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Frequently Asked Questions Insurance

I know you have to be enrolled in the FEHB Program for 5 years before retirement to continue coverage in retirement. Does previous enrollment count towards 5 years or does it have to be five continuous years? This employee was enrolled for about two years in the past and wonders if this counts towards the 5 years.

It depends.  FEHB law requires a retiring employee to be covered under FEHB for the 5 years of service immediately before retirement or, if less than 5 years, for all service since the employee’s first opportunity to enroll in FEHB.  In the above situation, the employee’s 2 years of previous FEHB coverage would count toward his 5-year FEHB coverage requirement if he had a break in service and therefore could not have had FEHB as an employee.

For example:  The employee was enrolled in FEHB from 2003-2005 and then separated from Federal employment.  He returned to Federal service in 2010 and was enrolled in FEHB from 2010-2013.  The 2 years he was enrolled in FEHB from 2003-2005 along with the 3 years he was enrolled in FEHB from 2010-2013 enable him to meet the 5-year coverage requirement. 

However, if the employee had been continuously employed and eligible for FEHB, but had a break in his FEHB coverage from 2003-2009 because he cancelled his FEHB, he would have to begin the 5-year period over again. 

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