Former Spouses
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This section provides information for Federal employees and annuitants on FEHB benefits
available under the Spouse Equity provisions of FEHB law. In this section:
- "you" means the Federal employee or annuitant; and
- "divorce" includes certain annulments.
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, annuitant, or a former Central Intelligence Agency (CIA) or Foreign Service employee 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:
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
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. If you complete the SF2809, 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 for health benefits coverage within:
- 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 former spouse 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.