If your enrollment is terminated because you separate from service on or after January 1, 1990, you may be eligible to temporarily continue your health benefits coverage under the FEHB Program after separation. Temporary continuation of coverage is available to you if your separation is voluntary or involuntary (unless it is for gross misconduct), and you would not otherwise be eligible for continued coverage under the Program. An example is separation for retirement when you are unable to meet the requirements for continuation of enrollment after retirement, see section titled "Circumstances Permitting Continuation of Enrollment".
Your temporary coverage continues for up to 18 months after your separation from service, and you must pay the total premium (both the Government and employee shares), plus a charge for administrative expenses of 2% of the total premium. When your temporary continuation of coverage ends (except by cancellation or nonpayment of premiums), you will be entitled to a 31-day extension of coverage for conversion to nongroup coverage, see section titled "Conversion Rights".
Electing Temporary Continuation of Coverage
Your employing office will notify you of your opportunity to elect temporary continuation of coverage within 61 days after your enrollment terminates because of separation from service. You have 60 days after separation (or after receiving the notice, if later) to elect continued coverage. Complete a Standard Form TCOC 2809 obtained from your employing office. You may choose:
Return the properly completed form to the employing office within the 60-day time limit.
Effective Date of Coverage
Your temporary continuation of coverage takes effect on the day after the 31-day extension of coverage described in the section titled "31-Day Extension of Coverage". Coverage is retroactive if you return the TCOC 2809 to the employing office after the 31-day extension period ends.
Other Individuals Eligible for Temporary Continuation of Coverage
On and after January 1, 1990, children who lose FEHB coverage and former spouses who are not eligible to enroll in the FEHB Program under the Spouse Equity law or similar statutes, see section titled "Enrollment of Former Spouses," may also be eligible for temporary continuation of coverage. Their temporary coverage continues for up to 36 months after the qualifying event occurs, e.g., child reaches age 22 or divorce.
Child and former spouse enrollees also must pay the premium plus the 2% administrative charge and are entitled to a 31-day extension of coverage for conversion to nongroup coverage when their temporary continuation of coverage ends (except by cancellation or nonpayment of premiums).
If temporary continuation of coverage is desired for your child or former spouse, the Office of Personnel and Benefits must be notified when the child or former spouse becomes eligible. For a child, you must notify the employing office within 60 days after the qualifying event occurs. For a former spouse, you or the former spouse must notify the Office of Personnel and Benefits within 60 days after the former spouse's change in status. We then notify the child or the former spouse of his or her temporary continuation of coverage rights. If a child wants continued coverage, he or she must elect it within 60 days after the date of the qualifying event (or after receiving the notice, if later). If a former spouse wants continued coverage, he or she must make the election within 60 days after the later of:
**Note: In the case of a child who becomes eligible for temporary continuation of coverage, if the employing office is not notified by the enrollee within the 60-day time limit, the opportunity to elect continued coverage ends 60 days after the qualifying event; in the case of a former spouse, if the employing office is not notified by the enrollee or the former spouse within the 60-day time limit, the opportunity to elect continued coverage ends 60 days after the change in status. if someone other than the enrollee notifies the employing office about a child's eligibility (or someone other than the enrollee or former spouse, in the case of a former spouse's eligibility), the employing office notifies the child (or former spouse) of his or her temporary continuation of coverage rights, but no additional time is given.
For a child who elects temporary continuation of coverage, the effective date of coverage is the same as described above. For a former spouse who elects temporary continuation of coverage, the effective date of coverage is the same as described above or the date of the qualifying event, if later.