Expert's View

When I was in elementary school, I wanted to be an archaeologist. One definition of archaeology is “the study of human history and prehistory through the excavation of sites and the analysis of artifacts and other physical remains.” While I never went into that field, I sometimes feel like an archaeologist when I have to dig into my files to find an answer to a writer’s question.

In this case, the writer wanted to know what the rules are for granting a waiver of the requirement that a retiring employee be enrolled in the Federal Employees Health Benefits for five consecutive years (or from his first opportunity to enroll) to carry that coverage into retirement.

Well, when I was in charge of the program, the rules were strict. We could, of course, grant pre-approved waivers if the employee had been enrolled continuously since the beginning date of an agency’ statutory buyout authority or OPM-approved buyout or early retirement authority and received a buyout, took early optional retirement, or took discontinued service retirement based on an involuntary separation due to a RIF, directed reassignment, reclassification to a lower grade, or abolishment of position.

Other than that, OPM was restricted to waiving the eligibility requirement only when in its sole discretion it would be against equity and good conscience not to do so. At the time, the circumstances under which a waiver would be granted were not only limited, but they excluded such specific situations as when a retirement was based on disability or involuntary separation, and even when an individual was misadvised by his or her employing office.

In May of 2007, OPM changed its mind about those specific exclusions and issued the following regulation:

[5 CFR] Sec. 890.108 Will OPM waive requirements for continued coverage

during retirement?

(a) Under 5 U.S.C. 8905(b), OPM may waive the eligibility

requirements for health benefits coverage as an annuitant for an

individual when, in its sole discretion, it determines that due to

exceptional circumstances it would be against equity and good

conscience not to allow a person to be enrolled in the FEHB Program as

an annuitant.

(b) The individual’s failure to satisfy the eligibility

requirements must be due to exceptional circumstances. An individual

requesting a waiver must provide OPM with evidence that:

(1) The individual intended to have FEHB coverage as an annuitant

(retiree);

(2) The circumstances that prevented the individual from meeting

the requirements of 5 U.S.C. 8905(b) were beyond the individual’s

control; and

(3) The individual acted reasonably to protect his or her right to

continue coverage into retirement.

Has that make a big difference in the number of waivers granted? Probably not. However, there’s more wiggle room in the current regulation than there was before. So, if you find yourself in a position where a waiver is your only hope, go for it.