More than 690,000 federal workers, including 206,000 in the District, Maryland and Virginia, who had Blue Cross-Blue Shield health insurance last year will get premium refunds ranging from $17 to $366 under a proposal approved yesterday by the Office of Personnel Management.

But because the contract between the government and the insurance company must be amended and notices mailed to eligible employes, it could be early spring before the refund checks are sent.

Blue Cross-Blue Shield asked OPM to clear the refunds for current employes after President Reagan vetoed legislation that would have given them to retirees as well.

Seven federal health plans are offering refunds on last year's premiums because policyholders didn't draw on the insurance as much as in the past. Other plans offering refunds are Aetna, the Foreign Service plan, Government Employees Hospital Association, Government Employees Benefit Association, the National Association of Letter Carriers and the American Federation of Government Employees health plan.

When Blue Cross-Blue Shield first proposed refunds last May for 1.4 million workers and retirees, Reagan approved of the plan. But the Justice Department said that while refunds could be made to workers, special legislation was required to include retirees. The insurance companies then decided, for political and public relations reasons, not to make refunds to employes until retirees could get them, too.

Congress approved the retiree rebate bill last month. But the bill included several unrelated provisions opposed by the administration because of the costs. One would have raised the government contribution to employe-retiree health premiums this year. Reagan vetoed it, but said that he still supports the refunds.

Once OPM and Blue Cross-Blue Shield amend the contract, which could take up to 30 days, the insurance company will mail out notices to employes holding 1985 policies. The notices will advise recipients of the amount of their refunds and ask for address confirmation. The company said that, after the forms are returned, the checks will be mailed out.