Information for Survivor Annuitants

Health Benefits

Widows and Widowers

Health benefits continue for all family members if there is a monthly survivor benefit payable and the deceased was enrolled in a "self and family" health benefits plan on the date of death. The enrollment will be changed to your name and premiums withheld from your annuity. If you are the only other person eligible for coverage under a "self and family" enrollment at the time of the employee's or retiree's death, your coverage will be changed to the less-expensive "self only" coverage. After the enrollment is changed to your name, the carrier will send you a new identification card.

If you are eligible for health benefits, your coverage generally continues for life unless you cancel your enrollment or lose eligibility for survivor annuity benefits due to marriage. If you lose eligibility for health benefits coverage and survivor annuity due to marriage and your survivor annuity is later restored due to marriage termination, you can re-enroll in a Federal health benefits plan.

Former Spouses

Former spouses may be eligible for health benefits coverage under the spouse equity provisions of Federal Employees Health Benefits (FEHB) Program if:

1. You currently receive or have future entitlement to a former spouse survivor annuity or a portion of the former employee's retirement benefits,
2. You were covered as a family member in an FEHB plan at any time during the 18 months preceding the termination of your marriage,
3. Your marriage ended while your former spouse was actually employed or retired from the Federal Government, and
4. You have not remarried before age 55 or you remarried before age 55 but were married for 30 years or more.

Former spouses must apply for health benefits coverage within 60 days of either the marriage termination or our notification that you are entitled to an annuity.

If you receive a former spouse survivor annuity or your marriage terminated after the employee retired, you must apply to us for health benefits coverage.

If your marriage ended while your former spouse was a Federal employee, you must apply to the agency where the employee worked at the time your marriage ended.

If you receive survivor annuity benefits, we will withhold the full cost of the enrollment from your annuity. If your annuity doesn't cover the full cost, you can enroll in a less-expensive plan or pay us directly. If you do not receive monthly benefits, you must pay the full cost directly to us.

If you do not meet the requirements for coverage under the spouse equity provisions as given above, you may be eligible for up to 36 months of coverage under the Temporary Continuation of Coverage provisions of the health benefits law.

Former spouse health benefits coverage generally continues for life unless you (1) lose entitlement to the survivor annuity, (2) cancel your enrollment, or (3) do not pay the full cost of your enrollment by the payment due date (if premiums are not being withheld from your annuity).

A "self and family" enrollment of a former spouse covers only the former spouse and any unmarried dependent children under age 22 or disabled children of the former spouse and the deceased employee or retiree.

If you are eligible for Federal Employees Health Benefits coverage as an employee or a family member under another enrollment, you may suspend coverage as a former spouse. If you later lose coverage as an employee or family member, you may resume health benefits coverage as a former spouse.

Children

To continue health benefits coverage, the dependent child must have been an eligible family member of the deceased. The child must be unmarried and under age 22 or disabled as described below.

Also, the deceased employee or retiree must have been enrolled in a "self and family" health benefits plan at the time of death (or the child is covered under a "self and family" enrollment of a former spouse).

Generally, an eligible child may receive health benefits coverage until he or she marries or reaches age 22, whichever occurs first. The child does not have to be enrolled as a full-time student to receive health benefits coverage as a family member. A child over age 22 may qualify for continued health benefits coverage if he or she is incapable of self support because of a disability that occurred before age 22.

A child's coverage will continue for 31 days after his or her eligibility for health benefits coverage ends unless the enrollment was canceled). During the 31-day extension of coverage period, the child may convert to a nongroup contract by writing directly to the nearest office of the plan.

Note: Many plans do not provide the same benefits under the converted nongroup contract that they provide under the Federal employee group plan. The Government will not contribute toward the cost of the nongroup conversion contract.

The child also has the right to request Temporary Continuation of Coverage as described below.

Temporary Continuation of Health Benefits Coverage

Temporary Continuation of Coverage is generally available to a covered child who, on or after January 1, 1990, loses eligibility for coverage because of loss of family member status. This coverage is also available to children who do not qualify for a survivor annuity. A former spouse who loses coverage on or after January 1, 1990, because of a divorce or annulment and who is not eligible (or has not yet been determined eligible) to enroll under the spouse equity law or similar statutes may qualify for Temporary Continuation of Coverage under the group plan. The temporary coverage may continue for up to 36 months after the qualifying event occurs.

The cost of the enrollment is the total premium (both the employee and Government shares) plus a charge of 2% of the total premium for administrative costs. The Government does not pay any portion of the cost of the enrollment. In addition, child and former spouse enrollees are entitled to a 31-day extension of coverage and can convert to a nongroup health benefits contract when their Temporary Continuation of Coverage ends (except by cancellation or nonpayment of premiums).

You must notify the retirement system if you are a former spouse who is eligible for Temporary continuation of Coverage or if you have children who are eligible. For child coverage, you must notify the retirement system within 60 days after the qualifying event described above occurs and provide the child's mailing address. A former spouse must notify the retirement system within 60 days after the marriage ends. Your retirement system then will notify the former spouse or the child of his or her Temporary Continuation of Coverage rights. If a former spouse or a child wants continued coverage, he or she must elect it within 60 days after receiving the notice (or after the date of the qualifying event, if later).

However, if you are a former spouse enrolled under the spouse equity provisions and you lose coverage because of remarriage or loss of qualifying court order within 36 months after your marriage ended, you may enroll for Temporary Continuation of Coverage within 60 days after the loss of coverage under the spouse equity provisions.

If we are not notified that a child or former spouse has lost coverage, the opportunity to elect continued coverage on a temporary basis ends 60 days after the event that caused the coverage loss.

The law specifies that the effective date of the Temporary Continuation of Coverage is the day after the 31-day extension of coverage the child or former spouse receives when eligibility for regular coverage ends. Because the effective date of continued coverage cannot be changed, the first payment may cover several installments.

For More Information

If you want more information about survivor benefits, write to our Retirement Operations Center in Boyers, Pennsylvania. Please be sure to follow the instructions given on page 1.

The pamphlets listed below offer more detailed information about their respective topics than is possible here. To request one or more of these pamphlets, call the Retirement Information Office or write to us at the address shown on page 1.

RI 25-26
Revised April 2001
Previous edition is not usable