Domestic partnerships, civil unions or other arrangements that aren’t formally recognized as a marriage don’t fit the definition of an eligible family member. Image: bbernard/Shutterstock.com
By: FEDweek StaffEligibility for Federal Employees Health Benefits program coverage as a family member has become an issue lately.
Several reports have pointed to ineligible persons being on family policies, meaning that the program is paying claims for their health care without an additional cost to the enrollee—a cost that is then passed along to all enrollees (and the government) in the form of higher premiums. The OPM has issued guidance on checking enrollments, and more may be coming; also, a congressional committee is pressing OPM to do more.
The law has a possibly more limited definition that you might have, regarding who is a family member.
By law, an “eligible family member” includes:
• your spouse;
• a former spouse under certain conditions;
• children under age 26, including legally adopted children, recognized children born out of wedlock, stepchildren and, in certain circumstances as explained below, foster children;
• children of any age if incapable of self-support because of a mental or physical disability that began before age 26; and
• children of a same-sex domestic partner under certain circumstances as explained below.
Domestic partnerships, civil unions or other arrangements that aren’t formally recognized as a marriage don’t fit the definition of an eligible family member. Nor do parents, brothers and sisters and other close relatives, even if they are dependent on you, even to the point of living with you.
Also, there are certain conditions that control the eligibility of stepchildren and foster children. For example, as an enrollee, your stepchildren remain eligible after a divorce, a domestic partnership ends, or your spouse or domestic partner dies, as long as the children continue to live with you in a regular parent-child relationship.
To be eligible as a foster child, the child must live with you and you must be the primary source of financial support for the child and expect to raise the child to adulthood. Further, you must sign a certification stating that your foster child meets those requirements.
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