Insurance Extensions

Lawmaker proposes disability coverage for feds; Defense expands TRICARE offerings.

Federal employees have a range of benefits related to their well-being, including group health, dental and vision coverage, flexible spending accounts, and access to group life insurance and long-term care insurance. But when it comes to assistance for those who are unable to work due to disability, the options narrow. One lawmaker is seeking to bridge that gap.

Del. Eleanor Holmes Norton, D-D.C., last week introduced a bill that would provide access to short-term disability insurance for federal employees with nonwork-related injuries and illnesses. Participants would pay the full premiums and receive benefits to replace lost income for up to one year.

Government workers injured on the job are covered under the 1916 Federal Employees' Compensation Act, which offers wage-loss and medical rehabilitation benefits. But those hurt outside work must use accumulated sick leave for short-term disabilities; for long-term illness and injury, they have access to disability retirement payments under the Civil Service Retirement System or the Federal Employees Retirement System, as well as Social Security disability benefits.

In both scenarios for nonwork injuries, employees who are relatively new to federal service could be out of luck. It takes time to accumulate sick leave, and conditions that last more than a few weeks could force workers to take leave without pay. In addition, employees must have 18 months of service to be eligible for disability retirement benefits.

"Although federal employees have good health insurance, health benefits do not replace lost income if employees are unable to work," Norton said in a statement introducing the bill. "And while federal employees may have limited available sick or annual leave days, these are often insufficient to cover the costs of an employee's living expenses if he or she has to be out of work for an extended period of time."

No Smoking

Military service members and their families hoping to kick a smoking habit soon could get some help from the government. The Defense Department on Tuesday issued a proposed rule detailing a cessation program to be offered through TRICARE, as required by 2009 authorization law.

Under the program, TRICARE beneficiaries would have access to mail-order smoking cessation drugs at no cost; face-to-face counseling; a toll-free quit line; and cessation information both in print and online. Two quit attempts, which include up to 18 counseling sessions and/or 120 days of drug intervention, are covered per year. Physicians can authorize a third attempt.

All TRICARE enrollees who live in the United States and are not eligible for Medicare can participate in the program. Some services also could be offered to active-duty personnel and their dependents stationed overseas and enrolled in TRICARE Prime.

Civilian workers covered under the Federal Employees Health Benefits Program haven't been forgotten. FEHBP plans in 2011 began offering smoking cessation programs that include four counseling sessions per quit attempt, for up to two tries annually.

TRICARE, Medicare

Defense also is seeking to ease coverage procedures for TRICARE beneficiaries who are eligible for Medicare due to a retroactive disability determination.

In a proposed rule, the department announced plans to implement a provision in the 2010 Defense authorization law exempting TRICARE enrollees under the age of 65 who become eligible for Medicare Part A hospital insurance based on a disability from the requirement to also enroll in Medicare Part B during that period. TRICARE benefits would continue as long as an individual's disability determination remains pending before the Social Security Administration.

In the past, beneficiaries would lose their TRICARE coverage if they declined to participate in Medicare Part B while enrolled in Part A. Beneficiaries eligible for Medicare based on age still would be required to enroll in Part B in order to maintain TRICARE coverage in future months.