FEDweek

Waivers of the Five-Year Rule: Possible but Rare

Carrying health benefits into retirement is so important that employees listening to their coworkers or attending retirement seminars are either prone to hear what they want to hear or are the recipients of erroneous information. It’s time to clear up any misinformation that may be floating about.

Under the law (5 U.S. Code 8905(b), you may continue your coverage under the Federal Employees Health Benefits program in retirement if you have been enrolled continuously in it for the five years immediately preceding retirement or from your first opportunity to enroll in it. This doesn’t mean that you have to be enrolled in a specific plan for that period of time. In fact, you could have changed plans every year and still meet the five year (or first opportunity) requirement.

For decades meeting the legal requirements was the only way you could be sure that you’d be able to carry your health benefits coverage into retirement. Then, around a dozen years ago, OPM was given the authority to grant waivers of the five-year requirement to individuals who applied for one. However, the criteria imposed by the Congress were so stringent that few waivers have ever been granted.

When early retirement offers and buyouts began coming thick and fast, it was recognized that one of the biggest impediments to some employees agreeing to retire was that they didn’t meet the five-year requirement and would lose their health insurance coverage. To correct this problem, OPM and DoD were separately authorized to grant pre-approved waivers under certain conditions. The rules differ slightly between those affecting DoD and other agencies of government:

DoD: The department’s authority to grant early retirements and buyouts is renewed each year and lasts from October 1 to September 30. To be eligible for a pre-approved waiver, an employee must have been continuously enrolled in the FEHB program since October 1 and retire during DoD’s early retirement/buyout period.

All other agencies: The employee must have been continuously covered under the FEHB program since the beginning date of either his agency’s most recent buyout authority or an OPM-approved early retirement or buyout authority.

If your retirement opportunity fits one of the above situations, your agency will have to attach a memorandum to your retirement papers stating that your retirement meets the requirements for a pre-approved waiver.

Just remember. These waivers only apply in certain situations. If you take it into your head to retire, don’t meet the requirements in law, and don’t meet the above waiver criteria, you’ll probably be out of luck. As noted above, OPM rarely grants individual waivers.