What is TCC for FEHB (federal employee health benefits) program? Learn about canceling coverage and temporary continuance of coverage.
This article covers canceling federal employee health insurance and temporary continuance of coverage (TCC). This is the tenth article in our ongoing series breaking down OPM’s FEHB Handbook,
The previous nine parts went over the following topics –
- Part One: General Overview
- Part Two: Legal Responsibilities
- Part Three: FEHB Premiums and Premium Conversion
- Part Four: FEHB Withholding, Contributions, and the Daily Rate
- Part Five: Types of Health Plans Available
- Part Six: FEHB Coordination with Other Health Insurance
- Part Seven: Eligibility
- Part Eight: Enrollment
- Part Nine: Keeping FEHB in LWOP Status
Canceling FEHB insurance is pretty straightforward, but before terminating your plan, it is important to be mindful of possible repercussions. Feds can cancel their coverage during the annual open season or within 60 days of a qualifying life event (QLE) such as marriage, divorce, and or birth of a child. Note re-enrolling can’t be done until the next open season or another QLE occurs. When an annuitant cancels their FEHB plan, they can never re-enroll unless they are rehired by the government or their FEHB coverage was suspended for Medicare, Medicaid, or TriCare coverage. They can resume their FEHB plan when that coverage ends. Most importantly, canceling FEHB at the end of one’s career will interrupt the 5 years of continuous coverage needed in the last 5 years before retiring to be eligible for FEHB in retirement.
Learn all about FEHB plans, TriCare, FEDVIP coverage, and Medicare at our no-cost webinar -
For those who are about to lose their FEHB eligibility, they can apply for TCC, and the timeframe for which FEHB enrollment is still allowed depends on various factors. But first, let’s review which individuals are not allowed to take advantage of a temporary continuance of coverage:
- A federal employee who moves from an FEHB-eligible position to a new federal job that is excluded from FEHB coverage.
- A person who loses their FEHB plan after their 12th month in LWOP (leave without pay) status.
- A family member part of a fed’s self-plus-one or family FEHB plan and the federal employee switches to “self-only.”
- A surviving spouse whose annuity get terminated.
- Employees who lost FEHB due to termination and were fired for gross misconduct.
If you were discharged from your federal job for reasons other than gross misconduct, a TCC can be granted for 31 days after the last pay period of employment.
FEHB coverage will end in the last pay period:
- of working in an FEHB eligible occupation before changing to a federal job that is ineligible.
- that a federal employee dies, a spouse can receive a TCC unless otherwise eligible for FEHB a survivor annuitant. (If not a survivor annuitant, FEHB is required to help the widow or widower find outside health insurance.)
- that an employee in LWOP status reaches their 365th day of LWOP (not eligible for TCC)
- that fed was employed before being furloughed, separated, or taking a leave of absence.
- in which a TCC ends
- in which a temporary employee can no longer be enrolled due to insufficient pay to cover FEHB premiums.
Upon retirement, a federal annuitant can receive a TCC up to 18 months after leaving their federal post, unless they were let go for gross misconduct. Family members who become ineligible for FEHB, usually children reaching age 26 or older than 26 having recovered from a disability, can get a TCC up to 36 months.
A TCC can also be granted to FEHB-covered individuals that experience a QLE. The timeframe of the TCC is dependent on the qualifying event itself. Divorce is one such event, and former spouses can usually request a TCC up to 36 months, beginning immediately after the divorce become official.
Some final notes regarding TCC of FEHB coverage:
- The employing agency is responsible for notifying eligible individuals of TCC information.
- A guardian may file for a TCC on behalf of a child age 26 or younger, or a disabled person.
- FEHB will coordinate benefits with worker’s compensation programs and spouse equity provisions.
- A person with a TCC who is then hired by the federal government in an FEHB-eligible position will see their TCC stop upon enrolling in an FEHB plan.
Upcoming articles in this FEHB series will be going over information for annuitants, military servicemembers, and families of feds. In the meantime, don’t forget to register for our next FEHB Webinar!
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