Office of Personnel Management
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United States Office of Personnel Management |
Retirement and Insurance Service | |
| CSRS: | Civil Service Retirement System | ||
Survivor Benefits for Children |
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Temporary Continuation of Coverage Generally, a child who loses eligibility for coverage may qualify for Temporary Continuation of Coverage under the Federal Employees Health Benefits Program. The temporary coverage would continue for up to 36 months after the coverage would have ended. The cost of the enrollment is the total premium plus 2 percent of the total premium for administrative expenses. There would be no Government contribution toward the cost of the coverage. When the temporary coverage ends, the child enrollee would be entitled to a 31-day extension of coverage and an opportunity to convert to a nongroup health benefits contract (unless the temporary coverage ends because of cancellation or non-payment of premiums).
You must notify your retirement system within 60 days after the child loses coverage and provide the childs mailing address. Your retirement system will notify the child of his or her Temporary Continuation of Coverage rights after receiving this information from you. If a child wants the temporary coverage, he or she must elect it within 60 days after receiving the notice (or after the date the child loses coverage, if later).
Important: The opportunity to elect temporary coverage ends 60 days after the event that caused the loss of coverage whether or not the retirement system is notified that a child has lost coverage.
The law requires that the effective date of the temporary coverage be the day after the 31-day extension of coverage the child received when his or her eligibility for regular coverage ended. Because the effective date of the temporary coverage cannot be changed, the first payment may cover several months premiums.
31-Day Temporary Extension of
Coverage and Conversion to a Nongroup
Contract
A child who loses regular health benefits coverage for any reason other
than by cancellation (including cancellation by nonpayment of premiums)
has a 31-day temporary extension of coverage, at no cost, for the purpose
of converting to a nongroup contract with his or her current health
benefits plan. This is true even when the child also has the right to
elect Temporary Continuation of Coverage as explained above. A child
who elects temporary coverage instead of the conversion policy has
another opportunity to convert to a nongroup contract when the temporary
coverage ends (other than by cancellation).
To convert the childs coverage to a nongroup plan, you or the child must apply directly to the health benefits plan within 31 days after the childs eligibility ends. Many plans provide fewer benefits under the converted nongroup contract and the premium rates are relatively more expensive. If you need to know the benefits and costs of the converted nongroup contract, get in touch with the childs health benefits plan.
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