FEHB Overview

The Federal Employee Health Benefits (FEHB) is a program offered to federal employees in a position that conveys benefits eligibility.

Employees are not required to participate in FEHB, but if you choose not to enroll as a new employee, you must experience a qualifying life event (QLE) or wait to enroll during the annual Open Season.

Review the resources below to learn more about the FEHB program and assist you with choosing a health plan.

FEHB Enrollments

FEHB offers three types of enrollments: Self Only, Self Plus One, and Self and Family.

Eligible employees may enroll within 60 days of their appointment or elect to participate during the annual FEHB Open Season. Outside of these election opportunities, employees may enroll, change or cancel coverage within 60 days of experiencing a qualifying life event (QLE). Learn more about QLEs on OPM’s life events page.

Employees who choose to cover eligible family members must provide supporting documentation to the Benefits Office to verify family member eligibility. 

IMPORTANT: It can take up to two pay periods to process your election. Your coverage is effective the pay period following receipt of your form and will be processed the pay period it becomes effective. Once processed, your FEHB carrier will be notified of your enrollment. If possible, delay scheduling doctor appointments until you receive your insurance cards from the carrier. The OHR Benefits Office cannot provide you with your member ID. This is provided by the FEHB carrier.

Important Information about Family Member Enrollment Verification

Federal law prescribes which family members may be covered under your Federal Employees Health Benefits (FEHB) Program plan. You are required to review eligibility rules and verify that your family members are eligible to be covered under your plan. Please carefully review the eligibility information in the Family Members section of the FEHB Handbook and ensure that all your family members are eligible to be covered. If you choose to cover eligible family members, you must provide supporting documentation to the Benefits Office to verify family member eligibility. 

It is your responsibility to contact the Benefits Office at AskBenefits@nih.gov to immediately remove family members who are no longer eligible for coverage.

As a reminder, any intentionally false statement or willful misrepresentation, such as including an ineligible family member on your health insurance coverage, is a violation of the law punishable by a fine of not more than $10,000 or imprisonment of not more than 5 years, or both (18 USC 1001), and may be subject to investigation. 

Family Member Resources

• Certification of Foster Child Status
• Common Law Marriage Declaration & Instructions
• Supporting Documentation for Family Members
• Medical Certificate

Temporary Continuation of Coverage (TCC)

TCC allows certain people to temporarily continue their FEHB coverage after regular coverage ends. Federal employees and family members who lose FEHB coverage because of a qualifying life event (QLE) may be eligible for TCC. Review additional information in OPM’s TCC pamphlet.