Federal Employee Health Benefits for Administrators
IDBENE7305

Module 1: Federal Employees’ Health Benefits (FEHB)

• Explain FEHB eligibility, plan types, government contributions, and coverage rules for employees, family members, retirees, and special populations.
• Apply procedures for processing FEHB actions (SF 2809 and SF 2810), determining effective dates, handling late elections, and administering premium conversion.
• Identify qualifying life events (QLEs), rules for TCC, terminations, cancellations, Children’s Equity, and former spouse provisions.
• Understand FEHB retirement requirements, five-year rule exceptions, waivers, VSIP/VERA provisions, and retiree enrollment change rules.

Module 2: Flexible Spending Account Program (FSAFEDS)

• Describe Health Care FSAs, Dependent Care FSAs, and Limited Expense FSAs, including eligibility, allowable expenses, and annual limits.
• Explain enrollment rules, open season requirements, new employee deadlines, and mid-year changes due to qualifying life events.
• Advise employees on tax benefits, contribution planning, reimbursement rules, grace periods, and interaction with FEHB, HDHPs, and HSAs.

Module 3: Federal Employees’ Group Life Insurance (FEGLI)

• Explain Basic, AD&D, Extra Benefit, and Optional FEGLI (A, B, C), including eligibility, effective dates, age-based premiums, and life-event elections.
• Apply procedures for waivers, conversions, living benefits, assignments, reconsiderations, and court-ordered beneficiary requirements.
• Determine eligibility to continue Basic and Optional FEGLI into retirement, including the five-year rule, reduction options, and post-retirement coverage.
• Process survivor and death-in-service FEGLI claims and apply the statutory order of precedence.

Module 4: Federal Long Term Care Insurance Program (FLTCIP)

• Explain the purpose of FLTCIP and the types of long-term care services the program is designed to cover.
• Summarize historical FLTCIP contract evolutions (1.0, 2.0, 3.0) and major program features.
• Understand the OPM suspension of new enrollments (effective December 19, 2022) and what current enrollees may and may not change during the suspension.
• Identify where to access updated FLTCIP resources for employees, retirees, and family members.

Module 5: Social Security and Medicare Benefits

• Define Social Security benefit types (retirement, disability, survivor, Medicare) and explain credit requirements, full retirement age, and eligibility rules.
• Understand AIME and PIA calculations, delayed retirement credits, and spousal, survivor, and former-spouse benefits, including the repeal of WEP/GPO.
• Apply earnings test rules, disability qualification criteria, and the relationship between Social Security, CSRS, and FERS.
• Explain Medicare Parts A–D, enrollment timing, penalties, and coordination with FEHB coverage for retirees.