While FEHB coverage under a parent’s enrollment ends at age 26, your child can personally enroll in the program for 36 months and pay the full premiums for his or her own coverage. Image: Sheila Fitzgerald/Shutterstock.com
By: Reg JonesIn last week’s article, I wrote about changes in designations of beneficiaries you might want to make in your insurance coverage when you get married. This time I want to focus on the benefits available under the Federal Employees Health Benefits (FEHB) program when a child enters your life.
Who is a child?
According to the definition provided by the Office of Personnel Management, the term “child” includes the following: children under age 26, including adopted children, recognized natural children born out of wedlock, stepchildren (including children of same-sex domestic partners), and foster children.
While there’s usually no requirement that your child be a student or live with you or be financially dependent on you, there’s one exception. To be considered a foster child, he or she must:
• be under age 26;
• currently live with you;
• have you as the primary source of financial support;
• enjoy a parent-child relationship with you, not with his or her biological parent(s).
In addition, you must expect to raise the foster child to adulthood. Finally, you must sign a certified statement that your foster child meets all these requirements.
When does your coverage end?
Your coverage doesn’t end unless you either cancel it or you resign from the government. If you resign, you’ll be entitled to 31 days of free FEHB coverage. You can then extend that coverage for up to 18 months under the Temporary Continuation of Coverage provision and pay the full cost of the premiums, plus 2 percent.
When does a child’s coverage end?
While FEHB coverage under a parent’s enrollment ends at age 26, your child can personally enroll in the program for 36 months and pay the full premiums for his or her own coverage. If you have no other family members eligible for coverage under your own plan, you can switch to Self Only. If you have one other eligible family member, you can switch to Self Plus One. And if you were enrolled in the Self and Family option and have at least three remaining family members to cover (including yourself), you can continue your enrollment in that option.
You have from 31 days before your child turns 26 to 60 days after that to make any change in your own coverage. If you are an employee, it’s up to you to let your agency know when a family member is no longer eligible for coverage under your enrollment. If you are a retiree, you’ll have to notify OPM.
Note: If you have a child who is unmarried and incapable of self-support because of a mental or physical disability that existed before age 26, that coverage can continue without interruption.
Former head of retirement and insurance policy at the Office of Personnel Management, and longtime FEDweek contributor, Reg Jones is known throughout the federal workforce community as an authority on pay and benefits.
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