If you became a part-time career employee (working 16 to 32 hours a week or 32 to 64
hours biweekly) on or after April 8, 1979, you are entitled to a partial Government
contribution in proportion to the number of hours you are scheduled to work in a pay
period.
Employees who served on a part-time basis before April 8, 1979, and who have continued
to serve on a part-time basis without a break in service (in that or any other position)
are eligible for the full Government contribution, as are part-time employees who work
less than 16 hours or more than 32 hours per week.
The amount of the Government contribution is determined by dividing the number of hours
you are scheduled to work during the pay period by the number of hours worked by a
full-time employee serving in the same or comparable position (normally 80 hours per
biweekly pay period). That percentage is then applied to the Government contribution made
for full-time employees enrolled in that plan.
The amount of the Government contribution is then deducted from the total premium
(Government plus employee shares), and the remaining amount is withheld from your pay.
Example
Faith is scheduled to work 36 hours during a biweekly pay period, and the
Government contribution for her health benefits plan is $61.38 biweekly for full-time
employees. The Government contribution for her health benefits is as follows:
36 (Hours scheduled during pay period) ÷ 80 (Hours worked by full-time employees)
= .4500
$61.38 (Government contribution/full-time employees) x .4500 = $27.62 (Government
contribution/part-time employee).
Since the total premium (Government and employee share) for her health benefits
plan is $92.35, Faith's share of premiums is $64.73 ($92.35 - $27.62).
The following chart shows the factor used to determine the amount of Government
contribution for health benefits for part-time career employees who, if in a full-time
position, would work 80 hours during a biweekly pay period (the amount considered as
full-time employment for most positions).
If the comparable full-time position would require you to work a tour of duty other
than 80 hours per biweekly pay period, or if you are paid on a monthly or semimonthly
basis, divide the actual number of hours or days you are scheduled to work on the
part-time schedule by the number of hours or days required for a full-time employee in the
same position to determine the Government contribution factor.
| 32 |
0.4000 |
49 |
0.6125 |
| 33 |
0.4125 |
50 |
0.6250 |
| 34 |
0.4250 |
51 |
0.6375 |
| 35 |
0.4375 |
52 |
0.6500 |
| 36 |
0.4500 |
53 |
0.6625 |
| 37 |
0.4625 |
54 |
0.6750 |
| 38 |
0.4750 |
55 |
0.6875 |
| 39 |
0.4875 |
56 |
0.7000 |
| 40 |
0.5000 |
57 |
0.7125 |
| 41 |
0.5125 |
58 |
0.7250 |
| 42 |
0.5250 |
59 |
0.7375 |
| 43 |
0.5375 |
60 |
0.7500 |
| 44 |
0.5500 |
61 |
0.7625 |
| 45 |
0.5625 |
62 |
0.7750 |
| 46 |
0.5750 |
63 |
0.7875 |
| 47 |
0.5875 |
64 |
0.8000 |
| 48 |
0.6000 |
<32 or > 64 |
1.00 |
If you are a former spouse enrolled under the spouse
equity provisions, you must pay both the employee and Government shares of your health
benefits premium. You will normally make your payments directly to your ex-spouse's
employing office.
If you are a temporary employee enrolled
under 5 U.S.C. 8906a, you must pay both the employee and Government shares of the health
benefits premium. (Exception: if you have a provisional
appointment under 5 CFR 316.403, an interim
appointment under 5 CFR 772.102, or if you continue
coverage after your employment status changes from nontemporary to temporary without a
break in service exceeding 3 days, you receive a Government contribution.)
If you enroll under the temporary
continuation of coverage (TCC) provisions, you usually must pay the full amount of the
premiums (both the employee and Government shares) plus an administrative charge of 2
percent of the total premium. You make your payments directly to your servicing employing
office.
Former Department of Defense employees who qualify for TCC based on a separation
described in 5 U.S.C. 8905a (d)(4) continue to pay the normal employee share of premiums.
You must still pay the
employee share of health benefits premiums if you are in leave without pay status
for an entire pay
period, or if your pay during a pay period
doesn't cover the full amount of withholdings due, unless you want your enrollment to
terminate. Your employing office must notify you of the choices available to you and
provide you with a method to make direct premium payments.
Your employing office must remit health benefits withholdings and contributions to OPM
on the same date it pays its payroll.
The method for remitting payments and supporting accounting information to OPM is the
Retirement and Insurance Transfer System (RITS).
OPM will credit the total amount reported for health benefits to the Employees Health
Benefits Fund.
Payroll offices must adjust errors in withholdings and contributions on a subsequent
payroll and must include the adjustments in a subsequent withholdings and contributions
report.
Your employing office must ensure that your individual payroll record shows not only
the regular (current) deductions for health benefits withholdings, but also the
adjustments.
Where annual appropriations are involved and the fiscal year changes between the
processing of the erroneous withholdings and/or contributions and the processing of the
adjustment, the proper appropriation must be adjusted.
When you participate in premium conversion, IRS rules require that no adjustments to taxable income be made as a result of an error correction (even when the employing office is at fault). When your employing office processes a correction, the actual amount of FEHB premiums deducted from your pay will receive pre-tax treatment.
Example
Wendy has $100 per pay period deducted from her pay for FEHB. Her employing office mistakenly deducted $150 during the last pay period before the effective date of her election to participate in premium conversion. To correct the error, the agency deducts $50 for FEHB from Wendy's pay in the following pay period, during which she becomes a premium conversion participant. Although if not for the error, $100 would have been deducted from her pay, only $50 is treated on a pre-tax basis.
When too much money has been withheld from your pay, or when withholdings have been
made when you are not enrolled, your payroll office must adjust the withholdings on a
subsequent payroll on which your name appears. This adjustment automatically corrects any
excess agency contribution.
When too little or no money has been withheld from your pay for health benefits
withholdings, your employing office must send the correct payment to OPM no later than 60
calendar days after it determines the amount of the underdeduction. This payment must be
made to OPM regardless of whether or when the underdeduction is recovered by your
employing office.
The underdeduction represents an overpayment of your pay. Your employing office must
determine whether to waive collection of the overpayment (up to $1,500), in accordance
with 5 U.S.C. 5584. The law provides that an employing office can waive recovery of the
overpayment if, in its judgment, you are without fault and recovery would be against
equity and good conscience. (If the employing office involved is excluded from the
provisions of 5 U.S.C. 5584, it can use any applicable authority to waive the collection.)
If the employing office waives the collection of the unpaid health benefits
withholdings, it must remit the payment, along with any applicable Government
contributions, out of its own funds.
Waiver is not available for unpaid withholdings when you are in leave without pay status or when your pay is
insufficient to make the withholding.
When an adjustment in withholdings is necessary after you have separated from service,
your payroll office must make the adjustment in your final pay (or payment to your
beneficiary or estate).
Employing offices must submit a semiannual headcount report on OPM Form 1523 for the
last payroll paid during the 1st through the 15th of March and September. It must also
report the number of enrollees from whom it made withholdings (or who paid directly or
through advanced pay) for that particular pay period for each enrollment code. An enrollee
for whom more than one payroll deduction was made in that pay period should be counted
only once.
Separate supplemental reports are required for:
- former spouses enrolled under the spouse equity provisions;
- temporary employees enrolled under 5 U.S.C. 8906a; and
- temporary continuation of coverage (TCC) enrollees.
Each payroll office is required to generate a quarterly report for each plan that lists
enrollee names, enrollment code, and total money (withholdings and contributions)
submitted to OPM for each enrollee. This report gives enrollment information for the
payroll paid during the 1st and 15th of the last month of each quarter. If there are two
payrolls paid during that period, the enrollment information for the second payroll paid
is reported.
The plans must be listed in enrollment code order and the enrollees within each
enrollment code must be listed in the order of their social security numbers. There must
be subtotals for each enrollment code and grand totals for each plan.
Some agencies have agreements with the Department of Agriculture's National Finance
Center (NFC) in New Orleans, Louisiana to perform the payroll functions for enrollees who
are making direct payments under the spouse equity and temporary continuation of coverage
(TCC) provisions. These agencies have the same responsibilities regarding FEHB enrollments
as the agencies that retain the payroll function for these enrollees; however, NFC acts as
their agent in servicing these enrollments. The agency must resolve any disputes between
NFC and enrollees; OPM will not intervene. The agency's responsibility in both initial and
reconsideration decisions about enrollees' enrollment complaints is explained in "Initial Decision and
Reconsideration."
