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It is your responsibility to know when a family member is no longer eligible for coverage - your agency will not notify you.
If you are enrolled in Self and Family or your child is the designated covered family member under your Self Plus One enrollment, your child is automatically covered until his/her 26th birthday.
There is no requirement that your child be a student, live with you, or be financially dependent upon you (except for a foster child) in order to be covered under your Self Plus One or Self and Family enrollment.
If you are enrolled in Self and Family when your child turns age 26 and you cover additional family members, you can contact your carrier directly to remove your child from your enrollment. If you have only one eligible family member remaining, your child turning age 26 is a QLE that allows you to decrease your enrollment to Self Plus One. If you have no eligible family members remaining, you may decrease to Self Only.
If you are enrolled in Self Plus One and your child is covered as your designated eligible family member, your child turning age 26 is a QLE allowing you to switch your covered family member. Alternatively, if no eligible members remain, you may decrease enrollment to Self Only.
You have from 31 days before until 60 days after the QLE to make an enrollment change. If you are an active employee, contact your agency’s Human Resources office. If you are a retiree, contract your retirement office.
Foster children, even if married, can be covered under their foster parent’s Self Plus One or Self and Family enrollment until their 26th birthday. To be considered a foster child for FEHB purposes, the following requirements must be met:
• the child must be under age 26• the child must currently live with you;• you must be the primary source of financial support for the child;• the parent-child relationship must be with you, not the child's biological parent; and• you must expect to raise the child to adulthood.
You must sign a certification stating that your foster child meets all the requirements. Contact your agency or Retirement System for more information.
A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.When your child reaches age 26, he/she is no longer an eligible family member. Your child will have a 31-day temporary extension of coverage at no cost after coverage ends. Your child is also eligible to enroll in Temporary Continuation of Coverage (TCC) or to convert to an individual policy with your carrier.If your child is interested in TCC, you must contact your Human Resources Office and inform them that your child is turning age 26. After your notification, your Human Resources Office will give you information about enrolling your child for TCC. You have 60 days from your child’s 26th birthday to notify your Human Resources Office your child turned 26. Your child has 60 days from the later of (1) your child’s 26th birthday, or (2) the date of the TCC notice from the Human Resources Office to request enrollment for TCC. For more information about TCC, please review the TCC coverage pamphlet.When your child's enrollment terminates, he/she is entitled to convert to an individual policy offered by the carrier of your plan. Your child is not required to provide evidence of insurability. To apply for conversion, you or your child must make a written request to the carrier of your plan. You or your child must apply for conversion within 31 days after his/her coverage as a family member terminated.
With one exception noted below, if your child turns 22 or marries, he/she is no longer eligible as a family member under your FEDVIP Self Plus One or Self and Family enrollment. There is no temporary continuation of coverage (TCC) or 31 day extension of coverage. Please log into your BENEFEDS account at www.BENEFEDS.com and remove your child from your enrollment immediately.
If your unmarried child is age 22 or older and incapable of self support due to a physical or mental condition that existed before age 22, your child may be eligible for continued coverage under your FEDVIP enrollment. Contact your FEDVIP carrier and ask for a determination concerning continued enrollment.
Health care reform does not affect eligibility for children under FEDVIP
A child's eligibility for Option C benefits ends once he/she reaches age 22, unless he/she is incapable of self-support because of a mental or physical disability that existed before the child reached age 22. Please refer to the FEGLI Handbook for more information.
Health care reform does not affect eligibility for children under FEGLI.
Call FSAFEDS at 1-877-FSAFEDS (372-3337), TTY: 1-800-952-0450 to discuss possible options.
FLTCIP coverage does not stop because a child turns 22. Your adult children (age 18 and over) are eligible to apply for FLTCIP coverage. If they are approved and enroll in the FLTCIP, their coverage will remain in effect, even beyond age 22, as long as they continue to pay premiums.
Health care reform does not affect eligibility for children under FLTCIP.