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Q: Health Care for Congress ( Answered,   0 Comments )
Subject: Health Care for Congress
Category: Health
Asked by: ldquinn-ga
List Price: $2.00
Posted: 22 Jul 2003 07:38 PDT
Expires: 21 Aug 2003 07:38 PDT
Question ID: 233718
What are the features of the health plan afforded to Congress and their staff
Subject: Re: Health Care for Congress
Answered By: thx1138-ga on 22 Jul 2003 07:59 PDT
Hello ldquinn and thank you for your question.

The health plan afforded to Congress and their staff is called the
Federal Employees Health Benefits Program (FEHBP)

"Under the Federal Employees Health Benefits Program (FEHBP) --
available to members of Congress and nine million other federal
workers, retirees and dependents -- health-care plans are offered in
competition with current fee-for-service and health maintenance
organization options""

The main website of the Federal Employees Health Benefits Program :


The main program features are:

"Some of our important program features are: 

No waiting periods. ou can use your benefits as soon as your coverage
becomes effective. There are no pre-existing condition limitations
even if you change plans.

A choice of coverage. You can choose self only coverage just for you,
or self and family coverage for you, your spouse, and unmarried
dependent children under age 22. Under certain circumstances, your
FEHB enrollment may cover your disabled child 22 years old or older
who is incapable of self-support.

A choice of plans and options. 

Fee-for-Service plans 
Plans offering a Point of Service product 
Health Maintenance Organizations 
A Government contribution. The Government pays 72 percent of the
average premium toward the total cost of the your premium, but not
more than 75 percent of the total premium for any plan.

Salary deduction. You pay your share of the premium through a payroll
deduction and have the choice of doing so using pretax dollars.

Annual enrollment opportunities. Each year you can enroll or change
your health plan enrollment. This year the Open Season runs from
November 11, 2002, through December 9, 2002. Other events allow for
certain types of changes throughout the year; see your human resources
office or retirement system for details.

Continued group coverage. The FEHB Program offers continued FEHB

for you and your family when you retire from Federal service (normally
you need to be covered in the FEHB Program for the five years before
you retire),
for your former spouse if you divorce and he or she has a qualifying
court order (see your human resource office for more information),
for your family if you die, or 
for you and your family when you move, transfer, go on leave without
pay, or enter military service (certain rules about coverage and
premium amounts apply; see your human resource office).
Coverage after FEHB ends. The FEHB Program offers either temporary
continuation of FEHB coverage (TCC) or conversion to non-group
(private) coverage:

for you and your family if you leave Federal service (including when
you can't carry FEHB into retirement),
for your covered dependent child if he or she marries or turns age 22,
for your former spouse if you divorce and he or she does not have a
qualifying court order (see your human resource office for more
If you lose coverage under the FEHB Program, you should automatically
receive a Certificate of Group Health Plan Coverage from the last FEHB
Plan to cover you. If not, the plan must give you one on request. This
certificate may be important to qualify for benefits if you join a
non-FEHB plan."


Thank you for your question and if you need any clarification of my
answer do not hesitate to ask.

Very best regards.


Search strategy included:
"members of Congress" "health care plan"
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