FEHB Protection Act of 2025

Increased Oversight of Eligibility: The bill requires the Director to implement a process to verify that life events and family members added to health plans are actually qualifying (Section 2(b)). This aims to ensure that only eligible individuals are covered under the Program.

Targeted Fraud Prevention: The bill mandates that fraud risk assessments specifically include individuals who are covered under a health benefits plan despite not being eligible (Section 2(c)).

Comprehensive Verification: Through a required three-year audit, the Director will review documents such as marriage and birth certificates to determine if family members are truly eligible for coverage (Section 2(d)).

Removal of Ineligible Enrollees: The bill requires the development of a process to disenroll or remove individuals from the health insurance program if they are found to be ineligible (Section 2(e)).

Increased Scrutiny of Documentation: To conduct required audits, the Director and employing offices will review sensitive personal documents, including marriage certificates and birth certificates (Section 2(d)).

Risk of Disenrollment: Individuals currently enrolled in a health benefits plan who are found to be ineligible will be subject to a process for disenrollment or removal from the program (Section 2(e)).