Coverage

Once you are enrolled in a Federal Employees Dental and Vision Insurance Program (FEDVIP) dental and/or vision plan, your coverage automatically continues as long as you remain eligible for the program—you do not have to enroll each year.

Viewing your plan information

To view your current coverage information for your dental and/or vision plan, log into your My BENEFEDS account, select "Plan Overview" on your dashboard, and then "Coverage Details." The information that's available to you includes:

  • plan brochures
  • provider networks
  • covered services
  • in- and out-of-network costs
  • annual maximum benefits
  • deductibles
  • enrollment type
  • covered family members
  • premium based on pay frequency

Adding or removing family members

Once you are enrolled in a FEDVIP dental and/or vision plan, you can only add or remove family members during open season, if you experience a qualifying life event (QLE), or if you have a self-and-family plan (see below).

Once a covered family member no longer meets the definition of an eligible family member, that family member must be removed from your coverage. You can make that update online or by contacting BENEFEDS Customer Service.

If an ineligible family member receives benefits after they become ineligible, you will be responsible for the full amount of any dental and/or vision expenses incurred.

Self-and-family plan

To add family members to or remove family members from a self-and-family plan, log into your My BENEFEDS account and select "Plan Overview" for your dental or vision coverage. Then select "Change Plan."

All of your eligible family members are covered under a self-and-family plan, but you still must add them to your coverage to avoid possible delays/denials in claims payments. Proof of dependent eligibility may be requested.

Modifying family member information

You can modify your covered family members' information, such as their names and addresses, at any time. To do this, log into your My BENEFEDS account and select "Plan Overview" for your dental or vision coverage on your dashboard. Then select "Change Plan" and "Edit" next to the family member whose information you want to modify.

You cannot modify your family members' other information because it may affect their eligibility. Please call BENEFEDS Customer Service if you need to change any other information for a covered family member. Proof of dependent eligibility may be requested.

What happens when I retire?

Federal civilians

If you enrolled in FEDVIP as a Federal employee and you retire or become a compensationer while you're enrolled, in most cases you don't need to do anything. Your FEDVIP coverage will automatically continue. We will work with your annuity system to set up premium deductions from your annuity, once we receive notification of your retirement from your payroll office.

We will not be notified of your retirement in some cases. Please call BENEFEDS Customer Service if you do not see a deduction after two full pay periods.

Keep in mind:

  • You cannot cancel your FEDVIP coverage just because you retire.
  • Your FEDVIP coverage will continue into retirement regardless of the length of time you had coverage as an employee. There is no requirement to have coverage for five years of service prior to retirement like there is with the Federal Employees Health Benefits (FEHB) Program.

Why am I receiving a direct bill?
Your FEDVIP premiums cannot be deducted from your annuity while you are receiving interim payments (sometimes called "special pay"). This means we cannot take deductions from your annuity/pension until the U.S. Office of Personnel Management (OPM) finalizes your annuity. While you're receiving interim payments, you may receive direct bills to pay for your premiums. You may also make secure premium payments online, if you receive a direct bill. It is expected that you pay any direct bill you receive for your FEDVIP premums.

Uniformed service members

If you're an active uniformed service member and you retire, you're now eligible to enroll in FEDVIP dental coverage and, if enrolled in a TRICARE health plan, FEDVIP vision coverage. You are considered newly eligible for the program and have 60 days from the date you became eligible (your retirement date) to enroll in a FEDVIP dental and/or vision plan.

If your family member enrolled in FEDVIP vision coverage while you were on active duty, he or she is no longer eligible as a primary enrollee upon your retirement. You or your family member must notify BENEFEDS and his or her coverage will be inactivated. You must then enroll in FEDVIP dental and/or vision coverage as a retired uniformed service member and add your eligible family members as dependents to your coverage.

Canceling your coverage

If you're enrolled in FEDVIP, you have the opportunity to cancel your coverage each year during open season.

Keep in mind, you can't cancel your coverage:

  • because you retire
  • because you can no longer afford the premiums
  • through your agency or a self-service program (like EBIS or Employee Express)—you must cancel through BENEFEDS

Outside of open season

The only time you can cancel your FEDVIP coverage outside of open season is if you experience the following qualifying life events (QLEs):

  • you or your spouse return to active military duty
  • you are a Federal employee and you transfer to an eligible position at a Federal agency that provides dental and/or vision coverage with 50% or more employer-paid premiums and you enroll in that coverage

You must cancel your coverage within the QLE timeframe that's permitted, otherwise it will automatically continue and you will have to wait until open season. Call BENEFEDS Customer Service to cancel your coverage outside of open season.

Coordination of benefits

You will be asked if you have other insurance coverage when you enroll in FEDVIP in order to coordinate your benefits if necessary. This includes coverage under the Federal Employees Health Benefits (FEHB) Program, Medicare, TRICARE, and other dental or vision insurance providers. FEHB plans are the first payors before FEDVIP plans by law.

BENEFEDS is not involved in the coordination of benefits process. Contact your dental or vision carrier, or other insurance provider, directly if you have questions about the coordination of your benefits.

When to contact your carrier

BENEFEDS administers the enrollment, plan change, and premium payment processes for FEDVIP. If you are enrolled in FEDVIP, contact your dental or vision carrier directly if you have questions about:

  • ID cards
  • covered services
  • claims
  • coordination of benefits
  • provider networks
  • rating regions