U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce
Insurance Services Programs
Appendix C
Qualifying Life Events (QLEs)
that May Permit a Change in Your FEHB Enrollment
RI 70-01 For Federal Civilian Employees
Premium Conversion allows employees who are eligible for FEHB the opportunity to pay for their share of FEHB premiums with pretax dollars. Premium conversion plans are governed by the Internal Revenue Code, and IRS rules govern when a participant may change his or her enrollment outside of the annual Open Season. When an employee experiences a qualifying life event, changes to the employee¡¯s FEHB enrollment may be permitted. Individuals who don¡¯t participate in Premium Conversion (retirees and employees who waived participation) may cancel their enrollment or change to Self Only at any time.
Below is a brief list of the more common QLEs. Be aware that time limits apply for requesting changes. A complete listing of QLEs can be found at www.opm.gov/forms/pdf_fill/sf2809.pdf. For more details about these and other QLEs, contact the human resources office of your employing agency.
From Not Enrolled to Enrolled |
From Self Only to Self and Family |
From One Plan or Option to Another |
Cancel or Change to Self Only |
|
|---|---|---|---|---|
Change in family status that results in increase or decrease in number of eligible family members. |
Yes |
Yes |
Yes |
Yes |
Any change in employee's employment status that could result in entitlement to coverage. |
Yes |
Not Applicable |
Not Applicable |
Not Applicable |
Employee restored to civilian position after serving in uniformed services |
Yes |
Yes |
Yes |
Yes |
Employee (or covered family member) enrolled in an FEHB health maintenance organization (HMO) moves or becomes employed outside the geographic area from which the FEHB carrier accepts enrollment or, if already outside the area, moves further from this area. |
Not Applicable |
Yes |
Yes |
Not Applicable |
Employee or eligible family member loses coverage under FEHB or another group insurance plan. |
Yes |
Yes |
Yes |
Yes |
Enrolled employee or eligible family member gains coverage under FEHB or another group insurance plan. |
No |
No |
No |
Yes |
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