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Table of Effective Dates: Changes in Life Insurance Coverage Deductions: Begin, increase, stop or decrease in the same pay period in which coverage begins, increases, stops, or decreases.

Event Allowing Change

0. New/Newly Eligible Employee:

1. PROVIDING

MEDICAL INFORMATION: Approval of Request for

Insurance

(SF 2822) by

the Office of Federal Employees' Group Life Insurance (OFEGLI).

2. LIFE EVENT: Marriage, divorce, death of spouse, or acquisition of an eligible child.

Basic

Yes. See "Instructions to Agencies", #5, back of Part 1.

Yes. Coverage is automatically effective the first day the employee is in a pay and duty status on or after date of OFEGLI's approval.

Time Limit - on or after OFEGLI's date of approval. If employee is not in a pay and duty status within 60 days, Basic does NOT become effective, and the employee must start over.

Yes. Coverage is effective the day of the event if the SF 2817 is received before the event and the employee is in pay and duty status on the day of the event. Otherwise, Coverage is effective the first day in pay and duty status after the event and after receipt of the SF 2817.

Time Limit - Agency must receive the SF 2817 and proof of the event within 60 days after the day of the event.

Yes. Same as Basic.

Yes. Same as Basic.

Yes. Coverage is effective the first day the employee is in a pay and duty status on or after the date of OFEGLI's approval and the agency receives the SF 2817.

Yes. Same as Option A.

Time Limit - Employee must submit the SF 2817 and be in a pay and duty status within 60 days after date of OFEGLI's approval. If employee is not in a pay and duty status or doesn't submit the SF 2817 within those 60 days, Option A does not become effective, and the employee must start over.

Yes. Same as Basic. Coverage - Same as Basic. Time Limit - Same as Basic.

Yes. Same as Basic. Employee may elect or increase multiples (up to 5 total). Coverage - Same as Basic. Time Limit - Same as Basic.

Yes. Employee may elect or increase multiples (up to 5 total). If the employee has Basic, Coverage is effective the day the employing office receives the election, or the date of the event, whichever is later. If Basic and Option C are elected at the same time, Option C is effective when Basic becomes effective.

Time Limit - Same as Basic.

(Note: If the employee already has Basic, there is no pay and duty status requirement for Option C.)

Change Permitted? (To elect any option, employee must elect or retain Basic)

Option A - Standard

Option B - Additional

Option C - Family Yes. Same as Basic.

No. An employee may NOT elect Option C by providing medical information.

  • 3.

    REINSTATEMENT: Employee is reinstated after a break in service of at least 180 days in a position that is not excluded from life insurance by law or regulation.

  • 4.

    REINSTATEMENT: Employee is reinstated after a break in service of at least 180 days in a position that is excluded from life insurance by law or regulation.

5A. CANCELING/ WAIVING COVERAGE: employee/assignee

or

Yes. Coverage is effective on the first day the

Yes. Employee may elect Option A within 60 days after

Same as Option A.

e m p l o y e e i s i n a p a y a n d d u t y s t a t u s , u n l e s s w a i v e d b y r e i n s t a t e m e n t . H o w e v e r , i f e m p l o y e e d o e s n o t s u b m i t S F 2 8 1 7 e l e c t i n g c o v e r a g e w i t h i n 6 0 d a y s a f t e r employee. r e i n s t a t e m e n t , s / h e h a s t h e s a m e O p t i o n a l i n s u r a n c e c a r r i e d b e f o r e t h e b r e a k i n s e r v i c e e f f e c t i v e t h e b e g i n n i n g o f t h e r e i n s t a t e m e n t .

No. However, if employee is later converted to a

No. However, if employee is later converted to a

non-excluded position, the coverage is effective on the non-excluded position, the coverage is effective on the first

first day the employee is in a pay and duty status on or

day the employee is in a pay and duty status in the

after being converted to such a position.

converted position on or after the date the agency receives the SF 2817 electing such coverage.

Same as Option A.

A.

Yes. If the coverage is canceled in the first pay period, no premiums are due. Otherwise, coverage stops at the end of the last day of the pay period in which the agency receives the SF 2817, with no 31-day extension of coverage.

A. Same as Basic.

Time Limit - Employee must submit the SF 2817 within 60 days after conversion to an eligible position.

A.Same as Basic.

Time Limit - None. Employee may cancel coverage at any time. However, if the insurance is assigned, only the assignee(s) may cancel

Same as Option A.

Same as Option A.

A. Same as Basic. Option C cannot be assigned.

If Option C is canceled because there no longer are eligible family members, the effective date is retroactive to the end of the pay period in which there no longer are any eligible family members. The employing agency must refund Option C premiums retroactive to that effective date.

5B. REDUCING OPTION B and/or OPTION C MULTIPLES: employee/assignee

B.

Not applicable.

B. Not applicable.

  • B.

    Yes. Employee may at any time reduce the number of multiples, unless the insurance has been assigned. In that case, only the assignee(s) may reduce coverage

    • the employee may not. This new coverage is effective at the beginning of the pay period following the one in which the employing office receives the SF 2817.

B.Yes. Employee may at any time reduce the number of multiples. This new coverage is effective at the beginning of the pay period following the one in which the employing office receives the SF 2817. Assignee(s) cannot reduce Option C.

6. Open Season.

If permitted under conditions specified by OPM.

7. CERTAIN DEPT. OF DEFENSE AND CIVILIAN EMPLOYEES AFFECTED BY PUBLIC LAWS 106-398 AND 110-417:

Yes, if employing agency determines employee meets criteria to elect coverage. Coverage is effective the first day the employee is in a pay and duty status on or after the date the agency receives the SF 2817.

Time Limit - Agency must receive the SF 2817 within 60 days of the date the employee receives official notice of deployment in support of a contingency operation or designation as an emergency essential employee.

Same as Basic. Same as Basic.

Same as Basic. Same as Basic.

Employee may elect or increase multiples (up to 5 total).

Same as Basic.

No. An employee may NOT elect Option C via these provisions of law.

Back of Part 2

Standard Form 2817, Revised November 2011

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