- By Milt x_Zall
- Jan 21, 2001
The Office of Personnel Management recently issued well- intentioned instructions
that are bound to create an administrative nightmare for federal agencies.
OPM says it considers a court or administrative order requiring employees
to provide health benefits for their children to be a change in family status
that allows an enrollment change in the government's health program. But
there was nothing in the Federal Employees Health Benefits (FEHB) law that
actually required an employee to make the change.
Now there is. A law that took effect last Oct. 30 requires mandatory
self and family coverage for FEHB-eligible employees who are under court
order to provide such health benefits to their children. If the employee
does not enroll in a health plan or provide documentation of other coverage
for the children, OPM says the agency must enroll the employee for self
and family coverage in the standard option of the Blue Cross and Blue Shield
Service Benefit Plan. I bet the other FEHB carriers will be thrilled with
How this law is supposed to work is peculiar. It appears it will only
work if a representative of a child who will benefit from this law is aware
of this provision and submits the necessary documentation to an employee's
agency. But if the representative is unaware of this provision, the child
is out of luck.
If a federal employee gains custody of a child as a result of a court
order, then the employee will probably enroll that child in the FEHB plan.
But if a non-fed obtains custodypresumably as a result of a divorce or
separation settlementthat person would have to know about the provisions
of this law and submit the necessary documentation to the other parent's
OPM has told agency officials that if they receive a court order, they're
supposed to determine whether the employee has enrolled the child in an
FEHB plan. If so, the official should notify whoever sent in the court order.
The official must also send a copy of the enrollment form to the carrier,
along with a copy of the court order.
I don't understand this. If the employee has enrolled his or her child,
why send anything to the carrier? The carrier already has the necessary
If the employee is eligible for FEHB but doesn't have coverage for his
or her child, the agency official must notify the employee that it has received
a court order requiring it. If the employee doesn't enroll in an appropriate
plan or provide documentation of other coverage for the child, the agency
must enroll the child. The health plan must get the name and birth date
of the child from the court order or from the custodial parent. How the
plan is supposed to do this isn't specified.
This is sloppy work by both OPM and Congress. The law and regulations
are too ambiguous and, while well-intentioned, will create many problems.
Zall is a retired federal employee who since 1987 has written the Bureaucratus
column for Federal Computer Week. He can be reached at [email protected].