Federal Employees Health Benefits Program; Miscellaneous Changes, 20314-20316 [2010-8957]

Agencies

• Office of Personnel Management
• Personnel Management Office

[Federal Register Volume 75, Number 74 (Monday, April 19, 2010)]
[Proposed Rules]
[Pages 20314-20316]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-8957]


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OFFICE OF PERSONNEL MANAGEMENT

5 CFR Parts 890 and 892

RIN 3206-AL95


Federal Employees Health Benefits Program; Miscellaneous Changes

AGENCY: U.S. Office of Personnel Management.

ACTION: Proposed rule.

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SUMMARY: The U.S. Office of Personnel Management is proposing to amend 
its regulations to provide for continuation of Federal Employees Health 
Benefits (FEHB) coverage for certain former Senate Restaurant employees 
who transferred to employment with a private contractor. We are also 
proposing to change the annual FEHB Program Open Season from the Monday 
of the second full workweek in November through the Monday of the 
second full workweek in December, to November 1st through November 30th 
of each year. We are also adding a new opportunity for eligible 
employees to enroll in the FEHB Program or to change enrollment from 
self only to self and family under the Children's Health Insurance 
Program Reauthorization Act of 2009. Finally, we are proposing to allow 
FEHB plans to offer three options, without the requirement that one of 
the options be a high deductible health plan.

DATES: OPM must receive comments on or before June 18, 2010.

ADDRESSES: Send written comments to Ronald L. Brown, Healthy Policy, 
Planning & Policy Analysis, Office of Personnel Management, 1900 E 
Street NW., Washington, DC 20415-3666; or deliver to OPM, Room 3425, 
1900 E Street NW., Washington, DC or FAX to (202) 606-0633.
    Comments may also be sent through the Federal eRulemaking Portal 
at: https://www.regulations.gov. All submissions received through the 
Portal must include the agency name and docket number or Regulation 
Identifier Number (RIN) for this rulemaking.

FOR FURTHER INFORMATION CONTACT: Ron Brown, (202) 606-0004, or e-mail 
at ronald.brown@opm.gov.

SUPPLEMENTARY INFORMATION:

Background

Senate Restaurants Employees

    Public Law 110-279, enacted July 17, 2008, provides for certain 
Federal employee benefits to be continued for certain employees of the 
Senate Restaurants after the operations of the Senate Restaurants are 
contracted to be performed by a private business concern. The law 
provides that a Senate Restaurants employee who was an employee of the 
Architect of the Capitol on the date of enactment and who accepted 
employment by the private business concern as part of the transition, 
may elect to continue Federal benefits during continuous employment 
with the business concern. We are proposing to conform the regulations 
to these provisions of Public Law 110-279.

Change in Dates of Open Season

    The current regulations provide for the FEHB Program Open Season to 
be held from the Monday of the second full workweek in November through 
the Monday of the second full workweek in December of each year. We are 
revising the regulations to change these dates to the month of 
November. Therefore, beginning in 2010, the Open Season dates will be 
November 1st through November 30th of each year. This will simplify the 
annual announcement of the time period for Open Season and allow 
agencies and employees to better plan for the enrollment opportunity 
since they will know well in advance when it will occur each year.

New Enrollment Opportunities

    Public Law 111-3, the Children's Health Insurance Program (CHIP) 
Reauthorization Act of 2009 (the Act), enacted on February 4, 2009, 
allows States to subsidize health insurance premium payments for 
certain low-income children who have access to qualified employer-
sponsored health insurance coverage. FEHB-eligible enrollees who meet 
the criteria for child health assistance are eligible to receive State 
premium subsidy assistance payments to help them pay for their FEHB 
plan premiums. Current FEHB Program regulations already allow an 
eligible enrollee who loses coverage under the FEHB Program or another 
group health plan, including loss of eligibility or assistance under 
Medicaid or CHIP, to enroll or change enrollment from self only to self 
and family within the period beginning 31 days before and ending 60 
days after the date of loss of coverage. The Act provides new 
opportunities for eligible employees to enroll in the FEHB Program or 
to change enrollment from self only to self and family when the 
employee or an eligible family member becomes eligible for premium 
assistance under CHIP. Employees must request the change in enrollment 
within 60 days after the date the employee or eligible family member is 
determined to be eligible for assistance. Employees may make these

[[Page 20315]]

enrollment changes regardless of whether they are covered under premium 
conversion (pay premiums with pre-tax dollars).

Change in Options Offered

    The current regulations state that an FEHB plan shall not have more 
than two options and a high deductible health plan. We are proposing to 
revise the regulations to allow employee organization plans and health 
maintenance organizations to both offer two options and a high 
deductible health plan or to offer three options, without the 
requirement that one of the options be a high deductible health plan. 
This will provide for more flexibility in contracting with health plans 
for modern types of benefits.

Regulatory Flexibility Act

    I certify that this regulation will not have a significant economic 
impact on a substantial number of small entities because the regulation 
only affects health insurance benefits of Federal employees and 
annuitants.

Executive Order 12866, Regulatory Review

    This rule has been reviewed by the Office of Management and Budget 
in accordance with Executive Order 12866.

Federalism

    We have examined this rule in accordance with Executive Order 
13132, Federalism, and have determined that this rule will not have any 
negative impact on the rights, roles, and responsibilities of State, 
local, or Tribal governments.

List of Subjects in 5 CFR Parts 890 and 892

    Administrative practice and procedure, Employee benefit plans, 
Government employees, Reporting and recordkeeping requirements, 
Retirement.

John Berry,
Director, U.S. Office of Personnel Management.
    Accordingly, OPM is proposing to amend 5 CFR parts 890 and 892 as 
follows:

PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM

    1. The authority citation for part 890 is revised to read as 
follows:

    Authority: 5 U.S.C. 8913; Sec.  890.301 also issued under sec. 
311 of Pub. L. 111-03, 123 Stat. 64; Sec.  890.111 also issued under 
section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec.  890.112 
also issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 
U.S.C. 8913; Sec.  890.803 also issued under 50 U.S.C. 403p, 22 
U.S.C. 4069c and 4069c-1; subpart L also issued under sec. 599C of 
Pub. L. 101-513, 104 Stat. 2064, as amended; Sec.  890.102 also 
issued under sections 11202(f), 11232(e), 11246 (b) and (c) of Pub. 
L. 105-33, 111 Stat. 251; and section 721 of Pub. L. 105-261, 112 
Stat. 2061.

Subpart A--Administration and General Provisions

    2. Add Sec.  890.112 to subpart A to read as follows:


Sec.  890.112  Continuation of coverage for certain Senate Restaurants 
employees.

    (a) A Senate Restaurants employee who was an employee of the 
Architect of the Capitol on July 17, 2008, who accepted employment with 
the private business concern to which the Senate Restaurants' food 
service operations were transferred as described in section 1 of Public 
Law 110-279, and who elected to continue his or her Federal employee 
retirement benefits is deemed to be an employee for purposes of this 
part during continuous employment with the private business concern or 
its successor. The individual shall be entitled to the benefits of, and 
be subject to all conditions under, the FEHB Program on the same basis 
as if the individual were an employee of the Federal Government.
    (b) Cessation of employment with the private business concern or 
its successor for any period terminates eligibility for coverage under 
the FEHB Program as an employee during any subsequent employment by the 
private business concern.
    (c) The private business concern or its successor must make 
arrangements for the withholding from pay of an individual described by 
paragraph (a) of this section of an amount equal to the premiums 
withheld from Federal employees' pay for FEHB coverage and, in 
accordance with procedures established by OPM, pay into the Employees 
Health Benefits Fund the amounts deducted from the individual's pay.
    (d) The private business concern or its successor shall, in 
accordance with procedures established by OPM, pay into the Employees 
Health Benefits Fund amounts equal to any agency contributions required 
under the FEHB Program.

Subpart B--Health Benefits Plans

    3. Revise Sec.  890.201(b)(3) to read as follows:


Sec.  890.201  Minimum standards for health benefits plans.

* * * * *
    (b) * * *
    (3)(i) Have more than two options and a high deductible health plan 
(26 U.S.C. 223(c)(2)(A)) if the plan is described under 5 U.S.C. 
8903(1) or (2); or
    (ii) Have either more than three options, or more than two options 
and a high deductible health plan (26 U.S.C. 223(c)(2)(A)) if the plan 
is described under 5 U.S.C. 8903(3) or (4).
* * * * *

Subpart C--Enrollment

    4. Amend Sec.  890.301 as follows:
    a. Revise paragraph (f)(1) to read as set forth below.
    b. Add a new paragraph (m) to read as set forth below.


Sec.  890.301  Opportunities for employees who are not participants in 
premium conversion to enroll or change enrollment; effective dates.

* * * * *
    (f) * * * (1) An open season will be held each year from November 
1st through November 30th.
* * * * *
    (m) An employee or eligible family member becomes eligible for 
premium assistance under Medicaid or a State Children's Health 
Insurance Program (CHIP). An eligible employee may enroll and an 
enrolled employee may change his or her enrollment from self only to 
self and family, from one plan or option to another, or make any 
combination of these changes when the employee or an eligible family 
member of the employee becomes eligible for premium assistance under a 
Medicaid plan or CHIP. An employee must enroll or change his or her 
enrollment within 60 days after the date the employee or family member 
is determined to be eligible for assistance.

PART 892--FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENT OF HEALTH 
BENEFITS PREMIUMS

    5. The authority citation for part 892 is revised to read as 
follows:

    Authority: 5 U.S.C 8913; 5 U.S.C. 1103(a)(7); 26 U.S.C. 125; 
Sec.  892.101 also issued under sec. 311 of Pub. L. 111-3, 123 Stat. 
64.

    6. In Sec.  892.101, amend the definition of qualifying life event 
by adding a new paragraph (13) to read as follows:


Sec.  892.101  Definitions.

* * * * *
    Qualifying life event * * *
    (13) An employee or eligible family member becomes eligible for 
premium assistance. An eligible employee may enroll and an enrolled 
employee may change his or her enrollment from self only to self and 
family, from one plan

[[Page 20316]]

or option to another, or make any combination of these changes when the 
employee or an eligible family member of the employee becomes eligible 
for premium assistance under a Medicaid plan or a State Children's 
Health Insurance Program. An employee must enroll or change his or her 
enrollment within 60 days after the date the employee or family member 
is determined to be eligible for assistance.

[FR Doc. 2010-8957 Filed 4-16-10; 8:45 am]
BILLING CODE 6325-39-P