Eligibility Requirements

RI 70-05 For TCC and Former Spouse Enrollees

These individuals are eligible to enroll in the FEHB Program but do not receive a Government contribution toward the cost of their enrollment.

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Individuals eligible for temporary continuation of coverage (TCC), including:

• former employees whose FEHB coverage ended because they separated from service, unless they were separated for gross misconduct, including employees who are not eligible to continue FEHB into retirement;
• children who lose FEHB coverage under a family enrollment; and
• former (divorced) spouses who are not eligible for FEHB coverage under the Spouse Equity provisions of FEHB law because they have remarried before age 55 or are not entitled to a portion of the Federal employee's annuity or a former spouse survivor annuity.

You may voluntarily cancel your enrollment at any time. However, once your cancellation takes effect, you cannot reenroll. You will not be entitled to a 31-day extension of coverage for conversion to a non-group (private) policy. Family members who lose coverage upon your cancellation may enroll only if they are eligible in their own right as Federal employees or annuitants. If your TCC enrollment terminates because you acquire other FEHB coverage, and that coverage ends before your original TCC eligibility period ends, you may reenroll for the time remaining until your original TCC ending date.

Note: The office that maintained the other FEHB enrollment can advise you on your eligibility for a new TCC enrollment period.

Strict time limits for electing TCC apply. As early as possible before (or after) the qualifying event for TCC occurs, contact the employee's human resources office or the annuitant's retirement system to get more facts about the requirements for electing coverage.

Former (divorced) spouses eligible to enroll under the Spouse Equity Provisions of FEHB Law or similar statutes. If you are the spouse of a Federal employee or annuitant and lose FEHB coverage because of divorce, you may elect FEHB coverage - under certain circumstances. Contact the employee's human resources office or the annuitant's retirement system for the requirements for electing coverage.

Former spouses enrolled under the Spouse Equity Provisions of FEHB Law or similar statute who cancel their enrollment cannot reenroll as a former spouse unless they cancel because they acquire other coverage under the FEHB Program and that coverage ends. You may suspend your FEHB enrollment because you are enrolling in one of the following programs:

• A Medicare Advantage health plan;
• Medicaid or similar State-sponsored program of medical assistance for the needy;
• TRICARE (including Uniformed Services Family Health Plan or TRICARE for Life);
• CHAMPVA; or
• Coverage as a Peace Corps volunteer.

For more information on how to suspend your FEHB enrollment, contact the human resources office or retirement system that handles your account. Time limitations and other restrictions apply. For instance, you must submit documentation that you are suspending FEHB for one of the reasons stated above in case you wish to reenroll in the FEHB Program at a later time. If you had suspended FEHB coverage for one of these reasons (and had submitted the required documentation) but now want to enroll in the FEHB Program again, you may enroll during Open Season. You may reenroll outside of Open Season only if you involuntarily lose coverage under one of these programs. For more information on enrolling in the FEHB Program, contact your human resources office or retirement system.

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