Federal Employees Health Benefits Program: Enrollment Options Following the Termination of a Plan or Plan Option, 929-931 [2014-30636]
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Federal Register / Vol. 80, No. 4 / Wednesday, January 7, 2015 / Proposed Rules
submitted cost or pricing data which
was incomplete, inaccurate, or
noncurrent; and
(3) Simple interest on the MLR
penalty from the date on which the
penalty should have been paid to the
FEHB Fund to the date on which the
penalty was or will be actually paid to
the FEHB fund. The interest rate shall
be calculated as specified in paragraph
(c)(1) of this clause.
■ 9. In 1652.216–70, revise paragraphs
(b)(2), (3), (7), and (8) to read as follows:
1652.216–70
adjustment.
Accounting and price
asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
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(b) * * *
(2) Effective January 1, 2013 all
community-rated plans must develop
the FEHBP’s rates using their State-filed
rating methodology or, if not required to
file with the State, their standard
written and established rating
methodology. A carrier who mandated
by the State to use traditional
community rating will be subject to
paragraph (b)(2)(ii) of this clause. All
other carriers will be subject to
paragraph (b)(2)(i) of this clause.
(i) The subscription rates agreed to in
this contract shall meet the FEHBspecific MLR threshold as defined in
FEHBAR 162.170–14. The ratio of a
plan’s incurred claims, including the
carrier’s expenditures for activities that
improve health care quality, to total
premium revenue shall not be lower
than the FEHB-specific MLR threshold
published annually by OPM in its rate
instructions.
(ii) The subscription rates agreed to in
this contract shall be equivalent to the
subscription rates given to the carrier’s
similarly sized subscriber group (SSSG)
as defined in FEHBAR 1602.170–13.
The subscription rates shall be
determined according to the carrier’s
established policy, which must be
applied consistently to the FEHBP and
to the carrier’s SSSG. If the SSSG
receives a rate lower than that
determined according to the carrier’s
established policy, it is considered a
discount. The FEHBP must receive a
discount equal to or greater than the
carrier’s SSSG discount.
(3) If subject to paragraph (b)(2)(ii) of
this clause, then:
(i) If, at the time of the rate
reconciliation, the subscription rates are
found to be lower than the equivalent
rates for the SSSG, the carrier may
include an adjustment to the Federal
group’s rates for the next contract
period, except as noted in paragraph
(b)(3)(iii) of this clause.
(ii) If, at the time of the rate
reconciliation, the subscription rates are
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17:45 Jan 06, 2015
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found to be higher than the equivalent
rates for the SSSG, the carrier shall
reimburse the Fund, for example, by
reducing the FEHB rates for the next
contract term to reflect the difference
between the estimated rates and the
rates which are derived using the
methodology of the SSSG, except as
noted in paragraph (b)(3)(iii) of this
clause.
(iii) Carriers may provide additional
guaranteed discounts to the FEHBP that
are not given to the SSSG. Any such
guaranteed discounts must be clearly
identified as guaranteed discounts. After
the beginning of the contract year for
which the rates are set, these guaranteed
FEHBP discounts may not be adjusted.
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(7) Carriers may provide additional
guaranteed discounts to the FEHBP.
Any such guaranteed discounts must be
clearly identified as guaranteed
discounts. After the beginning of the
contract year for which the rates are set,
these guaranteed FEHBP discounts may
not be adjusted.
(8) Carriers may not impose
surcharges (loadings not defined based
on an established rating method) on the
FEHBP subscription rates or use
surcharges in the rate reconciliation
process. If the carrier is subject to the
SSSG rules and imposes a surcharge on
the SSSG, the carrier cannot impose the
surcharge on FEHB.
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[FR Doc. 2014–30633 Filed 1–6–15; 8:45 am]
BILLING CODE 6325–63–P
OFFICE OF PERSONNEL
MANAGEMENT
5 CFR Part 890
RIN 3206–AN07
Federal Employees Health Benefits
Program: Enrollment Options
Following the Termination of a Plan or
Plan Option
Office of Personnel
Management.
ACTION: Proposed rule.
AGENCY:
The U.S. Office of Personnel
Management (OPM) is issuing a
proposed rule to amend the Federal
Employees Health Benefits (FEHB)
Program regulations regarding
enrollment options following the
termination of a plan or plan option.
DATES: OPM must receive comments on
or before March 9, 2015.
ADDRESSES: Send written comments to
Chelsea Ruediger, Planning and Policy
Analysis, U.S. Office of Personnel
SUMMARY:
PO 00000
Frm 00005
Fmt 4701
Sfmt 4702
929
Management, Room 4312, 1900 E Street
NW., Washington, DC 20415. You may
also submit comments using the Federal
eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
FOR FURTHER INFORMATION CONTACT:
Chelsea Ruediger at (202) 606–0004.
SUPPLEMENTARY INFORMATION: When a
plan or plan option in the Federal
Employees Health Benefits (FEHB)
Program terminates, OPM provides the
enrollees of that plan or plan option a
time period in which they may elect to
enroll in a new plan or plan option.
This proposed rule clarifies the actions
that OPM and employing agencies may
take when an enrollee fails to make an
enrollment election during the time
period provided.
Current regulation ends an
employee’s enrollment in the FEHB
Program if he or she fails to make an
enrollment election during the time
period provided by OPM following a
plan termination. This proposed
regulation amends 5 CFR 890.301 to
require the employing office to enroll
automatically these employees into the
lowest-cost nationwide plan option
based on the enrollee share of the cost
of a self only enrollment. Under the
proposed regulation, a plan will not be
considered the lowest-cost nationwide
plan option if it is a High Deductible
Health Plan (HDHP) or if it requires a
membership fee or an association fee.
For annuitants, current regulation
provides that individuals who fail to
make an enrollment election during the
time provided by OPM following a plan
termination shall be considered to be
enrolled in the option of the Blue Cross
and Blue Shield Service Benefit Plan
that OPM determines most closely
approximates the terminated plan. The
proposed regulation amends 5 CFR
890.306 to provide that these annuitants
will be enrolled into the lowest-cost
nationwide plan option that is available
to the individual based on the same
criteria listed above.
Current regulation provides that when
a plan discontinuation occurs due to a
disaster, employees and annuitants who
fail to make an enrollment election
within 60 days of the disaster, as
announced by OPM, shall be considered
to be enrolled in the Standard Option of
the Blue Cross and Blue Shield Service
Benefit Plan. The proposed rule amends
the regulation to provide that these
individuals will be enrolled into the
lowest-cost nationwide plan option that
is available to the individual based on
the same criteria listed above. It also
provides belated enrollment authority
for individuals who, for causes beyond
E:\FR\FM\07JAP2.SGM
07JAP2
930
Federal Register / Vol. 80, No. 4 / Wednesday, January 7, 2015 / Proposed Rules
their control, are unable to make
enrollment changes and are enrolled in
the lowest-cost nationwide plan.
Since 2004, OPM has allowed up to
three plan options under a plan. See 69
FR 31721. Accordingly, the proposed
rule also updates outdated language in
5 CFR 890.301 and 890.306 that
considers the termination of a plan
option under a plan with a total of only
two plan options. Under the proposed
rule, when two or more plan options
remain after a different plan option is
terminated, the employing office will
enroll the employee in the lowest-cost
remaining plan option that is not an
HDHP.
Conforming edits have been made to
5 CFR 890.806 for former spouses and
5 CFR 890.1108 for enrollees in
temporary continuation of coverage
status.
We are seeking comment on these
provisions.
OPM has reviewed this proposed rule
for PRA implications and have
determined that it does not apply to this
action.
Regulatory Impact Analysis
OPM has examined the impact of this
proposed rule as required by Executive
Order 12866 and Executive Order
13563, which directs agencies to assess
all costs and benefits of available
regulatory alternatives and, if regulation
is necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public, health, and
safety effects, distributive impacts, and
equity). A regulatory impact analysis
must be prepared for major rules with
economically significant effects of $100
million or more in any one year. After
completing this analysis, OPM has
determined that this rule is not
considered a major rule.
Regulatory Flexibility Act
asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
I certify that this regulation will not
have a significant economic impact on
a substantial number of small entities
because the regulation only impacts
options available for FEHB enrollees
when the plan or plan option in which
they are enrolled terminates.
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,
17:45 Jan 06, 2015
Jkt 235001
List of Subjects in 5 CFR Part 890
Administrative practice and
procedure, Government employees,
Health facilities, Health insurance,
Health professions, Hostages, Iraq,
Kuwait, Lebanon, Military personnel,
Reporting and recordkeeping
requirements, Retirement.
U.S. Office of Personnel Management.
Katherine Archuleta,
Director.
Accordingly, OPM proposes to amend
title 5, Code of Federal Regulations, part
890 as follows:
PART 890—FEDERAL EMPLOYEES
HEALTH BENEFITS PROGRAM
1. The authority citation for part 890
continues to read as follows:
■
Paperwork Reduction Act (PRA)
VerDate Sep<11>2014
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.
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; Pub. L. 111–148, as
amended by Pub. L. 111–152.
2. Amend § 890.301 by revising
paragraphs (i)(4)(ii), (iii), and (iv) and
adding paragraphs (i)(4)(v) and (n) to
read as follows:
■
§ 890.301 Opportunities for employees
who are not participants in premium
conversion to enroll or change enrollment;
effective dates.
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(i) * * *
(4) * * *
(ii) If the whole plan is discontinued,
an employee who does not change the
enrollment within the time set in
paragraph (i)(4)(i) of this section will be
enrolled in the lowest-cost nationwide
plan option, as defined in paragraph (n)
of this section;
(iii) If one or more options of a plan
are discontinued, an employee who
does not change the enrollment will be
enrolled in the remaining option of the
plan, or in the case of a plan with two
or more options remaining, the lowestcost remaining option that is not a High
Deductible Health Plan (HDHP).
(iv) If the discontinuance of the plan,
whether permanent or temporary, is due
PO 00000
Frm 00006
Fmt 4701
Sfmt 4702
to a disaster, an employee must change
the enrollment within 60 days of the
disaster, as announced by OPM. If an
employee does not change the
enrollment within the time frame
announced by OPM, the employee will
be enrolled in the lowest-cost
nationwide plan option, as defined in
paragraph (n) of this section. The
effective date of enrollment changes
under this provision will be set by OPM
when it makes the announcement
allowing such changes;
(v) An employee who is unable, for
causes beyond his or her control, to
make an enrollment change within the
60 days following a disaster and is, as
a result, enrolled in the lowest-cost
nationwide plan as defined in paragraph
(n) of this section, may request a belated
enrollment into the plan of his or her
choice subject to the requirements of
paragraph (c) of this section.
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(n) OPM will annually determine the
lowest-cost nationwide plan option
calculated based on the enrollee share of
the cost of a self only enrollment. The
plan option identified may not be a
High Deductible Health Plan (HDHP) or
an option from a health benefits plan
that charges an association or
membership fee.
■ 3. Amend § 890.306 by revising
paragraphs (l)(4)(ii), (iii), (iv), and (v)
and adding paragraph (l)(4)(vi) to read
as follows:
§ 890.306 When can annuitants or survivor
annuitants change enrollment or reenroll
and what are the effective dates?
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(l) * * *
(4) * * *
(ii) If a plan discontinues all of its
existing options, an annuitant who does
not change his or her enrollment is
deemed to have enrolled in the lowestcost nationwide plan option, as defined
in § 890.301(n); except when the
annuity is insufficient to pay the
withholdings, then paragraph (q) of this
section applies.
(iii) If one or more options of a plan
are discontinued, an annuitant who
does not change the enrollment will be
enrolled in the remaining option of the
plan, or in the case of a plan with two
or more options remaining, the lowestcost remaining option that is not a High
Deductible Health Plan (HDHP). In the
event that the annuity is insufficient to
pay the withholdings, then paragraph
(q) of this section applies;
(iv) After an involuntary enrollment
under paragraph (l)(4)(ii) or (iii) of this
section becomes effective, the annuitant
may change the enrollment to another
option of the plan into which he or she
E:\FR\FM\07JAP2.SGM
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Federal Register / Vol. 80, No. 4 / Wednesday, January 7, 2015 / Proposed Rules
was enrolled or another health plan of
his or her choice retroactively within
90-days after OPM advises the annuitant
of the new enrollment;
(v) If the discontinuance of the plan,
whether permanent or temporary, is due
to a disaster, an annuitant must change
the enrollment within 60 days of the
disaster, as announced by OPM. If an
annuitant does not change the
enrollment within the time frame
announced by OPM, the annuitant will
be enrolled in the lowest-cost
nationwide plan option, as defined in
§ 890.301(n). The effective date of
enrollment changes under this provision
will be set by OPM when it makes the
announcement allowing such changes;
(vi) An annuitant who is unable, for
causes beyond his or her control, to
make an enrollment change within the
60 days following a disaster and is, as
a result, enrolled in the lowest-cost
nationwide plan as defined in
§ 890.301(n), may request a belated
enrollment into the plan of his or her
choice subject to the requirements of
paragraph (c) of this section.
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■ 4. Amend § 890.806 by revising
paragraphs (j)(4)(ii), (iii), and (iv) and
adding paragraph (j)(4)(v) to read as
follows:
§ 890.806 When can former spouses
change enrollment or reenroll and what are
the effective dates?
asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
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(j) * * *
(4) * * *
(ii) If the whole plan is discontinued,
a former spouse who does not change
the enrollment within the time set will
be enrolled in the lowest-cost
nationwide plan option, as defined in
§ 890.301(n);
(iii) If one or more options of a plan
are discontinued, a former spouse who
does not change the enrollment will be
enrolled in the remaining option of the
plan, or in the case of a plan with two
or more options remaining, the lowestcost remaining option that is not a High
Deductible Health Plan (HDHP);
(iv) If the discontinuance of the plan,
whether permanent or temporary, is due
to a disaster, the former spouse must
change the enrollment within 60 days of
the disaster, as announced by OPM. If
a former spouse does not change the
enrollment within the time frame
announced by OPM, the former spouse
will be enrolled in the lowest-cost
nationwide plan option, as defined in
§ 890.301(n). The effective date of
enrollment changes under this provision
will be set by OPM when it makes the
announcement allowing such changes;
VerDate Sep<11>2014
17:45 Jan 06, 2015
Jkt 235001
(v) A former spouse who is unable, for
causes beyond his or her control, to
make an enrollment change within the
60 days following a disaster and is, as
a result, enrolled in the lowest-cost
nationwide plan as defined in
§ 890.301(n), may request a belated
enrollment into the plan of his or her
choice subject to the requirements of
paragraph (c) of this section.
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■ 5. Amend § 890.1108 by revising
paragraphs (h)(4)(ii), (iii), and (iv) and
adding paragraph (h)(4)(v) to read as
follows:
§ 890.1108 Opportunities to change
enrollment; effective dates.
*
*
*
*
*
(h) * * *
(4) * * *
(ii) If the whole plan is discontinued,
an enrollee who does not change the
enrollment within the time set will be
enrolled in the lowest-cost nationwide
plan option, as defined in § 890.301(n);
(iii) If one or more options of a plan
are discontinued, an enrollee who does
not change the enrollment will enrolled
in the remaining option of the plan, or
in the case of a plan with two or more
options remaining, the lowest-cost
remaining option that is not a High
Deductible Health Plan (HDHP);
(iv) If the discontinuance of the plan,
whether permanent or temporary, is due
to a disaster, the enrollee must change
the enrollment within 60 days of the
disaster, as announced by OPM. If the
enrollee does not change the enrollment
within the time frame announced by
OPM, the enrollee will be enrolled in
the lowest-cost nationwide plan option,
as defined in § 890.301(n). The effective
date of enrollment changes under this
provision will be set by OPM when it
makes the announcement allowing such
changes;
(v) An enrollee who is unable, for
causes beyond his or her control, to
make an enrollment change within the
60 days following a disaster and is, as
a result, enrolled in the lowest-cost
nationwide plan as defined in
§ 890.301(n), may request a belated
enrollment into the plan of his or her
choice subject to the requirements of
paragraph (c) of this section.
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[FR Doc. 2014–30636 Filed 1–6–15; 8:45 am]
BILLING CODE 6325–63–P
PO 00000
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931
OFFICE OF PERSONNEL
MANAGEMENT
5 CFR Part 890
RIN 3206–AN14
Federal Employees Health Benefits
Program; Subrogation and
Reimbursement Recovery
Office of Personnel
Management.
ACTION: Proposed rule.
AGENCY:
The United States Office of
Personnel Management (OPM) is issuing
a proposed rule to amend the Federal
Employees Health Benefits (FEHB)
Program regulations to clarify the
conditional nature of FEHB Program
benefits and benefit payments under the
plan’s coverage as subject to a carrier’s
entitlement to subrogation and
reimbursement recovery, and therefore,
that such entitlement falls within the
preemptive scope of the U.S.C. FEHB
contracts must include a provision
incorporating the carrier’s subrogation
and reimbursement rights and FEHB
plan brochures must explain the
carrier’s subrogation and reimbursement
policy.
DATES: Comments are due on or before
February 6, 2015.
ADDRESSES: Send written comments to
Marguerite Martel, Senior Policy
Analyst, Planning and Policy Analysis,
U.S. Office of Personnel Management,
Room 4312, 1900 E Street NW.,
Washington, DC; or FAX to (202) 606–
4640 Attn: Marguerite Martel. You may
also submit comments using the Federal
eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
FOR FURTHER INFORMATION CONTACT:
Marguerite Martel at Marguerite.Martel@
opm.gov or (202) 606–0004.
SUPPLEMENTARY INFORMATION: The FEHB
Act, as codified at 5 U.S.C. 8902(m)(1)
provides: ‘‘The terms of any contract
under this chapter which relate to the
nature, provision, or extent of coverage
or benefits (including payments with
respect to benefits) shall supersede and
preempt any State or local law, or any
regulation issued thereunder, which
relates to health insurance or plans.’’
This proposed regulation reaffirms that
a covered individual’s entitlement to
FEHB benefits and benefit payments is
conditioned upon, and limited by, a
carrier’s entitlement to subrogation and
reimbursement recoveries pursuant to a
subrogation or reimbursement clause in
the FEHB contract. This proposed
regulation also reaffirms that a FEHB
carrier’s rights and responsibilities
SUMMARY:
E:\FR\FM\07JAP2.SGM
07JAP2
]]>Agencies
[Federal Register Volume 80, Number 4 (Wednesday, January 7, 2015)]
[Proposed Rules]
[Pages 929-931]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-30636]
-----------------------------------------------------------------------
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN 3206-AN07
Federal Employees Health Benefits Program: Enrollment Options
Following the Termination of a Plan or Plan Option
AGENCY: Office of Personnel Management.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The U.S. Office of Personnel Management (OPM) is issuing a
proposed rule to amend the Federal Employees Health Benefits (FEHB)
Program regulations regarding enrollment options following the
termination of a plan or plan option.
DATES: OPM must receive comments on or before March 9, 2015.
ADDRESSES: Send written comments to Chelsea Ruediger, Planning and
Policy Analysis, U.S. Office of Personnel Management, Room 4312, 1900 E
Street NW., Washington, DC 20415. You may also submit comments using
the Federal eRulemaking Portal: https://www.regulations.gov. Follow the
instructions for submitting comments.
FOR FURTHER INFORMATION CONTACT: Chelsea Ruediger at (202) 606-0004.
SUPPLEMENTARY INFORMATION: When a plan or plan option in the Federal
Employees Health Benefits (FEHB) Program terminates, OPM provides the
enrollees of that plan or plan option a time period in which they may
elect to enroll in a new plan or plan option. This proposed rule
clarifies the actions that OPM and employing agencies may take when an
enrollee fails to make an enrollment election during the time period
provided.
Current regulation ends an employee's enrollment in the FEHB
Program if he or she fails to make an enrollment election during the
time period provided by OPM following a plan termination. This proposed
regulation amends 5 CFR 890.301 to require the employing office to
enroll automatically these employees into the lowest-cost nationwide
plan option based on the enrollee share of the cost of a self only
enrollment. Under the proposed regulation, a plan will not be
considered the lowest-cost nationwide plan option if it is a High
Deductible Health Plan (HDHP) or if it requires a membership fee or an
association fee.
For annuitants, current regulation provides that individuals who
fail to make an enrollment election during the time provided by OPM
following a plan termination shall be considered to be enrolled in the
option of the Blue Cross and Blue Shield Service Benefit Plan that OPM
determines most closely approximates the terminated plan. The proposed
regulation amends 5 CFR 890.306 to provide that these annuitants will
be enrolled into the lowest-cost nationwide plan option that is
available to the individual based on the same criteria listed above.
Current regulation provides that when a plan discontinuation occurs
due to a disaster, employees and annuitants who fail to make an
enrollment election within 60 days of the disaster, as announced by
OPM, shall be considered to be enrolled in the Standard Option of the
Blue Cross and Blue Shield Service Benefit Plan. The proposed rule
amends the regulation to provide that these individuals will be
enrolled into the lowest-cost nationwide plan option that is available
to the individual based on the same criteria listed above. It also
provides belated enrollment authority for individuals who, for causes
beyond
[[Page 930]]
their control, are unable to make enrollment changes and are enrolled
in the lowest-cost nationwide plan.
Since 2004, OPM has allowed up to three plan options under a plan.
See 69 FR 31721. Accordingly, the proposed rule also updates outdated
language in 5 CFR 890.301 and 890.306 that considers the termination of
a plan option under a plan with a total of only two plan options. Under
the proposed rule, when two or more plan options remain after a
different plan option is terminated, the employing office will enroll
the employee in the lowest-cost remaining plan option that is not an
HDHP.
Conforming edits have been made to 5 CFR 890.806 for former spouses
and 5 CFR 890.1108 for enrollees in temporary continuation of coverage
status.
We are seeking comment on these provisions.
Paperwork Reduction Act (PRA)
OPM has reviewed this proposed rule for PRA implications and have
determined that it does not apply to this action.
Regulatory Impact Analysis
OPM has examined the impact of this proposed rule as required by
Executive Order 12866 and Executive Order 13563, which directs agencies
to assess all costs and benefits of available regulatory alternatives
and, if regulation is necessary, to select regulatory approaches that
maximize net benefits (including potential economic, environmental,
public, health, and safety effects, distributive impacts, and equity).
A regulatory impact analysis must be prepared for major rules with
economically significant effects of $100 million or more in any one
year. After completing this analysis, OPM has determined that this rule
is not considered a major rule.
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 impacts options available for FEHB enrollees when the plan or plan
option in which they are enrolled terminates.
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 Part 890
Administrative practice and procedure, Government employees, Health
facilities, Health insurance, Health professions, Hostages, Iraq,
Kuwait, Lebanon, Military personnel, Reporting and recordkeeping
requirements, Retirement.
U.S. Office of Personnel Management.
Katherine Archuleta,
Director.
Accordingly, OPM proposes to amend title 5, Code of Federal
Regulations, part 890 as follows:
PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
0
1. The authority citation for part 890 continues 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;
Pub. L. 111-148, as amended by Pub. L. 111-152.
0
2. Amend Sec. 890.301 by revising paragraphs (i)(4)(ii), (iii), and
(iv) and adding paragraphs (i)(4)(v) and (n) to read as follows:
Sec. 890.301 Opportunities for employees who are not participants in
premium conversion to enroll or change enrollment; effective dates.
* * * * *
(i) * * *
(4) * * *
(ii) If the whole plan is discontinued, an employee who does not
change the enrollment within the time set in paragraph (i)(4)(i) of
this section will be enrolled in the lowest-cost nationwide plan
option, as defined in paragraph (n) of this section;
(iii) If one or more options of a plan are discontinued, an
employee who does not change the enrollment will be enrolled in the
remaining option of the plan, or in the case of a plan with two or more
options remaining, the lowest-cost remaining option that is not a High
Deductible Health Plan (HDHP).
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, an employee must change the enrollment
within 60 days of the disaster, as announced by OPM. If an employee
does not change the enrollment within the time frame announced by OPM,
the employee will be enrolled in the lowest-cost nationwide plan
option, as defined in paragraph (n) of this section. The effective date
of enrollment changes under this provision will be set by OPM when it
makes the announcement allowing such changes;
(v) An employee who is unable, for causes beyond his or her
control, to make an enrollment change within the 60 days following a
disaster and is, as a result, enrolled in the lowest-cost nationwide
plan as defined in paragraph (n) of this section, may request a belated
enrollment into the plan of his or her choice subject to the
requirements of paragraph (c) of this section.
* * * * *
(n) OPM will annually determine the lowest-cost nationwide plan
option calculated based on the enrollee share of the cost of a self
only enrollment. The plan option identified may not be a High
Deductible Health Plan (HDHP) or an option from a health benefits plan
that charges an association or membership fee.
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3. Amend Sec. 890.306 by revising paragraphs (l)(4)(ii), (iii), (iv),
and (v) and adding paragraph (l)(4)(vi) to read as follows:
Sec. 890.306 When can annuitants or survivor annuitants change
enrollment or reenroll and what are the effective dates?
* * * * *
(l) * * *
(4) * * *
(ii) If a plan discontinues all of its existing options, an
annuitant who does not change his or her enrollment is deemed to have
enrolled in the lowest-cost nationwide plan option, as defined in Sec.
890.301(n); except when the annuity is insufficient to pay the
withholdings, then paragraph (q) of this section applies.
(iii) If one or more options of a plan are discontinued, an
annuitant who does not change the enrollment will be enrolled in the
remaining option of the plan, or in the case of a plan with two or more
options remaining, the lowest-cost remaining option that is not a High
Deductible Health Plan (HDHP). In the event that the annuity is
insufficient to pay the withholdings, then paragraph (q) of this
section applies;
(iv) After an involuntary enrollment under paragraph (l)(4)(ii) or
(iii) of this section becomes effective, the annuitant may change the
enrollment to another option of the plan into which he or she
[[Page 931]]
was enrolled or another health plan of his or her choice retroactively
within 90-days after OPM advises the annuitant of the new enrollment;
(v) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, an annuitant must change the
enrollment within 60 days of the disaster, as announced by OPM. If an
annuitant does not change the enrollment within the time frame
announced by OPM, the annuitant will be enrolled in the lowest-cost
nationwide plan option, as defined in Sec. 890.301(n). The effective
date of enrollment changes under this provision will be set by OPM when
it makes the announcement allowing such changes;
(vi) An annuitant who is unable, for causes beyond his or her
control, to make an enrollment change within the 60 days following a
disaster and is, as a result, enrolled in the lowest-cost nationwide
plan as defined in Sec. 890.301(n), may request a belated enrollment
into the plan of his or her choice subject to the requirements of
paragraph (c) of this section.
* * * * *
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4. Amend Sec. 890.806 by revising paragraphs (j)(4)(ii), (iii), and
(iv) and adding paragraph (j)(4)(v) to read as follows:
Sec. 890.806 When can former spouses change enrollment or reenroll
and what are the effective dates?
* * * * *
(j) * * *
(4) * * *
(ii) If the whole plan is discontinued, a former spouse who does
not change the enrollment within the time set will be enrolled in the
lowest-cost nationwide plan option, as defined in Sec. 890.301(n);
(iii) If one or more options of a plan are discontinued, a former
spouse who does not change the enrollment will be enrolled in the
remaining option of the plan, or in the case of a plan with two or more
options remaining, the lowest-cost remaining option that is not a High
Deductible Health Plan (HDHP);
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, the former spouse must change the
enrollment within 60 days of the disaster, as announced by OPM. If a
former spouse does not change the enrollment within the time frame
announced by OPM, the former spouse will be enrolled in the lowest-cost
nationwide plan option, as defined in Sec. 890.301(n). The effective
date of enrollment changes under this provision will be set by OPM when
it makes the announcement allowing such changes;
(v) A former spouse who is unable, for causes beyond his or her
control, to make an enrollment change within the 60 days following a
disaster and is, as a result, enrolled in the lowest-cost nationwide
plan as defined in Sec. 890.301(n), may request a belated enrollment
into the plan of his or her choice subject to the requirements of
paragraph (c) of this section.
* * * * *
0
5. Amend Sec. 890.1108 by revising paragraphs (h)(4)(ii), (iii), and
(iv) and adding paragraph (h)(4)(v) to read as follows:
Sec. 890.1108 Opportunities to change enrollment; effective dates.
* * * * *
(h) * * *
(4) * * *
(ii) If the whole plan is discontinued, an enrollee who does not
change the enrollment within the time set will be enrolled in the
lowest-cost nationwide plan option, as defined in Sec. 890.301(n);
(iii) If one or more options of a plan are discontinued, an
enrollee who does not change the enrollment will enrolled in the
remaining option of the plan, or in the case of a plan with two or more
options remaining, the lowest-cost remaining option that is not a High
Deductible Health Plan (HDHP);
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, the enrollee must change the
enrollment within 60 days of the disaster, as announced by OPM. If the
enrollee does not change the enrollment within the time frame announced
by OPM, the enrollee will be enrolled in the lowest-cost nationwide
plan option, as defined in Sec. 890.301(n). The effective date of
enrollment changes under this provision will be set by OPM when it
makes the announcement allowing such changes;
(v) An enrollee who is unable, for causes beyond his or her
control, to make an enrollment change within the 60 days following a
disaster and is, as a result, enrolled in the lowest-cost nationwide
plan as defined in Sec. 890.301(n), may request a belated enrollment
into the plan of his or her choice subject to the requirements of
paragraph (c) of this section.
* * * * *
[FR Doc. 2014-30636 Filed 1-6-15; 8:45 am]
BILLING CODE 6325-63-P
