FEHB Handbook

Former Spouses Page 2 of 7

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• SPOUSE EQUITY ACT
• ELIGIBILITY
• ENROLLMENT
• OPPORTUNITIES TO ENROLL OR CHANGE ENROLLMENT
• PREMIUM PAYMENTS
• TERMINATION OF A FORMER SPOUSE ENROLLMENT
• REENROLLMENT

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

• "you" means the former spouse; and
• "divorce" includes certain annulments.

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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

You are eligible to enroll under spouse equity provisions if:

• you are divorced from a Federal employee or annuitant during his/her employment or receipt of annuity;
• you were 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 the Federal employee or annuitant have FEHB enrollments);
• you are entitled to a portion of the Federal employee's annuity or to a former spouse survivor annuity; and
• you have not remarried before age 55.

The employee or annuitant's employing office will determine whether you are eligible to enroll.

Loss of Coverage as a Family Member

When you lose coverage as a family member upon your divorce, you are entitled to a 31-day extension of coverage. However, your 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, you have two options. You 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 you will seek coverage under spouse equity provisions, it is advisable to stay with the same plan.

If you act promptly, you may request retroactive enrollment once your 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

• Type of Enrollment
• Where You Apply
• Application to Enroll
• Time Limit
• Deferred Enrollment
• Determination of Future Entitlement to Annuity
• Retirement System Addresses
• Determining Your Eligibility
• Employing Office Decision
• Enrollment Procedures
• Certification
• Sample Certification
• Health Benefits File
• Effective Date

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

Type of Enrollment

You may elect a self only or self and family enrollment. A self and family enrollment covers only you and any unmarried dependent natural or adopted children of you and the Federal employee or annuitant on whose service your coverage is based.

Where You Apply

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

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

• you are receiving a portion of a retirement benefit or a former spouse survivor annuity;
• the divorce occurred after the employee's retirement; or
• the divorce occurred before May 7, 1985, and the employee or former employee worked for the Central Intelligence Agency (CIA) or the Foreign Service.

OPM is your employing office if the employee or former employee is receiving compensation from the Office of Workers' Compensation Programs (OWCP), and his/her health benefits enrollment had been transferred to OWCP before your marriage ended.

Application to Enroll

Your 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. You must put your own name, date of birth, and Social Security number on Part A of the SF 2809. The employee, former employee, or annuitant's name and date of birth must be entered in the Remarks section.

If you have a mental or physical disability that prevents you from applying for benefits, a court appointed guardian may file the application.

Time Limit

You must apply to the employing office in writing by the latest of:

• 60 days after your marriage ends;
• 60 days after the date of OPM's notice of your eligibility to enroll based on a qualifying court order awarding entitlement to a portion of the employee's 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 your eligibility to enroll based on entitlement to a former spouse annuity under another retirement system for Government employees.

If you don't apply to the employing office in person, the employing office will use the postmark date on your application to determine if you meet the time limit.

Deferred Enrollment

Once you have applied to enroll within the required time limit, you may postpone actual enrollment indefinitely.

Determination of Entitlement to Future Annuity

When you apply to the employing office for benefits, it will advise you that you must send a written request to the retirement system for a determination of entitlement to either:

• a portion of the employee's future retirement annuity, or
• a former spouse survivor annuity.

Your 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);
• the employee's name, date of birth, Social Security number, and last employing agency.

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

OPM will send you a written decision. If you are eligible to enroll, you will submit the decision to the employing office.

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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