Frequently Asked Questions

Applying for Coverage Under the Federal Program

Actively at Work Requirement

1. Who needs to be actively at work in order for their coverage to become effective?
    
2. What does it mean to be "actively at work"?
    
3. What happens if I'm NOT actively at work at all during the week prior to the original effective date of my coverage?
    
4. I'm a new employee applying with the abbreviated underwriting application. WHY do I have to be actively at work for my coverage to be effective?
    
5. I'm an employee applying using the full underwriting application. Do I still have to be actively at work in order for my coverage to become effective?
    
6. I'm the new spouse of an employee. Does the employee I'm related to have to be actively at work in order for my coverage to become effective?
    
7. I'm the new spouse of an employee and am applying using the abbreviated underwriting application. I have a non-Federal job. Do I have to be actively at work at that job in order for my coverage to become effective?
    
8. I'm on leave without pay to work for the union. How can I meet the actively at work requirement if I'm not at my Federal job?
    
9. I'm a new employee and I'm also in the Reserves. I'm going to be activated very soon. My coverage is scheduled to go into effect on the first of the month. Your other FAQs say that if I'm in a leave status, I'm not actively at work. But what if I'm on leave without pay from my Federal job and instead on active duty in the uniformed services on that date -- will my coverage still become effective on my scheduled effective date?
    
10. I work from home (telework) every other week. Is this considered actively at work?
     

1. Who needs to be actively at work in order for their coverage to become effective?

If you are an employee or a member of the uniformed services who submitted an abbreviated underwriting application, you must be actively at work on the original effective date shown on your schedule of benefits. If your original effective date falls on a weekend or holiday, you must be actively at work on the last work-day before your original effective date. For employees working an alternative work schedule, an "AWS" day counts as a day you are actively at work.

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2. What does it mean to be "actively at work"?

For employees (other than members of the uniformed services) applying with the abbreviated underwriting application, it means:

• You are reporting for work at your usual place of employment or other location to which government business requires you to travel; and
• You are able to perform all the usual and customary duties of your employment on your regular work-schedule; and
• You are not absent from work due to sickness, injury, annual leave, sick leave or any other leave (for employees working an alternative work schedule, an "AWS" day off counts as a day you are Actively at Work);

For members of the uniformed services, actively at work means that you are on active duty and are physically able to perform the duties of your position.

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3. What happens if I'm NOT actively at work at all during the week prior to the original effective date of my coverage?

If you do not meet the actively at work definition requirement for your original effective date, you must contact Long Term Care Partners with that information. Long Term Care Partners will then issue a revised effective date, which is the first day of the month after the date you return to being actively at work.

However, for coverage to become effective on the revised effective date, you must meet the actively at work requirement for that date as well. Your coverage will not become effective until you meet the actively at work requirement for the coverage effective date issued by Long Term Care Partners. If Long Term Care Partners discovers that you did not meet the actively at work requirement for the "effective" date of your coverage, benefits will never be paid because your coverage never went into effect.

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4. I'm a new employee applying with the abbreviated underwriting application. WHY do I have to be actively at work for my coverage to be effective?

OPM negotiated premiums with Long Term Care Partners such that employees and members of the uniformed services using the abbreviated underwriting application receive this more limited underwriting as long as there was also an actively at work requirement.

An actively at work requirement is standard industry practice for employer-sponsored group long term care insurance. It acts as a type of proxy for asking additional questions about health.

It is important to realize that without this requirement, employees would have been subject to FULL underwriting ALWAYS (even when new or newly eligible).

Having only abbreviated underwriting for new and newly eligible employees is a tremendous advantage and allows many more employees to qualify for the insurance. Having to be actively at work (or else postponing the effective date) is a small price to pay for this advantage.

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5. I'm an employee applying using the full underwriting application. Do I still have to be actively at work in order for my coverage to become effective?

No. The actively at work requirement applies ONLY with the abbreviated underwriting application.

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6. I'm the new spouse of an employee. Does the employee I'm related to have to be actively at work in order for my coverage to become effective?

No. The actively at work requirement applies only to employees who are applying for coverage using the abbreviated underwriting application.

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7. I'm the new spouse of an employee and am applying using the abbreviated underwriting application. I have a non-Federal job. Do I have to be actively at work at that job in order for my coverage to become effective?

No. The actively at work requirement applies only to employees who are applying for coverage using the abbreviated underwriting application.

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8. I'm on leave without pay to work for the union. How can I meet the actively at work requirement if I'm not at my Federal job?

If you are on leave without pay from your eligible Federal position:

• to work full-time for an employee organization (e.g., union), or
• to work on a detail to an international organization, or
• to work on a temporary assignment to a State, local, or Indian tribal government, institution of higher education, or
• to work at any other organization eligible under the Intergovernmental Personnel Act of 1970

then you do not have to be actively at work with your Federal agency on your scheduled effective date. Instead, you must meet the actively at work requirements at your current employment site in order for your coverage to become effective.

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9. I'm a new employee and I'm also in the Reserves. I'm going to be activated very soon. My coverage is scheduled to go into effect on the first of the month. Your other FAQs say that if I'm in a leave status, I'm not actively at work. But what if I'm on leave without pay from my Federal job and instead on active duty in the uniformed services on that date -- will my coverage still become effective on my scheduled effective date?

YES, it will, assuming your health hasn't changed in such a way to change the answers to any questions on your application.

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10. I work from home (telework) every other week. Is this considered actively at work?

Yes, if you telework you are considered actively at work if you report to an approved work location at least one day during the week prior to your effective date, and you work at least one half of your regularly scheduled hours for that day.

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