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Federal Eye
Posted at 06:30 AM ET, 08/18/2011

Taking Stock: Coverage comes with options

Federal pay and benefits have come under increased scrutiny. But just what are the basics of working for Uncle Sam? We spend the week examining what is provided to federal workers.

Almost all federal jobs come with eligibility to enroll in four types of insurance: health, life, dental/vision and long-term care. In each case, the benefits are provided not by the government but by private-sector companies under contract with Uncle Sam.

The health insurance program and the dental/vision program allow employees to choose from a number of providers. Those two programs conduct an open enrollment period each fall, with choices effective at the start of the calendar year. Enrollment at other times is not allowed except when certain life events happen.

Eye Opener

The life insurance and long-term care insurance programs offer benefits through only one company each, but the benefits can be tailored in a variety of ways. Eligible persons may enroll in the long-term care program at any time. However, there are restrictions on enrolling in the life insurance program after being hired.

Each program is voluntary. The large majority of employees enroll in the health insurance and life insurance programs, in part because the government contributes toward the cost. The cost of long-term care insurance and dental/vision insurance is paid entirely by the enrollees and enrollment in them is lower.

Another feature of the programs is that, generally, coverage in each can be carried into retirement.

Health insurance:The Federal Employees Health Benefits (FEHB) program covers employees under a group health benefits plan regardless of medical condition — there are no waiting periods and no pre-existing condition limitations. Employees may cover themselves, their spouses and children under age 26.

All employees may choose from a variety of national and localized plans. The number of plans available to an individual depends largely on how many health maintenance organization plans participate in the employee’s area. Some of the nationwide plans have restrictions on eligibility. There are about 200 plans in all.

On average, the government pays 70 percent of the cost, with the Postal Service paying slightly more for its employees. Employees can pay their share of premiums from pre-tax dollars, effectively reducing their cost.

Retirees don’t get that tax break but they pay the same premiums as do active non-postal employees, only on a monthly basis rather than biweekly.

Life insurance: Unless they waive coverage, all employees are automatically covered under the Federal Employees Group Life Insurance (FEGLI) program, with no physical examination required. The basic benefit is equal to an employee’s annual basic pay plus $2,000. Additional coverage is provided for free for employees under age 45. The government pays about a third of the premium for basic insurance.

There are three forms of optional insurance: Option A is an additional $10,000; Option B is coverage for up to five times of salary; and Option C is coverage on family members up to $25,000 on a spouse and $12,500 on each child.

For optional coverage, premiums vary according to the individual’s age, and the enrollee pays the entire premium cost.

FEGLI is term insurance only; it has no cash-accumulating feature. However, FEGLI does have certain other features common in privately offered insurance, such as accidental death and dismemberment coverage and “living benefits” for the terminally ill.

Long-Term Care Insurance: The Federal Long-Term Care Insurance Program (FLTCIP) allows employees, retirees and certain family members to buy coverage for nursing home care, at-home care and other forms of living assistance.

Coverage can cost up to $450 a day for life. There are numerous options available, including several types of inflation protection, differing lengths of benefit periods and different daily benefit amounts. All of these choices also affect the premium. Premiums also vary according to the enrollee’s age at the time at which they purchase coverage but become fixed for at least the seven-year term of the carrier’s contract.

The LTC program is the only federal insurance program that covers domestic partners, although they must meet certain standards.

Dental and vision insurance: The Federal Dental and Vision Insurance Program (FEDVIP) offers employees the chance to sign up for dental coverage, vision coverage or both. Enrollment options include self-only, self and family or self plus one — although the “one” would have to be someone eligible for family coverage. Some plans have both high and low options.

There are three vision plans, each with national coverage, which offer services such as annual exams, lenses and frames, discounts on laser vision correction and other vision care.

There are seven dental plans, four of them national and three of them regional. Covered services include exams, fillings, oral surgery and other dental care; orthodontic services also are provided, although only after a waiting period.

By  |  06:30 AM ET, 08/18/2011

Categories:  The Federal Eye, Workplace Issues

 
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