Code

Event

From Not Enrolled to Enrolled

From Self Only to Self and Family

From One Plan or Option to Another

When You Must File Health Benefits Election Form With Your Employing Office

5

Employees Who Are Not Participating In Premium Conversion

5A

Initial opportunity to enroll.

Yes

N/A

N/A

Within 60 days after becoming eligible.

5B

Open Season.

Yes

Yes

Yes

As announced by OPM.

5C

Change in family status; for example: marriage, birth or death of family member, adoption, legal separation, or divorce

Yes

Yes

Yes

From 31 days before through 60 days after event.

5D

Change in employment status; for example:

• Reemployment after a break in service of more than 3 days;
• Return to pay status following loss of coverage due to expiration of 365 days of LWOP status or termination of coverage during LWOP;
• Return to pay sufficient to make withholdings after termination of coverage during a period of insufficient pay;
• Restoration to civilian position after serving in uniformed services;
• Change from temporary appointment to appointment that entitles employee receipt of Government contribution;
• Change to or from part-time career employment.

Yes

Yes

Yes

Within 60 days of employment status change.

5E

Separation from Federal employment when the employee is or employee’s spouse is pregnant.

Yes

Yes

Yes

Enrollment or change must occur during final pay period of employment.

5F

Transfer from a post of duty within the United States to a post of duty outside the United States, or reverse.

Yes

Yes

Yes

From 31 days before leaving old post through 60 days after arriving at new post.

5G

Employee or eligible family member loses coverage under FEHB or another group insurance plan; for example:

• Loss of coverage under another FEHB enrollment due to termination, cancellation, or change to Self Only of the covering enrollment;
• Loss of coverage under another federally-sponsored health benefits program;
• Loss of coverage due to termination of membership in the employee organization sponsoring the FEHB plan;
• Loss of coverage under Medicaid or similar State-sponsored program;
• Loss of coverage under a non-Federal health plan.

Yes

Yes

Yes

From 31 days before through 60 days after loss of coverage.

5H

Enrollee or eligible family member loses coverage due to the discontinuance, in whole or part, of an FEHB plan.

N/A

Yes

Yes

During open season, unless OPM sets a different time.

5I

Loss of coverage under a non-Federal group health plan because an employee moves out of the commuting area to accept another position and the employee’s non-federally employed spouse terminates employment to accompany the employee.

Yes

Yes

Yes

From 31 days before the employee leaves the commuting area through 180 days after arriving in the new commuting area.

5J

Employee or covered family member in a Health Maintenance Organization (HMO) moves or becomes employed outside the geographic area from which the carrier accepts enrollments, or if already outside the area, moves or becomes employed further from this area.

N/A

Yes

Yes

Upon notifying the employing office of the move or change of place of employment.

5K

On becoming eligible for Medicare
(This change may be made only once in a lifetime.)

N/A

No

Yes

At any time beginning on the 30th day before becoming eligible for Medicare.

5L

Temporary employee completes one year of continuous service in accordance with 5 U.S.C. Section 8906a.

Yes

N/A

N/A

Within 60 days after becoming eligible.

5M

Salary of temporary employee insufficient to make withholdings for plan in which enrolled.

N/A

No

Yes

Within 60 days after receiving notice from employing office.