Federal · Title 5 — Government Organization and Employees

5 U.S.C. § 8905a: Continued coverage

Read the full statutory text
Any individual described in subsection (b) may elect to continue coverage under this chapter in accordance with the provisions of this section. is separated from service, whether voluntarily or involuntarily, except that if the separation is involuntary, this section shall not apply if the separation is for gross misconduct (as defined under regulations which the Office of Personnel Management shall prescribe); and would not otherwise be eligible for any benefits under this chapter (determined without regard to any temporary extension of coverage and without regard to any benefits available under a nongroup contract); ceases to meet the requirements for being considered an unmarried dependent child under this chapter; on the day before so ceasing to meet the requirements referred to in subparagraph (A), was covered under a health benefits plan under this chapter as a member of the family of an employee or annuitant; and would not otherwise be eligible for any benefits under this chapter (determined without regard to any temporary extension of coverage and without regard to any benefits available under a nongroup contract); and is enrolled in a health benefits plan under this chapter; is a member of a reserve component of the armed forces; is called or ordered to active duty in support of a contingency operation (as defined in section 101(a)(13) of title 10 ); is placed on leave without pay or separated from service to perform active duty; and serves on active duty for a period of more than 30 consecutive days. with respect to an employee who becomes (or will become) eligible for continued coverage under this section as a result of separation from service, the separating agency shall, before the end of the 30-day period beginning on the date as of which coverage (including any temporary extensions of coverage) would otherwise end, notify the individual of such individual’s rights under this section; and to the employee’s employing agency; or in the case of an annuitant, to the Office; and if the notice referred to in clause (i) is received within 60 days after the date as of which the child involved first ceases to meet the requirements involved, the employing agency or the Office (as the case may be) must, within 14 days after receiving such notice, notify the child of such child’s rights under this section. the effective date of the separation; or the date the separated individual receives the notice required under paragraph (1)(A); or the date as of which such individual first ceases to meet the requirements for being considered an unmarried dependent child; or the date such individual receives notice under paragraph (1)(B)(ii); the employee and agency contributions which would be required in the case of an employee enrolled in the same health benefits plan and level of benefits; and an amount, determined under regulations prescribed by the Office, necessary for administrative expenses, but not to exceed 2 percent of the total amount under clause (i). in the case of an individual whose continued coverage is based on such individual’s separation, be made through the agency which last employed such individual; or the Office, if, at the time coverage would (but for this section) otherwise have been discontinued, the individual was covered as the child of an annuitant; or if, at the time referred to in subclause (I), the individual was covered as the child of an employee, the employee’s employing agency as of such time. If an individual elects to continue coverage under this section before the end of the applicable period under subsection (c)(2), but after such individual’s coverage under this chapter (including any temporary extensions of coverage) expires, coverage shall be restored retroactively, with appropriate contributions (determined in accordance with paragraph (1), (4), or (5), as the case may be) and claims (if any), to the same extent and effect as though no break in coverage had occurred. An individual making an election under subsection (c)(2)(B) may, at such individual’s option, elect coverage either as an individual or, if appropriate, for self plus one or for self and family. For the purpose of this paragraph, members of an individual’s family shall be determined in the same way as would apply under this chapter in the case of an enrolled employee. Nothing in this paragraph shall be considered to limit an individual making an election under subsection (c)(2)(A) to coverage for self alone. the individual shall be liable for not more than the employee contributions referred to in paragraph (1)(A)(i); and the agency which last employed the individual shall pay the remaining portion of the amount required under paragraph (1)(A). December 31, 2016 ; or February 1, 2017 , if specific notice of such separation was given to such individual before December 31, 2016 . For the purpose of this paragraph, “surplus position” means a position which is identified in pre-reduction-in-force planning as no longer required, and which is expected to be eliminated under formal reduction-in-force procedures. the individual shall be liable for not more than the employee contributions referred to in paragraph (1)(A)(i); and the agency which last employed the individual shall pay the remaining portion of the amount required under paragraph (1)(A). This paragraph shall only apply with respect to individuals whose continued coverage is based on a separation occurring on or after the date of the enactment of this paragraph. the individual shall be liable for not more than the employee contributions referred to in paragraph (1)(A)(i); and the National Aeronautics and Space Administration shall pay the remaining portion of the amount required under paragraph (1)(A). This paragraph shall only apply with respect to individuals whose continued coverage is based on a separation occurring on or after the date of enactment of this paragraph and before December 31, 2010 . identified in pre-reduction-in-force planning as no longer required, and which is expected to be eliminated under formal reduction-in-force procedures as a result of the termination of the Space Shuttle Program; or encumbered by an employee who has received official certification from the National Aeronautics and Space Administration consistent with the Administration’s career transition assistance program regulations that the position is being abolished as a result of the termination of the Space Shuttle Program. in the case of an individual whose continued coverage is based on separation from service, the date which is 18 months after the effective date of the separation; in the case of an individual whose continued coverage is based on ceasing to meet the requirements for being considered an unmarried dependent child, the date which is 36 months after the date on which the individual first ceases to meet those requirements, subject to paragraph (2); or in the case of an employee described in subsection (b)(3), the date which is 24 months after the employee is placed on leave without pay or separated from service to perform active duty. ceases to meet the requirements for being considered an unmarried dependent child; as of the day before so ceasing to meet the requirements referred to in subparagraph (A), was covered as the child of a former employee receiving continued coverage under this section based on the former employee’s separation from service; and so ceases to meet the requirements referred to in subparagraph (A) before the end of the 18-month period beginning on the date of the former employee’s separation from service, if subparagraphs (A) and (C) of paragraph (10) of section 8901 were disregarded, would be eligible to be considered a former spouse within the meaning of such paragraph; but would not, but for this subsection, be eligible to be so considered; and to any individual whose coverage as a family member would otherwise terminate as a result of a legal separation. consistent with subsection (c), any necessary notification provisions, and provisions under which an election period of at least 60 days’ duration is afforded; terms and conditions identical to those under subsection (d), except that contributions to the Employees Health Benefits Fund shall be made through such agency as the Office by regulation prescribes; provisions relating to the termination of continued coverage, except that continued coverage under this section may not (subject to paragraph (3)) extend beyond the date which is 36 months after the date on which the qualifying event under this subsection (the date of divorce, annulment, or legal separation, as the case may be) occurs; and provisions designed to ensure that any coverage pursuant to this subsection does not adversely affect any eligibility for coverage which the individual involved might otherwise have under this chapter (including as a result of any change in personal circumstances) if this subsection had not been enacted. who becomes eligible for continued coverage under this subsection based on a divorce, annulment, or legal separation from a person who, as of the day before the date of the divorce, annulment, or legal separation (as the case may be) was receiving continued coverage under this section based on such person’s separation from service under a self plus one enrollment that covered the individual or under a self and family enrollment; and whose divorce, annulment, or legal separation (as the case may be) occurs before the end of the 18-month period beginning on the date of the separation from service referred to in subparagraph (A),

Verify at the official source: Federal legislative text

Facing this? Know exactly what happens next.

MOFRD turns this code section into your situation: the deadlines that apply to you, the forms your county uses, and the resolution paths people in your position actually take. Free for 3 days — no card required.

This page is legal information, not legal advice. Code text is sourced from official publications and may lag amendments — always confirm at the official source linked above. Plain-English summaries and relationship data are AI-derived and reviewed on an ongoing basis; verify with a licensed attorney before acting.