Parameters to Consider in the FEHB Five-Year Service Requirement, by Bill Hoff

bill hoff
January 22, 2021

Suppose you want to carry the Federal Employees Health Benefits (FEHB) program coverage into your retirement. In that case, you must have been covered for the program for the five years immediately preceding your retirement. You don’t have to be a continuous enrollee, but you must have continuous coverage because of an FEHB enrollment requirement. The period during which you are covered under another person’s FEHB enrollment as a family member also counts. This is a common occurrence due to the increase in marriage between two federal employees.

Your FEHB coverage also considers the period of your military Tricare program coverage, but this comes with an essential caveat: you must be enrolled under the FEHB program during your retirement period.

When the program administrators determine your continuous coverage, your Medicare coverage doesn’t count, just like your service as a non-appropriated fund worker. Your service as a non-appropriated worker doesn’t add to your continuous coverage because it is not a federal service. Thus, it is not under the FEHB coverage.

During the determination of your service requirements, your break in service may be counted except in one case. This exceptional case occurs when you re-enroll for the program within sixty days after returning to the federal government service.

Suppose your employing office discovered that you were not enrolled in time due to reasons beyond human control; you can make a late election. If you can make a late election, then you are continuously enrolled under the FEHB program.