Exercise Caution if Spouse is Not a Fed
Now that you know the two requirements that must be met to allow your surviving family members the right to continue FEHBP coverage in the event of your death, a federal retiree/employee who has a spouse that is NOT a federal retiree/employee should be cautious if he/she doesn’t have his/her spouse covered under the FEHBP program.
I have seen many federal retirees/employees who were married to someone who had inexpensive (or free) health insurance coverage from their private sector companies. The federal retiree/employee’s intention is to enroll the spouse under his/her FEHBP plan once the spouse leaves the private sector company. But until that day comes, the federal retiree/employee is taking a chance.
As the federal retiree/employee, if you are in a Self Only plan at the time of your death, your surviving spouse would not be allowed to enroll under the FEHBP even if a full survivor benefit was payable.
While living, this particular retiree/employee could always switch from a Self Only plan to a Self and Family plan and enroll his/her spouse later, but until then, if the spouse is potentially eligible for a survivor benefit, the retiree/employee is taking a chance. However, if the spouse was not potentially eligible for a survivor benefit, then it really isn’t a problem as the surviving spouse wouldn’t qualify for the FEHBP coverage anyway.
Let’s take a look at another example where this federal retiree/employee (who is married to someone who is NOT a federal retiree/employee) has his/her spouse covered under his/her Self and Family plan. It’s possible that the spouse may not have wanted the federal employee to elect a survivor benefit for retirement (or at the time of marriage if marrying after the employee is retired) for personal or financial reasons. Under a situation like this, the federal retiree could elect no survivor benefits for his/her spouse and could continue to keep the spouse under his/her Self and Family plan into retirement as long as the federal retiree is alive.
But as you have most likely guessed, if the federal retiree dies and there is no survivor benefit payable (because it was previously waived or never elected), then the surviving spouse would not be able to keep the FEHBP coverage. So if a federal employee is married to someone who is not entitled to his/her own FEHBP coverage at the time of retirement, the survivor benefit election opportunity at the time of retirement is not only a financial decision, but it’s also an FEHBP issue.
One Last Fed Married to a Fed Example
Let’s look at one final example of a federal employee who IS married to a federal employee/retiree who is (or will be) eligible for his/her own FEHBP coverage. When this employee prepares to retire, the survivor benefit election that he/she is considering for his/her spouse is purely a financial decision (and vice versa when his/her spouse retires and is considering a survivor benefit election).
If this person’s spouse will be entitled to FEHBP coverage under his/her own right, then this person wouldn’t be as concerned with the FEHBP issue and can keep it separate from his/her decision to provide a survivor benefit from his/her federal retirement.
Options for Surviving Family Members Not Eligible for FEHBP
If you die and your eligible family members don’t meet the requirements to continue FEHBP coverage, then they may be eligible for a 31-day extension of coverage and conversion. Once these 31 days expire, they may also be eligible to convert to Temporary Continuation of Coverage (TCC). TCC is also available to federal employees who leave federal service before they are eligible for retirement. Under TCC, enrollees must pay the full premium for the plan they select (which includes both the employee and government shares of the premium, plus a 2% administrative charge).
Hopefully I have given you some good information regarding the FEHBP. There are many situations that I didn’t cover, and there are so many more examples that I wanted to share, but there is only so much room to fit the words into these articles. I recommend the reader take some time to review their own situation with an agency benefits officer (or OPM if you are already retired), as well as the FAQs that OPM posted at the following web-link for additional information regarding the FEHBP:
http://www.opm.gov/insure/health/faq/index.asp
I wish you the very best in retirement!!
