Separation Date
Separation from the 104th Congress will be January 2, 1997 unless your employing authority submits a Payroll Authorization Form separating you prior to that date.
Required Withholdings
The full month premium for Health Insurance coverage for January will be withhold from your 2-day January paycheck. If you have insufficient funds to cover the payment, the Human Resources' Office of Personnel and Benefits will bill you directly for the premiums due.
Cancellation
If you do not wish coverage to be withheld from your 2-day paycheck, you may voluntarily cancel your Health Benefits Enrollment by submitting a signed Health Benefits Registration Form (SF 2809) to the Human Resources' Office of Personnel and Benefits. The form must be received by December 15th to effect this cancellation.
Consequences of Cancellations
If you cancel your enrollment, neither you nor any family member covered by your enrollment will be entitled to a 31 day extension of coverage or conversion to nongroup coverage. Moreover, family members who lose coverage because of your cancellation will not be eligible for temporary continuation of coverage.
In addition, you will not be eligible for health benefits coverage after retirement unless upon reemployment you reenroll before you retire and meet all the requirements for continuation after retirement including five years continuous coverage before the date of retirement.
Coordination of Coverage
If you intend to be covered by another Federal enrollment at the time you cancel and wish to avoid a gap in your coverage, you should coordinate the effective date of your cancellation with the effective date of you new coverage.
Temporary Continuation of Coverage
Separating employees interested in Temporary Continuation of Health Benefits should refer to page 4 of "Information For Separating Employees" regarding their options.
If you need requisite forms or have additional questions, please call a Human Resources Assistant in the Office of Personnel and Benefits at 202-225-2450.