Jeffrey Wade
The Blue Cross Blue Shield Association is a national federation of independent, community-based and locally operated Blue Cross Blue Shield companies that collectively provide health care coverage for one in three Americans. The Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program (FEP), has been part of the Federal Employees Health Benefits (FEHB) Program since 1960 and covers roughly 5.6 million federal employees, retirees and their families. During a government shutdown, health care coverage for members of the Blue Cross Blue Shield Federal Employee Program remains in place and active. This means that employees won't be dropped from coverage even if they're furloughed or not receiving a paycheck.
| Characteristics | Values |
|---|---|
| Number of federal employees, retirees and their families covered by the Federal Employee Program® (FEP®) | 5.6-5.7 million |
| FEP® coverage during government shutdown | Remains in place and active |
| FEP® claims processing during government shutdown | Continues |
| FEP® reimbursement during government shutdown | Continues |
| FEP® customer service during government shutdown | Continues |
| FEP® coverage after separation from Federal service | Continues until premiums are not paid |
| FEDVIP Dental Plan primary payor | FEHB Plan |
| FEDVIP Dental Plan secondary payor | FEDVIP Plan |
| FEDVIP Dental Plan inpatient and outpatient hospital care coverage | Covered for children up to age 22 with severe dental caries |
| FEDVIP Dental Plan inpatient and outpatient hospital care coverage for other dental procedures | Covered when a non-dental physical impairment exists that makes hospitalization necessary to safeguard the health of the patient |
| FEDVIP Dental, Vision and Long-Term Care Insurance payments during government shutdown | Pause for a few pay periods |
| FEDVIP Dental, Vision and Long-Term Care Insurance coverage during non-payment | Continues |
| FEDVIP Dental, Vision and Long-Term Care Insurance missed premium payments | Paid from back pay received upon the end of a funding lapse |
| FEDVIP Dental, Vision and Long-Term Care Insurance billing for missed premium payments | Sent after two consecutive pay periods |
| FEDVIP Long-Term Care Insurance grace period for missed premium payments | Three pay periods |
| FEP® Open Season dates for 2023 | November 13 through December 11 |
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What You'll Learn
Federal Blue Cross Insurance is not affected by the shutdown
Federal Blue Cross Insurance, also known as the Federal Employee Program (FEP), is not affected by the shutdown. The Blue Cross Blue Shield Association has stated that health care coverage for members of the FEP remains in place and active during a government shutdown. This means that eligible members will continue to have full access to their health care coverage. The FEP will continue to process claims and reimburse doctors, hospitals, and other healthcare providers.
The FEP has been a part of the Federal Employees Health Benefits (FEHB) Program since 1960 and covers roughly 5.6 million federal employees, retirees, and their families. The Blue Cross Blue Shield Association negotiates annually with the US Office of Personnel Management (OPM) to determine the benefits and premiums for the FEP. The local Blue Cross Blue Shield companies are the primary points of contact for FEP members and are responsible for processing claims and providing customer service.
During a government shutdown, federal employees who depend on the government for employment benefits will not lose their health insurance coverage, even if their paychecks stop. This is because health insurance coverage is paid via payroll deduction, so even if paychecks are affected, workers won't be dropped from their coverage. Additionally, the Office of Personnel Management instituted a rule in 2021 that ensures federal employees remain in "pay status" during a shutdown for insurance eligibility purposes.
While health insurance coverage under the FEP is not directly impacted by a government shutdown, there may be some temporary disruptions to certain services. For example, dental, vision, and long-term care insurance payments may pause for a few pay periods before resuming. Employees should be prepared to pay these bills when they come due. Additionally, there may be delays in processes such as insurance card requests and benefit verification. However, overall, Federal Blue Cross Insurance remains committed to providing continuous coverage and access to healthcare services for its members during a government shutdown.
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Health care coverage remains in place and active
The Blue Cross Blue Shield Association is a national federation of independent, community-based, and locally operated Blue Cross Blue Shield companies that collectively provide healthcare coverage for one in three Americans. The FEP, specifically, covers roughly 5.6 million federal employees, retirees, and their families out of the more than 8.5 million people who receive their benefits through the Federal Employees Health Benefits (FEHB) Program.
During a government shutdown, federal employees who depend on the government for employment benefits will not lose their health insurance coverage, even if they don't receive paychecks. Tammy Flanagan, a benefits and retirement expert, affirms this by stating, "With your health insurance and your life insurance, that’s going to continue."
While health insurance coverage will remain active, dental, vision, and long-term care insurance payments will pause for a few pay periods before resuming. This is because coverage for dental and vision typically stops once an employee enters a period of non-pay or insufficient pay. However, in 2021, the Office of Personnel Management implemented a rule ensuring that federal employees remain in "pay status" during a shutdown for insurance eligibility purposes. As a result, missed premiums will be paid to the insurance company from back pay once the funding lapse ends.
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Doctors can still submit claims for payment
During a government shutdown, federal employees who depend on the government for their health insurance coverage will continue to receive it, even if their paychecks stop. This means that workers won't be dropped from coverage even if they're furloughed.
The Blue Cross Blue Shield Association has confirmed that health care coverage for members of the Blue Cross Blue Shield Federal Employee Program® (FEP®) remains in place and active during a government shutdown. The BCBS Federal Employee Program continues to process claims and reimburse doctors, hospitals, and other healthcare providers.
Additionally, Medicare is considered mandatory government spending, so it is not fully affected by a government shutdown. The Department of Health and Human Services (HHS) has stated that the Centers for Medicare and Medicaid Services (CMS) will continue to support Medicare activities. People with a Medicare plan will still be able to use their health benefits, and doctors and hospitals will still be able to submit Medicare claims and receive payment.
However, it is important to note that dental, vision, and long-term care insurance may be affected by a shutdown. While coverage will not be lost, employees should be aware that payments will pause for a few pay periods before resuming, so they need to be prepared to pay the bill when it comes.
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Dental, vision, and long-term care insurance payments will pause
During a government shutdown, federal employees who depend on the government for their paychecks and employment benefits will continue to have their health insurance coverage, even if their paychecks stop. This means that workers won't lose their coverage even if they're furloughed. Tammy Flanagan, a benefits and retirement expert, stated that "you're still covered [for] up to 12 months of non-pay status".
However, dental, vision, and long-term care insurance payments will pause during a government shutdown. Normally, coverage for dental and vision stops once an employee enters a period of non-pay or insufficient pay, or if they stop making direct premium payments. In 2021, the Office of Personnel Management instituted a rule that ensures federal employees remain in "pay status" during a shutdown for insurance eligibility purposes. Under this rule, missed premiums will be paid to the insurance company retroactively once the shutdown ends.
Benefeds, which administers the FEDVIP program, will send a bill to enrollees for unpaid premiums after two consecutive pay periods. The grace period is three pay periods for long-term care insurance. If you don't pay that bill when it arrives, you could lose your coverage and may have to reapply, potentially at a higher cost.
It's important to note that Blue Cross Blue Shield Association has stated that health care coverage for members of the Blue Cross Blue Shield Federal Employee Program® (FEP®) remains active during a government shutdown. The BCBS Federal Employee Program continues to process claims and reimburse healthcare providers. Eligible FEP members can contact their local Blue Cross and Blue Shield company if they experience a Qualifying Life Event, such as the birth of a baby, allowing them to adjust their coverage accordingly.
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Medicare is considered mandatory government spending
Federal government spending covers a range of areas, including Social Security, Medicare, military equipment, highway maintenance, and education. This spending can be divided into two main categories: mandatory and discretionary. Mandatory spending, also known as direct spending, is spending that is required by existing laws and does not require an annual vote by Congress. It includes funding for entitlement programs, such as Medicare and Social Security, as well as other payments to people, businesses, and state and local governments.
As mandatory spending, Medicare accounts for a significant portion of federal spending. Together with Social Security and Medicaid, it represents about 78% of all mandatory spending. In 2023, mandatory outlays by the federal government totalled $3.8 trillion, with more than half going towards Social Security and Medicare. The bulk of mandatory spending is for entitlement programs, with Congress setting eligibility requirements and benefits. Medicare and Medicaid have seen persistent increases in spending, driven by rising healthcare costs.
While Medicare is largely unaffected by a government shutdown, there may be some minor disruptions. According to Blue Cross of Idaho, certain processes within Medicare may experience delays, such as insurance card requests and benefit verification. However, doctors and hospitals will still be able to submit Medicare claims and receive payment during a shutdown. Additionally, private health insurance plans, such as those offered by Blue Cross Blue Shield, remain active during a government shutdown. They continue to process claims and reimburse healthcare providers, ensuring that their members have full access to their healthcare coverage.
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Frequently asked questions
Health insurance coverage paid via payroll deduction will not lapse during a government shutdown, meaning that federal Blue Cross Insurance members will continue to have full access to their health care coverage.
Payments will pause for a few pay periods before resuming, so workers need to be prepared to pay that bill when it comes.
The Federal Employee Program (FEP) is a Blue Cross and Blue Shield Service Benefit Plan that has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. It covers roughly 5.6 million federal employees, retirees, and their families.
