Coverage

Once you're 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

Qualifying life events (QLEs)

Qualifying life events (QLEs) are certain life events that allow you to enroll in FEDVIP or make changes to your existing FEDVIP plan outside of open season.

Select a QLE type below for more details.

This QLE allows you to:

  • enroll
  • increase your enrollment type to self-plus-one or self-and-family (add eligible family members to your existing enrollment)
  • change your plan

You can submit this QLE anytime from 31 days before to 60 days after the date of the event.

This QLE applies if it happens to you and/or your eligible family members. It allows you to:

  • enroll
  • increase your enrollment type to self-plus-one or self-and-family (add eligible family members to your existing enrollment)

You can submit this QLE anytime from 31 days before to 60 days after the date of the event.

This QLE allows you to:

  • increase your enrollment type to self-plus-one or self-and-family (add eligible family members to your existing enrollment)

You can submit this QLE anytime from 31 days before to 60 days after the date of the event.

This QLE applies if the family member was already covered under your FEDVIP plan. It allows you to:

  • decrease your enrollment type to self-plus-one or self-only

You can submit this QLE anytime starting from 31 days before the date of the event. There is no time limit.

This QLE applies if you did not have FEDVIP coverage before your period of leave without pay or if your coverage was terminated or canceled during your period of leave without pay. It allows you to:

  • enroll
  • change your plan (if you had FEDVIP coverage)

If you're enrolling, you can submit this QLE anytime from 31 days before to 60 days after the date of the event. If you're changing your plan, you can submit this QLE anytime from the date of the event up to 60 days after.

This QLE applies if it happens to you or your spouse. It allows you to:

  • enroll

You can submit this QLE anytime from the date of the event up to 60 days after.

This QLE allows you to:

  • enroll

You can submit this QLE anytime from the date of the event up to 60 days after.

This QLE only applies if you're enrolled in a regional dental plan and you're moving out of the plan's service area. It allows you to:

  • change your plan

You can submit this QLE anytime. There is no time limit.

This QLE applies if it happens to you or your spouse. It allows you to:

  • cancel

You can submit this QLE anytime from 31 days before to 60 days after the date of the event.

This QLE only applies if you are transferring 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. It allows you to:

  • cancel

You can submit this QLE anytime from 31 days before to 60 days after the date of the event.

How to submit a QLE

If you experience a QLE that allows you to enroll, log into your My BENEFEDS account and select "Enroll" for dental or vision coverage on your dashboard. We will ask for your QLE type and the date of the event as part of the enrollment process.

If you experience a QLE that allows you to change your existing coverage, log into your My BENEFEDS account and select "Plan Overview" for your dental or vision coverage on your dashboard. Then select "Submit QLE."

If you experience a QLE that allows you to cancel your coverage, you must call BENEFEDS Customer Service.

During open season

If you experience a QLE during open season and want to enroll, change, or cancel your dental and/or vision coverage for the current plan year, you must call BENEFEDS Customer Service.

How to view a pending QLE or cancel a QLE

To view a pending QLE that is not yet effective, log into your My BENEFEDS account and select "Plan Overview" for your dental or vision coverage on your dashboard. Then select "Submit QLE." The first page will display any pending QLEs that you have. It will also display the effective date for that QLE.

You can cancel a submitted QLE within one business day by calling BENEFEDS Customer Service.

Adding or removing family members

Once you're 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).

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."

Modifying family members' information

You can modify your covered family members' information, such as their names and addresses, at any time. To modify a covered family member's name and address, 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.

What happens when I retire?

To determine if you're eligible for FEDVIP when you retire, check your eligibility.

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.

Keep in mind:

  • You can't 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.

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 to enroll in a FEDVIP dental and/or vision plan.

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 have to do it 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 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

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 pay before FEDVIP plans by law.

When to contact your carrier

BENEFEDS administers the enrollment, plan change, and premium payment processes for FEDVIP. If you're 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