How to Remove a Family Member from a FEHB Plan

The Office of Personnel Management released a new rule amending Federal Employee Health Benefits Program regulations to allow family members to be removed from existing Self Plus One and Self Plus Family enrollments. The new rules allow this to occur in certain situations, however, it’s not always an option.

OPM has issued a Benefits Administration Letter providing guidance explaining when the removal of eligible family members is allowed.

Who Can Be Removed?

The following eligible family members can be removed from Self Plus One or Self Plus Family plans during the plan year:

• Spouse—a spouse may be removed if the enrollee provides a notarized request for removal, signed by both the enrollee and the spouse.
• Adult Child—a child who has reached the age of majority in their state of residence (the enrollee’s state is the residence of the child is unknown). An adult child can be removed in 2 situations:
  • The enrollee provides proof that the child is no longer his/her dependent. The child does not have to provide consent in this case.
  • The child requests to be removed and provides a notarized request for removal.

A child’s removal is a cancellation by OPM. That child isn’t eligible for the 31-day temporary extension of coverage, conversion to an individual policy, or temporary continuation of coverage. This could also impact eligibility for surviving family members to continue health benefits enrollment if the enrolled federal employee dies.

A removed child may only regain coverage under the applicable Self Plus One or Self Plus Family enrollment if requested by the enrollee during the annual Federal Benefits Open Season, or within 60 days of losing health coverage.

Minor children can only be removed from enrollment with a court order.

A federal employee who is the adult child or spouse of another federal employee can be removed from an enrollment. This is not considered a “qualifying life event” that allows the adult child or spouse to enroll in his or her own FEHB plan unless the adult child has a spouse and/or child(ren) to cover.

A separate BAL will be issued and will provide specific guidance to agencies on the situations that allow for removal of ineligible family members and the removal process.