By Reg Jones
Q. My disabled adult child is covered under my Federal Employees Health Benefits. How can I ensure that she will remain covered by FEHB after I pass on?
Q. I am retired CSRS. I’m marrying a woman who has a minor child. Can I have the child on my Federal Employees Health Benefits and/or as a survivor under any circumstance short of outright adoption?
Q. My wife just resigned from the U.S. Forest Service. She is 44 with more than 20 years of service. Did she lose all of her retirement, or is she still eligible to receive a portion at the reduced rate of 5 percent?
She was always in a position covered under firefighter retirement, eligible at 50 to retire. Also, is she still eligible for health benefits?
February 24th, 2012 | Eligibility
Q: My daughter was declared permanently disabled and allowed to remain on my FEHB plan. What happens when I pass on? Will she have an option to continue coverage?
A: Yes, as long as she continues to be eligible for the disabled child benefit.
December 13th, 2011 | Eligibility
Q: I have worked for the Veterans Affair Department for the past 16 years. My husband retired there, and has us on his FEHB health insurance plan. With open season coming up, we would like to take individual plans. Will this mean I have to work five years before retiring if I do, or is that only for life insurance?
A: No, you won’t have to work five years. The only requirement is that you be enrolled in or covered by the FEHB program for the five consecutive years before you retire.
Tags: HEALTH INSURANCE
December 13th, 2011 | Eligibility
Q: I am a 57-year-old employee in the federal court system with five years of qualified service. If for some reason the judge I work for should decide to leave or be unable to work, my position would officially end. If I cannot find another position with the court, would I be able to continue my FEHB health care coverage after my job ends?
A: You would be able to continue your FEHB coverage for up to 18 months under the Temporary Continuation of Coverage provision. You would be required to pay the whole premium, plus 2 percent to cover administrative expenses. If you left your retirement contributions in the fund, you would be able to apply for a deferred annuity at age 62. However, you would not be able to re-enroll in the FEHB program at that time. No one who retires on a deferred annuity can do that.
June 1st, 2011 | Eligibility
Q: I’m in CSRS and I’m 55 with 27-and-a-half years service. I’m considering getting married and would like to know if my future spouse can be covered under my FEHB enrollment if I get married and retire within two years of retirement or, if I wait to get married until after I retire would he eligible for FEHBP? Also, he is a FERS employee but he isn’t eligible for FEHB if he retires early with me.
A: I’m not sure I understand the scenarios you presented. Fortunately, that doesn’t matter. If you get married, you can switch your enrollment from self only to self and family within 60 days of that event. Also, once married, you can make that switch during any open season, whether you are employed or retired.
May 20th, 2011 | Eligibility
Q: I have worked for the DHS for a little more than four years, and have four years of military time which I bought back. I am 59 years old and would like to retire sometime around 62. I have been in one of the health care plans, but would like to use it when I retire. My wife had a cheaper plan where she worked, so I never switched over. When I was hired, I was never told of the need to be in the plan for five years before I retired. Why would this have any affect on me enrolling in the future? I have saved the government money by not being in the plan. They have had to spend zero on me for health care, but someone who has used the health care for five years would then be eligible at 62 to keep it. Please tell me how this makes any sense? If I had been told when I was hired I would have chosen the health-care option. If I retire at 62, my wife would like to retire also, and we can’t get into her health-care plan when we retire. How would saving the government money affect my ability to get into the system? We had been in her plan for a number of years, and hated to switch when I got hired. Can you give me some guidance on this issue, or who I can contact?
A: By law, you would have to be enrolled in an FEHB plan for five years or from your first opportunity to enroll to carry that coverage into retirement. In your case, your first opportunity to enroll was when you were hired by the federal government. There are only two exceptions to this rule. First, if you can prove that you were prevented by circumstances beyond your control from enrolling in the FEHB, which is an exceedingly difficult standard to meet, since ignorance of the law is no excuse. Second, if you were enrolled in an FEHB plan, were eligible to retire – in your case, age 62 with five years of service – and your agency offered you an opportunity to retire early.
March 11th, 2011 | Eligibility
Q: My husband was married when he retired. They later divorced and he married me. I was added to his insurance a few years later. If he dies, will I still be able to continue to be covered by his federal insurance and pay the premiums?
A: Only if you are entitled to receive a survivor annuity based on his federal employment.
Tags: survivor annuity
Q: My spouse and I are both under the Federal Employees Retirement System and our service computation dates are within weeks of each other. We would both like to retire under the minimum retirement age plus-10 provision. My spouse wants to retire in 2011 at age 58, with 26 1/2 years of continuous service, the entire time enrolled in a Federal Employees Health Benefits individual plan. The earliest I would retire is 2012 at age 57, with 27 1/2 years of continuous service, all in an FEHB individual plan.
Here is our plan: During this open season, I should enroll my spouse and myself in an FEHB family plan. She could then retire in 2011 and elect a postponed annuity. She would have health benefits under my family plan, while her annuity entitlement increases 5 percent for each year she postpones receipt of her annuity. When she elects to receive her annuity at age 59 or 60, she can then re-enroll in an FEHB family plan. At that time, I could retire (also with a postponed annuity) and receive health benefits under my wife’s plan. Again, when I start receiving my postponed annuity several years later, I can re-enroll in an individual FEHB plan, and she could change her family coverage to an individual plan during open season. This way, we have two individual FEHB plans and we won’t have to worry about electing FERS survivor benefits that would otherwise reduce our annuities. Is this a reasonable plan?
A: Sounds like a reasonable plan. However, because you cannot have dual coverage (i.e., self and family plus self only for one family member, or self and family for both members), you’ll have to time the switch from one covered member to the other. As a rule, this would be easiest to do during the annual open season.
Q: I am 53 years old and have 36 years of federal service. One catch: I don’t have the five years of coverage under a Federal Employees Health Benefit plan (I’m still four years short). If my office offers early out through downsizing or restructuring, approved by the Office of Personnel Management, can I retire and carry my health benefits into retirement, even though I don’t have five years of coverage?
A: Yes, you would be eligible to carry your coverage into retirement because you would have been enrolled in the program at the time your agency received approval from OPM to offer early retirements. Your agency would attach a memo to your retirement application stating that you meet the requirements for an immediate waiver of the five-year rule.
Q: My wife and I are both federal employees. We each have had individual coverage under the Federal Employees Health Benefits plan since we began working for the government. We both plan on retiring next year. She will be 61 and have 26 years of service; I will be 58 and have 20 years of service. I will postpone my retirement until age 60 to avoid the penalty. We plan on converting to a family plan this open season (2010) so that I am covered during those two years of my postponement. Is this the correct way to guarantee that I maintain my eligibility under FEHB for the past five years and be able to go back to an individual FEHB plan when I begin collecting my annuity at age 60?
A: Having your wife enroll in the self and family option of her plan will assure that you have health benefits coverage during the period between when you retire and when your annuity begins. You can both revert to self-only coverage during the following open season.
Q: I retired from the U.S. Postal Service in 2000 after being divorced in 1997. I gave my ex-wife 100 percent survivor benefits; she recently turned 55. I remarried in 2004 and sent the proper forms needed to add my current wife to my Federal Employees Health Benefits plan. I now have the American Postal Workers Union (472) plan, and I assumed that if I died, my present wife would be able to keep the plan. After talking with the Office of Personnel Management, I was told that I need to have my present wife named as survivor beneficiary for her to keep it, even though my ex-wife has 100 percent survivor benefits. They said that I had to do that within two years after our marriage. I was never advised of this and have never read anything on the matter. Can you please explain this to me?
A: Under 5 CFR 831.631, a retiree can elect a survivor annuity for a spouse acquired after retirement. That election must be made within two years after the marriage. Although your former spouse has entitlement to the full survivor annuity, if she were to die and you had elected a survivor annuity for your current spouse, your current spouse would be entitled to that survivor annuity. Because your annuity has already been reduced to pay for the original survivor annuity, your election of one for your current spouse wouldn’t cost you anything. Note: Even if you died after electing a survivor annuity for your current spouse, she would only be eligible to continue her FEHB coverage if she was actually receiving a survivor annuity.
Q: My husband and I are both federal law enforcement officers. The family health plan is under my husband. We both plan to retire this year. He wants me to waive my survivor annuity and he says I will still be covered under our federal Blue Cross/Blue Shield plan because I was covered for the last five years of my employment under the Federal Employees Health Benefits family plan that he carried. He wants a bigger retirement check. My question is, if I sign the survivor annuity waiver and he dies before me, am I still automatically covered under our FEHB plan because I was also a federal retiree and would have been eligible for coverage? I think he is wrong and will not sign any waiver. I told him there is no “federal spouse rule” laid out in the Office of Personnel Management’s guidelines concerning FEHB.
A: Whether you decide to waive your entitlement to a survivor annuity is entirely up to you. However, your husband’s explanation of why you would be able to continue your FEHB coverage if he were to die before you is wrong. As long as you are covered under his FEHB plan enrollment and either employed or receiving an annuity when he dies, you would be able to continue that coverage. As the one carrying the enrollment, it’s your husband who needs to be enrolled for the five consecutive years before he retires, not you.
Q: Is the provision in the new health care law for children 26 years old or younger to be on their parents’ health plan to be delayed until Jan. 1, 2011 for those in the Federal Employees Health Benefits Program, rather than the quoted six months after signature by the president?
A: To quote the Office of Personnel Management, “The effective date of this provision is the first day of the plan year that is six months following enactment of the law. For the Federal Employees Health Benefits Program, that means January 1, 2011.”
March 29th, 2010 | Eligibility
Q. Per the new Health Reform Act, the FEHB has been extended for FEHB dependents till 26 years old; would the temporary continuation of coverage (TCC) be available for these dependents aged 26 for three years, as currently designed for dependents 22 years old? My son was under the TCC from 22 to 25. Currently, he is 25 and under an individual health insurance policy. He turns 26 years old on Nov 29, 2010; unfortunately, before this new reform law becomes effective. Would he be eligible for another three-year TCC term since he is still a full-time student, at medical school?
A. To the best of my knowledge, there is nothing in the new law that would allow that to happen.
March 26th, 2010 | Eligibility
Q. I am retired (single ) but I have two daughters ages 24 & 23 who go to school and live at home. How and when can I add them to my FEHB policy?
A. The effective date of this new provision of law is the first day of the plan year that is six months following enactment of the law. For the FEHB program, that means Jan. 1, 2011. OPM will take the necessary actions to comply with the new law by this effective date so that employees and retirees have the information in time for the annual Open Season, which begins in November.
Q. I am 36 years old and plan on retiring at age 40 from the VA, giving me 10 years of service, during which time I have been continuously enrolled in FEHB. I know I will not be eligible for my annuity until around age 60, which means I will not be eligible for FEHB from age 40-60. However, once I reach age 60 or so, and start collecting my annuity, will I be eligible to enroll in the FEHB again? I know you have to enrolled for the five years of service prior to retirement, but does that mean I have to actually be working up until I am eligible for my annuity?.
A. No, you won’t. No one who leaves government and later applies for a deferred annuity is eligible to re-enroll in the Federal Employees Health Benefits program. By the way, if you leave with fewer than 20 years of service, you wouldn’t be able to apply for a deferred annuity until you reach age 62.
Q. I was in the Marine Corps for 22 months from 1969-1971. I will be 63 years old in May 2010. I started work at the VA hospital on July 3, 2006 and am currently still employed. I bought back (made deposit for) the 22 months military time in 2008. I am getting conflicting answers from the HR dept.
1. When can I retire with the “age 62 and five years” rule? I was first told by HR that my 22 months buyback would count towards the five years but am now being told it will not and that I will have to work until September 2011 rather than being eligible since September 2009 as first told.
2. I went on the health insurance within the first 60-day grace period of being hired and so the effective date of my health enrollment is September 2006. When can I retire and carry my health insurance? The Web site says you have to be on the health insurance five years or less if you went on it when first offered (which I did). HR is saying I absolutely have to be on it for five years.
A. Your folks in HR were correct when they told you that you had to have five years of civilian service to retire at age 62 or later. However, they were wrong about the five-year requirement to carry your health insurance into retirement. The law specifies that you need to be covered for five years or from your first opportunity to enroll.
March 19th, 2010 | Eligibility
Q. My wife’s health insurance is currently covered by her private employer. I have am currently enrolled under self only. I have been covered for 30 years in the FEHB. I plan to retire in two years and add my wife to my health insurance, self and family . My wife will lose her health insurance when she retires . Can I add her to my health insurance?
A. Whether you are still employed, you could add your wife to your plan 31 days before she retires. If you are retired, you can do it 31 days before she retires up to 60 days after the event. Whether you are still employed or retired, you can always add her during any health benefits open season.