An employee, a child, and a former spouse are eligible for temporary continuation of coverage based on specific qualifying events. Image: Christian Delbert/Shutterstock.com
By: FEDweek StaffAlthough most federal employees are eligible to carry FEHB coverage into retirement and most of them do, there are situations in which a feature of FEHB known as temporary continuation of coverage (TCC) may be valuable. This is similar to the “COBRA” coverage available to private sector health plans.
TCC is available to (1) employees who lose their FEHB coverage because they leave their federal jobs, (2) children who lose FEHB family member status, and (3) former spouses who lose their FEHB family member status because of divorce or annulment. TCC allows former employees to continue FEHB coverage for up to 18 months, and former family members (children and former spouses) to continue FEHB coverage for up to 36 months.
An employee, a child, and a former spouse are eligible for temporary continuation of coverage based on specific qualifying events, as follows:
Employee–You are eligible when you separate from federal employment, voluntarily or involuntarily, unless your separation is due to gross misconduct. Under TCC, a self-and-family enrollment covers the same family members as were covered prior to separation. You are also eligible for TCC when you separate for retirement if you are not eligible to continue your health insurance into retirement.
Children–Your child is eligible when he/she has been covered and stops meeting the requirements and would not otherwise be eligible to continue health insurance coverage (not counting the 31-day extension of coverage). This primarily means turning age 26.
Former Spouses–Your former spouse is eligible upon divorce or annulment of the marriage, as long as he/she was covered as a family member at some time during the 18 months before the marriage ended, but does not meet the remaining requirements for coverage under the spouse equity provisions of the FEHB law because he/she remarried before reaching age 55; or is not entitled to a portion of your annuity benefits or a survivor benefit based on your service. For a former spouse, family members are limited to those individuals who are children of both you and the former spouse. The new husband or wife of a remarried former spouse is not covered as a family member.
There is no government contribution toward the premiums for TCC enrollment. In each case, the former employee, child, or former spouse is responsible for paying both the employee and government share of the premium, plus a 2 percent administrative fee. (Exception: If the employee is involuntarily separated due to a reduction in force (RIF), the agency may pay the government share of the premium and the administrative charge.) Premium charges, and TCC coverage, begin on the day after the free 31-day extension of coverage ends. If you elect TCC after the 31-day extension of coverage, you will be billed for premiums retroactive to the effective date of coverage.
The election must be made within 60 days after you lose your FEHB coverage or 60 days from the date you are notified of your eligibility to elect TCC, whichever is later.
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See also,
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