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Federal employee health plans now cover same-sex spouses

August 23, 2013

Optometrists who see patients under the Federal Employees Health Benefits (FEHB) Program or Federal Employees Dental and Vision Insurance Program (FEDVIP) should be aware the health plans now extend coverage to same-sex spouses of married federal employees, according to the U.S. Office of Personnel Management (OPM).

FEDVIP plans are stand-alone vision programs offered by several FEHB programs. Health insurance industry observers expect enrollment in FEHB and FEDVIP plans to increase, although estimates vary on how much.

The OPM issued letters to administrators for the two health plans July 3, 2013, indicating benefits coverage is effective immediately to any legally married same-sex spouse of a federal employee, as well as to the children of such same-sex couples.

The coverage is available regardless of the employee’s state of residency, according to the OPM. However, the coverage decision does not extend to registered domestic partners or individuals in civil unions.

The coverage policy change comes following a June 26, 2013, ruling by the U.S. Supreme Court declaring a key section of the federal Defense of Marriage Act (DOMA) unconstitutional.

In the wake of the Supreme Court ruling, other public and private insurance plans may issue similar coverage policy changes, the AOA Advocacy Group noted.

Because existing same-sex marriages were not recognized by the federal government before the Supreme Court decision, all legal same-sex marriages that predate the decision are being treated as new marriages; enrollees will have 60 days from June 26, 2013, (i.e., until Aug. 26, 2013) for enrollment actions.

For additional information on the FEHB and FEDVIP coverage policy change, visit www.opm.gov.

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