Basic FEHB Eligibility
As a Federal employee, you are eligible to elect FEHB coverage, unless your position is excluded by law or regulation. Your agency applies these rules and determines your eligibility. However, there are numerous special provisions for people in part-time or intermittent employment, temporary appointments, and specifically named positions. This chapter in the FEHB Handbook explains these provisions.
Retirees and Survivor Annuitants
Federal retirees and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees. In order to carry your FEHB coverage into retirement, you must be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement) and must have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person's FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.
Temporary Continuation of Coverage (TCC)
Temporary Continuation of Coverage is a feature of the FEHB Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends. TCC enrollees must pay the full premium for the plan they select (that is, both the employee and Government shares of the premium) plus a 2 percent administrative charge.
FEHB for Family Members
Family members eligible for coverage under your Self and Family enrollment are your spouse (including a valid common law marriage) and children under age 26, including legally adopted children, recognized natural (born out of wedlock) children and stepchildren. A child is eligible for coverage under your Self and Family enrollment, if a state-issued birth certificate lists you as a parent of that child.
Children of Same-Sex Domestic Partners
Beginning in January 2014, OPM extended coverage under FEHB and FEDVIP enrollments to children of same-sex domestic partners of Federal employees and annuitants who would marry their partners but lived in states that did not allow same-sex couples to marry (“stepchildren.”) Since the Supreme Court’s decision in Obergefell v. Hodges (June 26, 2015) all states are now required to allow same-sex couples to marry.
As a result, no employees or annuitants live in states where they are not allowed to marry. Children of same-sex domestic partners generally are no longer eligible as family members for FEHB coverage. For more information see BAL 15-207.
Former Spouses
Under the Civil Service Retirement Spouse Equity Act of 1984, certain former spouses of Federal employees, former employees, and annuitants may qualify to enroll in a health benefits plan under the FEHB Program.
CHAMPUS, TRICARE and Tricare-for-Life
OPM has issued a final rule to allow TRICARE and CHAMPVA eligible FEHB Program annuitants, survivors, and former spouses to suspend their FEHB enrollments, and then return to the FEHB Program during the Open Season, or return to FEHB coverage immediately if they involuntarily lose this non-FEHB coverage.
Civilian Employees on Active Military Duty
Federal employee reservists who are placed in a leave without pay status when called to active duty for more than 30 days can keep their FEHB coverage for up to 24 months. The reservist is responsible for paying the enrollee share of the premium during the first 12 months, and the agency pays the agency's share.
Full-time Temporary, Seasonal & Intermittent Employees
- Employees on temporary appointments who are expected to work 130 hours per month or more for at least 90 days;
- Employees on seasonal schedules who will be working a schedule of less than six months per year who are expected to work 130 hours per month or more for at least 90 days;
- Intermittent employees who are expected to work 130 hours per month or more for at least 90 days
Are now eligible to enroll in an FEHB plan. These newly eligible employees receive the same government contribution as full-time permanent employees.
FEHB for Employees
As a Federal employee, you are eligible to elect FEHB coverage, unless your position is excluded by law or regulation. Your agency applies these rules and determines your eligibility. However, there are numerous special provisions for people in part-time or intermittent employment, temporary appointments, and specifically named positions.
FEHB Handbook Chapter
This chapter in the FEHB Handbook discusses employee eligibility and explains the special provisions for people in part-time or intermittent employment, temporary appointments, and specifically named positions.