Except as indicated below, a “Federal employee” could be covered under FEHBA. The term “Federal employee” for FEHBA purposes means: an appointive or elective officer or employee in or under the executive, judicial, or legislative branch of the United States Government (including a Government-owned or controlled corporation) or of the municipal government of the District of Columbia; an Official Reporter of the Debates of the Senate and persons employed by the Official Reporters of Debates of the Senate in connection with the performance of their official duties; and an employee of Gallaudet College.

If the employee could be covered, the spouse could also be covered, and will be precluded from HI under the deemed insured provision.

Excluded from the definition of “Federal employee” under FEHBA and thus not precluded from entitlement to deemed insured HI are those engaged in:

Under Civil Service Commission regulations, Federally-appointed cooperative employees serving with non-Federal agencies and paid in whole or part from non-Federal funds (e.g., county agricultural agents) may enroll under FEHBA if the non-Federal agency arranges with the Commission for the payment of premiums. In the absence of such arrangements, these employees and their spouses would not be considered to have had an opportunity to enroll in a FEHBA plan. They would not, therefore, be precluded from entitlement to HI under the deemed insured provision. Those who retired before an arrangement was made would also not be precluded from HI entitlement.

Most of these arrangements under the Civil Service Commission regulations have been made through the Department of Agriculture and only with State Extension Services in the following States:

If consistent with the above information, accept the statement of a Federally-appointed cooperative employee (or a civil service annuitant who formerly was such an employee) that had no opportunity to enroll under FEHBA. If, on the other hand, such employee served in one of the listed States after the date of the arrangement with the Civil Service Commission, apply the rules in HI 00801.081.

A former Federal employee or the spouse of a former Federal employee can be covered under FEHBA if (or spouse) is an “annuitant” and meets certain other conditions. Under the 1959 Act, an “annuitant” includes an individual who:

1. 1. 

   Retired on an immediate retirement annuity after 12 or more years of service; or

2. 2. 

   Retired on a disability annuity; or

3. 3. 

   Receives an annuity as the deceased spouse of a Federal employee; or

4. 4. 

   Receives monthly compensation under the Federal Employees Compensation Act and is, as determined by the Secretary of Labor, unable to work; or

5. 5. 

   Receives monthly compensation as a surviving spouse of an individual who qualified to receive compensation under 4, above.

To be covered under FEHBA, an individual's annuity must be sufficient to cover the cost of the premium. An individual who started receiving an annuity before 7/60 but had no Federal employment after 6/60, could not be covered before 7/74.