[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR890.808]

[Page 481-482]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
                  Subpart H_Benefits for Former Spouses
 
Sec. 890.808  Employing office responsibilities.

    (a) Application for benefits. The former spouse's application for 
health benefits may be in the form of a Standard Form 2809, letter, or 
written statement to the employing office. Former spouses applying for 
benefits under Sec. 890.803(a)(3)(iv) of this part must also include 
with their application a request for waiver of the application time 
limitation in accordance with Sec. 890.805(b) of this part. Former 
spouses applying for benefits under Sec. 890.803(a)(3)(v) of this part 
must also include with their application a request for waiver of the 
application time limitation in accordance with Sec. 890.805(c) of this 
part.
    (b) Administration of the enrollment process. (1) The employing 
office will set up a method for accepting applications for enrollment 
informing the former spouse what documents to submit and where to submit 
them for an eligibility determination, and collecting premium payments. 
The method will include procedures for verifying the eligibility 
requirements under Sec. 890.803(a) (1) and (2) of this part. The 
employing office must obtain OPM, Foreign Service Retirement and 
Disability System (FSRDS), or CIA Retirement and Disability System 
(CIARDS) documentation that the former spouse meets the additional 
requirement under Sec. 890.803(a)(3) (i), (ii), (iii), (iv), or (v) of 
this part. A request for the retirement system's determination whether a 
court order is a qualifying court order for health benefits enrollment 
under this subpart must be accompanied by the documentation specified in 
Sec. 838.221, Sec. 838.721, or Sec. 838.1005 of this chapter.
    (2) The employing office will send the former spouse notice, in 
writing, of its decision. When an employing office informs a former 
spouse of his or her eligibility to enroll, it will identify the 
documents on which it based its decision and will include a premium 
payment schedule and statement of the requirements for continued 
enrollment under Sec. 890.803. If the former spouse does not qualify 
for health benefits coverage, the employing office must give the former 
spouse a reconsideration right under Sec. 890.104. Reconsideration 
requests from former spouses applying for benefits under Sec. 
890.803(a)(3)(iv) of this part must be directed to the Office of 
Personnel, Retirement Division, Central Intelligence Agency, Washington, 
DC 20505. Reconsideration requests from former spouses applying for 
benefits under Sec. 890.803(a)(3)(v) of this part must be directed to 
the Department of State, Retirement Division, Washington, DC 20520.
    (3) The agency employing office will maintain a health benefits file 
for the former spouse as a file separate from the personnel records of 
the employee or former employee. The retirement system acting as 
employing office for the former spouse may file the former spouse health 
benefits records in with the annuitant's retirement records.
    (4) The former spouse will be required to certify that he or she 
meets the requirements listed in Sec. 890.803 and that he or she will 
notify the employing office within 31 days of an event that results in 
failure to meet one or more of the requirements.

[[Page 482]]

    (c) Qualifying court order. Subject to a 31-day extension period for 
conversion, the duration of health benefits coverage will coincide with 
any period specified in the qualifying court order providing for an 
annuity. A court order not meeting the requirements under part 838 of 
this chapter will not be used to establish or continue entitlement to a 
former spouse's health benefits coverage.
    (d) Premium payments. (1) The former spouse must remit to the 
employing office the full subscription charge for the enrollment for 
every pay period during which the enrollment continues, exclusive of the 
31-day temporary extension of coverage for conversion provided in 
Sec. Sec. 890.401 and 890.807(a)(2). Payment must be made after the pay 
period in which the former spouse is covered in accordance with a 
schedule established by the employing office (see definition of pay 
period under Sec. 890.101(a)). If the employing office does not receive 
payment by the due date the employing office must notify the former 
spouse in writing that continuation of coverage depends upon payment 
being made within 15 days (45 days for enrollees residing overseas) 
after receipt of the notice. If no subsequent payments are made, the 
employing office terminates the enrollment 60 days (90 days for 
enrollees residing overseas) after the date of the notice. Termination 
for nonpayment of premium is considered a voluntary cancellation under 
Sec. 890.807(d). A former spouse whose enrollment is terminated because 
of nonpayment of premium may not reenroll or reinstate coverage except 
as provided in paragraph (d)(2) of this section.
    (2) If the individual was prevented by circumstances beyond his or 
her control from making payment within 15 days after receipt of the 
notice, he or she may request reinstatement of coverage by writing to 
the employing office. Such a request must be filed within 30 calendar 
days from the date of termination and must be accompanied by 
verification that the individual was prevented by circumstances beyond 
his or her control from paying within the time limit. The employing 
office will determine if the individual is eligible for reinstatement of 
coverage; and, when the determination is affirmative, the individual's 
coverage may be reinstated retroactively to the date of termination. If 
the determination is negative, the individual may request a review of 
the decision from the employing agency as provided under Sec. 890.104.
    (3) The employing office will submit all premium payments collected 
from former spouses along with its regular health benefits payments to 
OPM in accordance with procedures established by that Office.
    (e) Withholding from annuity. The retirement system acting as 
employing office for a former spouse will establish a method for 
withholding the full subscription charge from the former spouse's 
annuity check. When the annuity is insufficient to cover the full 
subscription charge, the retirement system will follow the procedures 
specified in Sec. 890.806(l).

[51 FR 15748, Apr. 28, 1986, as amended at 52 FR 2506, Jan. 23, 1987; 52 
FR 39497, Oct. 22, 1987, and 53 FR 32368, Aug. 25, 1988; 53 FR 45071, 
Nov. 8, 1988; 56 FR 25997, June 6, 1991; 57 FR 21192, May 19, 1992; 57 
FR 33598-33599, July 29, 1992; 59 FR 60297, Nov. 23, 1994; 59 FR 67607, 
Dec. 30, 1994; 61 FR 37810, July 22, 1996; 62 FR 38442, July 18, 1997]