Misplaced Pages

#538461

37-655: The FEHB program allows some insurance companies, employee associations, and labor unions to market health insurance plans to governmental employees. The program is administered by the United States Office of Personnel Management (OPM). The program was created in 1960. Employer sponsorship of health insurance in the United States became prevalent during World War II , as one of the few ways by which employers could escape wage and price control limitations on employee wages. The government originally proposed

74-620: A 2:1 ratio for Basic coverage only (except for USPS employees whose coverage is fully paid by USPS), any Optional coverage is paid fully by the employee. The FEGLI program also covers NASA astronauts, in particular, those astronauts who died on board the space shuttles Challenger and Columbia . For specific references to the below items, see the FEGLI booklet available on the OPM website . FEGLI offers four levels of coverage: Basic and three Options (A, B, and C). In order to enroll in any Option,

111-413: A premium which increases with age. Upon the death of an employee/retiree, death benefits (except for Option C) are paid as follows: Upon the death of any insured under Option C, benefits are paid to the employee/retiree, but if the employee/retiree dies before payment, payment is then made to the beneficiaries who would be paid under Basic coverage, excluding any assignment of insurance. In addition to

148-493: A qualifying "life event" (marriage, divorce, acquisition of a child, or death of a spouse). If an employee leaves government service with no coverage and subsequently returns, the break must be at least 180 days in order to become eligible once again barring either a rare open season, proof of satisfactory medical information, or life event. The employee pays 2/3 and the government pays 1/3 of Basic coverage premiums (except for United States Postal Service employees, whose coverage

185-405: A selection from those candidates, generally giving preference to veterans. OPM is also responsible for federal employee retirement applications for FERS and CSRS employees. OPM makes decisions on federal employee regular and disability retirement cases. OPM also oversees FEHB and FEGLI, the health insurance and life insurance programs for Federal employees. However, it does not oversee TSP, which

222-557: A system that would revolve around a dominant government-directed plan, but unions and employee associations, which had sponsored their own plans, protested. Reflecting the political pressure thus created, the Congress modified the Executive Branch proposal and all existing plans were "grandfathered" into the program. In 2010 about 250 plans participate in the program. About 20 plans are nationwide or almost nationwide, such as

259-644: Is 100% if two or more of the above are lost in the same accident, 50% if only one of the above is lost. In a specific accident no more than 100% of benefits can be paid and all injuries or death resulting from the same accident within one year of the accident are considered one event; however, in a subsequent accident benefits are paid separately. Employees are automatically enrolled in Basic upon appointment unless they choose to disenroll, while Optional coverage must be selected within 60 days of appointment, and in both cases enrollment and coverage are guaranteed regardless of

296-409: Is discontinued and cannot be reinstated. AD&D benefits cease upon the employee's retirement and do not continue into retirement. For retirees under age 65, the employee and government will continue to pay the same ratio of cost for Basic coverage as during employment (2/3 employee, 1/3 government except for USPS employees) at a rate which remains the same regardless of age, if the employee chooses

333-452: Is found in a number of plans, but in some plans the cap may reach $ 15,000 or more (HMOs typically have no cap, but control potential cost exposure by using copayments). The FEHB program has on several occasions been proposed as a model for national health insurance or a program that could directly enroll the uninsured. In the 2004 presidential campaign , Senator John Kerry proposed opening enrollment in this plan to all Americans. In enacting

370-534: Is handled by the Federal Retirement Thrift Investment Board (FRTIB), a separate independent agency. OPM implements Diversity, equity, and inclusion in line with Executive Order 13583 and Executive Order 13985 . Source: OPM's Agency Leadership Through Time Federal Employees%27 Group Life Insurance Act The Federal Employees' Group Life Insurance Act ( FEGLIA ) is a United States federal statute passed by

407-641: Is headed by a director, who is nominated by the President . The United States Civil Service Commission was created by the Pendleton Civil Service Reform Act of 1883. The commission was renamed as the Merit Systems Protection Board (MSPB), and most of commission's former functions—with the exception of the federal employees appellate function—were assigned to new agencies, with most being assigned to

SECTION 10

#1732764833539

444-452: Is paid fully by USPS). The rates for Basic coverage (per $ 1,000 of coverage) are the same for all employees regardless of age. The employee pays all cost of Optional coverage. The rates for each Option (per $ 1,000 of coverage) are determined by age ranges in increments of five years and increase with each increment (the rates increase substantially for employees beginning at age 50, and every five years thereafter). The newer rates begin with

481-524: The 83rd U.S. Congress and signed into law by President Dwight D. Eisenhower on August 17, 1954. The act provided for a group life insurance policy for most federal employees, similar to those provided for employees of most large industries. The act established the Federal Employee Group Life Insurance ( FEGLI ) program, which covers over 4 million federal employees and is the largest group life insurance program in

518-875: The Jiangsu State Security Department , a provincial branch of the Chinese Ministry of State Security spy agency obtained access to 22.1 million SF-86 records of US federal employees, contractors, and their friends and family. Representing one of the largest breaches of government data in U.S. history, information that was obtained and exfiltrated in the breach included personally identifiable information such as Social Security numbers , as well as names, dates and places of birth, and addresses. New updates regarding this security breach came to light on September 24, 2015. The agency then indicated that additional evidence showed that 5.6 million people's fingerprints were stolen as part of

555-878: The Medicare Modernization Act in 2003, the Congress modeled the reformed Medicare Advantage program and the new Medicare Part D Prescription Drug program after the FEHB program. United States Office of Personnel Management The United States Office of Personnel Management ( OPM ) is an independent agency of the United States government that manages the United States federal civil service . The agency provides federal human resources policy, oversight, and support, and tends to healthcare ( FEHB ), life insurance ( FEGLI ), and retirement benefits ( CSRS and FERS , but not TSP ) for federal government employees, retirees, and their dependents. OPM

592-445: The "75% Reduction" option (see below). Payments for lesser Basic coverage reductions and for Optional coverage are paid fully by the employee. Beginning the second full month after the retiree turns age 65 (e.g. beginning March 1 for an employee with a January 20 birthday), Basic coverage with 75% Reduction, Option A, and Options B/C with Full Reduction is free; Basic coverage and Options B/C coverage with lesser or no reduction requires

629-469: The FEHB program: fee-for-service and preferred provider organization (PPO), usually offered in combination; HMOs; and high-deductible health plans and other consumer-driven plans. In the Washington, D.C. metropolitan area, plans open to all federal employees and annuitants include 10 fee-for-service and PPO plans, seven HMOs, and eight high-deductible and consumer-driven plans. In the FEHB program

666-407: The above, if an insured is diagnosed as terminally ill with a life expectancy of nine months or less, the insured can also elect a "living benefit", which is an accelerated payment of benefits. The benefits are paid directly to the insured, not to the beneficiaries. The benefit can either be a full benefit or a partial benefit (in multiples of $ 1,000); the amount paid will be less than the face value,

703-414: The appearance of independence and neutrality in the administrative law system. While technically employees of the agencies they work for, administrative law judges (or ALJs) are hired exclusively by the OPM, effectively removing any discretionary employment procedures from the other agencies. The OPM uses a rigorous selection process which ranks the top three candidates for each ALJ vacancy, and then makes

740-411: The bill as a response to accusations of fraud and concerns about security clearance background investigations. The bill would fund the expenses for investigations, oversight activities and audits from the revolving fund. The bill was in response to a find that between 2002 and 2012, OPM's revolving fund had tripled, totaling over $ 2 billion, or 90% of OPM's budget. In February 2014, President Obama signed

777-497: The bill into law. The fund's history goes back to the early 1980s, where it was used for two main activities: training and background investigations for government personnel. Between 2018 and 2019, as part of a larger initiative to restructure the executive branch, President Donald Trump (R) submitted a proposal to congress to merge OPM into the General Services Administration (GSA) while returning

SECTION 20

#1732764833539

814-571: The completion of an "independent report" issued by the federally-chartered National Academy of Public Administration was added to the 1,120 page bill S-1790, a.k.a. the National Defense Authorization Act for Fiscal Year 2020 . According to its website, the mission of the OPM is "recruiting, retaining and honoring a world-class force to serve the American people." The OPM is partially responsible for maintaining

851-440: The employee must be enrolled in Basic. Accidental death and dismemberment (AD&D) insurance is included under Basic and Option A ($ 10,000) at no additional charge, and is paid in addition to life insurance if applicable. There is no AD&D coverage under Options B or C. For accidental death, payment is 100% of the above amounts. For accidental dismemberment (defined as loss of a hand, foot, or sight in an eye) payment

888-448: The employee retires after then) the employee may choose coverage options with no cost to the employee (i.e. premiums fully paid by the government) but which reduce levels of coverage over time (as explained below) or may choose to continue higher levels of coverage for additional premiums paid. An employee cannot increase coverage in retirement (except under Options B and C), only to reduce or discontinue it. If no choices are made, coverage

925-811: The employee's earliest opportunity to enroll). Unlike with the Federal Employees Health Benefits system, the five-year rule cannot be waived by the employee's agency. If a deferred annuity is taken, coverage is suspended (not terminated) from the date of retirement until the date the annuity begins. At retirement, the employee must (for whatever coverage s/he had prior to retirement) choose how much coverage to take into retirement, and (in some cases) how much coverage will be reduced beginning at age 65 or, if still working at age 65, at retirement. An employee cannot increase coverage at retirement or at any time thereafter, nor can it be renewed once discontinued. After age 65 (or upon retirement, if

962-458: The employee's prior medical history. Otherwise, coverage can only be obtained during an open season (unlike for Federal Employees Health Benefits insurance coverage, open seasons are not annual, and are in fact quite rare; there have been only nine open seasons in the program's history and none since 2016), by providing satisfactory medical information (after one year from the date of any prior waiver, but Option C cannot be selected on this basis), or

999-400: The federal government sets minimal standards that, if met by an insurance company, allows it to participate in the program. The result is numerous competing insurance plans that are available to federal employees. Local plans have ready access to participation in the program, but the underlying statute prohibits entry of new national plans. Because OPM requires plans to price offerings closely to

1036-831: The federal personnel policy-making components under the direct authority of the Executive Office of the President of the United States to the Office of Management and Budget in the White House . House Rep. Gerry Connolly (D-VA), chairman of the Subcommittee on Government Operations under the House Committee on Oversight and Reform, was the fiercest critic of the proposal. During a congressional hearing, Connolly claimed: "The administration wants to take over

1073-454: The first full pay period following the employee's birthday when s/he would reach the beginning of the new range. Premiums are paid either bi-weekly or monthly, depending on the frequency of employee's pay, and are automatically deducted from pay. In order to maintain continuous coverage at retirement, the employee must take an immediate annuity and must have maintained coverage for five years preceding (or, if less than five years, coverage from

1110-478: The hacks, more than five times the 1.1 million originally estimated. The total number of individuals whose records were disclosed in whole or part, including Social Security numbers and addresses, remained at 21.5 million. In July 2013, Rep. Blake Farenthold (R-Texas) introduced the Office of Personnel Management Inspector General Act. The bill would increase oversight of OPM's revolving fund. Farenthold introduced

1147-449: The health care costs of enrollees, and to offer comprehensive benefits, there is broad similarity in plan offerings. However, total premiums can vary substantially, and in 2010 the lowest cost plan option had a self-only premium cost of about $ 2,800 and the highest cost plan option for self-only enrollment was about $ 7,200. As an example of benefit variation, a cap of about $ 5,000 a year on potential out-of-pocket costs for self-only enrollment

Federal Employees Health Benefits Program - Misplaced Pages Continue

1184-462: The merit policy-making functions and put them into the highly politicized environment of the White House itself, away from direct congressional oversight and inspector general review." Political pressure against the proposal peaked when a provision barring the President from transferring any function, responsibility, authority, service, system or program that is assigned in law until 6 months after

1221-606: The newly created U.S. Office of Personnel Management (OPM) on January 1, 1979, and Reorganization Plan No. 2 of 1978. On January 1, 1979, the Office of Personnel Management was established with the dissolution of the U.S. Civil Service Commission following the passage and signing of the Civil Service Reform Act of 1978 into law by then President Jimmy Carter (43 FR 36037 , 92  Stat.   3783 ). The United States Office of Government Ethics , responsible for directing executive branch policies relating to

1258-778: The ones offered by some employee unions such as the National Association of Letter Carriers , by some employee associations such as GEHA , and by national insurance companies such as Aetna and the Blue Cross and Blue Shield Association on behalf of its member companies. There are about 230 locally available plans, almost all Health maintenance organizations (HMOs). The FEHBP's cost is about $ 40 billion in 2010, including both premiums and out-of-pocket costs. About four million employees and annuitants are enrolled, totaling eight million people when dependents are included. There are three broad types of plans available on

1295-411: The prevention of conflicts of interest on the part of Federal executive branch officers and employees, was formerly a part of OPM, until being spun off as an independent agency in 1989. In 1996 the investigation branch of the OPM was privatized, and USIS was formed. In 2014, after several scandals, OPM declined to renew its contract with USIS and brought background investigations back in house under

1332-628: The short-lived National Background Investigations Bureau . In 2019, the responsibility for conducting federal background checks changed hands again when NBIB was dissolved and its functions given to the Defense Security Service, part of the Department of Defense , which was reorganized into the Defense Counterintelligence and Security Agency for the purpose. In April 2015, hackers working on behalf of

1369-406: The world. Under the program, new federal employees are automatically enrolled in a basic insurance program (group term with no cash value) with the option of waiving enrollment, and may also obtain additional coverage for themselves and their families. Insurance premiums are deducted from the employees' payroll checks. The cost of the plan is shared between the employee and the federal government in

#538461