Temporary Continuation of Coverage

Temporary continuation of coverage allows you to keep your insurance benefits for a limited period after your regular coverage ends — usually due to leaving a job, changing employment status, or other qualifying life events.

For example, in health insurance, if you leave a job that provided coverage, you may be eligible to temporarily continue that coverage by paying the full premium yourself. This helps you avoid a gap in insurance while you arrange new coverage.

Canceling your Federal Employees Health Benefits (FEHB) coverage is relatively simple, but it’s important to understand the potential consequences before making a final decision.

‍

You can cancel your FEHB plan either during the annual Open Season or within 60 days of a Qualifying Life Event (QLE)—such as marriage, divorce, or the birth of a child. Keep in mind, once you cancel your plan, you can’t re-enroll until the next Open Season or unless you experience another QLE.

If you're an annuitant (retiree) and you cancel your FEHB coverage, you generally cannot re-enroll unless:

You’re rehired by the federal government, or You had suspended your coverage for Medicare, Medicaid, or TRICARE (in which case, you can resume your FEHB when that other coverage ends).

Most importantly, canceling your FEHB near retirement can have serious long-term effects. To be eligible for FEHB in retirement, you must have had continuous FEHB coverage (or been covered as a family member) for at least 5 years immediately before retiring. Canceling your plan could break this requirement and make you ineligible for FEHB in retirement.

‍

Temporary Continuation of Coverage (TCC) for FEHB: Who Qualifies and What to Know

‍

If you're about to lose your Federal Employees Health Benefits (FEHB) coverage, you may be eligible for Temporary Continuation of Coverage (TCC)—a short-term extension that allows you to maintain your health insurance for a limited time.

‍

Before we dive into the details, here’s who is not eligible for TCC:

 ‍

Who Cannot Get TCC

‍

• Employees moving to a non-FEHB-eligible federal job (e.g., certain political or part-time positions).
• Employees in Leave Without Pay (LWOP) status who have already used up their 365 days.
• Family members removed from a plan when the enrollee switches from Self Plus One or Family to Self Only coverage.
• Surviving spouses who lose their annuity benefits (unless they qualify as survivor annuitants).
• Employees dismissed for gross misconduct.

‍

Who Can Get TCC and When

‍

If you lose FEHB coverage for reasons other than gross misconduct, you may qualify for TCC. Here’s when coverage typically ends and TCC may begin:

• At the end of the last pay period in your FEHB-eligible position before switching to a non-eligible federal job.
• When an employee dies, the surviving spouse may receive TCC if they’re not eligible as a survivor annuitant. FEHB will assist in finding alternate health coverage.
• After reaching the 12-month limit on LWOP (TCC not available if already at 365 days).
• When you're separated, furloughed, or take a leave of absence.
• When a temporary employee can no longer be enrolled due to insufficient pay to cover premiums.
• When the TCC period ends (either 18 or 36 months depending on the situation).

‍

TCC Coverage Timeframes

‍

Federal employees who separate (not for gross misconduct) are eligible for TCC up to 18 months.

• Family members (e.g. children who age out at 26 or recover from a disability) may receive TCC for up to 36 months.
• Former spouses following a divorce can usually get TCC up to 36 months from the date the divorce is final.
• TCC may also be offered in other Qualifying Life Events (QLEs), and the coverage period will depend on the event itself.

Important TCC Notes

‍

• Your employing agency is responsible for notifying you if you're eligible for TCC.
• A guardian can apply for TCC on behalf of a dependent under age 26 or a disabled child.
• FEHB coordinates with workers’ compensation and spouse equity benefits where applicable.
• If you’re covered by TCC and later get hired into an FEHB-eligible position, your TCC ends once you enroll in a new FEHB plan.

‍

Also read - proposed changes to federal retirement benefits

General Questions:

‍

1. How much does TCC cost?

‍

Under TCC, enrollees are responsible for the full premium amount, which includes both the employee and government shares, plus a 2% administrative fee. This means the total cost is 102% of the regular premium. For specific premium rates, you can refer to the official OPM premium tables.

2. What is a qualifying event?

‍

• Qualifying events that make individuals eligible for TCC include:
• Separation from federal service (e.g., resignation, termination).
• Loss of FEHB coverage due to divorce or annulment.
• Loss of dependent child status (e.g., reaching age 26).
• These events allow former employees and certain family members to continue FEHB coverage temporarily.

‍

3. Who is covered under a TCC family enrollment?

‍

A TCC family enrollment covers the enrollee and eligible family members, which include:

• The enrollee's spouse (if not divorced).
• Unmarried dependent children under age 26, including adopted children.
• It's important to note that certain individuals, such as grandchildren (unless they qualify as foster children), parents, and siblings, are not eligible family members under FEHB.

4. How long can coverage continue under TCC?

‍

The duration of TCC coverage depends on the individual's status:

• Former employees: Up to 18 months from the date of separation.
• Former spouses and dependent children: Up to 36 months from the date of the qualifying event (e.g., divorce or loss of dependent status).
• After TCC ends, individuals may have a 31-day extension of coverage and the option to convert to an individual policy.

5. How to obtain TCC if you are a separating employee

‍

If you're separating from federal service and wish to enroll in TCC:

• Notification: Your Human Resources (HR) office will provide you with a notice of your TCC rights within 61 days after separation.
• Election Period: You must elect TCC within 60 days from the later of:
• The date of separation.
• The date of the HR office's notice.
• Enrollment: Submit the required forms to your employing office to initiate coverage.

6. How to obtain TCC for children who lose FEHB coverage

‍

When a child loses eligibility (e.g., turns 26):

• Notification: The enrolled employee or annuitant must notify their HR office or retirement system within 60 days of the child's loss of eligibility.
• Election Period: The child must elect TCC within 60 days from the later of:
• The date they lose eligibility.
• The date of the HR office's notice.
• Enrollment: Complete the necessary forms to begin TCC coverage.

7. How to obtain TCC for former spouses

‍

Former spouses who lose FEHB coverage due to divorce can apply for TCC if they were covered under the FEHB plan at least one day during the 18 months before the marriage ended. The process involves:

• Notification: Either the former spouse or the enrolled employee/annuitant must notify the HR office within 60 days of the divorce.
• Election Period: The former spouse must elect TCC within 60 days from the later of:
• The date of divorce.
• The date of the HR office's notice.
• Enrollment: Submit the required documentation to initiate coverage.

8. What are the Spouse Equity provisions?

‍

• The Spouse Equity provisions allow certain former spouses of federal employees or annuitants to enroll in FEHB if they meet specific criteria:
• They were covered as a family member under the FEHB plan at least one day during the 18 months before the marriage ended.
• They have not remarried before age 55.
• They are entitled to a portion of the employee's annuity or a survivor annuity, as specified by a qualifying court order.

To apply, the former spouse must contact the employing office or retirement system of the federal employee/annuitant and provide the necessary documentation.

‍