Eligibility as a family member under the Federal Employees Health Benefits Program and the Federal Dental and Vision Insurance Program extends to a spouse and to an employee or retiree’s own children or stepchildren up to a cutoff age — 26 in the FEHBP and 22 in the FEDVIP — unless they are disabled before that age.
Same-sex spouses were made eligible in both programs along with opposite-sex spouses under the 2013 U.S. v. Windsor decision that invalidated the part of the Defense of Marriage Act that had defined marriage, for federal benefits purposes, as only between a man and a woman.
Also as a result of that decision, starting in 2014 the Office of Personnel Management broadened eligibility as a stepchild under the two programs. It made children of an employee or retiree’s same-sex domestic partner — although not the partner himself or herself — eligible if the couple met certain standards, lived in a state that did not recognize same-sex marriage, and certified that they would marry if their state allowed it.
“Based on the Supreme Court’s decision in Obergefell v. Hodges, published June 26, 2015, all states are now required to allow same-sex couples to marry,” said the OPM directive, called a benefits administration letter.
Effective immediately, it said, “agencies and/or retirement systems should no longer add children of same-sex domestic partners to FEHB enrollments as no new children are eligible. Stepchildren that are already covered under an enrollment for plan year 2015, based on a domestic partner certification, remain eligible family members only until the end of the plan year. For plan year 2016 and beyond, couples must be married in order to cover (or continue to cover) stepchildren under their FEHB and FEDVIP enrollment,” the instruction says.
The OPM recently announced new rates for both the health-care and vision-dental programs in advance of an open season that starts Nov. 9.
Starting in 2009, the Obama administration extended coverage under several other benefits programs to same-sex partners, but not to opposite-sex partners, on the premise that opposite-sex partners always had the option to marry while same-sex partners didn’t.
For example, eligibility to take unpaid parental and emergency medical leave extends only to same-sex partners, as does eligibility to enroll in the long-term care insurance program for federal employees and retirees, eligibility for agency-paid child care subsidies for lower-income parents, access to family services through employee assistance programs, and numerous other minor benefits.
Those policies remained unchanged as growing numbers of states recognized same-sex marriage even before this year’s Obergefell decision.
Some federal benefits policies apply to domestic partners of either gender. These include eligibility to use sick leave for family purposes and to designate a partner as a beneficiary under the federal employee life insurance program.
The administration last year proposed, but never finalized, rules to make children of same-sex domestic partners eligible as covered family members under the life insurance program on the same terms as those now dropped for health and vision-dental insurance. It also has proposed extending eligibility under the long term care program to opposite-sex partners, as well.