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The Workplace of Personnel Administration (OPM) introduced important modifications for some FEHB plans in 2026. Federal staff and retirees ought to pay attention to these modifications previous to the Federal Advantages Open Season which runs by Dec. 8, 2025.
There are plans leaving the FEHB Program on the finish of 2025.” OPM wrote in a letter earlier this month. “Staff in these terminating plans should enroll in a brand new plan throughout Open Season or they are going to be enrolled in GEHA Profit Plan – Excessive Choice (the designated plan choice for 2026 as decided by OPM).”
SEE ALSO: 2026 FEHB Plan Comparability Software
OPM Record of 2026 FEHB Plan Modifications
To view the record of 2026 FEHB plan modifications, go right here (8-page PDF obtain).
OPM additionally mentioned there may be one dental plan leaving the Federal Emloyees Dental and Imaginative and prescient Insurance coverage Program (FEDVIP) on the finish of 2025. Federal staff within the terminating plan should enroll in a brand new plan throughout open season in the event that they need to have dental insurance coverage protection in 2026, in response to OPM. There is no such thing as a enrollment into a chosen plan choice beneath FEDVIP.
SEE ALSO: 2026 FEDVIP Plan Comparability Software
OPM Record of 2026 FEDVIP Plan Modifications
To view the record of 2026 FEDVIP plan modifications, go right here (1-page PDF obtain).
OPM additionally supplied a often requested questions truth sheet concerning the modifications (see beneath):
What to do When Your Well being Plan is Terminating Protection in Your Space or Leaving the Federal Staff Well being Advantages (FEHB) Program
The next are 4 methods your FEHB plan could change. Chances are you’ll must take an enrollment motion relying on the kind of change.
- Plan leaves FEHB Program
- Plan reduces its service space and eliminates its enrollment
- Plan reduces its service space and retains its enrollment
- Plan eliminates an choice (reminiscent of Normal or Excessive).
Inquiries to Think about:
How will I do know if my enrollment is affected?
It is best to have obtained a letter out of your plan stating that it’s not collaborating within the FEHB Program, that it’s not offering protection in your space (and is eliminating or protecting the enrollment code), or that it’s eliminating an choice. See our Open Season web site for added data. You’ll be able to contact your Human Assets (HR) workplace with extra questions.
What ought to I do if my enrollment is affected?
Chances are you’ll want to vary your enrollment to a different plan throughout Open Season, or throughout the time interval set by OPM.
My plan is leaving the FEHB Program solely. What occurs if I don’t change to a different plan?
As a Federal worker, annuitant, or Tribal worker, in case your plan is leaving the FEHB Program and you don’t change your enrollment, your using company will enroll you within the designated plan choice as decided by OPM. Observe the directions within the letter you obtain out of your plan or contact your HR workplace. See our Open Season web site for added data.
My plan is lowering its service space and eliminating my enrollment code. What occurs if I don’t change to a different plan?
If you’re a Federal worker, annuitant, or Tribal worker and you don’t change plans, you can be routinely enrolled into the designated plan choice out there as decided by OPM. See our Open Season web site for added data.
My plan is lowering its service space the place I dwell or work however not eliminating my enrollment code. What occurs if I don’t change to a different plan?
You’ll solely be coated in your space for emergency care providers within the new plan 12 months. You will need to journey to the plan’s remaining service space to obtain full protection on your care.
My plan is eliminating my choice. What occurs if I don’t change to a remaining choice or to a different plan?
You can be routinely enrolled into one of many plan’s choices that stay. If solely a Excessive Deductible Well being Plan (HDHP) stays, you can be routinely enrolled into the designated plan choice as decided by OPM. Please seek advice from the letter you obtain out of your plan for extra data or contact your HR workplace.
If my Excessive Deductible Well being Plan (HDHP) is terminating protection in my service space or is leaving the FEHB Program, what occurs to my Well being Financial savings Account (HSA) or my Well being Reimbursement Association (HRA)?
If you happen to want to proceed contributing to your HSA, it’s essential to enroll in one other HDHP. If you don’t enroll in one other HDHP, you aren’t eligible to contribute to your HSA, however it’s possible you’ll request withdrawals for certified medical bills. It is best to examine Inner Income Service (IRS) steering on use of HSA {dollars} for non-qualified medical bills. It is best to contact your plan’s HSA fiduciary earlier than making choices concerning your HSA.
Any unused HRA credit shall be forfeited as soon as the brand new plan you’ve elected turns into efficient.
How do I alter my enrollment to a different plan?
If you’re a Federal worker, use your company’s on-line self-service system reminiscent of Worker Specific, MyPay, Worker Private Web page, EBIS, and many others. If you happen to want extra assist, contact your HR workplace.
If you’re a Tribal worker, contact your Tribal Employer.
If you’re a Civil Service Retirement System (CSRS) or Federal Staff Retirement System (FERS) retiree, name Open Season Specific at 1.800.332.9798 or entry Open Season On-line.
If you happen to obtain an annuity from one other retirement system, please learn extra about well being advantages after retirement.
When does protection beneath my present plan or choice finish and protection beneath my new plan or choice start?
Your present plan will proceed to offer advantages till the efficient date of the brand new plan or choice you’ve elected throughout Open Season or throughout the time interval supplied by OPM. There shall be no hole in protection. Open Season enrollment modifications take impact the primary day of your first full pay interval in January of the next 12 months.
What are my rights if I’m pregnant or I’ve a power or disabling situation?
Beneath the Sufferers’ Invoice of Rights, enrollees who’re in any trimester of a being pregnant or who’re seeing a specialist for a power or disabling situation have a proper to continued therapy by the tip of past-partum care or therapy for as much as 90 days of care, as relevant, following discover {that a} well being plan is leaving the FEHB Program.
How can I examine the completely different well being plans out there to me?
There are a number of sources out there that will help you examine plans: Use the Plan Comparability Software.
Seek the advice of Client’s Checkbook.
Assessment and examine out there well being plan brochures.
The place can I discover Well being Plan Brochures and Info?
How do I discover out if my physician participates with the well being plan?
Entry to supplier directories can be found on our plan data webpage. Alternatively, you’ll be able to name the plan immediately. I’ve supplemental protection (i.e. dental) provided by my present FEHB plan. What occurs to that protection?
In case your plan is terminating protection within the service space or leaving the FEHB Program, any supplemental dental and/or imaginative and prescient protection that you’ve by your FEHB plan may also terminate. The Federal Staff Dental and Imaginative and prescient Insurance coverage Program (FEDVIP) gives dental and imaginative and prescient insurance coverage for eligible Federal staff and retirees. Tribal staff should not eligible for FEDVIP. For extra data, please learn extra about dental and imaginative and prescient insurances.
The place can I am going for extra data on Open Season?
Federal staff can go to Open Season web page.
Tribal staff can go to OPM Tribal Staff Open Season web page.
The Open Season web site will present up to date data by early November.
Who can I contact with extra questions?
When you have extra questions, you’ll be able to contact your well being plan immediately or your native HR workplace or Tribal employer.
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