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Insurance Services Programs
Appendix C
Qualifying Life Events (QLEs) that May Permit Change
in Your Enrollment for Individuals
Who are not
Participating in Premium Conversion
RI 70-09 - For Federal Retirees and Their Survivors
Below is a brief list of the more common qualifying life events. Be aware that time limits apply for requesting changes. A complete listing of qualifying life events can be found at www.opm.gov/forms/pdf_fill/sf2809.pdf. For more details about these and other qualifying life events, contact your Retirement System office. Enrollment may be cancelled or changed from Family to Self Only at any time.
| From Not Enrolled to Enrolled | From Self Only to Self and Family | From One Plan or Option to Another | |
|---|---|---|---|
| Open Season | No | Yes | Yes |
| Change in family status, for example: marriage, birth or death of family member, adoption, legal separation or divorce. | No | Yes | Yes |
| Annuitant or eligible family member loses FEHB coverage due to termination, cancellation, or change to Self Only of the covering enrollment. | Yes | Yes | Yes |
| Annuitant (or covered family member) enrolled in an FEHB health maintenance organization (HMO) moves or becomes employed outside the geographic area from which the FEHB carrier accepts enrollment or, if already outside the area, moves further from this area. | Not Applicable | Yes | Yes |
| On becoming eligible for Medicare. (This change may be made once in a lifetime.) | Not Applicable | No | Yes |
This page can be found on the web at the following url: http://www.opm.gov/insure/archive/08/guides/70-09/appendixc.asp
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