Weekend update

Congress is out of town for two more weeks. The President returns from his working vacation today.

The FEHBlog noticed on Friday or Saturday that Modern Healthcare had issued its annual list of top 100 healthcare influencers. For several years running, the President has been the number one influencer. This year, however, the new President is ranked seventh just after the House Speaker and the top three, as the FEHBlog expected because Modern Healthcare is vocally pro-ACA, are the Republican Senators with their fingers in the dike to block the repeal and replace effort. The list is interesting but a mish mosh at the end.

FedSmith.com features an article about temporary continuation of coverage under FEHBP.

If you depart from Federal Service, you could be eligible for Temporary Continuation of Coverage (TCC) for up to 18 months under the Federal Employee Health Benefits (FEHB). Temporary Continuation of Coverage exists as a feature of the FEHB Program. It lets certain former employees temporarily continue their FEHB coverage after regular coverage ends. However, they must exhaust TCC eligibility as one condition for guaranteed access to individual health coverage. This is according to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 

Temporary Continuation of Coverage enrollees are required to pay the full premium for any plan they select. In other words, a former employee will have to pay both the employee and the government shares of the premium. In addition, they must pay a 2% administrative charge.

The article omits an important fact. If you lose your FEHB coverage, you can bypass TCC pick up coverage in the ACA healthcare marketplace. Indeed particularly if you are not high earner, it’s in your best interest to find out whether you can get a better deal than TCC in the ACA marketplace — healthcare.gov. The catch is that FEHB coverage typically ends 31 days after the date on which coverage otherwise would terminate (except in the case of a cancellation).  TCC coverage can begin on that date.  ACA marketplace coverage begins on the first day of the following month if you select a plan in the first 15 days of the month; if you make your selection in the second half of the month then your ACA coverage begins on the first day of the next following month.

What’s more with TCC you don’t have to stay with your last FEHB plan as an employee, you can switch to a lower premium plan if you like because you have the rights of an FEHB enrollee.

The article was valuable to the FEHBlog because it includes a list of folks who are not eligible for TCC, which is somewhat narrower in scope than it’s private sector analog, COBRA. Those people are eligible for ACA marketplace coverage. For more details on TCC, check out this OPM website.