5 C.F.R. Subpart C—Eligibility
Title 5 - Administrative Personnel
(a) Each nonexcluded employee is automatically insured for Basic insurance unless he/she waives it. (b)(1) Optional insurance must be specifically elected; it is not automatic. (2) An employee may elect one or more types of Optional insurance if: (i) He/she has Basic insurance; and (ii) He/she does not have a waiver of that type (or types) or Optional insurance still in effect. (c) Notwithstanding any other provision in this part, the hiring of a Federal employee, whether in pay status or nonpay status, for a temporary, intermittent position with the decennial census has no effect on the amount of his/her Basic or Option B insurance, the withholdings or Government contribution for his/her insurance, or the determination of when 12 months in nonpay status ends. [62 FR 48731, Sept. 17, 1997, as amended at 63 FR 9402, Feb. 25, 1998; 64 FR 72461, Dec. 28, 1999] (a) The following employees are excluded from life insurance coverage by law: (1) An employee of a corporation suspervised by the Farm Credit Administration, if private interests elect or appoint a member of the board of directors. (2) An individual who is not a citizen or national of the United States and whose permanent duty station is outside the United States. Exception: an individual who met the definition of employee on September 30, 1979, by service in an Executive agency, the United States Postal Service, or the Smithsonian Institution in the area which was then known as the Canal Zone. (3) An individual first employed by the government of the District of Columbia on or after October 1, 1987. Exceptions: (i) An employee of St. Elizabeths Hospital, who accepts employment with the District of Columbia Government following Federal employment without a break in service, as provided in section 6 of Pub. L. 98–621 (98 Stat. 3379); (ii) An employee of the District of Columbia Financial Responsibility and Management Assistance Authority (Authority), who makes an election under the Technical Corrections to Financial Responsibility and Management Assistance Act (section 153 of Pub. L. 104–134 (110 Stat. 1321)) to be considered a Federal employee for life insurance and other benefits purposes; employees of the Authority who are former Federal employees are subject to the provisions of §§870.503(d) and 870.705 of this part; (iii) The Corrections Trustee and the Pretrial Services, Parole, Adult Probation and Offender Supervision Trustee and employees of these Trustees who accept employment with the District of Columbia government within 3 days after separating from the Federal Government; (iv) Effective October 1, 1997, judicial and nonjudicial employees of the District of Columbia Courts, as provided by Pub. L. 105–33 (111 Stat. 251); and (v) Effective April 1, 1999, employees of the Public Defender Service of the District of Columbia, as provided by Pub. L. 105–274 (112 Stat. 2419). (4) Teachers in Department of Defense dependents schools overseas, if employed by the Federal Government in a nonteaching position during the recess period between school years. (b) The following employees are also excluded from life insurance coverage: (1) An employee serving under an appointment limited to 1 year or less. Exceptions: (i) An employee whose full-time or part-time temporary appointment has a regular tour of duty and follows a position in which he/she was insured, with no break in service or with a break in service of no more than 3 days; (ii) An acting postmaster; (iii) A Presidential appointee appointed to fill an unexpired term; and (iv) Certain employees who receive provisional appointments as defined in §316.403 of this title. (2) An employee who is employed for an uncertain or purely temporary period, who is employed for brief periods at intervals, or who is expected to work less than 6 months in each year. Exception: An employee who is employed under an OPM-approved career-related work-study program under Schedule B lasting at least 1 year and who is expected to be in pay status for at least one-third of the total period of time from the date of the first appointment to the completion of the work-study program. (3) An intermittent employee (a non-full-time employee without a regularly scheduled tour of duty). Exception: An employee whose intermittent appointment follows, with no break in service or with a break in service of no more than 3 days, a position in which he/she was insured and to which he/she is expected to return. (4) An employee whose pay, on an annual basis, is $12 a year or less. (5) A beneficiary or patient employee in a Government hospital or home. (6) An employee paid on a contract or fee basis. Exception: an employee who is a United States citizen, who is appointed by a contract between the employee and the Federal employing authority which requires his/her personal service, and who is paid on the basis of units of time. (7) An employee paid on a piecework basis. Exception: An employee whose work schedule provides for full-time or part-time service with a regularly scheduled tour of duty. (c) OPM makes the final determination about whether the above categories apply to a specific employee or group of employees. [62 FR 48731, Sept. 17, 1997, as amended at 64 FR 15289, Mar. 31, 1999] (a) Effective October 30, 1998, foster children are eligible for coverage as family members under Option C. (b) To qualify for coverage as a foster child, the child must meet the following requirements: (1) The child must live with the insured employee, annuitant, or compensationer; (2) The parent-child relationship (as defined in §870.101) must be with the insured employee, annuitant, or compensationer, not the biological parent; (3) The employee, annuitant, or compensationer must be the primary source of financial support for the child; and (4) The employee, annuitant, or compensationer must expect to raise the child to adulthood. (c) A child placed in an insured individual's home by a welfare or social service agency under an agreement by which the agency retains control of the child or pays for maintenance does not qualify as a foster child. (d)(1) An insured individual wishing to cover a foster child must sign a certification stating that the child meets all the requirements and that he/she will notify the employing office or retirement system if the child marries, moves out of the home, or stops being financially dependent on the employee, annuitant, or compensationer. (2) The employing office or retirement system must keep the signed certification in the insured individual's file, along with other life insurance forms. (e) A foster child who moves out of the insured individual's home to live with a biological parent loses eligibility and cannot again be covered as a foster child unless: (1) The biological parent dies; (2) The biological parent is imprisoned; (3) The biological parent becomes unable to care for the child due to a disability; or (4) The employee, annuitant, or compensationer obtains a court order taking parental responsibility away from the biological parent. [64 FR 72461, Dec. 28, 1999]
Title 5: Administrative Personnel
PART 870—FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM
Subpart C—Eligibility
§ 870.301 Eligibility for life insurance.
§ 870.302 Exclusions.
§ 870.303 Eligibility of foster children under Option C.
