• I am a Federal employee. How can I get information about enrolling in the Federal Employees Health Benefits Program?
• Generally, what events allow me to enroll and then to change my enrollment?
• I am a Federal employee. How do I actually enroll in the FEHB Program?
• When I change plans, when will the change be effective?
• Can a temporary employee enroll?
• I want to enroll in a Health Maintenance Organization (HMO) but I don't live or work in the Plan's area as required by that particular plan's brochure. Why can't I enroll in it?
• I just had a baby. My coworker just adopted a little child. Do either of us need to complete another Standard Form 2809, Health Benefits Registration Form, to have our children covered?
• My child is in college; how long can my child stay covered under my enrollment?
• Can my children get coverage when they lose coverage as family members?
• I am not a Federal employee and am divorcing my spouse, who is a Federal employee. Can I get coverage when I lose coverage as a family member?
• If I decide to choose "spouse equity" coverage when we divorce, how do I qualify?
• I believe I am eligible; how do I enroll for spouse equity coverage?
• When my youngest child turns 22 and only my spouse and I are covered under my self-and-family enrollment, will my premiums decrease? Can I enroll in a "self-and-spouse" enrollment?
• Who can be included on my Federal Employees Health Benefits Program enrollment? Can I cover my mother?
• Can I cover my common-law spouse under my self-and-family enrollment?
• My Federally-employed spouse and I have one child. My spouse and I are separating. Will I be covered during the separation?

I am a Federal employee. How can I get information about enrolling in the Federal Employees Health Benefits Program?

To get information about enrolling in the Federal Employees Health Benefits Program, contact your agency human resources office. They will also explain the program to you, determine if you are eligible, give you appropriate literature, caution you against canceling any private health insurance you may already have before coverage becomes effective; and urge you to study the literature and decide which plan is best suited to your needs.

Generally, what events allow me to enroll and then to change my enrollment?

You can change from a self-and-family enrollment to a self-only enrollment or cancel your enrollment at any time. Other changes may be made during open season or because certain events take place. The most common reasons for changing enrollment type or plans, other than during open season, are when enrollees get married, have babies, move away from the area served by their Health Maintenance Organization (HMO), or go to overseas posts of duty. Your human resources office can give you more information about the events that allow you to change your enrollment.

I am a Federal employee. How do I actually enroll in the FEHB Program?

To enroll in the FEHB Program, you must follow the instructions of your agency human resources office. There you can get information about FEHB and whether you are eligible to enroll. If you are eligible, they will also advise you about when your FEHB coverage will become effective. You will fill in a Standard Form 2809, Health Benefits Registration Form, or perhaps will use Employee Express.

When I change plans, when will the change be effective?

Open season changes are effective the first day of the first full pay period that begins in January. Generally, mid-year changes are effective on the first day of the pay period which begins after your enrollment is received by your human resources office.

Can a temporary employee enroll?

Yes, after completing one year of current continuous government service. Your human resources office can tell you whether you are eligible.

I want to enroll in a Health Maintenance Organization (HMO) but I don't live or work in the Plan's area as required by that particular plan's brochure. Why can't I enroll in it?

Health maintenance organizations (HMO) often restrict enrollment to an area where its doctors and hospitals are accessible. Although some HMOs do not have restrictions on where you live or work, please recognize that if you later find it is inconvenient to get to a plan provider, you will not be allowed to change plans until an event occurs that allows you to change, such as the next open season.

I just had a baby. My coworker just adopted a little child. Do either of us need to complete another Standard Form 2809, Health Benefits Registration Form, to have our children covered?

How you acquire a child (e.g., birth or adoption) does not matter. If you have self-only enrollment, you each need to complete an enrollment form to change to a self-and-family enrollment. If you already have a self-and-family enrollment, you do not need to complete a new form; in this case, contact your plan to let them know about the new family member.

My child is in college; how long can my child stay covered under my enrollment?

Your child can be covered under your self-and-family enrollment until he or she marries or turns age 22. It does not matter whether he or she attends college.

Can my children get coverage when they lose coverage as family members?

Yes. Children who lose coverage under your self-and-family enrollment may enroll for Temporary Continuation of Coverage for a period of time after they lose coverage as your family member. Contact your human resources office within 60 days of the child's 22nd birthday. Your children may also choose to convert to a private policy.

I am not a Federal employee and am divorcing my spouse, who is a Federal employee. Can I get coverage when I lose coverage as a family member?

Although you cannot remain covered as a family member under your spouse's self-and-family enrollment (even if a court order requires it), you may be eligible for Federal Employees Health Benefits Program coverage under either the spouse equity provisions or the Temporary Continuation of Coverage provisions of the law. You would be enrolled in your own right and would pay both the Government and employee shares of the premium yourself. See RI 70-5 Guide for Temporary Continuation of Coverage (TCC) and Former Spouse Enrollees for more information.

If I decide to choose "spouse equity" coverage when we divorce, how do I qualify?

To qualify for spouse equity coverage, submit an application to your former spouse's human resources office (or, if applicable, the former spouse's retirement system) within 60 days after your divorce; you must be covered as a family member under your spouse's Federal Employees Health Benefits Program enrollment at least one day during the 18 months prior to divorce; and you must have future entitlement to receive a portion of your spouse's retirement annuity or survivor annuity. Also, if you remarry prior to age 55 you will lose this coverage.

If you do not qualify under the spouse equity provisions, you may be eligible for coverage under the Temporary Continuation of Coverage provisions. You may also convert to a private policy. See RI 70-5 Guide for Temporary Continuation of Coverage (TCC) and Former Spouse Enrollees for more information.

I believe I am eligible; how do I enroll for spouse equity coverage?

Contact the agency human resources office (or retirement system, if applicable) for information on how to enroll. You will need to document your eligibility. See RI 70-5 Guide for Temporary Continuation of Coverage (TCC) and Former Spouse Enrollees for more information.

When my youngest child turns age 22 next month, I won't have any family members who are eligible for coverage. Do I have to wait until open season to change from self-and-family to a self-only enrollment?

You can change from a self-and-family enrollment to a self-only enrollment at any time.

Who can be included on my Federal Employees Health Benefits Program enrollment? Can I cover my mother?

Federal Employees Health Benefits Program coverage is available for the employee's spouse and unmarried dependent children under age 22, including legally adopted children and children born out of wedlock. Stepchildren and foster children (including grandchildren, if they qualify as foster children) are included if they live with the employee in a regular parent-child relationship. Also, an unmarried dependent child age 22 or over who is incapable of self support because of a mental or physical incapacity which existed before age 22 may qualify for coverage under certain conditions. You cannot cover other relatives, such as your mother, even if they are otherwise considered your dependents.

An employee's agency makes enrollment eligibility decisions in accordance with the law and regulations. Ask your human resources office for help in deciding whether your circumstances meet the requirements.

Can I cover my common-law spouse under my self-and-family enrollment?

If the State in which you reside recognizes common-law marriages, yes.

My Federally-employed spouse and I have one child. My spouse and I are separating. Will I be covered during the separation?

As long as your spouse has a self-and-family enrollment and you are still married to your spouse, you will be covered under the enrollment. Your eligibility for coverage under your spouse's self-and-family enrollment will cease after a divorce or annulment.