Which Family Members Are Eligible for FEHB? (or Out)
The Federal Employees Health Benefits (FEHB) program, which covers 8 million federal employees, former employees, annuitants, family members, and former spouses, is the world’s largest employer-sponsored group health insurance program. Federal employees can participate in the FEHB program and cover eligible family members such as spouses and kids under the age of 26 in their coverage.
The FEHB program has three levels of enrollment:
- Self Only
- Self Plus One
- Self And Family
The employee or annuitant and just one eligible family member are covered by a “self plus one” registration. The employee or annuitant, as well as various family members, such as a spouse and children under the age of 26, are covered under a “self and family” enrolment.
Each health insurance plan offered under the FEHB program has a different premium. The federal government covers 72% to 75% of an employee’s or annuitant’s FEHB premium, with the remaining 25% to 28% paid by the employee or annuitant.
It doesn’t matter which FEHB health insurance plan you have or what type of coverage you have (self only, self and family, or self plus one). The percentages of who pays what portion of the FEHB premiums (the annuitant, employee, or the federal government) are always the same and are regulated by law.
The FEHB Program offers over 200 health insurance plan options. Several fee-for-service plans are open to all participants, while others are only available to certain types of employees. Preferred provider organization (PPO) plans are available. Health maintenance organizations (HMOs) are also available in most locations of the United States. To be eligible to enroll in a specific HMO, an employee or annuitant must reside or work within a specific geographic area.
So Which Family Member is Eligible for The FEHB Program?
The FEHB covers you and your “eligible” family members. “Eligible” is the essential word here. Some people you consider family members — and in some situations, even those who live with you — may not be eligible for under the program.
An eligible family member is defined as:
- Your partner;
- A former spouse in some circumstances;
- Children under the age of 26, including legitimately adopted children, acknowledged out-of-wedlock children, stepchildren, and foster children under certain circumstances (see below);
- Children of any age who are unable to support themselves due to a mental or physical handicap that started before the age of 26.
Domestic partnerships, civil unions, and other arrangements that aren’t legally recognized as marriages don’t qualify as eligible family members. Even though they are financially reliant on you and/or live with you, your parents, siblings, and sisters, and other close relatives do not.
In addition, there are several restrictions on stepchildren and foster children’s eligibility. Your stepchildren, for example, remain eligible as enrollees even if you divorce or die, as long as the children live with you in a parent-child relationship.
To be considered for foster care, the child must live with you, and you must be the child’s principal financial supporter and expect to look after the child to adulthood. You must also sign a document stating that your foster child satisfies the standards.
Contact Information:
Email: [email protected]
Phone: 6232511574
Bio:
I grew up in Dubuque, Iowa, where I learned the concepts of hard work and the value of a dollar. I spent years in Boy Scouts and achieved the honor of Eagle Scout. I graduated from Iowa State University and moved to Chicago and spent a few years managing restaurants. I then started working in financial services and insurance helping families prepare for the high cost of college for their children. After spending years in the insurance industry, I moved to Arizona and started working with Federal Employees offing education and options on their benefits. I became a Financial Advisor / Fiduciary to further help people properly plan for the future. I enjoy cooking and traveling in my free time.
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