If you’re planning to add a spouse or child to your Federal Employees Health Benefits (FEHB) coverage during the 2026 Open Season, don’t assume the enrollment process ends when you submit your election.
OPM is moving toward 100% verification of Open Season elections that add family members to FEHB and the Postal Service Health Benefits (PSHB) Program. That means employees should be prepared to provide documentation showing that anyone they’re adding is actually eligible for coverage.
What Is Changing?
OPM has been tightening its oversight of FEHB family-member eligibility for several years.
Under previous procedures, agencies were required to verify a sample of Open Season elections. For the 2025 Open Season, OPM required agencies to review at least 10% of Self Plus One and Self and Family elections and encouraged agencies to review 100%.
OPM’s 2026 guidance is preparing agencies for 100% verification of Open Season elections when a family member is added.
In other words, don’t treat the family-member portion of your Open Season election as a box you check and forget about.
What Documentation Might You Need?
The exact documentation depends on who you’re adding.
For a spouse, that generally means a government-issued marriage certificate. Children may require documentation such as a birth certificate, adoption documentation or other proof of the parent-child relationship.
Disabled children age 26 or older can also qualify if they meet specific requirements, including having a disability that began before age 26.
OPM also recognizes other situations, such as certain foster children and common-law marriages, that have their own documentation requirements.
What If You Can’t Prove Eligibility?
This is the part employees should pay attention to.
If an agency determines that the documentation doesn’t establish eligibility, the family member may not be covered. OPM’s existing procedures also provide a reconsideration process when an employing office determines that submitted documentation is insufficient.
For existing enrollments, agencies, carriers and OPM can also request verification of family-member eligibility at any time. If the requested documentation isn’t provided, the family member can be removed from coverage after the required notice period.
So this isn’t simply an Open Season paperwork issue. OPM is putting more emphasis on making sure the people receiving FEHB coverage actually qualify for it.
Don’t Wait Until Open Season
The 2026 Open Season is still months away, but there’s little reason to wait until November to start looking for documents.
If you’re planning to add a spouse or child, make sure you know where to find:
- Marriage documentation
- Birth or adoption records
- Foster-child documentation, if applicable
- Disability documentation for an adult child, if applicable
- Any additional documents your agency may require
OPM’s list of eligible family members is relatively specific: generally, coverage can include your spouse and children under 26, along with certain disabled adult children and qualifying foster children. Parents, siblings, and other relatives aren’t eligible simply because you claim them as dependents.
If you’re planning a family-member change for the 2026 Open Season, getting the paperwork together now could save you a scramble later.
