Termination, Conversion and Temporary Continuation of Coverage
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Temporary Continuation of Coverage (Continued)
Time Limits for Electing Temporary Continuation of Coverage (Continued)
Guardian may File
A court-appointed guardian may file a temporary continuation of coverage (TCC) election
on behalf of an eligible person that is unable to file because of a mental or physical
disability.
Late Election
Your employing office may allow a late temporary continuation of coverage (TCC)
election if it determines that you or your family member were unable to elect it on a
timely basis for reasons beyond your control. It must accept the TCC election within 31
days after it provides notification of its decision to allow a late enrollment. Coverage
is made retroactive, and retroactive premiums are due, to the date it would have been
effective if elected on a timely basis.
Your employing office cannot accept a late election when it did not receive the
required notification of your family member's eligibility for TCC within the time limits set by law and regulation.
Election Options
When you elect Temporary Continuation of Coverage (TCC), you may choose Self Only or
Self and Family coverage in any plan or option that you are eligible to join. You are not
limited to the plan, option, or type of enrollment under which you had been covered.
Covered Family Members
If you are a former employee with a Temporary Continuation of Coverage (TCC) self and
family enrollment, the eligibility
requirements for your family members are the same as for active employees.
When your child enrolls for Self and Family, covered family members are his/her spouse
and eligible children.
When your former spouse enrolls for Self and Family, covered family members are limited
to the children of both you (the employee) and your former spouse. If your former spouse
remarries, the new husband or wife is not covered. Stepchildren that were covered under
your enrollment because they lived with you are not covered under your former spouse's TCC
enrollment. (Usually, a stepchild's coverage ends before the divorce because he/she stops
living with you. The stepchild then becomes eligible to enroll
under TCC because he/she is no longer a covered family member.)
After the initial enrollment, a TCC enrollee may change enrollment during an open
season or when another event occurs that would allow a change in enrollment.
Election Procedures
To make a Temporary Continuation of Coverage (TCC) election, you should submit a Health
Benefits Election Form (SF 2809) to the employing office that is servicing your account.
If you submit a signed election request in a format other than the SF 2809, your employing
office must complete a SF 2809 on your behalf based on your written request. Your name,
date of birth, and social security number must be entered in part A of the form.
If you are a separated employee, your employing office must enter the following
information under Remarks: "Eligibility expires: (enter date 18 months after
separation date)."
If you are a child or former spouse, your servicing employing office must enter the
following information under Remarks: name, date of birth, and social security number of
the employee or annuitant; the expiration date of eligibility for enrollment; and your
relationship to the employee.
Example:
Employee: Archibald M. Higgenbottom, SSN 123 45 6789, DOB 12/12/55. Eligibility
ends: 4/20/97. Former spouse.
Effective Date of
Coverage
The effective date of your Temporary Continuation of Coverage (TCC) enrollment is the
day after the 31-day extension of coverage
ends. Your coverage is retroactive to that date if you elect TCC after the 31-day
extension of coverage ends.
Exception: When your former spouse loses coverage in the 18 month period before your
divorce or annulment because you change to a Self Only enrollment, the 31-day extension of
coverage takes place after he/she loses coverage, not after the divorce or annulment. In
this case, your former spouse's TCC enrollment is effective the day after the date of your
divorce or annulment. Since there is a gap in FEHB coverage between the end of the 31-day
extension of coverage and the beginning of the TCC enrollment, your former spouse may want
to convert his/her coverage to an individual
contract until the TCC enrollment can begin.
If you elect a different plan or option when you enroll under TCC, and you or a covered
family member are an inpatient in a hospital on the 31st day of the extension
of coverage, coverage under your old plan or option will continue for the hospitalized
person for the length of the confinement, up to 60 days. The other family members'
coverage will switch to the new plan or option after the 31-day extension of coverage
ends.
Length of
Temporary Continuation of Coverage
Former Employee
If you are a former employee, your Temporary Continuation of Coverage (TCC) eligibility
time period continues up to 18 months from the date you separated from service.
Example
Laura separates from service on February 3, 1998. She is no longer an employee on
February 4. Her period of TCC coverage expires on August 3, 1999.
Child
Your child's TCC eligibility time period continues for up to 36 months from the date of
his/her change in status as a family member. If the change in status as a family member
takes place while he/she is covered as a family member under your TCC enrollment as a
former employee, he/she is eligible to enroll under TCC in his/her own right, but the TCC
enrollment cannot continue beyond 36 months after the date of your separation from
service.
Example 1
Robert's child turns 22 on April 22, 1997. She is considered to have turned 22 at
midnight on April 21 and on April 22 is no longer a family member. She enrolls under TCC;
her TCC eligibility ends on April 21, 2000.
Example 2
Laura separates from service on February 3, 1998. She enrolls under TCC for a self
and family enrollment. Her child turns 22 on April 22, 1998 and enrolls under TCC. Her
child's TCC eligibility ends on February 3, 2001.
Former Spouse
Your former spouse's TCC eligibililty time period continues for up to 36 months from
the date of your divorce or annulment that takes place before your separation from
service. If your divorce or annulment takes place while he/she is covered as a family
member under your TCC enrollment as a former employee, he/she is eligible to enroll under
TCC in his/her own right, but the TCC enrollment cannot continue beyond 36 months after
the date of your separation from service.
Example 1
Paul (the employee) and Betsy divorce becomes final on December 10, 1998. She is
considered to no longer be a family member on December 11. She enrolls under TCC; her TCC
eligibility ends on December 10, 2001.
Example 2
Maria separates from service on September 1, 1998 and enrolls under TCC for a self
and family enrollment. On December 10, 1998, her divorce from Eugene becomes final. Eugene
enrolls under TCC; his TCC eligibility ends on September 1, 2001.
Length of Coverage Based
on Qualifying Event
Your Temporary Continuation of Coverage (TCC) eligibility time period is based on the
qualifying event that made you eligible for TCC.
Separating Employee
If you are a separating employee, you lose regular FEHB coverage at the end of the pay
period in which you separate. Then you have a 31-day
extension of coverage, at no cost to you, before your TCC coverage begins. Your
18-month eligibility time period begins immediately after your separation, although the
first 31 days fall under the 31-day extension of coverage provision. Your TCC coverage is
effective on the day after the 31-day extension of coverage ends.
If you change plans or options upon election of TCC, your enrollment in your previous
plan or option will continue through the 31-day extension of coverage. Your enrollment in
the new plan or option will become effective the day after the 31-day extension of
coverage and will continue for up to 17 months.
After your TCC coverage ends (except if you canceled your enrollment or your plan was
discontinued), you are eligible for another 31-day extension of coverage at no cost to
you, and you are eligible to convert to an
individual contract offered by your health benefits plan.
Example
Tyra separates from service on January 15, 1999. She enrolls under TCC and changes
her enrollment to a different health benefits plan. Her enrollment with her previous plan
continues for the first 31 days after separation. Her TCC coverage with the new plan
begins on February 16, 1999. Her TCC eligibility time period ends on July 15, 2000. Her
31-day extension of coverage ends on August 16, 2000.
Child or Former Spouse
If you are a child or former spouse of a Federal employee or annuitant, you also have a
31-day extension of regular FEHB coverage (at no cost to you) before your TCC coverage
begins, beginning the day after the event that caused the loss of coverage. The 36-month
TCC eligibility time period begins immediately after the event, although the first 31 days
fall under the 31-day extension of coverage provision. TCC coverage is effective on the
day after the 31-day extension of coverage ends, and continues for up to 35 more months.
If you change plans or options upon election of TCC, your enrollment in the previous
plan or option will continue through the 31-day extension of coverage. Your enrollment in
the new plan or option will become effective the day after the 31-day extension of
coverage and will continue for up to 35 more months.
After your TCC coverage ends (except if you canceled your enrollment or your plan was
discontinued), you are eligible for another 31-day extension of coverage at no cost to
you, and you are eligible to convert to an
individual contract offered by your health benefits plan.
Example
Caroline turns age 22 on October 1, 1999 and loses coverage under her father's self
and family enrollment. She elects TCC coverage and decides to enroll in the same plan that
she was enrolled in under her father's coverage. Her 31-day extension of coverage ends on
October 31, 1999 and her TCC eligibility time period ends on September 30, 2002. Her
second 31-day extension of coverage ends on October 31, 2002.