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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:
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.
You are eligible to enroll under spouse equity provisions if:
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.
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.
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.
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:
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.
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.
You must apply to the employing office in writing by the latest of:
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.
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:
Your request must include:
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.