3 FAM 3620
FEDERAL EMPLOYEES' GROUP LIFE INSURANCE (FEGLI) PROGRAM
(CT:PER-1008; 07-15-2020)
(Office of Origin: GTM/ER/WLD)
3 FAM 3621 AUTHORITY
3 FAM 3621.1 Legal Authority
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/ Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The legal authorities for the Federal Employees' Group Life Insurance (FEGLI) Program are 5 U.S.C. Chapter 87 and 5 CFR 870.
b. In addition, the U.S. Office of Personnel Management (OPM) has published the FEGLI Handbook. This handbook provides guidance to FEGLI enrollees, their employing offices, and beneficiaries, on the policies and procedures of the program. The FEGLI Handbook is available on the OPM website.
3 FAM 3622 APPLICABILITY
(CT:PER-944; 05-15-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The administrative responsibilities and internal procedures described in this subchapter apply to all eligible Foreign Service employees of the participating agencies (Department of State, USAID, USAGM, Commerce and the Foreign Service Corps of USDA), and to Civil Service employees of the Department of State.
b. These regulations address only certain aspects of the FEGLI Program. More comprehensive information is available through the authorities referred to in 3 FAM 3621.1.
3 FAM 3623 RESPONSIBILITIES
3 FAM 3623.1 U.S. Office of Personnel Management
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The U.S. Office of Personnel Management (OPM) is responsible for the government-wide administration of the FEGLI Program.
b. There are no regularly scheduled open enrollment periods for life insurance to elect, increase, or change coverage under FEGLI. Open seasons are held only when specifically scheduled by OPM. Employees do not have to wait for an Open Season to reduce or cancel coverage. This can be done at any time (unless employees have assigned their coverage).
3 FAM 3623.2 Office of Federal Employees’ Group Life Insurance
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The FEGLI Program is underwritten by several private insurance companies, which share the risk of providing insurance to enrollees. The Office of Federal Employees’ Group Life Insurance (OFEGLI), a unit of Metropolitan Life Insurance Company, is the administrative office established by the insurance companies that underwrites the FEGLI Program.
b. OFEGLI’s responsibilities include processing and paying claims, determining eligibility for living benefits, eligibility to cancel a waiver of insurance based on medical evidence, and processing requests for conversion.
c. OFEGLI’s address:
OFEGLI
P.O. Box 6080
Scranton, PA 18505-6080
Telephone number: 1-800-633-4542.
Overseas number: (212) 578-2975.
3 FAM 3623.3 Agency Life Insurance Officer
(CT:PER-994; 05-22-2020)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Within each department or agency’s headquarters, a life insurance officer is designated coordinator of the program. This officer is the liaison with OPM on life insurance within the department or agency, and provides input to OPM on government-wide life insurance matters.
b. Questions not adequately covered in this subchapter or in the applicable laws, regulations, and guidelines published by OPM, should be referred to the life insurance office listed below:
|
State |
GTM/ER/WLD |
|
USAID |
OHR/ELR |
|
Commerce |
USFCS/OFSHR |
|
Agriculture FAS |
HRD/FSA |
|
APHIS |
IS/RMS |
3 FAM 3623.4 Agency Designated Certifying Personnel Officer
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Each agency designated certifying human resources or administrative officer, whether in the United States or at a post abroad, is responsible for:
(1) Individual certification of an employee’s FEGLI status;
(2) Counseling and providing information to employees about the FEGLI Program; and
(3) Performing the certifying agency responsibilities outlined in the FEGLI Handbook.
b. These functions are performed under guidance received from OPM and instructions issued by the life insurance officer of the employee’s agency.
3 FAM 3624 INITIAL ELECTION AND EFFECTIVE DATES
3 FAM 3624.1 Initial Election
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Unless an employee’s position is excluded from FEGLI coverage by law or regulation, the employee is automatically enrolled in Basic insurance. If the employee does not want this coverage, s/he can either waive it when first becoming eligible for coverage, or cancel it at a later date.
b. Optional insurance must be specifically elected within 60 days of becoming eligible; it is not automatic. An employee may elect one or more types of Optional insurance if:
(1) He/she has Basic insurance;
(2) He/she does not have a waiver of that type (or types) of Optional insurance still in effect.
c. Employees who waived Basic insurance, did not elect Optional insurance when first hired, or want to elect different coverage, have two opportunities, other than an open enrollment period, to make changes:
(1) By providing satisfactory medical evidence of insurability when at least one year has passed since the date of waiver; or
(2) Upon occurrence of a Qualifying Life Event. A Qualifying Event is a marriage, divorce, death of spouse, or the birth or adoption of a child.
3 FAM 3624.2 Effective Date
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Basic insurance coverage is effective on the first day an employee is in a pay and duty status in an eligible position.
b. Option A and Option B insurance coverage is effective on the first day an employee is in a pay and duty status on or after the day the employing office receives the election. If the employee is not in a pay and duty status on the date the employing office receives the election, the coverage becomes effective the next date that the employee is in a pay and duty status.
c. Option C insurance coverage is also effective on the first day an employee is in a pay and duty status on or after the day the employing office receives the election, if Option C insurance is elected within 60 days of first becoming eligible. Option C insurance coverage elected later because of a qualifying life event is effective on the day the employing office receives the election, or the day of the event, whichever is later, without regard to the employee’s pay and duty status.
3 FAM 3625 COVERAGE Types and amount of insurance
3 FAM 3625.1 Basic Insurance
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. All eligible employees automatically have basic coverage unless they waive it.
b. The amount of coverage is based on the employee’s annual rate of pay. Normally, basic coverage equals the employee’s per annum salary rounded up to the next thousand dollars, plus $2,000, or $10,000, whichever is higher.
c. An employee must have basic coverage in order to elect optional insurance under the FEGLI Program.
3 FAM 3625.2 Option A – Standard
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
Option A – Standard: This option permits an employee to buy additional insurance in the amount of $10,000.
3 FAM 3625.3 Option B – Additional
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Option B – Additional: This option permits an employee to buy additional insurance coverage in an amount equal to one, two, three, four or five times the employee’s annual basic pay (after rounding up to the next even $1,000).
b. The cost of Option B insurance depends on an employee’s age. When an employee has a birthday that moves him/her to another age group, the employee will begin paying the premiums for the new age group in the first pay period that starts after the birthday. The premiums increase depending on age group. To find out the amount of the premium, check the OPM website.
3 FAM 3625.4 Option C – Family
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Option C – Family: This option permits an employee to buy life insurance for spouse and eligible dependent children. When the employee elects Option C coverage, all of the employee’s eligible family members are automatically covered.
b. The employee may choose one, two, three, four or five multiples of coverage. Each multiple is equal to $5,000 for the spouse and $2,500 for each eligible dependent child. The insured enrollee receives the life insurance payment when an eligible family member dies.
c. Each multiple is a unit. For example, if the employee elects two multiples, that means the employee has two multiples on the spouse and two multiples on each eligible dependent child. The employee cannot elect a number of multiples for the spouse that is different from the number for eligible children.
d. The cost for Option C insurance remains the same regardless of the number of eligible dependent children. Dependent children must be unmarried and under age 22, or if 22 or older, incapable of self-support. Dependent children include the employee’s children, adopted children, foster children, and stepchildren (if they are living with the employee in a regular parent-child relationship), and recognized natural children. Stillborn children are not covered. Grandchildren are covered only if they meet the requirements of foster children.
e. The cost of Option C insurance depends on an employee’s age, and the number of multiples elected. When the employee has a birthday that moves him/her to another age group, the employee will begin paying the premiums for the new age group in the first pay period that starts after the birthday. The premiums increase depending on age group. To find out the amount of the premium, check the OPM website.
3 FAM 3626 LIVING BENEFITS ACT
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The Living Benefits Act (Public Law 103-409) under FEGLI became effective July 25, 1995. It provides that an employee or annuitant who has been certified as terminally ill by his or her doctor, meaning that he or she has a medical prognosis of a life expectancy of no more than 9 months, may cash in his or her BASIC life insurance only. Optional insurance is not available for payment as a Living Benefit.
b. Applications for Living Benefits should be requested directly from OFEGLI at 1-800-633-4542 or if overseas at (212) 578-2975.
c. Additional information is available on the U.S. Office of Personnel Management (OPM) website and in the FEGLI Program Booklet FE 76-21.
3 FAM 3627 ASSIGNMENT of Life insurance
(CT:PER-948; 06-04-2019)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Effective October 3, 1994, Public Law 103-306 amended the life insurance law to allow employees and annuitants enrolled in FEGLI to assign their insurance to another person, firm, or trust. After the assignment the employee continues to pay the premiums, but someone else “owns” and controls the coverage
b. Viatical settlement companies are private-sector businesses not connected with the Federal Government. Viatical assignments are intended to help terminally ill (life expectancy of 24 months or less) employees and annuitants by giving them an influx of cash to finance medical care and improve the quality of their final days of life. Employees cannot apply in advance; they must be terminally ill at the time of application. The amount of cash received is a percentage of the face value of FEGLI Basic, Option A and Option B insurance. Employees cannot assign Option C coverage. Once assignments are made they cannot be changed, canceled, or assigned to another person. Employees can elect living benefits only once. Additional information is found in the FEGLI Program Booklet FE 76-21.
3 FAM 3628 RECONSIDERATION AND APPEAL
(CT:PER-993; 05-26-2020)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The Office of Employee Relations (GTM/ER) or the employee’s agency determines whether an employee is eligible to elect or increase FEGLI life insurance coverage. Employees have the right to ask GTM/ER or their life insurance officer to reconsider its initial denial of coverage or the opportunity to change coverage. Employees must make a request for reconsideration in writing within 30 days from the date of the Department’s or agencies initial decision. For USAID, these determinations are made by the Office of Employee and Labor Relations (OHR/ELR).
b. The U.S. Office of Personnel Management (OPM) has delegated the authority to agencies to reconsider initial decisions pertaining to life insurance enrollment issues. Reconsideration consists of a review of an initial decision to determine whether laws and regulations were correctly applied. It is the employee’s final level of administrative review for enrollment and coverage issues under FEGLI. For information on filing a request for reconsideration and appeal, the employee should contact his or her agency insurance officer (see section 3 FAM 3623.3).
3 FAM 3629 election opportunity for certain employees
(CT:PER-1008; 07-15-2020)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps/USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Section 1103 of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (NDAA) provides an opportunity for certain employees who have previously waived Federal Employees' Group Life Insurance (FEGLI) coverage to elect certain types of coverage as described herein. The election may be made outside of an open season and without experiencing a life event or providing medical information.
b. Qualifying employees are employees of any agency who are deployed, (i.e., assigned) for any length of time, in support of a contingency operation, as defined by 10 U.S.C. 101(a)(13). Elections must be made within 60 days after receipt of assignment notification (TMONE). As of the effective date of this section, only our employees in Afghanistan and Iraq have been “deployed in support of” contingency operations within the meaning of this section. Assignments in countries which are considered to be in support of a contingency operation are subject to change as declared by the President or Congress.
c. Qualifying employees may elect the following FEGLI coverage (see 3 FAM 3625):
(1) Basic; and if they elect or already have Basic;
(2) Option A (standard) coverage; and/or
(3) Option B (additional) coverage, from one to five multiples.
(4) Option C (Family) is not applicable for this opportunity.