Continuing Care

If you are a Federal Employees Health Benefits Program enrollee with a child over age 22, it could pay to consider the SAMBA Health Benefit Plan this open season, which runs through Dec. 8.

Traditionally, FEHBP has provided coverage to dependents only until age 22, forcing federal employees to shell out a lot more money for health insurance if their children do not secure their own coverage by that time. While the government offers temporary continuation of coverage for federal dependents over age 22, dependents or their parents are responsible for paying the full cost of the coverage plus a 2 percent administrative charge.

During this open season, however, employees who enroll in the SAMBA plan will have the option of signing up for a separate benefit plan for their dependents age 22 through 26 at very affordable rates. To qualify, your child must be unmarried and wholly reliant on you for support.

FEHBP participants might not be aware of the SAMBA plan, largely because it previously was restricted to law enforcement and intelligence employees. But in August, the Office of Personnel Management notified agencies that the plan would be available to all FEHBP enrollees in 2009.

The 2009 monthly premium for the SAMBA's dependent health plan is $214.50. That's on top of the regular premium federal employees must pay for coverage; those premiums range from $212.10 for self to $529.88 for family in the plan's High Option, and $102.46 for self to $234 for family in the plan's Standard Option.

Walter Wilson, executive director of SAMBA, said on Tuesday that the dependent care plan provides the same coverage as the Standard Option. The plan also offers some preventive dental coverage for young adult dependents, he noted.

"This is a great alternative to the temporary continuation of coverage [option], and it is, of course, a very comprehensive plan, unlike some of the other plans," Wilson said.

SAMBA participants can enroll an eligible child at any time during the plan year, provided it is immediately following the child's loss of health insurance coverage as a result of turning 22. Employees also may enroll a child at the same time they sign up for the plan. SAMBA must receive the application within 60 days of the employee's enrollment or the child's loss of coverage. Click here to download an enrollment form.

Also, employees enrolled in SAMBA's dental and vision care plan can add their dependent children to the plan up until they turn 26. The children do not have to be enrolled in the dependent health care plan to qualify, and employees can sign their children up at any time. The 2009 premium rate for dental and vision will be $37 per child per month.

Federal employees who have dependent children age 22 or older but don't want to switch their current plan also might consider waiting for premium savings that could come through legislation in 2009.

Rep. Danny K. Davis, D-Ill., chairman of the House Oversight and Government Reform Subcommittee on the Federal Workforce, introduced a bill in the 110th Congress that would increase the maximum age of federal employee dependents eligible for FEHBP from 22 to 25. The legislation would create a young adult dependent option in FEHBP, under which dependents would still have to pay the full premium, but not the 2 percent administrative fee.

It's unclear whether Davis will introduce the legislation in the 111th Congress, and whether the measure would differ from the current version. Davis and Del. Eleanor Holmes Norton, D-D.C., have expressed concern that the measure's potentially high price tag could stifle support.

Still, many federal labor unions, including the American Federation of Government Employees and the National Treasury Employees Union, have argued that increasing the dependent age by three years is likely to decrease premiums, since infusing a larger number of young and generally health adults into the risk pool of typically older or retired federal employees should come at very little cost.

"The committee is in transition at this time, but we believe the chairman intends to address the issue next session in the form of legislation," said Marcus Williams, press secretary for the subcommittee.