Federal Employees Receiving Premium Conversion Tax Benefits 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election1
 

Premium Conversion allows employees who are eligible for FEHB the opportunity to pay for their share of FEHB premiums with pre-tax dollars. Premium conversion plans are 

governed by Section 125 of the Internal Revenue Code, and IRS rules govern when a participant may change his or her election outside of the annual open season. All employees 

who enroll in the FEHB Program automatically receive premium conversion tax benefits, unless they waive participation. When an employee 

experiences a qualifying life event (QLE) as described below, changes to the employee's FEHB coverage (including change to self only and cancellation) and premium 

conversion election may be permitted, so long as they are because of and consistent with the QLEs. For more information about premium conversion, please visit 

www.opm.gov/insure/health. 

Qualifying Life Events (QLEs) that May 

Permit Change in FEHB Enrollment or 

Premium Conversion Election 

FEHB Enrollment Change that May Be Permitted Premium Conversion 

Election Change that 

May Be Permitted 

Time Limits in which 

Change May Be 

Permitted 

Code Event From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 

Participate Waive When You Must File 

Health Benefits Election 

with Your Employing 

Office 

1 Employee electing to receive or receiving premium conversion tax benefits 

1A Initial Opportunity to Enroll, for example: 

¤ New employee 

¤ Change from excluded position 

¤ Temporary employee who completes 1 year 

of service and is eligible to enroll under 5 

USC 8906a 

Yes N/A N/A N/A Automatic 

unless 

waived 

Yes Within 60 days after 

becoming eligible 

1B Open Season Yes Yes Yes Yes Yes Yes As announced by OPM 
Qualifying Life Events (QLEs) that May Permit 

Change in FEHB Enrollment or Premium 

Conversion Election 

FEHB Enrollment Change that May Be Permitted Premium Conversion 

Election Change that May 

Be Permitted 

Time Limits in which Change 

May be Permitted 

Code Event From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 2 

Participate Waive When you Must File Health 

Benefits Election with Your 

Employing Office 

1C Change in family status that results in increase or 

decrease in number of eligible family members, 

for example: 

¤ Marriage, divorce, annulment, legal 

separation 

¤ Birth, adoption, acquiring foster child or 

stepchild, issuance of court order requiring 

employee to provide coverage for child 

¤ Last dependent child loses coverage, for 

example, child reaches age 22 or marries, 

stepchild moves out of employee’s home, 

disabled child becomes capable of selfsupport, child acquires other coverage by 

court order 

¤ Death of spouse or dependent 

Yes 

Employees may enroll or change 

beginning 31 days before the event. 

Yes Yes Yes Yes Yes Within 60 days after change in 

family status 

1D Any change in employee’s employment status that 

could result in entitlement to coverage, for 

example: 

¤ Reemployment after a break in service of 

more than 3 days 

¤ Return to pay status from nonpay status, or 

return to receiving pay sufficient to cover 

premium withholdings, if coverage terminated 

 (If coverage did not terminate, see 1G.) 

Yes N/A N/A N/A Automatic 

unless 

waived 

Yes Within 60 days after 

employment status change 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 
Qualifying Life Events (QLEs) that May Permit 

Change in FEHB Enrollment or Premium 

Conversion Election 

FEHB Enrollment Change that May Be Permitted Premium Conversion Election 

Change that May Be 

Permitted 

Time Limits in which 

Change May Be 

Permitted 

Code Event From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 

Participate Waive When You Must File 

Health Benefits 

Election with Your 

Employing Office 

1E Any change in employee’s employment status 

that could affect cost of insurance, including: 

¤ Change from temporary appointment with 

eligibility for coverage under 5 USC 8906a to 

appointment that permits receipt of 

government contribution 

¤ Change from full time to part-time career or 

the reverse 

Yes Yes Yes Yes Yes Yes Within 60 days after 

employment status 

change 

1F Employee restored to civilian position after 

3 serving in uniformed services .

Yes Yes Yes Yes Yes Yes Within 60 days after 

return to civilian 

position 

1G Employee, spouse or dependent: 

¤ begins nonpay status or insufficient pay4

 or 

¤ ends nonpay status or insufficient pay if 

coverage continued 

¤ (If employee’s coverage terminated, see 1D.) 

¤ (If spouse’s or dependent’s coverage 

terminated, see 1 M).) 

No No No Yes Yes Yes Within 60 days after 

employment status 

change 

1H Salary of temporary employee insufficient to 

make withholdings for plan in which enrolled. 

N/A No Yes Yes Yes Yes Within 60 days after 

receiving notice from 

employing office 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 
Qualifying Life Events (QLEs) that May Permit 

Change in FEHB Enrollment or Premium 

Conversion Election 

FEHB Enrollment Change that May Be Permitted Premium Conversion 

Election Change that 

May Be Permitted 

Time Limits in which 

Change May Be Permitted 

Code Event From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 

Participate Waive When You Must File Health 

Benefits Election with 

Your Employing Office 

1I Employee (or covered family member) enrolled in 

FEHB health maintenance organization (HMO) 

moves or becomes employed outside the 

geographic area from which the FEHB carrier 

accepts enrollments or, if already outside the 

5 area, moves further from this area. 

N/A Yes Yes N/A 

(see 1M) 

No 

(see 1M) 

No 

(see 1M) 

Upon notifying employing 

office of move 

1J Transfer from post of duty within a State of the 

United States or the District of Columbia to post of 

duty outside a State of the United States or 

District of Columbia, or reverse. 

Yes Yes Yes

Employees may enroll or change beginning 

31 days before leaving the old post of duty. 

Yes Yes Yes Within 60 days after arriving 

at new post 

1K Separation from Federal employment when the 

employee or employee's spouse is pregnant. 

Yes Yes Yes N/A N/A N/A During employee's final pay 

period 

1L Employee becomes entitled to Medicare and 

6 wants to change to another plan or option.

No No Yes 

(Change may 

be made only 

once.) 

N/A 

(see 1M) 

N/A 

(see 1M) 

N/A 

(see 1M) 

Any time beginning on the 

30th day before becoming 

eligible for Medicare 

 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 
Qualifying Life Events that May Permit Change 

in FEHB Enrollment or Premium Conversion 

Election 

FEHB Enrollment Change that May be Permitted Premium 

Conversion Election 

Change that May Be 

Permitted 

Time Limits in which 

Change May be Permitted 

Code Event From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 

Participate Waive When You Must File 

Health Benefits Election 

With Your Employing 

Office 

1M Employee or eligible family member loses 

coverage under FEHB or another group insurance 

plan including the following: 

¤ Loss of coverage under another FEHB 

enrollment due to termination, cancellation, or 

change to self-only of the covering enrollment 

¤ Loss of coverage due to termination of 

membership in employee organization 

sponsoring the FEHB plan7 

¤ Loss of coverage under another federallysponsored health benefits program, including: 

TRICARE, Medicare, Indian Health Service 

¤ Loss of coverage under Medicaid or similar 

State-sponsored program of medical 

assistance for the needy 

¤ Loss of coverage under a non-Federal health 

plan, including foreign, state or local 

government, private sector 

¤ Loss of coverage due to change in worksite 

or residence (Employees in an FEHB HMO, 

also see 1I.) 

Yes Yes Yes

Employees may enroll or change beginning 

31 days before the event. 

Yes Yes Yes Within 60 days after loss of 

coverage 

1N Loss of coverage under a nonFederal group 

health plan because an employee moves out of 

the commuting area to accept another position 

and the employee’s nonFederally employed 

spouse terminates employment to accompany the 

employee. 

Yes Yes Yes Yes Yes Yes 

From 31 days before the 

employee leaves the 

commuting area to 180 

days after arriving in the 

new commuting area 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 
 

 

 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 

Qualifying Life Events that May Permit 

Change in FEHB Enrollment or Premium 

Conversion Election 

FEHB Enrollment Change that May be Permitted Premium 

Conversion Election 

Change that May Be 

Permitted 

Time Limits in which 

Change May be Permitted 

Code Events From Not 

Enrolled 

to 

Enrolled 

From Self 

Only to 

Self and 

Family 

From One 

Plan or 

Option to 

Another 

Cancel or 

Change to 

Self Only 

Participate Waive When You Must File 

Health Benefits Election 

With Your Employing 

Office 

1O Employee or eligible family member loses 

coverage due to discontinuance in whole or part 

of FEHB plan.8 

Yes Yes Yes Yes Yes Yes During open season, 

unless OPM sets a different 

time 

1P Enrolled employee or eligible family member 

gains coverage under FEHB or another group 

insurance plan, including the following: 

¤ Medicare (Employees who become eligible 

for Medicare and want to change plans or 

options, see 1l.) 

¤ TRICARE for Life, due to enrollment in 

Medicare. 

¤ TRICARE due to change in employment 

status, including: (1) entry into active military 

service, (2) retirement from reserve military 

service under Chapter 67, title 10. 

¤ Medicaid or similar state sponsored program 

of Medical assistance for the needy 

¤ Health insurance acquired due to change of 

worksite or residence that affects eligibility 

for coverage 

¤ Health insurance acquired due to spouse’s 

or dependent’s change in employment 

status (includes state, local, or foreign 

government or private sector employment).

9 

No No No Yes Yes Yes Within 60 days after QLE 
 

 

 

Federal Employees Receiving Premium Conversion Tax Benefits
 

Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election
 

Qualifying Life Events that May Permit 

Change in FEHB Enrollment or Premium 

Conversion Election 

FEHB Enrollment Change that May be Permitted Premium 

Conversion Election 

Change that May Be 

Permitted 

Time Limits in which 

Change May be 

Permitted 

1Q Change in spouse's or dependent's coverage 

options under a non-Federal health plan, for 

example: 

¤ Employer starts or stops offering a different 

type of coverage (If no other coverage is 

available, also see 1M.) 

¤ Change in cost of coverage 

¤ HMO adds a geographic service area that 

now makes spouse eligible to enroll in that 

HMO 

¤ HMO removes a geographic area that 

makes spouse ineligible for coverage under 

that HMO, but other plans or options are 

available 

(if no other coverage is available, see 1M) 

No No No Yes Yes Yes Within 60 days after QLE 

1 If you have waived premium conversion tax benefits, see July 1999 edition of SF 2809 for permissible changes in your FEHB election. 

2 Employees may change to self only outside of open season only if the QLE caused the enrollee to be the last eligible family member under the FEHB 

enrollment. Employees may cancel enrollment outside of open season only if the QLE caused the enrollee and all eligible family members to acquire 

other health insurance coverage. 

3 Employees who enter active military service are given the opportunity to terminate coverage. Termination for this reason does not count against the 

employee for purposes of meeting the requirements for continuing coverage after retirement. Additional information on the FEHB coverage of 

employees who return from active military service will be forthcoming. 

4 Employees who begin nonpay status or insufficient pay must be given an opportunity to elect to continue or terminate coverage. A termination differs 

from a cancellation as it allows conversion to nongroup coverage and does not count against the employee for purposes of meeting the requirements for 

continuing coverage after retirement. 
 5 This code reflects the FEHB regulation that gives employees enrolled in an FEHB HMO who change to from self only to self and family or from 

one plan or option to another a different timeframe than that allowed under 1M. For change to self-only, cancellation, or change in premium 

conversion status see 1M. 

6

 This code reflects the FEHB regulation that gives employees enrolled in FEHB a one-time opportunity to change plans or options under a different 

timeframe than that allowed by 1P. For change to self only, cancellation, or change in premium conversion status, see 1P. 

7

 If employee's membership terminates, (e.g., for failure to pay membership dues), the employee organization will notify the agency to terminate the 

enrollment. 

8 Employee's failure to select another FEHB plan is deemed a cancellation for purposes of meeting the requirements for continuing coverage after 

retirement. 

9 Under IRS rules, this includes, start/stop of employment or nonpay status, strike or lockout, and change in worksite).