FEHB Handbook

Former Spouses Page 1 of 7

page: 1 2 3 4 5 6 7

---

• Information for Employees
• Information for Former Spouses
• Information for Employing Offices

This section provides information for Federal employees and annuitants on FEHB benefits available under the Spouse Equity provisions of FEHB law. In this section:

• "you" means the Federal employee or annuitant; and
• "divorce" includes certain annulments.

---

INFORMATION FOR EMPLOYEES

• SPOUSE EQUITY ACT
  • Law
• ELIGIBILITY
  • Loss of Coverage as a Family Member
• ENROLLMENT
  • Type of Enrollment
  • Where Former Spouses Apply
  • Application to Enroll
  • Time Limit
  • Deferred Enrollment
  • Determination of Entitlement to Future Annuity
  • Retirement System Addresses
  • Determining a Former Spouse's Eligibility
  • Effective Date
  • When Both You and Your Former Spouse have FEHB Enrollments

---

SPOUSE EQUITY ACT

Law

The Civil Service Retirement Spouse Equity Act of 1984 (Public Law 98-615) was enacted on November 8, 1984. Under this act, as amended, certain former spouses of Federal employees, former employees, and annuitants may qualify to enroll in a health benefits plan under the FEHB Program.

ELIGIBILITY

Your former spouse is eligible to enroll under Spouse Equity provisions if:

• you were divorced during your employment or receipt of annuity;
• he/she was covered as a family member under an FEHB enrollment at least one day during the 18 months before your marriage ended (Note: This requirement is also met when both you and your former spouse have FEHB enrollments);
• he/she is entitled to a portion of your annuity or to a former spouse survivor annuity; and
• he/she has not remarried before age 55.

Your employing office will determine whether your former spouse is eligible to enroll.

Loss of Coverage as a Family Member

Your former spouse loses coverage as a family member upon your divorce, subject to a 31-day extension of coverage. However, his/her enrollment under the spouse equity provisions may not begin for several months after the divorce, depending on how long it takes to establish eligibility. To avoid a gap in coverage for this period, your former spouse may:

• convert to an individual contract during the 31-day extension of coverage; or
• continue FEHB coverage under the Temporary Continuation of Coverage (TCC) provisions of the FEHB law.

If your former spouse will seek coverage under spouse equity provisions, it is advisable to stay with the same plan.

If your former spouse acts promptly, he/she may request retroactive enrollment once the application for enrollment under the spouse equity provisions has been approved. For enrollment to be retroactive, the employing office must receive an appropriate request and satisfactory proof of eligibility within 60 days after the date of divorce.

ENROLLMENT

Enrolling under the Spouse Equity provisions is a three-step process. First, your former spouse must apply to enroll within the required time limit. Second, he/she must establish eligibility to enroll. Third, actual enrollment can take place only after the first two steps have been completed.

Type of Enrollment

Your former spouse may elect a self only or self and family enrollment. A self and family enrollment covers only your former spouse and any unmarried dependent natural or adopted children of you and your former spouse.

Where Former Spouses Apply

If your marriage ends before your retirement, your former spouse must apply and pay premiums to the employing office of the agency for which you worked when your marriage ended. If the application is approved, this will be your former spouse's employing office until he/she begins receiving annuity payments, even if you transfer to another employing office.

Your former spouse must apply and pay premiums to the retirement system responsible for your annuity payment if:

• he/she is receiving a portion of your retirement benefit or a former spouse survivor annuity; or
• the divorce occurred after your retirement; or
• the divorce occurred before May 7, 1985, and you worked for the Central Intelligence Agency (CIA) or the Foreign Service.

OPM is your former spouse's employing office if you are receiving compensation from the Office of Workers' Compensation Programs (OWCP), and your health benefits enrollment had been transferred to OWCP before your marriage ended.

Application to Enroll

Your former spouse's application to enroll can either be a completed Health Benefits Election Form (SF 2809) or a written notice of intent to apply for health benefits. His/her own name, date of birth, and Social Security number is entered on Part A of the SF 2809. Your name and date of birth must be entered in the Remarks section.

If there is a mental or physical disability that prevents your former spouse from applying for benefits, a court appointed guardian may file the application.

Time Limit

Your former spouse must apply to his/her employing office in writing by the latest of:

• 60 days after your marriage ends;
• 60 days after the date of OPM's notice of his/her eligibility to enroll based on a qualifying court order awarding entitlement to a portion of your future annuity (see section 5A5.1-2 of the CSRS/FERS Handbook for Personnel and Payroll Offices), or to a former spouse survivor annuity; or
• 60 days after the date of the notice of his/her eligibility to enroll based on entitlement to a former spouse annuity under another retirement system for Government employees.

If your former spouse doesn't apply to the employing office in person, the employing office will use the postmark date on the application to determine if he/she meets the time limit.

Deferred Enrollment

Once your former spouse has applied to enroll within the required time limit, he/she may postpone actual enrollment indefinitely.

Determination of Entitlement to Future Annuity

When your former spouse applies to the employing office for benefits, it will advise him/her that he/she must send a written request to the retirement system for a determination of entitlement to either:

• a portion of your future retirement annuity, or
• a former spouse survivor annuity.

The request must include:

• a certified copy (not a photocopy of a certified copy) of the divorce decree, property settlement, and/or court order (if applicable);
• your name, date of birth, Social Security number, and last employing agency.

Unless you are subject to the CIA or Foreign Service retirement systems, OPM, not the agency, will make the annuity benefit determination based on the court order supplied. Your former spouse can not enroll until OPM makes its determination.

OPM will send your former spouse a written decision. If eligibility is determined, he/she will submit the decision to your employing office.

Retirement System Addresses

Your Retirement System:	Request for Review Sent to:
CSRS or FERS	Office of Personnel Management, Retirement and Insurance Service, Office of Retirement Programs, P.O. Box 17, Washington, D.C. 20044.
CIA	CIA Retirement and Disability System, Central Intelligence Agency, P.O. Box 1925, Washington, D.C. 20505.
Foreign Service	Foreign Service Retirement and Disability System, Department of State, Retirement Division, Room 1251, Washington, D.C. 20520.
Any Other Retirement System	Your former spouse must obtain that retirement system's certification of his/her eligibility to a portion of your future annuity or a former spouse survivor annuity, and must submit the certificate to OPM when applying for eligibility to enroll.

Determining a Former Spouse's Eligibility

When your former spouse applies for eligibility to enroll under the spouse equity provisions, his/her employing office must first verify that you were employed by the agency at the time of your divorce. If you separate from Federal service before becoming eligible for an immediate annuity, your former spouse is eligible to enroll only if your marriage ended before you left Federal service.

The employing office must then determine if your former spouse is eligible to enroll. To be eligible, he/she must meet all of the following requirements:

• He/she must not have remarried before age 55;
• He/she must have been covered as a family member in an FEHB plan at least one day during the 18 months before your marriage ended;
• He/she must provide documentation from OPM (or the CIA or Foreign Service retirement system, if applicable) of entitlement to a portion of your future annuity, or a former spouse survivor annuity.

If you worked for the CIA, your former spouse could qualify to enroll based on your CIA employment, if you were married for at least 10 years during your CIA service, at least 5 years of which both of you spent outside the United States, and your marriage ended before May 7, 1985.

If you worked for the Foreign Service, your former spouse could also qualify to enroll based on your Foreign Service employment if you were married for at least 10 years during your Government service, and your marriage ended before May 7, 1985.

Effective Date

The effective date of your former spouse's enrollment is the first day of the first pay period after the employing office receives the Health Benefits Election Form (SF 2809) and has approved eligibility.

If your former spouse requests immediate coverage, and the employing office receives the Health Benefits Election Form (SF 2809) and satisfactory proof of eligibility within 60 days after the date of the divorce, the enrollment may be made effective on the same day that temporary continuation of coverage would otherwise take effect.

When both You and Your Former Spouse have FEHB Enrollments

If both you and your spouse have your own FEHB enrollments and divorce, it is important for each of you to establish your eligibility for FEHB coverage under spouse equity provisions within the required time frame. In this way you can protect your future entitlement to FEHB coverage under spouse equity provisions if you lose your own FEHB coverage. You must apply to your former spouse's employing office for the determination, not your own employing office.

If you are enrolled as a Federal employee when your former spouse's employing office determines that you are eligible for coverage under spouse equity provisions, you must provide a copy of this determination to your current employing office. Your current employing office must note on your Individual Retirement Record that you are eligible for FEHB coverage under spouse equity provisions. Your former spouse's employing office must maintain a health benefits file for you and note that you are deferring your enrollment under spouse equity provisions until you lose enrollment as an employee.

page: 1 2 3 4 5 6 7

---

Handbook Contents

• Introduction
• Cost of Insurance
• Health Plans
• Eligibility for Health Benefits
• Enrollment
• Leave Without Pay Status and Insufficient Pay
• Termination, Conversion, and Temporary Continuation of Coverage
• Annuitants and Compensationers
• Military Service
• Family Members
• Former Spouses

Appendices

• Forms and Brochures
• Glossary
• Table of Permissible Changes
• Chapter 89 of title 5, United States Code
• Part 890 of title 5, Code of Federal Regulations

Other

• Search the Handbook
• Handbook Changes