Life events. If you have health insurance through your employer, you might — or might not — remember being told that you can update your health plan outside of the annual election period when a major life event happens.
But you might not have thought about those events as opportunities when it comes to your health care planning and expenses — and you should, said Sherri Hebert, vice president and chief operating officer of Compass Rose Benefits Group, which provides health insurance to employees and retirees of the Intelligence Community and the departments of State, Defense and Homeland Security.
“It’s definitely an opportunity for cost savings and to find a plan that better suits your new situation,” Hebert said.
But here’s the thing, when those events are about to happen, your Federal Employees Health Benefits plan might not be top of mind. When marital status changes, a new baby arrives or a foster child joins the family, those are qualifying life events that let federal employees make changes to their FEHB plan choices.
We asked Hebert and Joni Huber, director of health plan administration at Compass Rose, to share tips that will help people be in the best position to take advantage of improving their health plans based on life-changing events.
Tip #1: Do your FEHB research before the life event
Take the stress and pressure out of the equation, Huber advised. She suggested looking into possible new health plan options early rather than waiting until right before or after an event takes place.
“After the baby’s born or you get married and you’re on your honeymoon, the last thing on your mind is thinking about your health insurance,” Huber said. “Taking time leading up to the event makes a big difference because you’re able to identify your needs and evaluate those needs across different FEHB plans.”
For most life events, a lot of planning typically takes place. For example, when people are preparing for a wedding, they’re setting a timeline, booking vendors and finalizing a host of other details. Leading up to the arrival of a baby or foster child, people are likely to be getting car seats installed, figuring out other needs and picking pediatricians.
“Adding insurance coverage to the checklist of things that you’re working to complete before that date comes gives you the time to discover available benefits and to evaluate costs,” Huber said.
Tip #2: Weigh your options based on your expected health needs
As part of that research, Hebert suggested identifying current health needs and any health needs that might be on the horizon. For instance, maybe your new partner has a specific medical condition. How do different plans cover treatment for that condition? Will someone need surgery or other procedures?
“Take the time to do what you would do when buying a car or a house or making any other large purchase,” she said. “Check things out. Don’t just randomly select a plan because you know the name or because your friends have it.”
Huber recommended using the Office of Personnel Management comparison tool to identify available plans using its ZIP code filter and then comparing the costs. From there, people can look at specific plans for coverage details, to determine unique benefits available from each plan, to check if current doctors participate and find out about each plan’s covered medications, Huber said.
Tip #3: Know the timeframe for making a change
Their last tip? Be sure to know the deadlines for making changes. Although federal employees who experience qualifying life events can make changes to their current plan or move to an entirely new plan outside of the federal open season each fall, there is still a 90-day window for making these FEHB changes.
That window is based on when a life event occurs: The clock starts ticking 31 days before the event and runs until 60 days after the change in family status.
“Don’t miss your opportunity,” Hebert said. “It’s a great chance to improve your coverage.”