Alyssa Lane
Open season is the period during which federal employees can change their health insurance coverage without needing a qualifying life event, such as marriage or the birth of a child. During open season, employees can change their Federal Employees Health Benefits Plan, Federal Flexible Spending Accounts Program, or Federal Employees Dental & Vision Insurance Program. Open season for the Federal Employees Health Benefit (FEHB) program, Flexible Spending Account (FSA), and Federal Employees Dental and Vision Program (FEDVIP) typically begins on November 1 and ends on December 9. Outside of open season, employees can only enroll in or change their Marketplace plans due to a life event or based on their income.
| Characteristics | Values |
|---|---|
| Open Season for Federal Health Benefits | November 11 to December 9 |
| Open Enrollment | Starts November 1 |
| Special Enrollment Period | Outside of Open Enrollment |
| Enrollment in Medicaid or CHIP | Anytime if eligible |
| Federal programs not participating in Open Season | Federal Employees' Group Life Insurance Program and Federal Long Term Care Insurance Program |
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What You'll Learn
Federal employees can change their health insurance coverage
Outside of Open Season, federal employees can only change their health insurance coverage if they experience a Qualifying Life Event, such as the birth of a child, marriage, moving, or losing health coverage. Employees who are satisfied with their current benefits but wish to explore other coverage options should review any applicable plan changes. Employees can also take advantage of the Virtual Benefits Fair, typically available throughout the Federal Benefits Open Season, to discuss any benefits questions with specialists and meet health, dental, vision, and Flexible Spending Account vendors.
To make changes to their Federal Employees Health Benefits plan, employees can log in to their Employee Personal Page. For dental and vision plan changes, employees can log in to BENEFEDS. Additionally, employees can log in to the Flexible Spending Account (FSAFEDS) system to manage their accounts. It is important to note that FSAFEDS does not continue automatically from one year to the next, and employees must reenroll during Open Season.
During Open Season, employees can also change their coverage amount, such as changing from self-only coverage to self + family or self + one. These changes can be submitted via the Retirement and Benefits App. If an employee wishes to add or remove a family member from their current plan, they should indicate the family member's information in the "Remarks" section of the relevant form. If no changes are made during Open Season, the current plan will typically roll over automatically for the following year. However, if an employee's current plan is leaving the FEHB Program, they must make a positive election into another FEHB plan during Open Season to ensure continuous coverage.
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Open season for the Federal Employees Health Benefit program
Open Season is the only time federal employees can change their health insurance coverage without a qualifying life event, such as the birth of a child or marriage. During this period, employees can make changes to their Federal Employees Health Benefits (FEHB) Plan, Federal Flexible Spending Accounts Program, or Federal Employees Dental & Vision Insurance Program (FEDVIP). Employees who are content with their current benefits should nonetheless review any applicable plan changes and explore coverage options.
The Federal Employees' Group Life Insurance Program and the Federal Long Term Care Insurance Program do not participate in the annual open season. Employees who do nothing will have their current plans roll over automatically, unless their plan is leaving the FEHB Program at the end of the year. In this case, enrollees must make a positive election into another FEHB plan during Open Season or they will be enrolled in the lowest-cost nationwide plan option for the following year.
The 2024 Federal Benefits Open Season will run from Monday, November 13 to Monday, December 11, 2023. Employees can submit their Open Season FEHB SF-2809 changes via the Retirement and Benefits App if they do not have a self-service button. If an employee is keeping the same plan but adding or removing a family member, they should indicate the family member's details in the "Remarks" section of the SF-2809. Eligible employees may enroll, make changes, or cancel coverage during Open Season.
Employees should check for significant changes to their FEHB (medical), FSAFEDS (Flexible Spending Account), or FEDVIP (dental and vision) plans. They can do so by reviewing the Circle 'Round Your Benefits diagram and OPM's Open Season website for Active Federal Employees. They can also attend the Virtual Benefits Open Season Health Fair to discuss any questions with specialists and meet health, dental, vision, and Flexible Spending Account vendors.
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Enrolling or cancelling health benefits
Open Season is the only time federal employees can change, enrol in, or cancel their health benefits without a qualifying life event, such as the birth of a child or marriage. During Open Season, employees can change their Federal Employees Health Benefits Plan, Federal Flexible Spending Accounts Program, or Federal Employees Dental and Vision Insurance Program.
For example, the Federal Health Benefits Open Season usually starts on November 1, and ends on December 9. Employees satisfied with their current benefits do not have to take any action but should still review any applicable plan changes and explore coverage options. If you do nothing, your current plan will rollover automatically unless it is leaving the FEHB Program at the end of the year.
Employees who wish to cancel their FEHB election should keep in mind the five-year coverage rule for those close to retirement. Those who are keeping the same plan but adding or removing a family member should indicate the family member being added or removed in the "Remarks" section of the relevant form.
Outside of Open Season, you can only enrol in or change Marketplace plans during a Special Enrollment Period due to a life event or based on your income. For example, you can apply for free or low-cost coverage through an insurance program that provides this for low-income people, families, children, pregnant women, the elderly, and people with disabilities. You can also enrol in Medicaid or the Children's Health Insurance Program (CHIP) anytime if you're eligible.
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Special Enrollment Period outside of Open Enrollment
Open Enrollment is the designated time of year for Americans to make changes to their current policies or enroll for the first time in individual marketplace coverage. It typically runs from November through January in most states. However, outside of this period, you may qualify for a Special Enrollment Period (SEP) if you experience certain life events or meet specific income criteria.
A Special Enrollment Period is a period of time outside of Open Enrollment when individuals can make changes to their health insurance plans due to qualifying life events or income-based factors. This allows people to adjust their coverage if they experience unexpected life changes or financial circumstances.
Qualifying life events for an SEP can include:
- Losing health coverage: This includes losing employer-sponsored coverage, student health plan coverage, or eligibility for Medicaid or the Children's Health Insurance Program (CHIP).
- Aging out of a parent's plan: When individuals turn 26, they may lose their dependent status and access to their parent's health plan.
- Having a baby, adopting a child, or fostering a child: The entire family can use the SEP to enroll in insurance, with coverage starting from the day of the event or the first day of the following month.
- Divorce or legal separation: Losing health insurance due to divorce or legal separation may qualify for an SEP, but simply losing dependent status without losing coverage does not.
- Death: If someone on your Marketplace plan passes away, causing you to lose your current health plan, you may qualify for an SEP.
- Moving: Relocating to a different state or within a state and gaining access to new health insurance options may trigger an SEP. However, moving solely for medical treatment or vacation does not qualify.
Additionally, low-income households may qualify for an SEP outside of the normal open enrollment period. This is known as the low-income SEP, which was established by the U.S. Department of Health & Human Services (HHS) in September 2021. It applies to households with an annual income of less than 150% of the federal poverty level, provided they are also eligible for premium tax credits that cover the cost of a benchmark plan.
It's important to note that not all life events or income situations qualify for an SEP. For example, choosing to drop coverage voluntarily does not typically qualify. Additionally, specific requirements and time frames, such as a 60-day special enrollment period after the qualifying event, may apply. It is always best to review the specific guidelines and eligibility criteria provided by official government sources, such as HealthCare.gov or Covered California, to determine if you qualify for a Special Enrollment Period outside of Open Enrollment.
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Qualifying life events for insurance coverage
Open Enrollment is a period when you can enroll in, renew, or change health plans through the Marketplace for the coming year. In the US, Open Enrollment for health insurance typically begins on November 1. However, outside of Open Enrollment, certain life events or changes in circumstances may qualify individuals for a Special Enrollment Period (SEP). During an SEP, individuals can enroll in or change their Marketplace plans accordingly.
Loss of Health Insurance Coverage
The loss of health insurance coverage is a common qualifying life event. This can include aging out of a parent's insurance plan, typically when turning 26 years old, or losing job-based coverage, COBRA, or a student plan. Losing eligibility for programs like Medicare, Medicaid, or the Children's Health Insurance Program (CHIP) also qualifies, as long as the loss of coverage is not due to non-payment of premiums.
Household Changes
Household changes can trigger a qualifying life event. This includes instances where members of your immediate household gain or lose eligibility for coverage under an existing plan. For example, if your spouse was provided insurance coverage through their employer, and they quit or are terminated, resulting in a loss of coverage, this would be a qualifying life event. The addition of family members, such as through birth, adoption, or marriage, can also lead to a qualifying life event.
Change of Residence
Relocating to a different zip code, county, or state may qualify you for a Special Enrollment Period, especially if your new location impacts the insurance options available to you. This could involve moving into a new health insurance plan area.
It is important to note that specific documentation may be required to verify a qualifying life event, and the timing of Special Enrollment Periods can vary, typically lasting 30 to 60 days before or after the qualifying event. Contacting your insurer or the Marketplace in advance or as soon as possible after a life event can help avoid coverage gaps and ensure you understand your options.
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Frequently asked questions
Open season is a period during which federal employees can change their health insurance coverage without needing a qualifying life event, such as the birth of a child or marriage.
Open season for medical insurance typically begins on November 1 and ends on December 9.
If you are satisfied with your current benefits and do nothing during open season, your current plan will usually rollover automatically, unless it is leaving the Federal Employees Health Benefits (FEHB) program.
Open season refers specifically to federal employees changing their health insurance coverage. Open enrollment is a period during which anyone can enroll in or change their Marketplace health plans for the coming year.
A qualifying life event is a significant life change, such as getting married, having a baby, gaining or losing health coverage, or moving. These events allow you to change your insurance coverage outside of open season.
