Frequently Asked Questions

Eligibility

Continuing the Insurance After Leaving an Eligible Group

1. If I've already enrolled and my insurance coverage is effective, what happens to it if I leave my eligible group (e.g., I move from the Selected Reserve to the Individual Ready Reserve, or I resign from the Federal Government, or I divorce my Federal spouse)?
    
2. My qualified relatives are eligible to apply for this insurance. But what happens to their eligibility if I am no longer in an eligible group?
    
3. If I apply for this insurance as a member of one of the eligible groups, and I get the insurance coverage does this portability extend to my qualified relatives' eligibility too? As long as I have the coverage and leave an eligible group, do I also retain THEIR eligibility to apply?
    
4. What happens if I apply while I am in an eligible group, but then I leave the eligible group before my insurance is effective? Will my insurance still become effective?
    
5. Is there a "five-year rule" for continuing coverage into retirement like there is with the Federal Employees Health Benefits Program?

1. If I've already enrolled and my insurance coverage is effective, what happens to it if I leave my eligible group (e.g., I move from the Selected Reserve to the Individual Ready Reserve, or I resign from the Federal Government, or I divorce my Federal spouse)?

As long as you continue paying premiums, your insurance coverage will continue. It is fully portable. If you were paying premiums by payroll deduction and you leave the Government, you'll have to make arrangements with Long Term Care Partners to start paying premiums directly or by automatic debit from your bank account. But you get to keep the insurance at the same premiums as if you never left the eligible group.

[ Back to Top of Page ]
 

2. My qualified relatives are eligible to apply for this insurance. But what happens to their eligibility if I am no longer in an eligible group?

They are qualified relatives as long as you are in one of the groups eligible to apply for this insurance. And if they apply and are approved while you are eligible (whether you apply or not), they will keep the coverage even if you leave an eligible group. However, once you leave an eligible group, they can no longer apply for the insurance.

For example, when you are a Federal employee, your mother is eligible to apply for coverage under this program. If she applies, and gets coverage, she'll keep the insurance even if you quit working for the Federal government. BUT, if she does not apply while you are a Federal employee, she is NOT eligible to apply after you quit working for the Federal government. Remember that parents of retirees are not qualified relatives.

[ Back to Top of Page ]
 

3. If I apply for this insurance as a member of one of the eligible groups, and I get the insurance coverage does this portability extend to my qualified relatives' eligibility too? As long as I have the coverage and leave an eligible group, do I also retain THEIR eligibility to apply?

No. Please see the answer to the previous question. If you are no longer in any of the eligible groups, your qualified relatives are no longer eligible to apply for this insurance. But if they had the insurance before you left the eligible group, they get to keep it as long as they continue paying premiums.

[ Back to Top of Page ]
 

4. What happens if I apply while I am in an eligible group, but then I leave the eligible group before my insurance is effective? Will my insurance still become effective?

You must be in an eligible group on the date you apply for the insurance and on the date the insurance is supposed to become effective. Generally, if you leave the eligible group during this time period, your insurance will not become effective. But there are some exceptions.

If you apply as an employee and are involuntarily separated before your coverage is effective, it will still become effective as if you hadn't separated.

If you apply as an employee using the full underwriting application but are retired before your coverage becomes effective, it will still become effective on the scheduled effective date, as long as you meet the other requirements (such as needing to let Long Term Care Partners know if you've had a significant change in health since you completed your application).

If you apply as an employee using the abbreviated underwriting application but are retired before your coverage becomes effective, it will not become effective. You will have to reapply using the full underwriting application.

[ Back to Top of Page ]
 

5. Is there a "five-year rule" for continuing coverage into retirement like there is with the Federal Employees Health Benefits Program?

No. Coverage is fully portable. If, for instance, you retire, you keep your coverage as long as you pay your premiums. You do not have to be enrolled for any minimum length of time before retiring.

[ Back to Top of Page ]