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Frequently Asked Questions Insurance

Divorce

  • Only you and the children born to or adopted by you and your former spouse (the Federal employee or annuitant) are covered under a Self and Family enrollment. Your child must be under age 26 or be incapable of self-support because of a mental or physical disability that existed before age 26.

    Your children cannot be covered under more than one FEHB enrollment. If your former spouse (the Federal employee or annuitant) covers the children under his/her FEHB enrollment, your Spouse Equity enrollment should be for Self Only coverage.

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  • The "Federal Employees Health Benefits Children's Equity Act of 2000" requires mandatory Self Plus One or Self and Family enrollment coverage for FEHB-eligible employees who do not comply with a court or administrative order to provide health insurance coverage for their child(ren). You should send a copy of the court order to your ex-spouse's Human Resources Office. They will ensure that your ex-spouse has an FEHB Self Plus One or Self and Family enrollment that provides coverage for the children. If your ex-spouse does not have a Self Plus One or Self and Family enrollment, his or her Human Resources Office will enroll him or her in the Self Plus One or Self and Family option of his or her current FEHB plan. If his or her current plan is an HMO and the child(ren) don't live within the service area of this plan, they will enroll him in the Basic Option of the Blue Cross and Blue Shield Service Benefit Plan. If he or she is enrolled in Self Plus One but does not have the child listed in the court order designated as his or her covered famiy member, the Human Resources Office will increase his or her enrollment to Self and Family.
     
    Please be sure to include your home address in your notification so that the Human Resources Office can make this determination. The Human Resources Office will send you a copy of the SF 2809, Health Benefits Election Form. They will also send a copy to the FEHB plan so the plan can update their records and send ID cards to you. The Human Resources Office will flag your ex-spouse's health insurance records to prevent him or her from decreasing his or her enrollment or switching his or her covered family member under a Self Plus One enrollment for as long as the court order requires him or her to provide health insurance coverage to your child(ren) or until the youngest child reaches age 26, whichever occurs first.

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  • Although you cannot remain covered as a family member under your spouse's Self Plus One or Self and Family enrollment (even if a court order requires it), you may be eligible for FEHB 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.
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  • No, the children are entitled to receive benefits under only one enrollment.  Generally, when divorce occurs, one parent will enroll in Self Only coverage and the other parent will enroll in Self and Family coverage to provide benefits for the children.  If there is a reason for both parents to enroll in Self and Family coverage (i.e., both parents have remarried and need Self and Family enrollments to cover their new spouses and stepchildren), each enrollee must notify his or her insurance carrier of the name(s) of the child(ren) to be covered under his/her enrollment to prevent ant child from receiving dual coverage under FEHB (which is prohibited by Federal law). In cases where there are only two children, each parent could enroll in Self Plus One where they can each designate an eligible child.
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  • Only you or a child born to or adopted by you and your former spouse (the Federal employee or annuitant) are covered under a Self Plus One enrollment. Your child must be under age 26 or be incapable of self-support because of a mental or physical disability that existed before age 26. If you have more than one eligible child, only one child can be covered under a Self Plus One enrollment.

    Your children cannot be covered under more than one FEHB enrollment. If your former spouse (the Federal employee or annuitant) covers the children under his/her FEHB enrollment, your Spouse Equity enrollment should be for Self Only coverage.

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