5 C.F.R. Subpart F—Termination and Conversion
Title 5 - Administrative Personnel
(a) Except as provided in §870.701, the Basic insurance of an insured employee stops on the date he/she separates from service, subject to a 31–day extension of coverage. (b) The Basic insurance of an employee who separates from service after meeting the requirement for an immediate annuity under §842.204(a)(1) of this title and who postpones receiving the annuity, as provided by §842.204(c) of this title, stops on the date he/she separates from service, subject to a 31–day extension of coverage. (c) The Basic insurance of an insured employee who moves without a break in service to a position in which he/she is excluded from life insurance stops on his/her last day in the former position, subject to a 31–day extension of coverage. (d)(1) Except as provided in §870.701, the Basic insurance of an insured employee who is in nonpay status stops on the date the employee completes 12 months in nonpay status, subject to a 31–day extension of coverage. The 12 months' nonpay status may be broken by periods of less than 4 consecutive months in pay status. If an employee has at least 4 consecutive months in pay status after a period of nonpay status, he/she is entitled to begin the 12 months' continuation of Basic insurance again. If an employee has used up his/her 12 months' continuation in nonpay status and returns to duty for less than 4 consecutive months, his/her Basic insurance stops on the 32nd day after the last day of the last pay period in pay status. (2) For the purpose of paragraph (d)(1) of this section, 4 consecutive months in pay status means any 4–month period during which the employee is in pay status for at least part of each pay period. (3) For the purpose of paragraph (d)(1) of this section, an individual who is entitled to benefits under part 353 of this chapter is considered to be an employee in nonpay status. (e) Except for employees, annuitants, and compensationers who elect direct payment as provided in §870.405 of this part, Basic insurance stops, subject to a 31-day extension of coverage, at the end of the pay period in which the employing office or retirement system determines that an individual's periodic pay, annuity, or compensation, after all other deductions, is not enough to cover the full cost of Basic insurance. [62 FR 48731, Sept. 17, 1997, as amended at 64 FR 72463, Dec. 28, 1999] (a)(1) The Optional insurance of an insured employee stops when his/her Basic insurance stops, subject to the same 31-day extension of coverage. (2) An employee who meets the requirements for portability, as provided in subpart L of this part, may elect portability for his/her Option B coverage, instead of having it terminate. (b) The Optional insurance of an employee who separates from service after meeting the requirement for an immediate annuity under §842.204(a)(1) of this title and who postpones receiving the annuity, as provided by §842.204(c) of this title, stops on the date he/she separates from service, subject to a 31–day extension of coverage. (c)(1) If an insured employee is not eligible to continue Optional coverage as an annuitant or compensationer as provided by §870.701, the Optional insurance stops on the date that his/her Basic insurance is continued or reinstated under the provisions of §870.701, subject to a 31-day extension of coverage. (2) A compensationer who meets the requirements for portability, as provided in subpart L of this part, may elect portability for his/her Option B coverage, instead of having it terminate. (d) If, at the time of an individual's election of Basic insurance during receipt of annuity or compensation, he/she elects no Basic life insurance as provided by §870.702(a)(1), the Optional insurance stops at the end of the month in which the election is received in OPM, subject to a 31–day extension of coverage. (e) Except for employees, annuitants, and compensationers who elect direct payment as provided in §870.405 of this part, Optional insurance stops, subject to a 31-day extension of coverage, at the end of the pay period in which the employing office or retirement system determines that an individual's periodic pay, annuity, or compensation, after all other deductions, is not enough to cover the full cost of the Optional insurance. If an individual has more than one type of Optional insurance and his/her pay, annuity, or compensation is sufficient to cover some but not all of the insurance, the multiples of Option C terminate first, followed by Option A, and then the multiples of Option B. [62 FR 48731, Sept. 17, 1997, as amended at 64 FR 72463, Dec. 28, 1999] (a)(1) When group coverage terminates for any reason other than voluntary cancellation, an employee may apply to convert all or any part of his/her Basic and Optional insurance to an individual policy; no medical examination is required. The premiums for the individual policy are based on the employee's age and class of risk. An employee is eligible to convert the policy only if he/she doesn't return, within 3 calendar days from the terminating event, to a position covered under the group plan. If insurance has been assigned under subpart I of this part, it is the assignee(s), not the employee, who has(have) the right to convert. (2) The employing agency must notify the employee/assignee(s) of the loss of coverage and the right to convert to an individual policy either before or immediately after the event causing the loss of coverage. (3) The employee/assignee(s) must submit the request for conversion information to OFEGLI. It must be postmarked within 31 days following the date of the terminating event or within 31 days of the date the employee/assignee received the notice of loss of group coverage and right to convert, whichever is later. (4) An employee/assignee who fails to use his/her conversion right within 31 days after receiving notice of the right to convert or within 31 days of the terminating event, whichever is later, is considered to have refused coverage, unless OFEGLI determines the failure was for reasons beyond the employee's control, as described in paragraph (a)(5) of this section. (5) When an agency fails to provide the notification required in paragraph (a)(2) of this section, or the employee/assignee fails to request conversion information within the time limit set in paragraph (a)(3) of this section for reasons beyond his/her control, the employee may make a belated request by writing to OFEGLI. The employee/assignee must make the request within 6 months after becoming eligible to convert the insurance. The employee/assignee must show that he/she wasn't notified of the loss of coverage and the right to convert and was not otherwise aware of it or that he/she was unable to convert to an individual policy for reasons beyond his/her control. OFEGLI will determine if the employee/assignee is eligible to convert. If the request is approved, the employee must convert within 31 days of that determination. (b) The individual conversion policy is effective the day after the group coverage ends. The employee/assignee must pay the premiums for any period retroactive to that date. (c) The 31–day extension of coverage provided under this subpart does not depend upon timely notification of the right to convert to an individual policy. The extension cannot be continued beyond 31 days.
Title 5: Administrative Personnel
PART 870—FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM
Subpart F—Termination and Conversion
§ 870.601 Termination of Basic insurance.
§ 870.602 Termination of Optional insurance.
§ 870.603 Conversion of Basic and Optional insurance.
