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http://www.opm.gov/insure/life/faq/faqs-5.asp

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Life

Workers' Compensation and FEGLI


Q. I'm receiving benefits from the Department of Labor, Office of Workers' Compensation Programs (OWCP). Do I still have life insurance?

A. When you start receiving compensation, you remain insured as an employee until one of the following happens:

  • You complete 12 months in nonpay status; or
  • You separate from service.

You are entitled to continue life insurance for up to12 months while you are in nonpay status. The 12-month period starts when you are in nonpay status for an entire pay period. If you are receiving Workers' Compensation, OWCP withholds the FEGLI premiums from your compensation.


Q. What happens to my life insurance (FEGLI) coverage after 12 months on OWCP?

A. Your life insurance coverage terminates at the end of the 12-month period, with a 31-day extension of coverage and a right to convert to an individual policy. At the end of 12 months, your employing agency must complete an Agency Certification of Insurance Status (SF 2821) and a Notice of Conversion Privilege (SF 2819). If a claim needs to be filed while you are still covered under FEGLI, you or your survivors should contact your former employing agency.


Q. What is the five-year/all opportunity rule for continuing life insurance into compensation?

A. To continue life insurance benefits as an OWCP compensationer, you must meet all of the following requirements:

  • On the day you separate from service or on the day you end 12 months of nonpay status, you are still receiving compensation payments;
  • The Department of Labor has determined that you are unable to return to duty;
  • You have been insured for the 5 years of service immediately before the beginning date your compensation, or for the full period(s) of service during which you were eligible to be insured if less than 5 years; and
  • You have not converted to an individual policy. (If you have already converted the coverage before it is determined you are eligible to continue your coverage, you must void the conversion policy. To void the conversion policy, contact the insurance company. That company will send you a refund of any premiums you have already paid for the conversion policy.)

The year of continued coverage while in nonpay status cannot be counted toward meeting the 5-year requirement. You must meet the 5-year/all-opportunity requirement as of the date compensation begins. You must meet the five year/all opportunity requirement for Basic and each type of Optional insurance in order to continue it into compensation.

For purposes of continuing FEGLI coverage into compensation, “service” means time in a position in which you were eligible for coverage. Breaks in service are not counted as interruptions in coverage.

For the purpose of continuing insurance as a compensationer, you are not considered to have been eligible for Option C during any period when you had no eligible family member.

An example will help.

Example 1

Beatrice elected Basic insurance only when she became employed in 1997. In June 2004 Beatrice was hurt in an accident at work and began receiving compensation; she separated from service 11/12/04 and continued receiving compensation. Since Beatrice was insured for the 5 years of service immediately before the date that compensation started in June 2004, she was eligible to continue her FEGLI as a compensationer.

Example 2

Conrad waived all FEGLI when he became employed in 1997. During the 2004 open season he elected Basic insurance; the coverage was effective 9/04/05. In August 2009 Conrad was injured in an on-the-job accident and began receiving compensation. Since Conrad did not meet the 5-year or all-opportunity requirement at the time his compensation began, he was not eligible to continue coverage as a compensationer. However, Conrad's FEGLI continued while he was in nonpay status for a year. At the end of the year in nonpay status, since he did not meet the 5-year/all-opportunity requirement, Conrad's FEGLI terminated

You must work with your employing human resources office to receive the needed forms at the end of 12 months on OWCP. These forms include the Agency Certification of Insurance Status (SF 2821) and Notice of Conversion Privilege (SF 2819). You should contact your agency as your 12 months on OWCP approaches. If you are eligible to continue FEGLI as a compensationer, you will have an additional form to complete.


Q. I'm receiving benefits from the Department of Labor, Office of Workers' Compensation Programs (OWCP). Should FEGLI premiums be deducted from my compensation payments?

A. Yes, your FEGLI premiums should be deducted from your OWCP payments. You should check your payment stub to confirm that premiums are deducted. When you go on leave without pay to receive compensation, your employing office must notify the Office of Workers' Compensation Programs (OWCP) of the type and amount of life insurance you have. The form to use for this purpose is OWCP Form CA-7.

OWCP will make withholdings from your compensation starting from the first day of the pay period following the period in which your pay stops. Exception: OWCP doesn't make any withholdings if you receive compensation for fewer than 29 days. The withholdings are at the same rate that was withheld from your salary; however, they are computed on an every-4-weeks basis.

Whenever your pay changes during the time you are still covered as an employee (12 months), your employing office must notify OWCP, so any withholdings for Basic and Option B can be adjusted, if necessary.

IMPORTANT: If premiums are not being deducted, you must contact your employing agency so the proper documentation can be sent to OWCP. It is your responsibility to know your benefits.


Q. Where can I read more about FEGLI for those on OWCP?

A. You can read the procedures for compensationers in the FEGLI Handbook