Coverage information - 9 
• No pre-existing condition limitation - 9 
• Minimum essential coverage (MEC) - 9 
• Minimum value standard - 9 
• Where you can get information about enrolling in the FEHB Program - 9 
• Enrollment types available for you and your family - 9 
• Family member coverage - 10 
• Children’s Equity Act - 10 
• When benefits and premiums start - 11 
• When you retire - 11 
When you lose benefits - 11 
• When FEHB coverage ends - 11 
• Upon divorce - 12 
• Temporary Continuation of Coverage (TCC) - 12 
• Finding replacement coverage - 12 
• Health Insurance Marketplace - 12 

General features of our Standard and Basic Options - 13 
We have a Preferred Provider Organization (PPO) - 13 
How we pay professional and facility providers - 13 
Your rights and responsibilities - 14 
Your medical and claims records are confidential - 14 

Changes to our Standard Option only - 15 
Changes to our Basic Option only - 15 
Changes to both our Standard and Basic Options - 16 

Identification cards - 17 
Where you get covered care - 17 
Balance Billing Protection - 17 
• Covered professional providers - 17 
• Covered facility providers - 17 
What you must do to get covered care - 19 
• Transitional care - 20 
• If you are hospitalized when your enrollment begins - 20 
You need prior Plan approval for certain services - 20 
• Inpatient hospital admission, inpatient residential treatment center admission, or skilled nursing facility admission - 21 
• Other services - 21 
• Surgery by Non-participating providers under Standard Option - 24 
How to request precertification for an admission or get prior approval for Other services - 24 
• Non-urgent care claims - 24 
• Urgent care claims - 25