Appendix C: Qualifying Life Events (QLEs) that May Permit a Change in Your FEHB Enrollment (for Former Spouses under Spouse Equity provisions)
Qualifying Life Events are those events that permit individuals to change their health benefits
enrollment outside of the annual Open Season period. Below is a brief list of the more common
qualifying life events for Former Spouses under the Spouse Equity provisions. (Note: Former
spouses may change to Self and Family only if family members are also eligible family members of
the employee or annuitant.) 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
[848 KB]. For more
details about these and other qualifying life events, contact the Human Resources Office of your
employing agency or retirement system.
| |
From Not Enrolled to Enrolled |
From Self Only to Self and Family |
From One Plan or Option to Another |
| Change in family status based on
addition of family members who
are also eligible family members
of the employee or annuitant. |
No |
Yes |
Yes |
| Former spouse or eligible child
loses FEHB coverage due to
termination, cancellation, or
change to Self Only of the
covering enrollment. |
Yes |
Yes |
Yes |
| On becoming eligible for Medicare. This change may be
made only once in a lifetime.) |
Not Applicable |
No |
Yes |
Enrolled former spouse or eligible child loses coverage under another group insurance plan, for example:
- Loss of coverage under another federally-sponsored health benefits program;
- Loss of coverage under a non-Federal health plan
|
Not Applicable |
Yes |
Yes |
Qualifying Life Events (QLEs)
that May Permit a Change in Your FEHB Enrollment
(for Temporary Continuation of Coverage for Eligible Former Employees, Former Spouses, and Children)
Below is a brief list of the more common qualifying life events for Temporary Continuation of
Coverage (TCC) for Eligible Former Employees, Former Spouses, and Children. 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 [848 KB]. For more details about these and other
qualifying life events, contact the Human Resources Office of your employing agency or retirement
system.
| |
From Not Enrolled to Enrolled |
From Self Only to Self and Family |
From One Plan or Option to Another |
| Change in family status (except former spouse): for example, marriage, birth or death of family
member, adoption, legal separation, or divorce |
No |
Yes |
Yes |
| On becoming eligible for Medicare |
Not Applicable |
No |
Yes |
| Change in family status of former spouse, based on addition of family members who are eligible
family members of the employee or annuitant. |
No |
Yes |
Yes |