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FEHB Handbook

Annuitants and Compensationers
Page 6 of 6

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SURVIVOR ANNUITANTS Continued

Deferred Annuity

Since you generally are not eligible for FEHB coverage when you are receiving a deferred annuity, your surviving spouse is not eligible for FEHB coverage as a survivor annuitant even if he/she had FEHB coverage as an employee. If he/she loses coverage as an employee, it can't be transferred to the survivor annuity.

If you are receiving a deferred annuity, your former spouse may be eligible for FEHB coverage under the spouse equity provisions.

If You Die Before Receipt of MRA+10 Annuity

If you die before your postponed MRA+10 annuity begins, your surviving spouse is considered to be the surviving spouse of an annuitant. Your surviving spouse is eligible for FEHB coverage under the same conditions as any other survivor annuitant and may enroll under FEHB when his/her survivor annuity begins.

OPPORTUNITIES FOR SURVIVOR ANNUITANTS TO CHANGE ENROLLMENT

Enrolled survivor annuitants have the same opportunities to change enrollment as other annuitants, except when there is a change in family status because of the acquisition of a child.

Change in Family Status Due to Acquisition of an Eligible Child

A survivor annuitant's enrollment change based on the acquisition of a child can only be made when the child is an eligible family member of the deceased employee or annuitant. The enrollment can be changed from Self Only to Self and Family, from one plan or option to another, or any combination of these changes from 31 days before to 60 days after the acquisition of the child, and will be effective on the first day of the pay period in which the child is born or becomes an eligible family member.

Restoration of Survivor Annuity

Spouse

If your surviving spouse's:

  • survivor annuity or basic employee death benefit was terminated because he/she remarried;
  • he/she was covered under an FEHB enrollment immediately before his/her annuity or death benefit terminated; and
  • his/her survivor annuity or death benefit is later restored,

he/she may enroll in a health benefits plan within 60 days from OPM's notice of eligibility to enroll.

The restored survivor annuity enrollment is effective on the later of:

  • the first day of the month after OPM receives his/her enrollment request; or
  • the date the survivor annuity is restored.

The basic employee death benefit enrollment can only be restored when your surviving spouse's remarriage ends and he/she provides OPM with a certified copy of the death notice or the court order terminating the remarriage. The restored enrollment is effective on the first day of the month after OPM receives his/her enrollment request and documentation of the end of the marriage.

Child

If your surviving child's:

  • survivor annuity was terminated because he/she married or ceased being a student;
  • he/she was covered under an FEHB enrollment immediately before his/her annuity terminated; and
  • his/her survivor annuity is later restored,

he/she may enroll in a health benefits plan within 60 days from OPM's notice of eligibility to enroll. The enrollment is effective on the later of:

  • the first day of the month after OPM receives his/her enrollment request; or
  • the date the survivor annuity is restored.

COMPENSATIONERS

Requirements for Continued Coverage

Your health benefits enrollment will continue when you enter on the compensation rolls of the Office of Workers' Compensation Programs (OWCP) and the Secretary of Labor determines that you are unable to return to duty. If your compensation lasts fewer than 29 days, OWCP won't transfer your enrollment. Instead, your enrollment will remain with your employing office.

If you are receiving compensation, your enrollment may continue during the first 365 days in leave without pay status. After that period, you must meet the same participation requirements as for continuing an enrollment after retirement. You must meet the requirements as of the date you started receiving compensation. OWCP, not your employing office, is responsible for determining your eligibility.

Transferring Your Enrollment to OWCP

Your enrollment will be transferred to the Office of Workers' Compensation Programs (OWCP) when:

OWCP normally does not request an enrollment transfer unless it expects your compensation to continue for 6 months or longer.

OWCP will make withholdings when your compensation lasts more than 28 days, whether or not your enrollment has been transferred to OWCP.

Withholdings and Contributions

The Office of Workers' Compensation Programs (OWCP) makes health benefits withholdings regardless of whether your enrollment is transferred to OWCP. Withholdings begin on the later of:

  • the date your compensation begins, or
  • the date following the day your employing office stops making withholdings and contributions.

OWCP does not make withholdings when you receive compensation for fewer than 29 days. In this case, you must pay your share of the premiums and your employing office must pay its share.

(While OWCP is making the withholdings from compensation, its contributions are made from the Congressional appropriation authorized for the payment of Government contributions for retirees and compensationers.)

Reporting Your Enrollment to OWCP

When your employing office reports your compensable injury or illness on OWCP Form CA 7, it will show whether you were enrolled for health benefits on the date your pay stopped, your plan's enrollment code, and the ending date of the last pay period that insurance withholdings were made.

If OWCP determines that your compensation will continue for at least 6 months, it will normally request that your employing office transfer your enrollment to OWCP.

If you are separated before your employing office receives OWCP's request to transfer your enrollment, your employing office must check with OWCP to determine the status of your compensation claim. If your compensation is to continue beyond the date of separation, it will transfer your enrollment to OWCP.

If you make any permissible change in enrollment before your employing office receives OWCP's request for transfer, your employing office must promptly notify OWCP by letter of the change and its effective date.

If you are separated after your enrollment is transferred to OWCP, your employing office must notify OWCP by letter so it will know how to handle your enrollment if compensation payments end.

Transferring Your Enrollment at OWCP's Request

Your employing office will transfer your enrollment by attaching to the request form all Health Benefits Election Forms (SF 2809), Notice of Change in Health Benefits Enrollment forms (SF 2810), and any other related health benefits documentation and returning it to OWCP. Your employing office must keep a copy of the request form (and back-up copies of all other health benefits documentation) in your Official Personnel Folder to show that OWCP has the health benefits documentation. When OWCP receives the health benefits documentation, it must complete an SF 2810 transferring your enrollment to OWCP.

Transferring Your Enrollment when OWCP hasn't Requested it

If you are being separated or you have been in leave without pay status for 10 months and OWCP hasn't requested that your enrollment be transferred, your employing office must check with OWCP on the status of your OWCP claim. If compensation will continue beyond your separation date or beyond the 365th day of continuous leave without pay status, your employing office must transfer your enrollment to OWCP by sending all Health Benefits Election forms (SF 2809), Notice of Change in Health Benefits Enrollment forms (SF 2810), and any other related health benefits documentation to OWCP by letter, explaining the reason for the action. When OWCP receives the documentation, it must complete an SF 2810 transferring your enrollment to OWCP.

When Compensation Ends and You Return to Duty

If your compensation ends and you return to duty, OWCP will transfer your enrollment back to your employing office by letter, transmitting the health benefits documentation and giving the date compensation ended. If you are eligible for continued coverage, your employing office will transfer your enrollment in to the agency by completing a Notice of Change in Health Benefits Enrollment (SF 2810). The effective date of the transfer is the day after your compensation terminated.

If you aren't eligible for continued coverage, your employing office will complete an SF 2810 terminating your enrollment effective with the date your compensation ended. A copy of OWCP's letter transferring the enrollment back to your employing office must be attached to the carrier copy of the SF 2810.

When you return to duty on a part-time basis and compensation payments continue, OWCP will keep your enrollment and continue to make withholdings and contributions for you.

When Compensation Ends but You Don't Return to Duty

If your compensation ends, but you don't return to pay status, your enrollment terminates at midnight on the last day of the pay period in which your compensation terminates.

When You Return to Duty before Compensation Ends

If you return to duty on a full-time basis before OWCP terminates your compensation payments, your employing office must notify OWCP using OWCP Form CA 3. In the Remarks section, it will show the beginning and ending dates of the pay period in which you returned to work. Since OWCP will discontinue withholdings as of the beginning date of the pay period in which you return to full-time pay and duty status, your employing office will resume withholdings and contributions effective with the first pay period in which you return to pay status. If your enrollment had been transferred to OWCP, it will be transferred back to your employing office.

When You Elect Retirement

If you elect to retire and receive an annuity instead of compensation and your enrollment had been transferred to OWCP, the retirement system will ask OWCP to transfer your enrollment to the retirement system. If you are still in leave without pay status, your employing office will note under Remarks on the Individual Retirement Record: "Health benefits enrollment transferred to OWCP," and send it to the retirement system.

Restoration of Compensation Payments

If you were receiving compensation and:

  • your compensation was terminated because OWCP determined that you had recovered from your injury or disease;
  • you were enrolled in an FEHB plan immediately before your compensation was terminated; and
  • your compensation is later restored because your disability recurred,

you may reenroll in a health benefits plan within 60 days from OWCP's notice of your eligibility to reenroll. Your reenrollment is effective on the first day of the pay period after OWCP receives your enrollment request.

SURVIVORS OF COMPENSATIONERS

Requirements for Continued Coverage

If you die while a compensationer, your family members can continue your enrollment if you were enrolled for Self and Family at the time of your death and at least one of your covered family members receives compensation as a surviving beneficiary under the Federal Employees' Compensation law.

If Your Enrollment Wasn't Transferred to OWCP

If your enrollment had not been transferred to the Office of Workers' Compensation Programs (OWCP) before your death, your employing office must determine whether any surviving family members appear eligible to continue your enrollment. Your employing office will terminate your enrollment if it appears that you have no eligible survivors.

If it appears that your survivors are eligible to continue your enrollment, your employing office will send your health benefits documentation to the retirement system as if you had died in service. If your survivors elect to receive compensation rather than survivor benefits, the retirement system will transfer the enrollment to OWCP.

If Your Enrollment Was Transferred to OWCP

If your enrollment was transferred to OWCP before your death, your employing office must note in the Remarks section of your Individual Retirement Record, "Health benefits transferred to OWCP," and send it to the retirement system as usual. OWCP will determine whether you have any eligible survivors who want to continue your enrollment. If your survivors elect to continue to receive compensation, OWCP will continue or terminate your enrollment, as appropriate. If your survivors elect to receive survivor benefits instead of compensation, OWCP will transfer the enrollment to the retirement system.

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