Documenting Eligibility to Continue FEHB in Retirement

One of the major hangups in the processing of retirement applications involves the requirement for FEHB coverage for the five years before retirement in order to continue it as an annuitant.

Often the problem is that the documentation of electronic enrollment changes reflects the new plan and effective date, but not the old plan. Therefore, even though the years may appear to be fully documented, OPM cannot accurately determine the full coverage history of the years.

Ideally, OPM would prefer documentation of an employee’s coverage for their entire career. Lacking that, acceptable proof of coverage includes:

• a Standard Form 2809 (Health Benefits Election Form) or other enrollment form;

• a Standard Form 2810 (Notice of Change of Health Benefits Enrollment);

• history reports from on-line enrollments or screen shots that show both the old plan and new plan, and the effective dates for each change;

• evidence of coverage as a family member under another’s FEHB enrollment;

• evidence of TRICARE/CHAMPUS enrollment, including evidence of coverage as a family member; or

• a signed memo from the agency detailing the continuous coverage of the employee to prove that he or she meets the 5-year requirement and was covered under FEHB on the retirement date, with corroborating documentation showing payroll deductions for at least five years of service immediately before retirement.

You can help yourself greatly by gathering up supporting documentation yourself for the five years before you retire, and having that handy in case you need to prove your eligibility. Keeping the Standard Form 2809 that would show when you first enrolled, which would be a good start. Also helpful would be pay records that would show that deductions were taken out of your pay for FEHB coverage.