Document list

Document Name Document Number
Terms and Conditions and Privacy Policy SB-FBF-002
Cover page V26.00.1.1
Introduction V26.00.1.2
Table of Contents V26.00.1.3
A Choice of Plans and Options V26.00.2.1
Enroll Through BENEFEDS V26.00.2.2
Dual Enrollment V26.00.2.3
Coverage Effective Date V26.00.2.4
Pre-Tax Salary Deduction for Employees V26.00.2.5
Annual Enrollment Opportunity V26.00.2.6
Continued Group Coverage After Retirement V26.00.2.7
How We Have Changed for 2026 V26.00.3
Federal Employees V26.01.1
Temporary/Seasonal Employees V26.01.2
Federal Annuitants V26.01.3
Survivor Annuitants V26.01.4
Compensationers V26.01.5
TRICARE-eligible individual V26.01.6
Family Members V26.01.7
Not Eligible V26.01.8
Enroll Through BENEFEDS V26.02.1
Enrollment Types V26.02.2
Dual Enrollment V26.02.3
Opportunities to Enroll or Change Enrollment V26.02.4
When Coverage Stops V26.02.5
Continuation of Coverage V26.02.6
FSAFEDS/High-Deductible Health Plans and FEDVIP V26.02.7
Identification Cards/Enrollment Confirmation V26.03.1
Plan Providers V26.03.2
In-Network V26.03.3
Out-of-Network V26.03.4
Pre-Authorization V26.03.5
FEHB/PSHB First Payor V26.03.6
Coordination of Benefits V26.03.7
Limited Access Areas V26.03.8
Copayment V26.04.1
In-Network Services V26.04.2
Out-of-Network Services V26.04.3
Section 5 Vision Services and Supplies V26.05.0
Diagnostic V26.05.1
Eyewear V26.05.2
Contact Lenses V26.05.3
Warranty V26.05.3.1
Child Benefit V26.05.4
Medical Condition Benefit V26.05.5
Low Vision V26.05.6
Medically Necessary Contact Lenses V26.05.7
Discounts V26.05.8
Tools and Resources V26.05.9
Section 6 International Services and Supplies V26.06.0
International Claims Payment V26.06.1
Finding an International Provider V26.06.2
Filing International Claims V26.06.3
Customer Service Website and Phone Numbers V26.06.4
International Plan Allowances V26.06.5
Section 7 General Exclusions – Things We Do Not Cover V26.07
How to File a Claim for Covered Services V26.08.1
Deadline for Filing Your Claim V26.08.2
Disputed Claims Process V26.08.3
Annuitants V26.09.01
BENEFEDS V26.09.02
Benefits V26.09.03
Enrollee V26.09.04
FEDVIP V26.09.05
Plan Allowance V26.09.06
Pre-Authorization V26.09.07
Sponsor V26.09.08
TEI certifying family member V26.09.09
TRICARE-eligible individual (TEI) family member V26.09.10
We/Us V26.09.11
You V26.09.12
Stop Health Care Fraud! V26.10
Summary of Benefits V26.11
Rate Information V26.12