5 C.F.R. Subpart K—Living Benefits
Title 5 - Administrative Personnel
(a) Effective July 25, 1995, an insured individual who is certified by his/her doctor as terminally ill, as defined in §870.101, may elect to receive a lump-sum payment of Basic insurance. (b) Optional insurance is not available for payment as a Living Benefit. (c)(1) The effective date of a Living Benefit election is the date on which the Living Benefit payment is cashed or deposited. Once an election becomes effective, it can't be revoked. No further election of Living Benefits can be made. (2) If the insured individual dies before cashing or depositing the Living Benefit payment, the payment must be returned to OFEGLI. (d) If the insured individual has assigned his/her insurance, he/she cannot elect a Living Benefit; nor can an assignee elect a Living Benefit on behalf of an insured individual. (e) If an individual has elected a Living Benefit, he/she may assign his/her remaining insurance. (a)(1) An employee may elect to receive either: (i) A full Living Benefit, which is all of his/her Basic insurance, or (ii) A partial Living Benefit, which is a portion of his/her Basic insurance, in a multiple of $1,000. (2) An annuitant or compensationer may only elect to receive a full Living Benefit. (b) The amount of Basic insurance elected as a Living Benefit will be reduced by an actuarial amount representing the amount of interest lost to the Fund because of the early payment of benefits. (c)(1) If an individual elects a full Living Benefit, the post-election BIA will be 0. If an employee elects a partial Living Benefit, the post-election BIA will be the BIA reduced in proportion to the amount of Basic insurance elected as a Living Benefit, as prescribed by Pub. L. 103–409 (108 Stat. 4231). (2) The post-election BIA cannot change after the effective date of a Living Benefit election. (d)(1) If an employee elects a full Living Benefit, Basic accidental death and dismemberment coverage terminates as of the effective date of the election. (2) If an employee elects a partial Living Benefit, Basic accidental death and dismemberment coverage is reduced to equal the post-election BIA. (a) The insured individual must request information on Living Benefits and an application form directly from OFEGLI. (b)(1) Only the insured individual can apply for a Living Benefit; no one can apply on his/her behalf. (2) The insured individual must complete the first part of the application and have his/her physician complete the second part. The completed application must be submitted directly to OFEGLI. (c)(1) OFEGLI reviews the application, obtains certification from the insured's employing office regarding the amount of insurance and the absence of an assignment, and determines whether the individual meets the requirements to elect a Living Benefit. (2) If OFEGLI needs additional information, it will contact the insured or the insured's physician. (3) Under certain circumstances, OFEGLI may require a medical examination before making a decision. In these cases, OFEGLI is financially responsible for the cost of the medical examination. (d)(1) If the application is approved, OFEGLI sends the insured a check for the Living Benefit payment and an explanation of benefits. (i) Until the check has been cashed or deposited, the individual may change his/her mind about electing a Living Benefit; if this happens, the individual must mark the check “void” and return it to OFEGLI. (ii) Once the insured individual has cashed or deposited the payment, the Living Benefit election becomes effective and cannot be revoked; OFEGLI then sends explanations of benefits to the insured's employing office, so it can make the necessary changes in withholdings and deductions. (2) If the application is not approved, OFEGLI will notify the insured individual and the employing office. The decision is not subject to administrative review; however, the individual can submit additional medical information or reapply at a later date if future circumstances warrant. [62 FR 48731, Sept. 17, 1997; 62 FR 52181, Oct. 6, 1997]
Title 5: Administrative Personnel
PART 870—FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM
Subpart K—Living Benefits
§ 870.1101 Eligibility for a Living Benefit.
§ 870.1102 Amount of a Living Benefit.
§ 870.1103 Election procedures.
