FEHB – Waiver of 5-Year Enrollment Requirement

Picture of Brennan Rhule, CFP®, ChFEBC℠, AIF®

Brennan Rhule, CFP®, ChFEBC℠, AIF®


Waiver of the FEHB 5-Year Rule

The 5-year rule in the Federal Employees Health Benefits (FEHB) Program refers to the requirement that federal employees must have been enrolled in an FEHB plan for at least five years before retirement to continue coverage into retirement. This rule ensures that retiring federal employees can maintain their health insurance coverage under the FEHB Program into retirement. It’s important for federal employees to be aware of this rule and plan accordingly when considering retirement.

Below we discuss where and how OPM can waive the 5-year rule based on discretion. 

Waiver of 5-Year Enrollment Requirement

Public Law 99-251 gave OPM the authority to waive the 5 year service requirement when, in its sole discretion, it determines that it would be against equity and good conscience not to allow a person to be enrolled in the FEHB Program as an annuitant. An employee’s failure to satisfy the 5-year requirement must be due to exceptional circumstances. Employees requesting a waiver must provide OPM with evidence that:

  • the employee intended to have FEHB coverage as a retiree;
  • the circumstances that prevented the employee from meeting the 5-year requirement were essentially outside of the employee’s control; and
  • the employee acted reasonably to protect the right to continue FEHB coverage into retirement. (This includes reading and acting on information provided and requesting information if none is given automatically.)
  • Quoted from OPM FEHB Program Handbook


How OPM Applies Its Waiver Authority

OPM’s approval of a waiver request depends on the extent to which the individual could have controlled the events leading to the loss of coverage at retirement. When OPM reviews a waiver request, it considers:

  • whether the individual had a compelling reason to believe he/she was covered as a family member of another person enrolled in FEHB during the time in question;
  • evidence that an individual’s employing office would not allow him/her to enroll;
  • the extent to which an individual could have controlled the events that led up to the loss of the right to continued FEHB coverage;
  • whether the individual had acted to gain FEHB coverage at the earliest opportunity after learning of the loss of benefits or possible loss of future rights; and
  • whether the individual had substantial FEHB coverage during his/her career even though there was a break in continuity during the last 5 years of service.
  • Quoted from OPM FEHB Program Handbook


Reach Out to Us!


If you have additional federal benefit questions, contact our team of CERTIFIED FINANCIAL PLANNER™ (CFP®) and Chartered Federal Employee Benefits Consultants (ChFEBC℠). At PlanWell, we focus on retirement planning for federal employees. Learn more about our process designed for the career federal employee.

Preparing for federal retirement? Check out our scheduled federal retirement workshops. Sign up for our no-cost federal retirement webinars here! Make sure to plan ahead and reserve your seat for our FERS webinar, held every three weeks. Want to have PlanWell host a federal retirement seminar for your agency? Reach out, and we’ll collaborate with HR to arrange an on-site FERS seminar.

Want to fast-track your federal retirement plan? Skip the FERS webinar and start a one-on-one conversation with a ChFEBC today. You can schedule a one-on-one meeting here.