Is The FEDVIP More Adaptable Than The FEHB?

Even without the possibility to fill in any gaps in Federal Employees Health Benefits (FEHB) health insurance coverage, the Federal Employees Dental and Vision Insurance Program (FEDVIP) has some unique features that late-career workers and retirees may find interesting.

For instance, irrespective of their qualification for FEHB, all annuitants are qualified for FEDVIP. This is advantageous to retirees who, for some reason, are not eligible for FEHB, including those who did not yet have FEHB for the five years before retirement, those who ceased FEHB after retiring, and those who took discontinued service retirement, which disqualified them from FEHB. 

People are not required to have been enrolled in the FEDVIP for five years before retaining enrollment in retirement. There is also no service needed as with FEHB and FEGLI.

Annuitants cannot pay the premiums with pre-tax funds, while active employees can. As a result, FEDVIP is more expensive after retirement than during active service, similar to how FEHB increases in cost.

It’s essential to keep in mind how the two programs are connected. The OPM has selected several health insurance companies that provide FEDVIP benefits, some of which are associated with or related to FEHB carriers. The employee does not have to choose an eye or dental plan provided by an FEHB provider in which they are enrolled.

As secondary payors under the scheme, carriers are in charge of coordinating benefits with the FEHB plans that will offer the main benefits. 

For instance, the FEDVIP carrier will pay the rest of $75 at whichever rate it pays if a procedure costs $100, and the FEHB plan covers $25 of that amount. In general, if a service is not in either network, officials urge consumers in that position to use the in-network provider of the FEHB plan.

An eligible employee can register inside a benefits plan offering self-only coverage, self-coverage, family coverage, or self-coverage plus one (the “one” must be a person who would be qualified for coverage under the FEHB, such as a young person of a parent). 

Older employees, couples, and annuitants, who mostly don’t have children that qualify for FEHB family coverage, may be particularly interested in this provision. Both can be insured at the self-only rate, which is less expensive than the family rate, rather than purchasing dental and/or vision care at family rates for both themselves and their wives.

Similarities between the FEHB and FEDVIP programs

• Those who qualify may enroll at any time during a regular enrollment period or at the first available opportunity.

• Pre-existing conditions are not excluded.

• At-life events like marriage, the birth or adoption of a child, or enrollment changes are permitted.

• Employees, but not retirees, can pay their premiums before taxes (in fact, they must).

As opposed to the FEHB program, in the FEDVIP:

• Enrollees are responsible for paying the entire premium cost.

• There is no “five-year” requirement to qualify as a retiree.

• Children must be unmarried and also dependent on the enrollee, and coverage is only available until age 22 (not age 26).

• Employees who get an immediate annuity upon retirement may enroll in the program following their retirement and enter and exit the program as they like.

Notably, there is an exception to the age restriction for children who are disabled before the age that would otherwise be applicable under both FEDVIP and FEHB.

Contact Information:
Email: [email protected]
Phone: 9568933225

Bio:
Rick Viader is a Federal Retirement Consultant that uses proven strategies to help federal employees achieve their financial goals and make sure they receive all the benefits they worked so hard to achieve.

In helping federal employees, Rick has seen the need to offer retirement plan coaching where Human Resources departments either could not or were not able to assist. For almost 14 years, Rick has specialized in using federal government benefits and retirement systems to maximize retirement incomes.

His goals are to guide federal employees to achieve their financial goals while maximizing their retirement incomes.