§ 890.1603 Eligibility for the Postal Service Health Benefits Program

5 CFR 890.1603(a)(a) Except as provided by paragraph (b) of this section, the following individuals are eligible to enroll, or to be covered under an enrollment, in a health benefits plan described at 5 U.S.C. 8903c and under this subpart:

5 CFR 890.1603(a)(1)(1) Postal Service employee;

5 CFR 890.1603(a)(2)(2) Postal Service annuitant; and

5 CFR 890.1603(a)(3)(3) Member of family of an individual in paragraph (a)(1) or (2) of this section.

5 CFR 890.1603(b)(b) For purposes of this subpart, a Postal Service employee includes a Postal Service employee who receives monthly compensation under 5 U.S.C. chapter 81, subchapter I (“compensationer”), who is determined by the Secretary of Labor to be unable to return to duty.

5 CFR 890.1603(c)(c) The following individuals may not enroll, or be covered under an enrollment, in this subpart:

5 CFR 890.1603(c)(1)(1) Any Postal Service Medicare covered annuitant who is not enrolled in Medicare Part B and is required to be enrolled in Medicare Part B, in accordance with § 890.1604;

5 CFR 890.1603(c)(2)(2) Any Medicare covered member of family of a Postal Service Medicare covered annuitant who is not enrolled in Medicare Part B and is required to be enrolled in Medicare Part B, in accordance with § 890.1604; or

5 CFR 890.1603(c)(3)(3) Any individual covered by an FEHB plan under this part, except as permitted by § 890.302(a)(2).

5 CFR 890.1603(d)(d) Former spouses of Postal Service employees and Postal Service annuitants may establish their eligibility to enroll under subpart H of this part. A former spouse of a Postal Service employee or Postal Service annuitant who is enrolled in an FEHB plan on or before December 31, 2024, may continue enrollment in an FEHB plan and is not required to enroll in a PSHB plan. A former spouse who is eligible under § 890.803(a)(2) because of their enrollment in a PSHB plan is not eligible to enroll or remain enrolled in a PSHB plan; they may enroll in an FEHB plan and, accordingly, the Medicare enrollment requirements in § 890.1604 would not apply.

5 CFR 890.1603(e)(e) Survivor annuitants have the same eligibility for reinstatement of enrollment as described in § 890.303(d) for enrollment in a PSHB plan or an FEHB plan as applicable to the service that gives rise to the survivor annuitant status, except that the Medicare enrollment requirements in § 890.1604 would apply to reinstatements of enrollment into a PSHB plan.

5 CFR 890.1603(f)(f) Individuals enrolled or covered under the PSHB Program are eligible to elect temporary continuation of coverage as provided under subpart K of this part.