Annuitants and Compensationers
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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.