Web Procedure Manual

1

Employee electing to receive or receiving premium conversion tax benefits.

1A

Initial opportunity to enroll.

1B

Open season.

1C

Change in family status that results in increase or decrease in number of eligible family members.

1D

Any change in employee’s employment status that could result in entitlement to coverage.

1E

Any change in employee’s employment status that could affect cost of insurance.

1F

Employee restored to civilian position after serving in uniformed services.

1G

Employee, spouse, or dependent:

Begins nonpay status or insufficient pay

Ends nonpay status or insufficient pay if coverage continued

Note: If employee’s coverage is terminated, see 1D.

Note: If spouse’s or dependent’s coverage is terminated, see 1M.

1H

Salary of temporary employee insufficient to make withholdings for plan in which enrolled.

1I

Employee (or covered family member) enrolled in FEHB health maintenance organization (HMO) moves or becomes employed outside the geographic area from which the FEHB carrier accepts enrollments, or, if already outside the area.

1J

Transfer from post of duty within a State of the United States or the District of Columbia to a post of duty outside of the United States or District of Columbia, or reverse.

1K

Separation from Federal employment when the employee or employee’s spouse is pregnant.

1L

Employee becomes eligible for Medicare and wants to change to another plan or option.

1M

Employee or eligible family member loses coverage under FEHB or another group insurance plan including the following:

Loss of coverage under another FEHB Federal Employees Health Benefits enrollment due to termination, cancellation, or change to Self Only of the covering enrollment.

Loss of coverage due to termination of membership in employee organization sponsoring the FEHB Federal Employees Health Benefits plan.

Loss of coverage under another Federally sponsored health benefits program, including TRICARE, MEDICARE, Indian Health Service.

Loss of coverage under Medicaid or similar State-sponsored program of medical assistance for the needy.

Loss of coverage under a non-Federal Health plan, including foreign, State, or local Government, private sector.

Loss of coverage due to change in worksite or residence.

1N

Loss of coverage under a non-Federal group health plan because an employee moves out of the commuting area to accept another position and the employee’s non-Federally employed spouse terminates employment to accompany the spouse.

1O

Employee or eligible family members loses coverage due to discontinuance in whole or part of FEHB Federal Employees Health Benefits plan.

1P

Enrolled employee or eligible family member gains coverage under FEHB Federal Employees Health Benefits or another group insurance plan, including the following:

Medicare

TRICARE for life, due to enrollment in Medicare

TRICARE due to change in employment status, including (1) entry into active military service, or (2) retirement from reserve military service under Chapter 67, Title 10.

Medicaid or similar State-sponsored program of Medical assistance for the needy.

Health insurance acquired due to change of worksite or residence that affects eligibility for coverage.

1Q

Change in spouse’s or dependent’s coverage option under a non-Federal health plan.

1R

Employee or eligible family member becomes eligible for assistance under Medicaid or a State Children’s Health Insurance Program (CHIP).

1Z

Change from family or self to self plus 1.

5

Employees who are not participating in premium conversion.

5A

Initial opportunity to enroll

5B

Open season

5C

Change in family status; for example: marriage, birth or death of family member, adoption, legal separation, or divorce.

5D

Change in employment status.

5E

Separation from Federal employment when the employee is or the employee’s spouse is pregnant.

5F

Transfer from a post of duty within the United States to a post of duty outside the United States, or reverse.

5G

Employee or eligible family member loses coverage under FEHB Federal Employees Health Benefits or another group insurance plan.

5H

Enrollee or eligible family member loses coverage due to the discontinuance, in whole or part, of a FEHB Federal Employees Health Benefits plan.

5I

Loss of coverage under a non-Federal group health plan because an employee’s spouse terminates employment to accompany the employee.

5J

Employee or covered family member in an HMO moves or becomes employed outside the geographic area from which the carrier accepts enrollments, or if already outside the area, moves or becomes employed further from this area.

5K

On becoming eligible for Medicare.

Note: This change may be made only once in a lifetime.

5L

Temporary employee completes one year of continuous service in accordance with 5 U.S.C. Section 8906a.

5M

Salary of temporary employee insufficient to make withholdings for plan in which enrolled.

5R

Agency TA only