U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

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

2

Annuitant (Includes Compensationers)

Note for enrolled survivor annuitants: A change in family status based on additional family members can only occur if the additional eligible family members are family members of the deceased employee or annuitant.

2A

Open Season

No

Yes

Yes

As announced by OPM.

2B

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

No

Yes

Yes

From 31 days before through 60 days after the event.

2C

Reenrollment of annuitant who cancelled FEHB enrollment to enroll in a Medicare-sponsored plan, Medicaid, or similar State-sponsored program and who later was involuntarily disenrolled from the Medicare-sponsored plan, Medicaid, or similar State-sponsored program.

May Reenroll

N/A

N/A

From 31 days before through 60 days after disenrollment.

2D

Reenrollment of annuitant who cancelled FEHB enrollment to enroll in a Medicare-sponsored plan, Medicaid, or similar State-sponsored program and who later voluntarily disenrolls from the Medicare-sponsored plan, Medicaid, or similar State-sponsored program.

May Reenroll

N/A

N/A

During open season.

2E

Restoration of annuity or compensation (OWCP) payments; for example:

• Disability annuitant who was enrolled in FEHB, and whose annuity terminated due to restoration of earning capacity or recovery from disability, and whose annuity is restored;
• Compensationer whose compensation terminated because of recovery from injury or disease and whose compensation is restored due to a recurrence of medical condition;
• Surviving spouse who was covered by FEHB immediately before survivor annuity terminated because of remarriage and whose annuity is restored;
• Surviving child who was covered by FEHB immediately before survivor annuity terminated because student status ended and whose survivor annuity is restored;
• Surviving child who was covered by FEHB immediately before survivor annuity terminated because of marriage and whose survivor annuity is restored.

Yes

N/A

N/A

Within 60 days after the retirement system or OWCP mails a notice of insurance eligibility.

2F

Annuitant or eligible family member loses FEHB coverage due to termination, cancellation, or change to Self Only of the covering enrollment.

Yes

Yes

Yes

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

2G

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

• 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 (but see events 2C and 2D);
• Loss of coverage under a non-Federal health plan.

Yes

Yes

Yes

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

2H

Annuitant 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.

2I

Annuitant 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 this 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.

2J

Employee in an overseas post of duty retires or dies.

No

Yes

Yes

Within 60 days after retirement or death.

2K

An enrolled annuitant separates from duty after serving 31 days or more in a uniformed service.

N/A

Yes

Yes

Within 60 days after separation from the uniformed service.

2L

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.

2M

Annuitant’s annuity is insufficient to make withholdings for plan in which enrolled.

N/A

No

Yes

Employing office will advise annuitant of the options.