Last week I wrote about the option available to FEHB enrollees to elect either self only or self and family coverage. This time I want to talk about who is covered if you elect self and family coverage, and when that coverage ends for a family member.
When you enroll in the self and family option of an FEHB plan, all your eligible family members are automatically covered even if you haven’t included their names on the Standard Form 2808 you filled out when you first enrolled in the program. That’s right, you don’t have to go back and fill out another form each time there’s a change in your family situation.
The law’s definition of an eligible family member includes your spouse and any unmarried dependent children under the age of 22, unless a child is unmarried and incapable of self-support because of a disabling condition that occurred before age 22.
The word "children" includes your natural children, legally adopted children, children born out of wedlock that you acknowledge, and foster children or step-children, if they live with you in a regular parent-child relationship.
Other relatives, including your parents or significant others, are excluded from coverage no matter how close your relationship with them may be or even if they are living with you and are dependent on you.
For more information about who is eligible and the proofs needed in certain cases, go to www.opm.gov/insure/handbook/fehb28.asp#family.
If you lose coverage under the FEHB program you can temporarily continue that coverage for up to 18 months under the Temporary Continuation of Coverage provision of law. The same is true for any of your dependents who lose coverage, for example, a child who reaches age 22 or loses status as a stepchild, foster child or recognized natural child.
Under the TCC, enrollees can either stay in the same plan or switch to another. In either case, the enrollee will be required to pay 100 percent of the premiums plus 2 percent more to cover administrative costs.