Orlando Harmon
If you're a federal employee wondering what to do when your insurance ends, you may be eligible for a Temporary Continuation of Coverage (TCC) to extend your Federal Employees Health Benefits (FEHB). TCC allows you to temporarily continue your FEHB coverage after regular coverage ends, for up to 18 months, or 36 months in the case of divorce or annulment. To be eligible, you must have been enrolled in the FEHB program for the 5 years immediately preceding the end of your employment, or for the full period of service during which you were eligible to be insured if less than 5 years. You must pay the full premium for the plan, plus a 2% administrative charge. TCC is not available if you are involuntarily separated from your position due to gross misconduct, or if you move to a new federal job that is excluded from FEHB coverage.
| Characteristics | Values |
|---|---|
| If you are leaving federal service without retiring | You cannot enroll or continue FEDVIP enrollment. There is no 31-day temporary extension of coverage or opportunity to convert to private coverage. Your coverage ends on the last day of the pay period during which you separate. |
| If you are retiring | Your FEDVIP coverage will automatically continue. BENEFEDS.gov will work with your annuity system to set up premium deductions. |
| If your enrollment ends due to cancellation | You are not entitled to a 31-day extension of coverage. |
| If your enrollment ends for any other reason | You are entitled to a 31-day extension of coverage (at no cost) with the opportunity to convert to a non-group contract with your insurance carrier. |
| If you are a retiree, widow/widower survivor annuitant, former spouse survivor annuitant, or child of a deceased federal employee or retiree with coverage under the FEHB program in your name | If your enrollment terminates for any reason other than voluntary cancellation, you are entitled to convert to a non-group health benefits contract issued by the carrier of your previous plan. |
| If you are confined to a hospital on the 31st day of your extension | Your benefits will continue while you are confined, up to a maximum of 60 additional days (at no cost). |
| If you are a family member of an enrollee and your enrollment ends | You are entitled to a 31-day extension of coverage (at no cost) with the opportunity to convert to a non-group contract with your insurance carrier. You also have the right to temporarily continue your FEHB coverage for up to 36 months. |
| If your coverage as a family member ends due to divorce or annulment | You have the right to temporarily continue your FEHB coverage for up to 36 months after your divorce or annulment. You may select any plan in the FEHB Program in which you are eligible to enroll. |
| If you are a former spouse | You can enroll under TCC while waiting for Spouse Equity coverage to begin, to avoid any gap in health insurance coverage. There is no specific time limit on how long Spouse Equity enrollments can continue, as long as the former spouse meets the requirements and pays the premiums. |
| If you are a federal employee who is separating from federal service | You may be eligible for TCC, which allows you to temporarily continue your FEHB coverage after regular coverage ends. To be eligible, you must exhaust your TCC eligibility as one condition for guaranteed access to individual health coverage under the Health Insurance Portability and Accountability Act of 1996. You must pay the full premium for the plan you select (both the employee and government shares) plus a 2% administrative charge. |
| If you are a federal employee who moves to a new federal job that is excluded from FEHB coverage | You are not allowed to take advantage of a temporary continuance of coverage (TCC). |
| If you lose your FEHB plan after your 12th month in Leave Without Pay (LWOP) status | You are not allowed to take advantage of a temporary continuance of coverage (TCC). |
| If you are a family member part of a self-plus-one or family FEHB plan and the federal employee switches to "self-only" | You are not allowed to take advantage of a temporary continuance of coverage (TCC). |
| If you are an employee who lost FEHB coverage due to termination for gross misconduct | You are not allowed to take advantage of a temporary continuance of coverage (TCC). |
| If you are a federal employee who is rehired in an FEHB-eligible position while enrolled in TCC | Your TCC will stop upon enrolling in an FEHB plan. |
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What You'll Learn
If you're leaving federal service, not retiring
If you are leaving federal service without retiring, you are not eligible for a 31-day temporary extension of coverage or the opportunity to convert to private coverage. Your coverage ends on the last day of the pay period during which you separate.
If you are enrolled in the Federal Employees Health Benefits (FEHB) Program, you may be eligible for Temporary Continuation of Coverage (TCC). TCC allows you to temporarily continue your FEHB coverage after regular coverage ends. To be eligible for TCC, you must have been enrolled in the FEHB Program for at least five years of service immediately before your separation. You must also exhaust your TCC eligibility to gain access to individual health coverage under the Health Insurance Portability and Accountability Act of 1996.
As a TCC enrollee, you must pay the full premium for the plan you select (both the employee and government shares) plus a 2% administrative charge. You can select any plan in the FEHB Program that you are eligible to enrol in. If you choose family coverage, your spouse and children will also be covered.
If you are enrolled in the Federal Employees Dental and Vision Insurance Program (FEDVIP) and leave federal service without retiring, your coverage will end. You cannot continue FEDVIP enrollment after leaving federal service unless you are retiring.
If you are enrolled in the FEHB Program as a family member and your coverage ends due to divorce or annulment, you are entitled to a 31-day extension of coverage with the opportunity to convert to a non-group contract with your insurance carrier. You can also continue your FEHB coverage for up to 36 months after your divorce or annulment.
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If you're retiring
If you are retiring from federal service, you may be eligible to continue your Federal Employees Health Benefits (FEHB) Program coverage into retirement. To be eligible, you must meet the following conditions:
- You must be entitled to retire on an immediate annuity, which starts within 31 days of your separation from federal employment.
- You must have been continuously enrolled in any FEHB plan for the 5 years of service immediately preceding your retirement, or for the full period(s) of service during which you were eligible to enroll if less than 5 years.
- You must not have converted to an individual policy.
If you meet these requirements, you can continue your FEHB coverage into retirement by completing the SF 2818 (Continuation of Life Insurance Coverage) form. On this form, you can choose whether to continue your Basic life insurance into retirement and, if so, the amount of coverage you would like to keep after age 65 or retirement, whichever is later.
Additionally, if you are enrolled in the Federal Employees Dental and Vision Insurance Program (FEDVIP) as a federal employee and you retire while enrolled, your FEDVIP coverage will typically continue automatically. BENEFEDS.gov will work with your annuity system to set up premium deductions from your annuity. However, if you do not see deductions after two full pay periods, you should contact BENEFEDS Customer Service.
It is important to note that if you are enrolled in a family FEHB plan and wish to continue coverage for your family members, they must also meet certain requirements. For example, if you are enrolling a spouse, they must have been enrolled in an FEHB plan for the 5 years preceding your retirement, similar to your own requirement. Additionally, any children you wish to cover must be eligible according to the FEHB program guidelines.
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If you're a family member
If you are a family member of a federal employee and your Federal Employees Health Benefits (FEHB) coverage has ended, you may be eligible for a Temporary Continuation of Coverage (TCC). TCC allows you to temporarily continue your FEHB coverage after it ends. Here are the steps and conditions to consider:
Eligibility:
First, check your eligibility for TCC. Certain events qualify you for TCC, such as divorce or annulment, or if the federal employee switches from a family plan to a "self-only" plan. Note that if you are a family member who was part of a "self-plus-one" or family FEHB plan, and the federal employee switches to "self-only," you are not eligible for TCC.
Timeframe:
If eligible, you can continue your FEHB coverage for up to 36 months after the qualifying event. There is also a 31-day extension of coverage at no cost to you, during which you can convert to a non-group contract with your insurance carrier.
Costs:
To continue your coverage under TCC, you must pay the full amount of the premium (both the employee and government shares) plus a 2% administrative charge.
Enrollment:
You may select any plan in the FEHB Program for which you are eligible to enroll. If you choose a family enrollment, it will cover yourself and the children of both you and the federal employee under whose enrollment you were previously covered. If your former spouse still carries a family enrollment, you can enroll for "self-only."
Action:
Contact your health plan directly for assistance within 30 days of your coverage termination. You will need to fill out the Employee Health Benefits Registration Form (SF-2809).
It's important to note that TCC is a temporary solution, and you must exhaust TCC eligibility to gain guaranteed access to individual health coverage under the Health Insurance Portability and Accountability Act of 1996.
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If you're a former spouse
First, understand your rights under the Consolidated Omnibus Budget Reconciliation Act, or COBRA. COBRA is a federal law that allows you to continue your health insurance coverage under your former spouse's plan for a limited time after a qualifying event, such as divorce or legal separation. This continuation coverage usually lasts for up to 36 months, though there may be state laws that provide for longer periods of coverage. It's important to note that you'll likely have to pay the full cost of the premiums, plus a small administrative fee, so be prepared for potentially higher costs.
Make sure to enroll in COBRA coverage within 60 days of the divorce or separation, or within 60 days of losing your group health coverage, whichever is later. This is a strict deadline, and failing to enroll on time may result in a loss of coverage. You should receive a COBRA election notice and information from your former spouse's plan administrator outlining your rights and explaining how to enroll. Contact the plan administrator if you have any questions or concerns about the process.
If you're eligible for coverage under your own employer's health plan, consider enrolling in that plan. This may be a more cost-effective option compared to COBRA, as you may be able to take advantage of employer-provided subsidies. Additionally, if you're already enrolled in your own employer's plan, make sure to update your status following the divorce or separation, as you may now be eligible for a different level of coverage or benefits.
Explore your options on the Health Insurance Marketplace. If neither COBRA nor employer-provided insurance is feasible, you can purchase coverage through the Health Insurance Marketplace during a special enrollment period triggered by your change in marital status. You may be eligible for financial assistance through premium tax credits and cost-sharing reductions, which can help make coverage more affordable.
Finally, don't forget about other health coverage options, such as Medicaid or the Children's Health Insurance Program (CHIP). These programs often have income eligibility requirements, but they can provide comprehensive and affordable coverage if you qualify. The end of your federal insurance continuation is a qualifying life event that allows you to enroll outside the usual open enrollment periods.
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If you're a federal employee who moves to a non-FEHB-eligible position
If you're a federal employee transitioning to a position that is not eligible for the Federal Employees Health Benefits (FEHB) program, there are several important considerations to keep in mind regarding your health insurance coverage. Here's what you need to know and do:
Understand Your Options for Continuation Coverage: As a federal employee, you may be entitled to continue your FEHB coverage temporarily after leaving your FEHB-eligible position. This continuation of health insurance is made possible by the Comprehensive Omnibus Budget Reconciliation Act of 1985 (COBRA) and the Temporary Continuation of Coverage (TCC) provision of the FEHB program. With COBRA, you can generally extend your FEHB coverage for up to 18 months. On the other hand, TCC allows you to continue your FEHB coverage for up to 36 months in certain situations, such as when you're retiring or when your employment ends for reasons other than gross misconduct. Remember that you usually have 60 days from the loss of your FEHB coverage to elect TCC.
Evaluate Your New Position's Benefits: Carefully review the benefits offered by your new non-FEHB-eligible position. Some positions may provide access to alternative health insurance plans or options to purchase coverage through the organization. Understand the costs, coverage levels, and network restrictions associated with these alternatives. Compare them with the benefits you had under the FEHB program to make an informed decision.
Consider Individual Health Insurance Plans: If your new position does not offer satisfactory health insurance benefits, or if you're transitioning to self-employment or retirement, explore the individual health insurance market. You can purchase coverage through the Health Insurance Marketplace or directly from insurance providers. Keep in mind that you may be eligible for a special enrollment period when transitioning from FEHB coverage to an individual plan. This allows you to enroll outside the regular open enrollment period.
Weigh the Benefits of Spousal or Partner Coverage: If your spouse or domestic partner has access to health insurance through their employer or another organization, consider the feasibility of joining their plan. Compare the costs and benefits of their coverage with those of your FEHB continuation options and individual market plans. Sometimes, being a dependent on someone else's plan may provide more comprehensive or cost-effective coverage.
Stay Informed About Deadlines and Requirements: Pay close attention to deadlines associated with electing continuation coverage, enrolling in alternative insurance plans, or applying for special enrollment periods. Each option has its own set of rules and timelines. Missing a deadline could result in a lapse in coverage, so stay organized and informed throughout the transition process.
By understanding your continuation coverage options, evaluating alternative benefits, and exploring the individual health insurance market, you can make a seamless transition from your FEHB-eligible position to your new role while maintaining peace of mind about your health coverage needs. Remember to carefully review all the available choices and select the option that best suits your specific circumstances.
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Frequently asked questions
TCC stands for Temporary Continuation of Coverage. It is a feature of the Federal Employees Health Benefits (FEHB) Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends.
Federal employees and family members who lose their FEHB coverage due to a qualifying event may be eligible for TCC. For employees, the only qualifying event is separation from Federal service (except in cases of gross misconduct). For family members, divorce or annulment of marriage is a qualifying event.
TCC can last for up to 18 months for employees and up to 36 months for former spouses.
If you are hired by the federal government in an FEHB-eligible position, your TCC will stop upon enrolling in an FEHB plan.
