The Five Year Requirement Under FEHB

By on October 3, 2012 in Pay & Benefits with 29 Comments

With Federal Employees Health Benefit (FEHB) open season approaching in November, it might be helpful to take a look at the “five-year requirement”.  While we’re at it, we’ll look at how the five-year requirement applies to your Federal Employees Group Life Insurance (FEGLI).

Most federal employees are aware that, in order to carry your FEHB into retirement, you have to have been enrolled for the five-year period immediately preceding retirement (with few exceptions).  There is generally a great advantage in being able to carry your FEHB into retirement.  Uncle continues paying his share for as long as you remain enrolled.

A few things of which you should be aware are:

  • The five years refers to enrollment in the program.  You do not have to remain in the same plan for five years.
  • The five years refers to your enrollment.  Your spouse does not have to be enrolled for the five years immediately preceding your retirement in order to be covered.  You can bring your spouse on your insurance at any time before retirement, or even after retirement.  Do be aware that if you die after retirement but before bringing your spouse on your FEHB, your spouse will not be able to continue FEHB, even if you have elected a survivor annuity.
  • If you are enrolled as a family member on the FEHB policy of your spouse, that counts towards the five-year period the same as if you were enrolled on your own.
  • Tricare is viewed as equivalent to FEHB, and time spent on Tricare counts towards the five years as long as you are covered by FEHB when you retire.
  • A major exception to the five-year rule is in the case of a reduction-in-force.  OPM routinely waives the five-year requirement in the result of RIFs.
  • Another exception is for a former federal employee who returns to federal employment.  As long as they sign up for FEHB immediately upon their return, they do not have to have it for five years.  For example, if an employee returned to federal employment in January 2010 and retired in December 2012, they could carry their FEHB into retirement if they enrolled in FEHB when they were re-employed.

FEGLI has the same five-year requirement, but there are a few differences between FEGLI and FEHB.  First, FEGLI open seasons are not regularly scheduled.  In fact, the last FEGLI open season was in 2004 and the changes that were made in that open season were not effective until September 4, 2005.  OPM has not announced the next FEGLI open season, and passed on a chance to run an open season in late 2011.  Open seasons usually occur when there are changes in insurance or premiums.  Premiums changed on January 1, 2012, but OPM elected not to run an open season at that time.

You do not need an open season to cancel or drop your FEGLI; you may do that at any time.  You may also enroll or increase your coverage due to a qualifying life event (e.g., marriage, divorce, death of a spouse, birth of a child, etc.), or by providing medical evidence of insurability as long as at least one year has passed since you waived your FEGLI coverage.

FEGLI options B and C also have options regarding the level of coverage.  In option B you may have multiples of 1 to 5 times your salary, and in option C you may have options of 1 to 5 times the amounts of $5,000 for a spouse and $2,500 for a child.  If you have options B and C when retiring, you can only carry over the lowest level of multiples you had during the last five years.

John Grobe’s latest book, The Answer Book on Your Federal Employee Benefits, has just been released by LRP Publications. The book is written in an easy to understand question and answer format and covers all areas of federal benefits from the perspective of an employee at various stages of their career. Order your copy at shoplrp.com.

© 2016 John Grobe. All rights reserved. This article may not be reproduced without express written consent from John Grobe.

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About the Author

John Grobe is President of Federal Career Experts, a consulting firm that specializes in federal retirement and career transition issues. He is also affiliated with TSP Safety Net. John retired from federal service after 25 years of progressively more responsible human resources positions. He is the author of Understanding the Federal Retirement Systems and Career Transition: A Guide for Federal Employees, both published by the Federal Management Institute. Federal Career Experts provides pre-retirement seminars for a wide variety of federal agencies.

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  1. grizzmama says:

    So my husband is a federal retiree and carries our FEHB family plan. I am a current federal employee and I carry a supplemental family vision and dental plan on FEHB. I will not receive a survivor annuity at my husband’s death. My question is – when I retire do I need to continue FEHB into retirement (the family health or the vision/dental) in order to not risk losing my FEHB coverage if my husband dies before I do? I am worried that since I’m <5 yrs from retirement, and don’t have a survivor annuity – that I might lose my benefits if the plan stays in my husband’s name and he predeceases me. Anyone know?

    • kevmeist says:

      I believe that to qualify for FEHB coverage in retirement that the spouse has to to be signed up for a survivor benefit. Why not switch the dental and vision to your husband and take it off yourself? I believe that as long as you receive a survivors benefit that you will be OK. Certainly talk to HR and confirm…get it in writing.

      • grizzmama says:

        That’s my point. I don’t receive a survivors annuity; that ship sailed at the point he retired.

        • kevmeist says:

          So, then, it would seem that you could fix this (maybe) by having you carry the FEHB plan NOW (or are you retiring very soon?) and having him get a survivor annuity? Kinda like the reverse of what you have. As an point of interest, if you were both Federal employees…what was the reason behind the coverage split?

          It sounds like you should talk to the HR or retirement folks and get some advice specific to your case. I’m certainly no expert in this stuff…just trying to help.

          • grizzmama says:

            Yes, I appreciate your perspective and I’ve considered exactly the solution you mentioned. My concern with talking to HR is not getting the correct answer. 🙂 I am retiring in 3ish years, but I could still switch and carry the family health plan (as my previous enrollment for more than 5 yrs meets the requirement). It’s just not a change I want to make; it’s a hassle if it’s not necessary.
            No real reason behind the split in coverage; at the point when my husband retired the plan was in his name and we kept it that way to preserve his eligibility. When the supplemental plans became available through FEHB, I signed up during open season since I was still employed.

          • kevmeist says:

            I would also get a number/email address for the retirement folks and get a double check on the answers. Make sure you have it in writing!

            Good luck.

  2. kevmeist says:

    Be aware that you have to be enrolled for 5 years from the first payment to FEHB, not just 5 years from the time first employed (this hit me when I retired at 64 and just 5 years as a Federal employee). Luckily, the retirement folks caught that and I had to slip the initial retirement date by 2 weeks.

  3. David says:

    So I want to be sure that I can leave my wife not covered by my FEBH plan during the last five years before I retire and have single health coverage for myself to save money (she has her own health insurance now but will need to be on my FEHB upon my retirement) and when I retire I can add her on?

  4. fdafed says:

    What about Vision and Dental Care programs offered? Do I have to be enrolled for 5 years prior as well to get coverage after I retire?

  5. VA Trainer says:

    For FEGLI you said: “You may also enroll or increase your coverage due to a qualifying life event (e.g., marriage, divorce, death of a spouse, birth of a child, etc.)” What about reducing your coverage e.g. going from 5x to 2x?  Do you need a qualifying event?  And if so, does legal separation count, or just divorce?

  6. Reobed says:

    Question:  I was employed by USDA and enrolled in FEHB at time of employment.  I resigned my position after one year but retained FEHB under COBRA for another year.  I am now re-employed by USDA and remain enrolled FEHB.  In short, there was no break in FEHB coverage.  Question:  does the one year under COBRA count towards the five years?  Thanks in advance for your assistance!

  7. FED UP says:

    Does anyone feel their christian rights are being violated by our being forced to pay for health insurance that contains controversial non-health related items?  WE HAVE NO CHOICE…..I personally do not like to pay for something I do not believe in, do not want and do not use.

    • RetiredVA says:

      FEHB plans are group plans.  That keeps the premiums low. If you do not like some of the coverage, you do not have to take advantage of that particular coverage.  Since you are only paying 1/3 of the actual cost (Federal government is paying the other 2/3) you are not really paying for coverage you do not believe in.

      If you want coverage that is religion specific, you always have the option of cancelling FEHB and the 2/3 premium Federal subsidy and finding religion specific coverage in the marketplace.

  8. wanting to know says:

    If you’re in Tricare Prime or Tricare for Life, are you considered in FEHB at your retirement date?

    • RetiredVA says:

       To quote from the article
      Tricare is viewed as equivalent to FEHB, and time spent on Tricare
      counts towards the five years as long as you are covered by FEHB when
      you retire.

      so you must enroll in FEHB just before you retire and pay at least 1 month’s premium.  Of course, the only way to enroll in FEHB is during open season so if your are retiring just before open season, you have to joined FEHB in the previous open season.

  9. Hilda says:

    I retired as a civilian 3 years ago at 62.  At that time I elected the go with a basic FGLI of 12,000 in case of death and they were taking around $15 out of my retirement pay till the age of 65.  They no longer take out the premium but I think my spouse is eligible for only $3,000 upon death.  I think it remains this amount till death but I’m not sure where I read this or if this correct??

  10. Curious says:

    I enrolled in insurance coverage January 12, 2009.  I would like to retire January 10th, 2014 (last day of the last pay period for 2013).  Will the 2 day difference leave me ineligible to keep my coverage? 

    • RetiredVA says:

       Yes, it would.  Five years means five complete years.  I worked with someone who was in a similar situation and had 240 hours of annual leave accrued which he planned to cash in.  He had the choice of working an extra week (thereby losing the excess leave) or retire and take the leave cash in but lose his FEHB coverage.

    • kevmeist says:

      Please see my comment above…about being 5 years from PAYING for FEHB coverage, not just 5 years employed.

  11. Mike says:

    As a retired military veteran, I qualify for health insurance benefits.  Would it be beneficial to continue FEHB after retiring from federal civilian service?

  12. G-Man says:

    The paragraph stating that a re-employed Federal (working two years from 2010 through 2012) appears incomplete.  If the employee came back and worked for two years, but he/she did not have FEHBA for the last three years of their prior service, I don’t think they would be eligible.  The employee should have FEHBA in retirement if he/she had coverage for the last three years of his/her prior Federal service and the two years of his/her current service. 

  13. Vafd104 says:

    My wife is also a federal employee and plans on making a career out of the federal government. When I retire will my FEHB also cover her, so that she can drop hers?

    • BenSpec says:

      You will likely have the flexibility to carry the coverage however you want. Either of you could carry a Family policy, or (if no children are covered) you could each carry a Self Only policy. (Two Self Only policies are usually cheaper than a Family policy.)

      • OldRet says:

        Unless it’s changed, one thing to remember is that an employee does not pay tax on their health care portion while the retiree does so you may want to look into a family policy on the employees plan as the whole amount paid by the employee would not be taxed, whereas, a retiree’s portion of a self-only policy is taxed.

  14. Wgssns says:

    I just received a response to an inquiry of when I had to have my wife enrolled on my FEHB plan so she would be covered after I retire. The response from HR was she MUST enrolled in my FEHB plan for the last year I work. That if she wasn’t , she could not be covered after I retired.

    • BenSpec says:

      Your HR staff members are mistaken. Ask them to provide documentation of this requirement from the FEHB Handbook or regs. The only requirements are that the spouse be covered on the policy on the enrollee’s date of death and that the spouse (or other eligible family member) receive a survivor annuity. (Yes, the survivor annuity requirement may be met by a CHILD being eligible for a survivor annuity and the surviving spouse being eligible because of the child. In that case, however, the spouse’s coverage would end when the child’s annuity ends — not usually a good thing.)

  15. OldRet says:

    Anyone know why this is a requirement? I’m thinking it must be the insurers that want this because I know people who don’t need it and only get it because it is required for retirement. Why make the government pay 2/3’s of an insurance premium for 5 years that someone doesn’t need  because their spouse is currently providing coverage. Doesn’t make sense to me. Seems like the government would save money by dropping this requirement!

  16. GiGe says:

    NOT Caring!

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