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Indian Tribe FAQs - FEHB
How does a tribe, tribal organization, or urban Indian organization become entitled to purchase for FEHB coverage?
In order to be eligible for enrollment in FEHB, a tribe, tribal organization or urban Indian organization will have to verify that they are engaged in an ISDEAA or Title V contractual agreement with IHS or BIA before they begin enrolling employees.
Why is there an administrative fee being charged in addition to the FEHB premium?
As is the case for Federal agencies, a tribe, tribal organization or urban Indian organization will be responsible for the costs associated with administrative services related to processing of employee enrollments.
Will my tribe/tribal organization/urban Indian organization be able to purchase vision and/or dental coverage through the Federal Employees Dental and Vision Program?
No, the new law only affords tribe/tribal organization/urban Indian organization the opportunity to purchase FEHB and FEGLI coverage for eligible employees.
Will my tribe/tribal organization/urban Indian organization be able to split its eligible employee population and only provide FEHB coverage to some?
No. As is the case with participating federal agencies, a tribe/tribal organization/urban Indian organization wishing to access FEHB coverage will have to offer coverage to all of their eligible employees, or none at all.
Is there a required employer contribution to FEHB premiums?
Yes. In order to enroll eligible employees, a tribe, tribal organizations or urban Indian organization must pay at minimum, the lesser of: (1) 72 percent of the weighted average of premiums in effect each year, for Self Only and for Self and Family enrollments, respectively, or (2) 75 percent of the total premium for the particular plan an enrollee selects. A tribe, tribal organization or urban Indian organization may choose to pay more than the minimum as well. This is the same minimum standard that applies to Federal agencies, and is required in order to maintain the integrity of the FEHB pool.
Who chooses the insurance plan-the tribe employer or tribe employees?
In order to enroll eligible employees in FEHB coverage, it is required that the tribe, tribal organization or urban Indian organization allow each employee to choose their own coverage plan. This is the same standard used for Federal agencies and their employees.
Is coverage available for tribal retirees?
No. This new provision allows the tribe/tribal organization/urban Indian organization to purchase coverage for their employees. It does not provide retirees with rights as annuitants.
If an employee has a pre-existing condition, will there be a waiting period before they are able to receive coverage?
No. There are no exclusions or waiting periods for pre-existing conditions in the FEHB Program.
Can I cover my common-law spouse under my Self and Family enrollment?
Yes, if the State in which you reside recognizes common-law marriages.
Some of our employees are unionized and FEHB coverage does not meet negotiated health benefits coverage requirements. What can we do?
Union employees may be carved out if they receive alternative comprehensive health insurance coverage under the terms of a collective bargaining agreement. Alternative comprehensive coverage may not be offered to non-unionized tribal employees.