C.F.R. » Title 5 » CHAPTER I—OFFICE OF PERSONNEL MANAGEMENT › SUBCHAPTER B—CIVIL SERVICE REGULATIONS › PART 870—FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM › Subpart A—Administration and General Provisions

5 C.F.R. § 870.104

Incontestability

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(a) If an individual erroneously becomes insured, the coverage will remain in effect if at least 2 years pass before the error is discovered, and if the individual has paid applicable premiums during that time. This applies to errors discovered on or after October 30, 1998, and applies only to employees, not retirees or compensationers.

(b) If an employee is erroneously allowed to continue insurance into retirement or while receiving compensation, the coverage will remain in effect if at least 2 years pass before the error is discovered, and if the annuitant or compensationer has paid applicable premiums during that time. This applies to such errors discovered on or after October 30, 1998.

(c) If an individual is erroneously enrolled in life insurance on or after the date he or she retires or begins receiving compensation, the coverage cannot remain in effect even if 2 years pass and the individual paid applicable premiums.

(d) If an individual who is allowed to continue erroneous coverage under this section does not want the coverage, he or she may cancel the coverage on a prospective basis, effective at the end of the pay period in which the waiver is properly filed. There is no refund of premiums. Exception: If an employee obtained Option C erroneously and did not have any eligible family members, that coverage may be cancelled retroactively and the insured will obtain a refund of the erroneous Option C premiums.

[75 FR 60576, Oct. 1, 2010]
Notes of Decisions
Cited in 3 cases (1 in the last 5 years), 1997–2021 · leading case: Metro. Life Ins. v. Bush, 154 F.3d 1149 (10th Cir. 1998).
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Metro. Life Ins. v. Bush, 154 F.3d 1149 (10th Cir. 1998). · cites it 5× “§ 8705 ; 5 C.F.R. § 870.104 (1995), the court concluded that the determination of OPM and OFEGLI that Ms.”
Smith v. Metro. Life Ins. Co. (N.D. Iowa 2021). · cites it 7× “5 C.F.R. § 870.104 (b). But if the individual is erroneously enrolled in life insurance “on or after the date [the individual] retires,” then the coverage cannot remain in effect.”
Metro. Life Ins. v. Bremer, 955 F. Supp. 1283 (D. Colo. 1997). “* * * * * * 5 C.F.R. § 870.104 , effective February 27, 1995, sets out definitions that govern, including the following: Employing office means the office of the agency or retirement system to which jurisdiction and responsibility for life insurance have been delegated.”
— 5 C.F.R. § 870.104(b) — 1 case
Smith v. Metro. Life Ins. Co. (N.D. Iowa 2021). “5 C.F.R. § 870.104 (b). But if the individual is erroneously enrolled in life insurance “on or after the date [the individual] retires,” then the coverage cannot remain in effect.”
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