Removing a Family Member from the FEHB

When can a family member be removed from some FEHB plans? Here is OPM’s explanation.

Earlier this year, the Office of Personnel Management (OPM) released a rule amending Federal Employees Health Benefits (FEHB) Program regulations to allow family members to be removed from existing Self Plus One or Self and Family enrollments. The rules allow this to occur in some situations. It is not always an option.

OPM has issued a Benefits Administration Letter (BAL) providing guidance explaining when the removal of eligible family members is allowed.

Who Can Be Removed from Your FEHB Plan

The following eligible family members may be removed from a Self and Family or Self Plus One during the plan year:

  • Spouse – A spouse may be removed if the enrollee provides a notarized request for removal, signed by both the enrollee and the spouse, to the enrollee’s agency.
  • Adult child – A child who has reached the age of majority in the child’s state of residence (the enrollee’s state of residence if the child’s is not known) can be removed in one of two situations:
    • The enrollee provides proof that the child is no longer his or her dependent. A child can be removed without the child’s consent.
    • The child requests to be removed and provides a notarized request for removal.

More About Removing a Child from the FEHB Plan

A child’s removal is considered by OPM to be a cancellation. A child who has been removed from an FEHB plan is not eligible for the 31-day temporary extension of coverage, conversion to an individual policy, or temporary continuation of coverage. It may also impact eligibility for surviving family members to continue health benefits enrollment if the enrolled federal employee dies.

A removed child may only regain coverage under the applicable Self Plus One or Self and Family enrollment if requested by the enrollee during the annual Federal Benefits Open Season or within 60 days of the removed child losing other health insurance coverage.

Minor children can only be removed from enrollment in the FEHB with a court order.

A Federal employee who is the adult child or spouse of another Federal employee can be removed from an enrollment. Be aware that this is not a “qualifying life event” that allows the adult child or spouse to enroll in his or her own FEHB enrollment, unless the adult child has a spouse and/or child(ren) to cover.

A separate BAL will provide specific guidance to agencies on the situations that allow for removal of ineligible family members and the removal process.

Removal of Eligible Individuals from Existing Enrollments in the FEHB by FedSmith Inc. on Scribd

About the Author

Ralph Smith has several decades of experience working with federal human resources issues. He has written extensively on a full range of human resources topics in books and newsletters and is a co-founder of two companies and several newsletters on federal human resources. Follow Ralph on Twitter: @RalphSmith47