Understanding Your FEHB Coverage as a Survivor Annuitant: Continuing Federal Benefits

As a Federal employee, it is crucial to have a good understanding of your Federal Employee Health Benefits (FEHB) coverage. This becomes even more important if you are a survivor annuitant, which means you are the surviving spouse or eligible family member of a deceased federal employee or retiree. Did you know that a surviving spouse can be removed from FEHB if the Federal annuitant predeceases him/her? Proper planning and knowledge of your federal benefits can prevent this huge mistake.  

Importance of FEHB Coverage

Having eligibility for FEHB self and family coverage in retirement ensures that you and your family have access to quality health care. As a surviving spouse or annuitant, you have the opportunity to continue your FEHB coverage even after the death of the Federal employee or retiree. 

By continuing your FEHB coverage, you can keep the peace of mind that comes with knowing your health needs will be taken care of. It also provides financial security, as medical expenses can be a significant burden without proper insurance coverage. Currently, the federal government pays between 72-75% of the FEHB premium even in retirement! Therefore, it is important for surviving family members to understand the eligibility criteria and the process of continuing FEHB enrollment.

FEHB Coverage as a Survivor Annuitant

Definition of Survivor Annuitant

A survivor annuitant is someone who is entitled to receive a survivor annuity, which is a monthly payment made to the surviving spouse or eligible family member of a deceased federal employee or retiree. The annuity provides financial support to the survivor. The survivor annuity can be 50% or 25% of the gross FERS pension amount. Under CSRS, you can select any portion of your annuity up to 55% of your annuity and as little as 55% of $22.00, which results in a $1.00 per month survivor annuity.

Eligibility for FEHB in Retirement

• Federal employee retires on an immediate pension
• Have been enrolled in FEHB for 5 consecutive years prior to retirement

Eligibility for FEHB as a Surviving Annuitant

A surviving spouse is eligible to continue FEHB coverage if the following requirements are met:

• The surviving family member is entitled to a survivor annuity (FERS or CSRS)
• The deceased retired annuitant was enrolled in either a Self Plus One or Self and Family plan at the time of death 

If eligibility is met, you can continue coverage even after the death of the federal service retiree. It is important to note that not all survivors are eligible for FEHB coverage, so it is necessary to understand the specific eligibility criteria for a covered family member. 

Eligibility for FEHB When Both Spouses are Feds (Dual-Feds)

A survivor benefit is not required for either spouse to retain FEHB in retirement as long as the following requirements have been met by both:

• The retiree is receiving an immediate pension
• Have been enrolled in FEHB for 5 consecutive years prior to retirement. If you are on the deceased spouse’s FEHB, you will still qualify for the 5-year requirement since you were eligible to be on your own Self Only plan. 

If the primary payor of FEHB passes away, the surviving spouse can switch to their own FEHB plan right away since death is a qualifying event. 

Enrollment Process

There is no action to be taken if there is entitlement to a survivor annuity and the above requirements have been met. If you wish to cancel FEHB you must fill out form SF 2809 which can be found here.

Death Before Deferred Annuity Received

Generally, the employee who receives a deferred annuity will not receive FEHB in retirement. As a consequence, the spouse will not receive FEHB. There may be an exception through the FEHB spouse equity provisions which you can check out here.

Death Before Postponed Annuity Received 

The spouse or survivor annuitant is eligible for FEHB when their survivor annuity begins. This applies to Federal employees who have postponed their annuity at MRA+10. The difference here is that the spouse will have to wait until the annuity begins. 

FERS Survivor Benefits in the Event of Death While Working

Basic Employee Death Benefit (BEDB)

The BEDB is a lump sum death benefit payment made to the surviving spouse of a married FERS employee who dies while in federal service. If no survivor annuity is payable upon the employee/former employee’s death, a lump sum may be payable of the unpaid balance of retirement contributions made by the employee. 

If an employee dies with at least 18 months of creditable civilian service under FERS, a  survivor annuity may be payable if:

• the surviving spouse was married to the deceased for at least nine months, or
• the employee’s death was accidental, or
• there was a child born of the marriage to the employee.

The spouse may be eligible for the Basic Employee Death Benefit, which is equal to 50% of the employee‘s final salary or average salary if higher, plus a lump sum of $40,300, adjusted for inflation annually. 

Survivor Annuity – Spouse, Former Spouse, & Children

Spouse

In addition to the basic death benefit, if a FERS employee dies, recurring monthly payments may be made to the surviving spouse if the deceased employee completed at least 10 years of creditable service (18 months of which must be civilian service). The follow requirement applies to the spouse:

• was married to the deceased for a total period of at least nine months (the nine-month requirement does not apply if the death was accidental); or
• was the parent of a child born of the marriage (including one born posthumously, or out of wedlock if the parties later married).

The survivor benefit is equal to 50% of the unreduced annuity the deceased Federal employee would have been entitled to had the employee reached retirement age, without reduction for age. The annuity is adjusted for inflation and payable upon the death of the employee. 

Former Spouse

A survivor annuity may be paid in whole or in part to a former spouse if a court-ordered entitlement to a survivor is on file at OPM.

Children

The benefit is payable to the child of an employee with at least 18 months of creditable civilian service if the child is:

• an unmarried dependent up to age 18
• an unmarried dependent from age 18 to age 22 if attending an accredited educational institution full-time
• unmarried disabled dependent children may receive recurring monthly benefits if the disability occurred before age 18

The combined benefit of all the children is reduced by the total amount of child’s insurance benefits that are payable (or would, upon proper application, be payable) under Title II of the Social Security Act for the same month to all children of the deceased (including those of a former marriage who may not be living with the current spouse) based on the total earnings of the deceased. In many cases, the FERS children’s benefit is reduced to $0.

Lump-Sum Benefit 

If no survivor annuity is payable upon the employee/former employee’s death, a lump sum may be payable of the unpaid balance of retirement contributions made by the employee.  This lump sum is payable under the order of precedence.