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OPM cracks down on who’s eligible for federal health benefits

The Office of Personnel Management, the agency that acts as the HR department for the federal government, is setting new compliance requirements for federal agencies to root out ineligible family members who obtain health insurance coverage.

More broadly, this is an effort years in the making, officials told Federal Times, but it also serves as a response to watchdog reports recently that have estimated up to $1 billion in improper payments to family members who “ride” on a federal employee’s plan.

Examples of this include mistakenly retaining a former spouse on one’s plan or forgetting to drop a child from coverage once they reach adulthood. One report from 2022 shows a federal employee unlawfully claimed two dependents as eligible for 12 years and received $100,000 in fraudulent claims.

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