Understanding Federal Employees Health Benefits (FEHB) Insurance Plans
What is the FEHB Program?
Enacted on September 28, 1959, the Federal Employees Health Benefits (FEHB) Program is the largest employer-sponsored federal group health insurance program in the United States, covering over 9 million federal civilian employees, retirees, former employees, family members and former spouses. Like most employer-sponsored health insurance programs, FEHB is voluntary and paid for through employee and employer contributions.
Each federal health insurance carrier contracts with the Office of Personnel Management (OPM) to provide certain health benefits to all persons who enroll in its participating plan. Contract negotiation is a bilateral process, and both OPM and the federal health insurance carrier must approve the final contract.
Once health benefits have been agreed upon, OPM and each federal health insurance carrier jointly prepare a brochure describing each plan approved under the Federal Employees Health Benefits Program. This brochure is intended to be a complete statement of federal health benefits available to the enrollee, including the plan's benefits, limitations and exclusions.
Most federal employees and postal workers are eligible to elect Federal Employees Health Benefits Program coverage. There are primarily three types of federal health benefit plans—FFS/PPO, HMO and HDHP. For more details on each type of plan, visit our FEHB Eligibility & Enrollment page for more information.
Advantages of a FEHB Plan
FEHB plans offer certain advantages and guarantees, such as:
- An annual opportunity, known simply as “Open Season,” to enroll in a Federal Employees Health Benefits plan or change plans (usually mid-November to mid-December). You may also make changes to your FEHB plan upon experiencing certain Qualifying Life Events (QLE).
- A choice of federal health insurance plans and options with group-rated premiums and benefits.
- Guaranteed protection that cannot be canceled by the federal health insurance carrier.
- Coverage offered without medical examinations or restrictions because of age, current health or pre-existing medical conditions.
- No waiting periods after the effective date of enrollment in an approved FEHB plan.
- A government contribution toward the cost of your federal health insurance plan (unless you are on a temporary appointment).
- A payroll deduction method of making premium payments towards your FEHB plan.
- A temporary 31-day extension of coverage after separation from employment, during which you may convert to a private non-group health insurance plan.
- Continued enrollment for eligible family members after the death of the federal employee or annuitant.
- Ability to pay your premiums with pre-tax dollars (“Premium Conversion”).
FEHB Eligibility and Enrollment Information
Most federal employees and postal workers are eligible to elect Federal Employees Health Benefits (FEHB) program coverage. Please visit our FEHB Eligibility & Enrollment page for more information.
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