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FEHB Handbook

Termination, Conversion and Temporary Continuation of Coverage
Page 1 of 6

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CANCELLATION

Electing to Cancel

If you participate in premium conversion, you may cancel your enrollment:

  • During the annual Open Season; or
  • Within 60 days after you have a qualifying life event. Your cancellation must be consistent with and correspond to your qualifying life event.

Example

LaTonya gets married, and since her husband's company provides health insurance for a spouse, she wants to cancel her FEHB enrollment. She can make this enrollment change outside of Open Season since it is consistent with and corresponds to her qualifying life event (marriage).

If you do not participate in premium conversion, you may cancel your enrollment at any time.

Your cancellation becomes effective on the last day of the pay period in which your employing office receives your Health Benefits Election Form (SF 2809) or other enrollment request. When you cancel your enrollment, you are not eligible for the 31-day extension of coverage and you can't convert your coverage to an individual policy.

If your temporary continuation of coverage (TCC) or spouse equity enrollment ends because you didn't pay the premiums, it is considered to be a voluntary cancellation.

When you cancel your enrollment, your family members' coverage terminates at midnight of the day that your cancellation is effective, with no 31-day extension of coverage.

Your Responsibility

When you cancel your enrollment, your signature certifies that you are aware:

Your employing office will process your termination by following the applicable instructions in "Employing Office Review of SF 2809." It will use the old carrier copy to notify your carrier of your cancellation and discard the new carrier copy.

Annuitants

When you cancel your enrollment as an annuitant, you may never reenroll unless:

TERMINATION

Enrollees

Your enrollment will terminate, subject to a 31-day extension of coverage, on the earliest of the following dates:

  • the last day of the pay period in which you separate from service (unless you transfer, retire, or begin receiving Workers' Compensation benefits);
  • the last day of the pay period in which you separate after you meet the requirements for an immediate annuity under the FERS MRA+10 provision and you postpone receipt of your annuity (see chapter 42A of the CSRS/FERS Handbook for Personnel and Payroll Offices);
  • the last day of the pay period in which you change to a position that is excluded from coverage;
  • the last day of the pay period in which you die, unless you have a family member eligible to continue enrollment as a survivor annuitant;
  • the last day of the pay period that includes the 365th day of continuous leave without pay status or the last day of leave under the Family and Medical Leave Act, whichever is later;
  • the last day of the last pay period in pay status, if you haven't had 4 consecutive months of pay status after you exhausted the 365 days continuation of coverage in leave without pay status;
  • the day you are separated, furloughed, or placed on leave of absence to serve in the uniformed services for duty over 30 days, if you elect in writing to have your enrollment terminated;
  • the date that is 24 months after the date of your separation, furlough, or leave of absence to serve in the uniformed services for duty over 30 days, or the date your entitlement to continued coverage ends, whichever is earlier;
  • the day on which your temporary continuation of coverage (TCC) expires;
  • the last day of the pay period for which withholding was made when you are a temporary employee enrolled under 5 U.S.C. 8906a whose pay is insufficient to pay the withholdings and you didn't or couldn't choose a plan for which your pay would cover the premiums.

Your enrollment may also terminate when you enter leave without pay status.

Family Members

Your family member's coverage terminates, subject to a 31-day extension of coverage, at midnight on the earlier of the following dates:

You cannot continue coverage for your spouse under your self and family enrollment upon your divorce. He/she may be eligible for his/her own enrollment under either the spouse equity or temporary continuation of coverage provisions.

When you cancel your enrollment, your family members' coverage terminates at midnight of the day that your cancellation is effective, with no 31-day extension of coverage.

PROCESSING TERMINATIONS

Employing Office Responsibilities

When your enrollment terminates, your employing office must prepare a Notice of Change in Health Benefits Enrollment form (SF 2810), showing the reason for your termination in the remarks section. Your employing office must prepare, process and distribute the SF 2810 as quickly as possible so your carrier knows that you are no longer covered under the health benefits plan.

By Termination of Membership in Employee Organization

When the employee organization plan you are enrolled in instructs your employing office to terminate your enrollment because you are no longer a member, your employing office will do so on the Notice of Change in Health Benefits Enrollment (SF 2810). It will note in the Remarks section: "Your enrollment was terminated by the plan because you are no longer a member of the sponsoring employee organization. You may enroll in another plan from 31 days before to 60 days after the date in Part A, item 8, above." (This date is the last day of the pay period in which your employing office received the plan's notice of termination.) Your new enrollment will be processed as an enrollment change.

For Other Reasons

When your enrollment terminates for any reason other than cancellation or termination of your membership in an employee organization, your employing office must:

  • complete parts A, B, and H of the Notice of Change in Health Benefits Enrollment (SF 2810);
  • state the reason for the termination in the Remarks section (e.g., "Employee resigned"); and
  • send the carrier and payroll office copies to the payroll office for transmission to the carrier and for posting to the payroll records, respectively.

31-DAY EXTENSION OF COVERAGE AND CONVERSION

Extension of Coverage

You and your eligible family members' coverage continues at no cost for 31 days after your enrollment terminates for any reason except when you voluntarily cancel your enrollment or your plan is discontinued.

If you or a family member are an inpatient in a hospital on the 31st day of your extension of coverage, FEHB benefits for the hospitalized person will continue for the length of the hospitalization, up to a maximum of 60 more days, unless you convert to an individual contract.

Conversion Rights

When your enrollment terminates, you are entitled to convert to an individual policy offered by the carrier of your plan. You are not required to provide evidence of insurability.

Exception: you are not entitled to convert to an individual policy if you voluntarily canceled your enrollment or your plan was discontinued.

Benefits under a Conversion Contract

Many conversion contracts provide fewer benefits at a higher cost than what is offered under the FEHB Program. Also, there is no Government contribution to the cost of the individual conversion contract. If you anticipate that a family member will lose coverage in the near future, the benefits and cost of a plan's conversion contract may be an important consideration in your choice of a health plan. If you or a family member are considering converting to an individual policy, you should contact the carrier of your plan for information about the benefits and cost of its conversion contract.

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