With a new administration taking office, it’s a good time to review what would happen to your health benefits coverage if your agency is ordered to reshape itself or downsize, and you end up retiring, either voluntarily or involuntarily.
Under the law, you’d be able to continue your Federal Employees Health Benefits coverage if you have either been enrolled continuously in it for the five years immediately preceding retirement or from your first opportunity to enroll in the program. Notice that I wrote “program” not plan. You don’t have to be enrolled in a specific plan for that entire period. In fact, you could have changed plans every year and still meet the five-year/first opportunity requirement.
Fortunately, OPM and DoD are separately authorized to grant pre-approved waivers of the five-year requirement 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 the agency’s most recent buyout authority or an OPM-approved early retirement or buyout authority.
If your retirement fits into one of the above categories, your agency will attach a memorandum to your retirement application stating that your retirement meets the requirements for a pre-approved waiver of the five-year rule.
FYI. If you decide to retire and don’t meet the requirements in law or the waiver criteria to continue your FEHB coverage, you’ll probably be out of luck. Although you could ask OPM to grant you a waiver, it rarely does so.