Federal Long Term Care Insurance Program: Miscellaneous Changes, Corrections, and Clarifications, 12037-12038 [E7-4695]
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Federal Register / Vol. 72, No. 50 / Thursday, March 15, 2007 / Rules and Regulations
(2) The employee is separated or
placed in a leave without pay status
because of an on-the-job injury with
entitlement to injury compensation
under 5 U.S.C. chapter 81.
(g) The dollar value of compensatory
time off when it is liquidated is the
amount of overtime pay the employee
otherwise would have received for
hours of the pay period during which
compensatory time off was earned by
performing overtime work.
*
*
*
*
*
[FR Doc. E7–4696 Filed 3–14–07; 8:45 am]
BILLING CODE 6325–39–P
OFFICE OF PERSONNEL
MANAGEMENT
5 CFR Part 875
RIN 3206–AK99
Federal Long Term Care Insurance
Program: Miscellaneous Changes,
Corrections, and Clarifications
Office of Personnel
Management.
ACTION: Final regulation.
rmajette on PROD1PC67 with RULES
AGENCY:
SUMMARY: The Office of Personnel
Management (OPM) is issuing a final
rule to make miscellaneous changes,
corrections, and clarifications to the
Federal Long Term Care Insurance
Program (FLTCIP) regulations.
DATES: Effective Date: April 16, 2007.
FOR FURTHER INFORMATION CONTACT:
Edward M. DeHarde, Center for
Employee and Family Support Policy,
Strategic Human Resources Policy
Division, Office of Personnel
Management, 1900 E Street, NW.,
Washington, DC 20415; or call him at
202–606–0004.
SUPPLEMENTARY INFORMATION: The
current FLTCIP regulations were
published in the Federal Register at 70
FR 30605, May 27, 2005. In those
regulations OPM replaced references to
‘‘Federal civilian and Postal employees
and members of the uniformed services’’
with ‘‘active workforce member’’ in
several places. We are making a similar
change in two additional places:
§ 875.405 and § 875.410. We are also
correcting a section reference in
§ 875.209 of the previously published
regulations.
In addition, § 875.408 of the FLTCIP
regulations discusses incontestability, a
provision that allows coverage based on
an erroneous application to continue
under certain circumstances. The
FLTCIP contractor often doesn’t learn
that coverage is based on an erroneous
application until someone files a claim,
VerDate Aug<31>2005
16:47 Mar 14, 2007
Jkt 211001
and the contractor becomes aware that
the information on the individual’s
application differed from what is shown
in the individual’s medical records. If
the erroneous coverage has been in
effect less than two years, or if the
application contained knowingly false
or misleading information, the
contractor may rescind (void) the
coverage and refund the individual’s
premiums. Section 875.104 of the
FLTCIP regulations contains procedures
for resolving disputes concerning
eligibility for benefits and payment of
claims. These final regulations clarify
that the claims dispute procedures
apply only to persons who have valid
coverage under the Program. They do
not apply to individuals whose
erroneous coverage is rescinded.
A proposed rule was published to
amend 5 CFR part 875 in the Federal
Register at 71 FR 19459, April 14, 2006.
OPM requested comments by June 13,
2006. We received one comment by that
date, from an FLTCIP enrollee. The
issues raised by this commenter are
discussed below.
The commenter did not address the
miscellaneous changes, corrections, and
clarifications that were contained in the
proposed regulation. Instead, the
commenter suggested that OPM should
specifically list in the regulations which
injuries qualify for coverage under
FLTCIP to ensure that enrollees with
similar injuries receive similar coverage.
The comment received is beyond the
scope of the proposed change to FLTCIP
regulations. In addition, coverage under
FLTCIP is not based on an enrollee’s
injury or medical diagnosis; it is based
on an enrollee’s established inability to
perform defined activities of daily living
or an enrollee’s severe cognitive
impairment. Therefore, for the reasons
supplied in the proposed rule, the
proposed rule amending 5 CFR part 875
which was published in the Federal
Register at 71 FR 19459, April 14, 2006,
is adopted as a final rule without
change.
Executive Order 12866, Regulatory
Review
This rule has been reviewed by the
Office of Management and Budget in
accordance with Executive Order 12866.
Regulatory Flexibility Act
I certify that these regulations will not
have a significant economic impact on
a substantial number of small entities
because they affect only enrollees in the
Federal Long Term Care Insurance
Program.
PO 00000
Frm 00007
Fmt 4700
Sfmt 4700
12037
List of Subjects in 5 CFR Part 875
Administrative practices and
procedures, Employee benefit plans,
Government contracts, Government
employees, Health insurance, Military
personnel, Retirement.
Office of Personnel Management.
Linda M. Springer,
Director.
Accordingly, OPM is amending 5 CFR
part 875, as follows:
I
PART 875—FEDERAL LONG TERM
CARE INSURANCE PROGRAM
1. The authority citation for 5 CFR
part 875 continues to read as follows:
I
Authority: Authority: 5 U.S.C. 9008.
2. In § 875.104 add paragraph (f) to
read as follows:
I
§ 875.104 What are the steps required to
resolve a dispute involving benefit eligibility
or payment of a claim?
*
*
*
*
*
(f) The procedures described in
paragraphs (a), (b), (c), (d), and (e) of
this section apply only if you have valid
coverage under the FLTCIP. If the
Carrier determines that your coverage
was based on an erroneous application
and voids the coverage as described in
§ 875.408 of this part, these provisions
do not apply. The Carrier will provide
you with information on your review
rights in its rescission letter (letter
voiding your coverage).
3. In § 875.209 revise the last sentence
of paragraph (b) to read as follows:
I
§ 875.209 How do I demonstrate that I am
eligible to apply for coverage?
*
*
*
*
*
(b) * * * The incontestability
provisions in § 875.408 do not apply to
this section.
4. In § 875.405 revise the first
sentence of paragraph (a)(1) to read as
follows:
I
§ 875.405 If I marry, may my new spouse
apply for coverage?
(a)(1) If you are an active workforce
member and you have married, your
spouse is eligible to submit an
application for coverage under this
section within 60 days from the date of
your marriage and will be subject to the
underwriting requirements in force for
the spouses of active workforce
members during the most recent open
season. * * *
*
*
*
*
*
5. In § 875.408 revise paragraph (a) to
read as follows:
I
E:\FR\FM\15MRR1.SGM
15MRR1
12038
Federal Register / Vol. 72, No. 50 / Thursday, March 15, 2007 / Rules and Regulations
§ 875.408 What is the significance of
incontestability?
DEPARTMENT OF AGRICULTURE
(a) Incontestability means coverage
issued based on an erroneous
application may remain in effect. Such
coverage will not remain in effect under
any of the following conditions:
(1) If your coverage has been in force
for less than 6 months, the Carrier may
void your coverage upon a showing that
information on your signed application
that was material to your approval for
coverage is different from what is shown
in your medical records.
(2) If your coverage has been in force
for at least 6 months but less than 2
years, the Carrier may void your
coverage upon a showing that
information on your signed application
that was material to your approval for
coverage is different from what is shown
in your medical records and pertains to
the condition for which benefits are
sought.
(3) After your coverage has been in
effect for 2 years, the Carrier may void
your coverage only upon a showing that
you knowingly and intentionally made
a false or misleading statement or
omitted information in your signed
application for coverage regarding your
health status that was material to your
approval for coverage.
(4) If your coverage is voided, as
described in paragraph (a)(1), (a)(2), or
(a)(3) of this section, no claims will be
paid. In addition, the provisions of
§ 875.104 relating to the procedures for
resolving a dispute involving benefits
eligibility or claims denials do not apply
to your situation. You may request a
review by the Carrier if you believe that
your coverage was voided in error. You
must submit your request in writing to
the Carrier within 30 days of the date of
the rescission letter (letter voiding your
coverage).
*
*
*
*
*
Agricultural Marketing Service
6. In § 875.410 revise the first
sentence to read as follows:
I
rmajette on PROD1PC67 with RULES
§ 875.410 May I continue my coverage
when I leave Federal or military service?
If you are an active workforce
member, your coverage will
automatically continue when you leave
active service, as long as the Carrier
continues to receive the required
premium when due. * * *
[FR Doc. E7–4695 Filed 3–14–07; 8:45 am]
BILLING CODE 6325–39–P
7 CFR Parts 916 and 917
[Docket No. AMS–FV–06–0190; FV07–916/
917–2 FIR]
Nectarines and Peaches Grown in
California; Temporary Suspension of
Provisions Regarding Continuance
Referenda Under the Nectarine and
Peach Marketing Orders
Agricultural Marketing Service,
USDA.
ACTION: Final rule.
AGENCY:
SUMMARY: The Department of
Agriculture (USDA) is adopting, as a
final rule, without change, an interim
final rule temporarily suspending order
provisions that require continuance
referenda to be conducted for the
nectarine and peach marketing orders
during winter 2006–07. This rule
enables USDA to postpone conducting
the continuance referenda until the
industry has had sufficient time to
evaluate the effects of recent
amendments to the marketing orders.
Temporary suspension of the
continuance referenda should also
minimize confusion during the current
committee nomination period, which
overlaps with the scheduled referenda
period.
DATES:
Effective Date: April 16, 2007.
FOR FURTHER INFORMATION CONTACT:
Laurel May, Marketing Order
Administration Branch, Fruit and
Vegetable Programs, AMS, USDA, 1400
Independence Avenue SW, STOP 0237,
Washington, DC 20250–0237;
Telephone: (202) 720–2491, Fax: (202)
720–8938, or E-mail:
Laurel.May@usda.gov; or Kurt Kimmel,
Regional Manager, California Marketing
Field Office, Marketing Order
Administration Branch, Fruit and
Vegetable Programs, AMS, USDA, 2202
Monterey Street, Suite 102B, Fresno,
California 93721; Telephone: (559) 487–
5901, Fax: (559) 487–5906, or E-mail:
Kurt.Kimmel@usda.gov. The rule can be
viewed at https://www.regulations.gov.
Small businesses may request
information on complying with this
regulation by contacting Jay Guerber,
Marketing Order Administration
Branch, Fruit and Vegetable Programs,
AMS, USDA, 1400 Independence
Avenue SW., Stop 0237, Washington,
DC 20250–0237; Telephone: (202) 720–
2491, Fax: (202) 720–8938, or E-mail:
Jay.Guerber@usda.gov.
This rule
is issued under Marketing Order Nos.
SUPPLEMENTARY INFORMATION:
VerDate Aug<31>2005
14:08 Mar 14, 2007
Jkt 211001
PO 00000
Frm 00008
Fmt 4700
Sfmt 4700
916 and 917, both as amended (7 CFR
parts 916 and 917), regulating the
handling of nectarines and peaches
grown in California, respectively,
hereinafter referred to as the ‘‘orders.’’
The orders are effective under the
Agricultural Marketing Agreement Act
of 1937, as amended (7 U.S.C. 601–674),
hereinafter referred to as the ‘‘Act.’’
USDA is issuing this rule in
conformance with Executive Order
12866.
This rule has been reviewed under
Executive Order 12988, Civil Justice
Reform. This rule is not intended to
have retroactive effect. This rule will
not preempt any State or local laws,
regulations, or policies, unless they
present an irreconcilable conflict with
this rule.
The Act provides that administrative
proceedings must be exhausted before
parties may file suit in court. Under
section 608c(15)(A) of the Act, any
handler subject to an order may file
with USDA a petition stating that the
order, any provision of the order, or any
obligation imposed in connection with
the order is not in accordance with law
and request a modification of the order
or to be exempted therefrom. A handler
is afforded the opportunity for a hearing
on the petition. After the hearing, USDA
would rule on the petition. The Act
provides that the district court of the
United States in any district in which
the handler is an inhabitant, or has his
or her principal place of business, has
jurisdiction to review USDA’s ruling on
the petition, provided an action is filed
not later than 20 days after date of the
entry of the ruling.
This rule continues in effect the
action that temporarily suspends the
provisions in §§ 916.64(e) and 917.61(e)
of the orders, which specify when
continuance referenda should be
conducted to determine whether
growers favor continuance of the orders.
Temporary suspension of the provisions
for continuance referenda will provide
growers with more time to evaluate the
effects of recent amendments to the
orders before voting on continuance of
the marketing programs. Suspension of
the referenda requirements will also
diminish the confusion likely to occur
if the referenda are held during current
committee nominations. These actions
were unanimously recommended by the
Nectarine Administrative Committee
(NAC) and the Peach Commodity
Committee (PCC) (committees) at their
August 31, 2006, meetings.
Nectarines
Section 916.64(e) of the nectarine
marking order currently provides that
USDA shall conduct a continuance
E:\FR\FM\15MRR1.SGM
15MRR1
]]>Agencies
[Federal Register Volume 72, Number 50 (Thursday, March 15, 2007)]
[Rules and Regulations]
[Pages 12037-12038]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-4695]
-----------------------------------------------------------------------
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 875
RIN 3206-AK99
Federal Long Term Care Insurance Program: Miscellaneous Changes,
Corrections, and Clarifications
AGENCY: Office of Personnel Management.
ACTION: Final regulation.
-----------------------------------------------------------------------
SUMMARY: The Office of Personnel Management (OPM) is issuing a final
rule to make miscellaneous changes, corrections, and clarifications to
the Federal Long Term Care Insurance Program (FLTCIP) regulations.
DATES: Effective Date: April 16, 2007.
FOR FURTHER INFORMATION CONTACT: Edward M. DeHarde, Center for Employee
and Family Support Policy, Strategic Human Resources Policy Division,
Office of Personnel Management, 1900 E Street, NW., Washington, DC
20415; or call him at 202-606-0004.
SUPPLEMENTARY INFORMATION: The current FLTCIP regulations were
published in the Federal Register at 70 FR 30605, May 27, 2005. In
those regulations OPM replaced references to ``Federal civilian and
Postal employees and members of the uniformed services'' with ``active
workforce member'' in several places. We are making a similar change in
two additional places: Sec. 875.405 and Sec. 875.410. We are also
correcting a section reference in Sec. 875.209 of the previously
published regulations.
In addition, Sec. 875.408 of the FLTCIP regulations discusses
incontestability, a provision that allows coverage based on an
erroneous application to continue under certain circumstances. The
FLTCIP contractor often doesn't learn that coverage is based on an
erroneous application until someone files a claim, and the contractor
becomes aware that the information on the individual's application
differed from what is shown in the individual's medical records. If the
erroneous coverage has been in effect less than two years, or if the
application contained knowingly false or misleading information, the
contractor may rescind (void) the coverage and refund the individual's
premiums. Section 875.104 of the FLTCIP regulations contains procedures
for resolving disputes concerning eligibility for benefits and payment
of claims. These final regulations clarify that the claims dispute
procedures apply only to persons who have valid coverage under the
Program. They do not apply to individuals whose erroneous coverage is
rescinded.
A proposed rule was published to amend 5 CFR part 875 in the
Federal Register at 71 FR 19459, April 14, 2006. OPM requested comments
by June 13, 2006. We received one comment by that date, from an FLTCIP
enrollee. The issues raised by this commenter are discussed below.
The commenter did not address the miscellaneous changes,
corrections, and clarifications that were contained in the proposed
regulation. Instead, the commenter suggested that OPM should
specifically list in the regulations which injuries qualify for
coverage under FLTCIP to ensure that enrollees with similar injuries
receive similar coverage. The comment received is beyond the scope of
the proposed change to FLTCIP regulations. In addition, coverage under
FLTCIP is not based on an enrollee's injury or medical diagnosis; it is
based on an enrollee's established inability to perform defined
activities of daily living or an enrollee's severe cognitive
impairment. Therefore, for the reasons supplied in the proposed rule,
the proposed rule amending 5 CFR part 875 which was published in the
Federal Register at 71 FR 19459, April 14, 2006, is adopted as a final
rule without change.
Executive Order 12866, Regulatory Review
This rule has been reviewed by the Office of Management and Budget
in accordance with Executive Order 12866.
Regulatory Flexibility Act
I certify that these regulations will not have a significant
economic impact on a substantial number of small entities because they
affect only enrollees in the Federal Long Term Care Insurance Program.
List of Subjects in 5 CFR Part 875
Administrative practices and procedures, Employee benefit plans,
Government contracts, Government employees, Health insurance, Military
personnel, Retirement.
Office of Personnel Management.
Linda M. Springer,
Director.
0
Accordingly, OPM is amending 5 CFR part 875, as follows:
PART 875--FEDERAL LONG TERM CARE INSURANCE PROGRAM
0
1. The authority citation for 5 CFR part 875 continues to read as
follows:
Authority: Authority: 5 U.S.C. 9008.
0
2. In Sec. 875.104 add paragraph (f) to read as follows:
Sec. 875.104 What are the steps required to resolve a dispute
involving benefit eligibility or payment of a claim?
* * * * *
(f) The procedures described in paragraphs (a), (b), (c), (d), and
(e) of this section apply only if you have valid coverage under the
FLTCIP. If the Carrier determines that your coverage was based on an
erroneous application and voids the coverage as described in Sec.
875.408 of this part, these provisions do not apply. The Carrier will
provide you with information on your review rights in its rescission
letter (letter voiding your coverage).
0
3. In Sec. 875.209 revise the last sentence of paragraph (b) to read
as follows:
Sec. 875.209 How do I demonstrate that I am eligible to apply for
coverage?
* * * * *
(b) * * * The incontestability provisions in Sec. 875.408 do not
apply to this section.
0
4. In Sec. 875.405 revise the first sentence of paragraph (a)(1) to
read as follows:
Sec. 875.405 If I marry, may my new spouse apply for coverage?
(a)(1) If you are an active workforce member and you have married,
your spouse is eligible to submit an application for coverage under
this section within 60 days from the date of your marriage and will be
subject to the underwriting requirements in force for the spouses of
active workforce members during the most recent open season. * * *
* * * * *
0
5. In Sec. 875.408 revise paragraph (a) to read as follows:
[[Page 12038]]
Sec. 875.408 What is the significance of incontestability?
(a) Incontestability means coverage issued based on an erroneous
application may remain in effect. Such coverage will not remain in
effect under any of the following conditions:
(1) If your coverage has been in force for less than 6 months, the
Carrier may void your coverage upon a showing that information on your
signed application that was material to your approval for coverage is
different from what is shown in your medical records.
(2) If your coverage has been in force for at least 6 months but
less than 2 years, the Carrier may void your coverage upon a showing
that information on your signed application that was material to your
approval for coverage is different from what is shown in your medical
records and pertains to the condition for which benefits are sought.
(3) After your coverage has been in effect for 2 years, the Carrier
may void your coverage only upon a showing that you knowingly and
intentionally made a false or misleading statement or omitted
information in your signed application for coverage regarding your
health status that was material to your approval for coverage.
(4) If your coverage is voided, as described in paragraph (a)(1),
(a)(2), or (a)(3) of this section, no claims will be paid. In addition,
the provisions of Sec. 875.104 relating to the procedures for
resolving a dispute involving benefits eligibility or claims denials do
not apply to your situation. You may request a review by the Carrier if
you believe that your coverage was voided in error. You must submit
your request in writing to the Carrier within 30 days of the date of
the rescission letter (letter voiding your coverage).
* * * * *
0
6. In Sec. 875.410 revise the first sentence to read as follows:
Sec. 875.410 May I continue my coverage when I leave Federal or
military service?
If you are an active workforce member, your coverage will
automatically continue when you leave active service, as long as the
Carrier continues to receive the required premium when due. * * *
[FR Doc. E7-4695 Filed 3-14-07; 8:45 am]
BILLING CODE 6325-39-P
