What is the Direct Premium Remittance System (DPRS)?
The Direct Premium Remittance System is a centralized automated system that enrolls, bills, and collects health insurance premiums from eligible non-Federal enrollees who elect to participate in the Federal Employees Health Benefits (FEHB) Program or the Postal Service Health Benefits (PSHB) Program under the Temporary Continuation of Coverage (TCC) and Spouse Equity regulations. DPRS processes the reporting of information between the enrollees and the insurance carriers and the Office of Personnel Management (OPM).
What is Temporary Continuation of Coverage (TCC)? (Public Law 100-654)?
TCC is a feature of FEHB that allows eligible individuals to temporarily continue their FEHB coverage after regular coverage ends. TCC became effective January 1, 1990.
Who is eligible for TCC?
Federal employees and members of their families who lose their Federal Employees Health Benefits (FEHB) coverage because of a "qualifying event" may be eligible for TCC. The qualifying event must have occurred on or after January 1, 1990.
What constitutes a qualifying event?
For employees, the only qualifying event is separation from Federal Service. However, employees are not entitled to TCC if the separation is involuntary due to gross misconduct. The employing office is responsible for deciding whether conduct that leads to an involuntary separation is considered, "gross misconduct." For children, the qualifying events are:
- reaching age 26
- loss of status as stepchild, foster child, or recognized natural child
- in the case of children whose coverage has continued beyond age 26 because of their inability to support themselves due to a disability occurring before they reached age 26, recovering from the disability or becoming self-supporting
- death of the employee or annuitant if the child does not qualify for a survivor annuity
- survivor annuity stops for any reason, including because he or she is no longer a full-time student.
Spouses are not eligible for TCC in their own right, even if the Federal employee dies or separates and decides not to elect TCC. However, if the marriage ends other than by death, the former spouse is eligible for TCC. The qualifying events are divorce and annulment of the marriage.
Who do I call for further information on the Direct Premium Remittance System (DPRS)?
If you have questions regarding DPRS, Temporary Continuation of Coverage (TCC), or Spouse Equity, please contact your employing office (if a Federal employee) or call the USDA, National Finance Center, Direct Premium Remittance Unit at 1-800-242-9630. If you have questions related to Postal Service Health Benefit (PSHB) enrollments or processing please contact Office of Personnel Managment at 1-888-767-6738.
Additionally, DPRS handles billings and collections for the PSHB program. What is the Postal Service Health Benefits (PSHB) program?
https://www.opm.gov/healthcare-insurance/pshb/
How does PSHB relate to the DPRS program?
The National Finance Center, in partnership with the Office of Personnel Management, utilizes the DPRS program to provide billing for the PSHB population.
Does NFC process enrollments, billings, and collections for PSHB enrollees?
PSHB enrollments and enrollment changes are handled through the Postal Service health Benefits portal. The National Finance Center provides billing services only. DPRS only handles billing and collections for PSHB enrollees.