This section provides information for Federal employees and annuitants on FEHB benefits
available under the Spouse Equity provisions of FEHB law. In this section:
- "you" means the Federal employee or annuitant; and
- "divorce" includes certain annulments.
SPOUSE EQUITY ACT
Law
The Civil Service Retirement Spouse Equity Act of 1984 (Public Law 98-615) was enacted
on November 8, 1984. Under this act, as amended, certain former spouses of Federal
employees, former employees, and annuitants may qualify to enroll in a health benefits
plan under the FEHB Program.
ELIGIBILITY
Your former spouse is eligible to enroll under Spouse Equity provisions if:
- you were divorced during your employment or receipt of annuity;
- he/she was covered as a family member under an FEHB enrollment at least one day during
the 18 months before your marriage ended (Note: This requirement is also met when both you and your former spouse have
FEHB enrollments);
- he/she is entitled to a portion of your annuity or to a former spouse survivor annuity;
and
- he/she has not remarried before age 55.
Your employing office will determine whether your former spouse is
eligible to enroll.
Loss of
Coverage as a Family Member
Your former spouse loses coverage as a family member upon your divorce, subject to a 31-day extension of coverage. However, his/her
enrollment under the spouse equity provisions may not begin for several months after the
divorce, depending on how long it takes to establish eligibility. To avoid a gap
in coverage for this period, your former spouse may:
If your former spouse will seek coverage under spouse equity provisions, it is
advisable to stay with the same plan.
If your former spouse acts promptly, he/she may request retroactive enrollment once the
application for enrollment under the spouse equity provisions has been approved. For
enrollment to be retroactive, the employing office must receive an appropriate request and
satisfactory proof of eligibility within 60 days after the date of divorce.
ENROLLMENT
Enrolling under the Spouse Equity provisions is a three-step process. First, your
former spouse must apply to enroll within the
required time limit. Second, he/she must establish eligibility to enroll. Third,
actual enrollment can take place only after the first two steps have been completed.
Type of Enrollment
Your former spouse may elect a self only or self and family enrollment. A self and
family enrollment covers only your former spouse and any unmarried dependent natural or
adopted children of you and your former spouse.
Where Former Spouses
Apply
If your marriage ends before your retirement, your former spouse must apply and pay
premiums to the employing office of the agency for which you worked when your marriage
ended. If the application is approved, this will be your former spouse's employing office
until he/she begins receiving annuity payments, even if you transfer to another employing
office.
Your former spouse must apply and pay premiums to the retirement system responsible for
your annuity payment if:
- he/she is receiving a portion of your retirement benefit or a former spouse survivor
annuity; or
- the divorce occurred after your retirement; or
- the divorce occurred before May 7, 1985, and you worked for the Central Intelligence
Agency (CIA) or the Foreign Service.
OPM is your former spouse's employing office if you are receiving compensation from the Office of Workers'
Compensation Programs (OWCP), and your health benefits enrollment had been transferred to OWCP before your
marriage ended.
Application to Enroll
Your former spouse's application to enroll can either be a completed Health Benefits
Election Form (SF 2809) or a written notice of intent to apply for health benefits.
His/her own name, date of birth, and Social Security number is entered on Part A of the SF
2809. Your name and date of birth must be entered in the Remarks section.
If there is a mental or physical disability that prevents your former spouse from
applying for benefits, a court appointed guardian may file the application.
Time Limit
Your former spouse must apply to his/her employing
office in writing by the latest of:
- 60 days after your marriage ends;
- 60 days after the date of OPM's notice of his/her eligibility to enroll based on a qualifying court order awarding entitlement
to a portion of your future annuity (see section
5A5.1-2 of the CSRS/FERS Handbook for Personnel and Payroll Offices), or to a former
spouse survivor annuity; or
- 60 days after the date of the notice of his/her eligibility to enroll based on
entitlement to a former spouse annuity under another retirement system for Government
employees.
If your former spouse doesn't apply to the employing office in person, the employing
office will use the postmark date on the application to determine if he/she meets the time
limit.
Deferred Enrollment
Once your former spouse has applied to enroll within the required
time limit, he/she may postpone actual enrollment indefinitely.
Determination
of Entitlement to Future Annuity
When your former spouse applies to the employing
office for benefits, it will advise him/her that he/she must send a written request to the retirement system for a
determination of entitlement to either:
- a portion of your future retirement annuity, or
- a former spouse survivor annuity.
The request must include:
- a certified copy (not a photocopy of a certified copy) of the divorce decree, property
settlement, and/or court order (if applicable);
- your name, date of birth, Social Security number, and last employing agency.
Unless you are subject to the CIA or Foreign Service retirement systems, OPM, not the
agency, will make the annuity benefit determination based on the court order supplied.
Your former spouse can not enroll until OPM makes its determination.
OPM will send your former spouse a written decision. If eligibility is determined,
he/she will submit the decision to your employing office.
Retirement System
Addresses
| CSRS or FERS |
Office of Personnel Management, Retirement and Insurance Service, Office of Retirement
Programs, P.O. Box 17, Washington, D.C. 20044. |
| CIA |
CIA Retirement and Disability System, Central Intelligence Agency, P.O. Box
1925, Washington, D.C. 20505. |
| Foreign Service |
Foreign Service Retirement and Disability System, Department of State, Retirement
Division, Room 1251, Washington, D.C. 20520. |
| Any Other Retirement System |
Your former spouse must obtain that retirement system's certification of his/her
eligibility to a portion of your future annuity or a former spouse survivor annuity, and
must submit the certificate to OPM when applying
for eligibility to enroll. |
Determining
a Former Spouse's Eligibility
When your former spouse applies for eligibility to enroll under the spouse equity
provisions, his/her employing office must first
verify that you were employed by the agency at the time of your divorce. If you separate
from Federal service before becoming eligible for an immediate annuity, your former spouse
is eligible to enroll only if your marriage ended before you left Federal service.
The employing office must then determine if your former spouse is eligible to enroll.
To be eligible, he/she must meet all of the following requirements:
- He/she must not have remarried before age 55;
- He/she must have been covered as a family member in an FEHB plan at least one day during
the 18 months before your marriage ended;
- He/she must provide documentation from OPM (or the CIA or Foreign Service retirement
system, if applicable) of entitlement
to a portion of your future annuity, or a former spouse survivor annuity.
If you worked for the CIA, your former spouse could qualify to enroll based on your CIA
employment, if you were married for at least 10 years during your CIA service, at least 5
years of which both of you spent outside the United States, and your marriage ended before
May 7, 1985.
If you worked for the Foreign Service, your former spouse could also qualify to enroll
based on your Foreign Service employment if you were married for at least 10 years during
your Government service, and your marriage ended before May 7, 1985.
Effective Date
The effective date of your former spouse's enrollment is the first day of the first pay
period after the employing office receives the Health Benefits Election Form (SF 2809) and
has approved eligibility.
If your former spouse requests immediate coverage, and the employing office receives
the Health Benefits Election Form (SF 2809) and satisfactory proof of eligibility within
60 days after the date of the divorce, the enrollment may be made effective on the same
day that temporary continuation of
coverage would otherwise take effect.
When both
You and Your Former Spouse have FEHB Enrollments
If both you and your spouse have your own FEHB enrollments and divorce, it is important
for each of you to establish your
eligibility for FEHB coverage under spouse equity provisions within the required time frame. In this way you can protect your future entitlement to
FEHB coverage under spouse equity provisions if you lose your own FEHB coverage. You must
apply to your former spouse's employing office for the determination, not your own
employing office.
If you are enrolled as a Federal employee when your former spouse's employing office
determines that you are eligible for coverage under spouse equity provisions, you must
provide a copy of this determination to your current employing office. Your current
employing office must note on your Individual Retirement Record that you are eligible for
FEHB coverage under spouse equity provisions. Your former spouse's employing office must
maintain a health benefits file for you and
note that you are deferring your enrollment under spouse equity provisions until you lose
enrollment as an employee.
