance in light of new family circumstances, medical needs, or changes to available plans. Whether you’re an employee or a retiree, the choices you make can affect both your budget and the quality of care for you and your eligible family members. For example, switching between coverage levels or changing plans can impact the network of providers, prescription coverage, and out-of-pocket costs you experience in the coming year.

Who Is Eligible to Participate?

Most current federal employees, retirees receiving federal annuities, and eligible family members can make elections during FEHB Open Season. Active employees must generally be in permanent positions. Eligibility is also extended to:

• Part-time employees if their appointment is expected to exceed one year
• Some temporary employees, depending on specific hiring authority and hours worked
• Eligible family members such as spouses and children under age 26 (with certain exceptions for disabled adult children)

Always confirm your eligibility status with your agency’s human resources office or the U.S. Office of Personnel Management (OPM).

When Does FEHB Open Season Occur?

FEHB Open Season traditionally runs each fall, typically beginning in mid-November and ending in early December. The specific dates are released by OPM each year. You’ll find official announcements on OPM’s website and through your employing agency’s HR channels. Marking this period on your calendar helps ensure you don’t miss the opportunity to review and change your coverage.

What Changes Can You Make During Open Season?

Open Season is the main time each year when you can:

• Enroll in a new FEHB plan if you’re not already covered
• Change your current enrollment (for example, switching between “self only,” “self plus one,” or “self and family”)
• Switch between available FEHB plans (information about plan options can be accessed through OPM’s plan comparison tools)
• Cancel your FEHB coverage if you no longer wish to participate

Keep in mind that some changes, such as increasing your level of coverage, will require you to provide information about your dependents.

How Do You Make FEHB Changes?

Changes to your FEHB elections are made through official federal channels:

• Active employees: Typically use online agency self-service systems or submit paper forms to their HR office.
• Retirees: Use OPM’s Retirement Services Online or send a written request to OPM.

Your agency’s human resources team (for employees) or OPM (for retirees) is responsible for processing changes. Always keep a copy of your submitted elections and confirmation statements for your records.

What If You Miss Open Season?

If you don’t make any changes during Open Season, your current health plan will generally continue for the next year. You won’t be able to make adjustments until the next Open Season unless you experience a qualifying life event. Premium and coverage changes by plan providers will still apply, even if you don’t actively re-enroll. Once the window closes, your coverage choices are usually locked in.

Are There Exceptions to the Open Season Window?

Yes. Certain events, called Qualifying Life Events (QLEs), allow you to change your FEHB coverage outside of Open Season. Common QLEs include:

• Marriage or divorce
• Birth or adoption of a child
• Death of a family member
• Loss of other health insurance coverage

When a QLE occurs, you typically have a limited period (usually 60 days) to make a permitted change. Always report QLEs promptly to ensure your coverage aligns with your new circumstances.

Can You Cancel or Defer FEHB Coverage?

You can choose to cancel your FEHB coverage during Open Season or after certain QLEs. Retirees also have the option to suspend (defer) coverage if they gain other qualifying insurance, such as Medicare or TRICARE. Suspension allows you to keep the right to re-enroll later, while cancellation ends all future FEHB eligibility in most cases. The choice between canceling and suspending depends on your long-term coverage needs and eligibility for other federal benefits.

What Should You Consider Before Making Changes?

Consider these factors before making FEHB coverage decisions:

• Your recent health and expected needs for the next year
• Dependent eligibility—who needs to be covered on your plan?
• Upcoming life changes (retirement, family changes, new health conditions)
• Limitations for switching coverage outside Open Season (unless a QLE occurs)
• Coordination options with Medicare, TRICARE, or other coverage you hold

Weighing these points can help you select or adjust your benefits thoughtfully and in line with your personal situation.

How Does FEHB Open Season Differ From Other Enrollment Periods?

Open Season is unique because it is the only regularly scheduled, annual opportunity for the broad FEHB population to make coverage changes. Other enrollment windows exist, such as:

• Your first 60 days as a new federal hire
• Periods following a QLE (e.g., marriage, birth)

Unlike Open Season, these windows are tied to specific personal circumstances. Open Season is universal for eligible employees and retirees, while QLE and new hire windows are individual.

Frequently Asked Questions (FAQ)

Is enrollment ever automatic? Enrollment typically requires you to take action; automatic enrollment is rare and usually only during special circumstances, such as some new hires who do not waive coverage.

How are premium changes communicated? Your employing agency or OPM will issue notices about premium changes—usually via mail, official emails, and updates on OPM’s website.

What documentation is needed for dependent coverage? You may need to provide marriage certificates, birth or adoption paperwork, or documentation of dependency for stepchildren or disabled adult children.

Can retirees re-enroll if they cancel coverage? Generally, once FEHB coverage is canceled, retirees cannot re-enroll unless coverage was suspended for another qualifying plan.

Where can official FEHB guidance be found? Always refer to OPM’s official website or your agency HR for the most current, authoritative FEHB rules and updates.

Conclusion

Understanding FEHB Open Season rules is essential for making the right choices for your health coverage as a federal employee or retiree. Carefully review your benefits each year, consider your current needs, and always consult official OPM or HR resources for detailed guidance.