Privacy Act of 1974; System of Records, 72902-72905 [2024-20061]

Agencies

• Office of Personnel Management

[Federal Register Volume 89, Number 173 (Friday, September 6, 2024)]
[Notices]
[Pages 72902-72905]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-20061]


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OFFICE OF PERSONNEL MANAGEMENT


Privacy Act of 1974; System of Records

AGENCY: U.S. Office of Personnel Management, Healthcare and Insurance.

ACTION: Notice of modified system of records.

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SUMMARY: In accordance with the Privacy Act of 1974, the Office of 
Personnel Management (OPM) proposes to modify the current system of 
records titled ``OPM/Central-23 FEHB Program Enrollment Records.'' This 
system of records contains information about enrollees and their family 
members, who are or have been covered under the Federal Employees 
Health Benefits (FEHB) Program. The modification is necessary to add 
categories of records and record source categories to the system of 
records based upon information exchange necessary to implement the 
Postal Service Health Benefits (PSHB) Program and meet requirements 
under the Postal Service Reform Act of 2022 (PSRA). The modification is 
also necessary to clarify in the Purposes section that references in 
the system of records to the ``FEHB Program'' or ``FEHB'' will 
encompass the PSHB Program, a separate program within the FEHB Program. 
In addition, OPM is taking this opportunity to clarify two existing 
routine uses and make a technical correction to the Administrative, 
Technical, and Physical Safeguards section. We have also updated the 
policies and practices for retention and disposal of records to reflect 
that a new schedule that will incorporate Postal Service records is 
currently under review by the National Archives and Records 
Administration (NARA).

DATES: Please submit comments on or before October 7, 2024. This new 
system is effective upon today's publication in the Federal Register, 
with the exception of new or modified routine uses, which are effective 
October 11, 2024.

ADDRESSES: You may submit written comments by one of the following 
methods:
     Federal Rulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. All submissions 
received must include the agency name and docket number for this 
Federal Register document. The general policy for comments and other 
submissions from members of the public is to make these submissions 
available for public viewing at https://www.regulations.gov as they are 
received without change, including any personal identifiers or contact 
information.
     Mail: Padma Babubhai Shah, Senior Policy Analyst, 
Healthcare and Insurance, Office of Personnel Management, Suite 3468, 
1900 E Street NW, Washington, DC 20415.

FOR FURTHER INFORMATION CONTACT: For general questions, please contact 
Padma Babubhai Shah, Senior Policy Analyst, 202-606-4056. For privacy 
questions, please contact Kirsten J. Moncada, Senior Agency Official 
for Privacy, [email protected].

SUPPLEMENTARY INFORMATION: In accordance with the Privacy Act of 1974, 
5 U.S.C. 552a, the Office of Personnel Management proposes to modify a 
system of records titled ``OPM/Central-23, FEHB Program Enrollment 
Records.'' This system of records supports OPM's administration of the 
Federal Employees Health Benefits (FEHB) Program and contains 
information about enrollees and their family members, who are or have 
been covered under the FEHB Program. The records are used for business 
processes related to eligibility verification, enrollment transactions, 
enrollment reconciliation, and premium collection; and to support the 
evaluation of the effectiveness of the FEHB Program through statistical 
analysis, policy planning, and reporting. To effectuate these purposes, 
OPM also uses contracts and interagency agreements.

[[Page 72903]]

    Established in 1960 through the Federal Employees Health Benefits 
Act of 1959, 5 U.S.C. 8901 et seq., the FEHB Program is the largest 
employer-sponsored group health insurance program in the world, 
covering over 8 million individuals. Covered individuals, as defined in 
5 CFR 890.101, include employees of the Federal government, annuitants, 
members of their families, former spouses, and miscellaneous groups, 
enumerated in 5 U.S.C. 8901; United States Postal Service employees and 
annuitants, pursuant to 39 U.S.C. 1005; tribal employees, pursuant to 
25 U.S.C. 1647b; and separated employees and former dependents who are 
eligible for Temporary Continuation of Coverage under 5 U.S.C. 8905a.
    Section 101 of the Postal Service Reform Act of 2022 (PSRA) added 
new section 8903c to chapter 89 of title 5, United States Code. The 
statute directs OPM to establish the Postal Service Health Benefits 
(PSHB) Program as a new, separate program within the FEHB Program. 
Beginning in 2025, Postal Service employees, Postal Service annuitants, 
and their eligible family members will obtain health benefits coverage 
through PSHB plans. Accordingly, OPM proposes to modify the Purpose 
section of this system of records notice to indicate that references to 
the ``FEHB Program'' or ``FEHB'' (e.g., FEHB enrollment code) include 
the ``PSHB Program'' or ``PSHB.'' Administrative actions associated 
with the launch of the PSHB Program will be required prior to January 
1, 2025. For this reason, upon the effective date of this notice, 
references to the ``FEHB Program'' or ``FEHB'' will include the ``PSHB 
Program'' or ``PSHB.''
    As part of implementing the PSHB Program, OPM will be required to 
exchange information with other federal agencies to determine whether 
certain Postal Service annuitants and their family members are subject 
to the requirement that they enroll in Medicare Part B to enroll or 
continue enrollment in a PSHB plan and, if so, whether they can 
establish one of the exceptions to this requirement. These requirements 
necessitate the addition of categories of records and record source 
categories to this system of records.
    Accordingly, OPM proposes to modify this system of records to add 
two categories of records: ``gg. Information related to enrollment in 
health care benefits provided by the Department of Veterans Affairs'' 
and ``hh. Information related to eligibility for health services from 
the Indian Health Service.'' These record categories are being added 
because the information in both categories may be collected to 
establish whether certain Postal Service annuitants and their family 
members can establish an exception to the Medicare Part B enrollment 
requirement in order to enroll or continue enrollment in a PSHB plan. 
In addition, OPM proposes to modify this system of records to expand 
record source categories to include the Social Security Administration 
and other federal agencies as information from other agencies may need 
to be collected to establish the eligibility of Postal Service 
employees, annuitants, and their family members to enroll or continue 
enrollment in a PSHB plan.
    A technical correction has been made to the ``ADMINISTRATIVE, 
TECHNICAL, AND PHYSICAL SAFEGUARDS'' section. Specifically, this 
section now clarifies that OPM security measures are in compliance with 
the both the Federal Information Security Modernization Act of 2002 and 
the Federal Information Security Modernization Act of 2014, which 
amended the 2002 law. Previously, there was a citation only to the 2014 
law. Additionally, previous routine uses (a) and (b) have been revised 
to more clearly describe the disclosures covered--the disclosures 
covered by previous routine use (a) will now be covered in routine uses 
(a) and (b); the disclosures covered by previous routine use (b) will 
now be covered in routine use (c). The original routine uses will 
receive a new letter designation to accommodate this change.
    The policies and practices for retention and disposal of records 
have been updated to reflect that a new schedule that will incorporate 
Postal Service records is currently under review.
    In accordance with 5 U.S.C. 552a(r), OPM has provided a report of 
this modified system of records to the Office of Management and Budget 
and to Congress. This modified system of records will be included in 
OPM's inventory of record systems.

    U.S. Office of Personnel Management.
Stephen D. Hickman,
Federal Register Liaison.

SYSTEM NAME AND NUMBER:
    FEHB Program Enrollment Records, OPM/Central-23

SECURITY CLASSIFICATION:
    Unclassified.

SYSTEM LOCATION:
    Healthcare and Insurance, Office of Personnel Management, 1900 E 
Street NW, Washington, DC 20415, is responsible for this system of 
records. The records are maintained at OPM's data center in Macon, 
Georgia, and through an interagency agreement with the U.S. Department 
of Agriculture's National Finance Center in New Orleans, Louisiana.

SYSTEM MANAGER(S):
    Associate Director, Healthcare and Insurance, Office of Personnel 
Management, 1900 E Street NW, Washington, DC 20415.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    5 U.S.C. chapter 89, Health Insurance; 25 U.S.C. 1647b, (Tribal) 
Access to Federal Insurance; 39 U.S.C. 1005, Applicability of Laws 
Relating to Federal Employees; and 5 CFR part 890.

PURPOSE(S) OF THE SYSTEM:
    The purpose of this system of records is to support the 
administration of the Federal Employees Health Benefits (FEHB) Program, 
including business processes related to eligibility verification, 
enrollment transactions, enrollment reconciliation, and premium 
collection; and to support the evaluation of the effectiveness of the 
FEHB Program through auditing, statistical analysis, policy planning, 
and reporting. To effectuate these purposes, OPM also uses contracts 
and interagency agreements. References to the ``FEHB Program'' or 
``FEHB'' encompass the Postal Service Health Benefits Program (``PSHB 
Program'' or ``PSHB''), a separate program within the FEHB Program.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    Enrollees (defined in 5 CFR 890.101) and their family members, who 
are or have been covered under the FEHB Program.

CATEGORIES OF RECORDS IN THE SYSTEM:
    a. Full name, including any former names;
    b. Social Security number, or other current or previous unique 
identification number(s);
    c. Date of birth;
    d. Date of death;
    e. Sex;
    f. Relationship code of any covered family member(s) to enrollee;
    g. Mailing address;
    h. Indicator for non-deliverable mailing address;
    i. Date mailing address information was last processed;
    j. Marital status;
    k. Email address;
    l. Enrollee's employment status;
    m. Enrollee's employing office, including name and Personnel Office 
Identifier;

[[Page 72904]]

    n. Enrollee's payroll office number;
    o. Event code indicating the qualifying life event which permitted 
enrollment, a change in enrollment, or enrollment cancellation;
    p. Transaction code indicating the most recent action that resulted 
in the creation or change of enrollment;
    q. Date enrollment record was processed;
    r. FEHB enrollment code, indicating plan, plan option, and 
enrollment type (Self Only, Self Plus One, or Self and Family);
    s. Group insurance account identifier;
    t. Effective date of FEHB coverage and any change in coverage;
    u. Agency payroll office effective date;
    v. Agency payroll office enrollment match code;
    w. Code indicating the reason a family member's eligibility became 
effective;
    x. End date of FEHB coverage, including possible 31-day extension;
    y. Reason code for FEHB coverage termination;
    z. Retirement claim number;
    aa. Date employee retired;
    bb. Date enrollee is reemployed by the Federal government;
    cc. Medicare status, forms of Medicare coverage, and Medicare 
Beneficiary Identifier (formerly Medicare Claim Number);
    dd. Other insurance, including name and policy number;
    ee. Information related to tribal bank accounts in which FEHB 
premiums are maintained for monthly withdrawal;
    ff. Information necessary to verify family member eligibility, 
including but not limited to marriage certificates, birth certificates, 
and other information as set forth in OPM guidance;
    gg. Information related to enrollment in health care benefits 
provided by the Department of Veterans Affairs; and
    hh. Information related to eligibility for health services from the 
Indian Health Service.

RECORD SOURCE CATEGORIES:
    Records are obtained from employing agencies and retirement 
systems, FEHB Carriers, shared service centers, the Centers for 
Medicare & Medicaid Services, the Social Security Administration and 
other federal agencies, Official Personnel Folders, retirement records 
and indirectly from individuals who participate in the FEHB Program. 
Note: With the establishment of this SORN, although enrollment records 
may continue to be maintained in other systems of records, Central-23 
becomes the official, first line source for enrollment records.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES 
OF USERS AND PURPOSES OF SUCH USES:
    In addition to those disclosures generally permitted under 5 U.S.C. 
552a(b) of the Privacy Act, all or a portion of the records or 
information contained in this system may be disclosed outside OPM as a 
routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
    a. In an appropriate proceeding before a court, grand jury, or 
administrative or adjudicative body, when OPM or another agency 
representing OPM determines that the records are relevant and necessary 
to the proceeding; or in an appropriate proceeding before an 
administrative or adjudicative body when the adjudicator determines the 
records to be relevant to the proceeding.
    b. To the Department of Justice when (a) OPM, or any component 
thereof; (b) any OPM employee in their official capacity; (c) any OPM 
employee in their individual capacity where the Department of Justice 
has agreed to represent the employee; or (d) the United States, where 
OPM determines that litigation is likely to affect OPM or any of its 
components, is a party to litigation or has an interest in such 
litigation, and the use of such records by the Department of Justice is 
deemed by OPM to be relevant and necessary to the litigation.
    c. Where a record, either alone or in conjunction with other 
information, indicates a violation or potential violation of law--
criminal, civil, or regulatory in nature--the relevant records may be 
referred to the appropriate federal, state, local, territorial, tribal, 
or foreign law enforcement authority or other appropriate entity 
charged with the responsibility for investigating or prosecuting such 
violation or charged with enforcing or implementing such law.
    d. To a member of Congress from the record of an individual in 
response to an inquiry made at the request of the individual to whom 
the record pertains.
    e. To the National Archives and Records Administration (NARA) for 
records management inspections being conducted under the authority of 
44 U.S.C. 2904 and 2906.
    f. To appropriate agencies, entities, and persons when (1) OPM 
suspects or has confirmed that there has been a breach of the system of 
records, (2) OPM has determined that as a result of the suspected or 
confirmed breach there is a risk of harm to individuals, OPM (including 
its information systems, programs, and operations), the Federal 
Government, or national security; and (3) the disclosure made to such 
agencies, entities, and persons is reasonably necessary to assist in 
connection with OPM's efforts to respond to the suspected or confirmed 
breach or to prevent, minimize, or remedy such harm.
    g. To another Federal agency or Federal entity, when OPM determines 
that information from this system of records is reasonably necessary to 
assist the recipient agency or entity in (1) responding to a suspected 
or confirmed breach or (2) preventing, minimizing, or remedying the 
risk of harm to individuals, the recipient agency or entity (including 
its information systems, programs, and operations), the Federal 
Government, or national security, resulting from a suspected or 
confirmed breach.
    h. To contractors, grantees, experts, consultants, or volunteers 
performing or working on a contract, service, grant, cooperative 
agreement, or other assignment for OPM when necessary to accomplish an 
agency function related to this system of records. Individuals provided 
information under this routine use are subject to the same Privacy Act 
requirements and limitations on disclosure as are applicable to OPM 
employees.
    i. To employing offices, shared service centers, and FEHB Carriers, 
information necessary to identify, reconcile, and audit enrollment in a 
plan; to verify eligibility for or coverage under the FEHB Program; to 
verify eligibility for payment of a claim for health benefits; and to 
carry out coordination of benefits.
    j. To any source, including employing offices, from which 
additional information is requested relevant to OPM determination on an 
individual's eligibility for or enrollment in the FEHB Program, to the 
extent necessary to identify the individual and the type of information 
requested.
    k. To an official of another Federal agency, information needed in 
the performance of official duties related to reconciling or 
reconstructing data files; compiling descriptive statistics; and/or 
making analytical studies to support the function for which the records 
were collected and maintained.
    l. To a spouse or dependent child (or court-appointed guardian 
thereof) of an FEHB enrollee whether the enrollee has made enrollment 
changes, including changing FEHB plans; cancelling or suspending FEHB 
enrollment; and changing from a Self and Family to a Self Plus One or 
Self Only health benefits enrollment, or from a Self Plus One to Self 
Only health benefits enrollment.

[[Page 72905]]

    m. To provide an official of another Federal agency information 
needed in the performance of official duties related to Federal 
employee health benefits counseling, customer service, or operational 
readiness.
    n. To the following recipients, information needed to conduct an 
analytical study of benefits being paid under the FEHB Program or the 
recipient's benefits program(s): Federal, State, or local agencies.
    o. To the following recipients, information needed to adjudicate a 
claim for benefits under the FEHB Program or the recipient's benefits 
program(s): Federal, State, or local agencies.
    p. To another Federal or non-Federal entity, information needed to 
verify enrollment information through the use of computer matching 
agreements under the Privacy Act of 1974, as amended (5 U.S.C. 552a).

POLICIES AND PRACTICES FOR STORAGE OF RECORDS:
    These records in this system of records are stored electronically 
on OPM's servers hosted at an OPM data center and at the U.S. 
Department of Agriculture's National Finance Center. Access to the 
electronic systems is restricted to authorized users with a need to 
know.

POLICIES AND PRACTICES FOR RETRIEVAL OF RECORDS:
    These records in this system of records are retrieved primarily by 
name and Social Security number but may be retrieved by any personal 
identifier.

POLICIES AND PRACTICES FOR RETENTION AND DISPOSAL OF RECORDS:
    The current records retention schedule, which covers health benefit 
enrollments, is numbered DAA-0478-2017-0006. A new schedule, which will 
also include PSHB records, is currently under review by NARA and will 
supersede the existing schedule. Until that occurs, all records not 
governed by DAA-0478-2017-0006 will be treated as permanent.

ADMINISTRATIVE, TECHNICAL, AND PHYSICAL SAFEGUARDS:
    Records in this system are protected from unauthorized access and 
misuse through various administrative, technical, and physical security 
measures. OPM security measures are in compliance with the Federal 
Information Security Modernization Act of 2002, as amended by the 
Federal Information Security Modernization Act of 2014, associated OMB 
policies, and applicable standards and guidance from the National 
Institute of Standards and Technology (NIST).

RECORD ACCESS PROCEDURES:
    Individuals seeking notification of and access to their records in 
this system of records may do so by submitting a request in writing to 
the Office of Personnel Management, Office of the Executive 
Secretariat, Privacy, and Information Management--FOIA, 1900 E Street 
NW, Washington, DC 20415-7900 or by emailing [email protected]; ATTN: 
Healthcare and Insurance. Individuals must furnish the following 
information for their records to be located:
    1. Full name, including any former name.
    2. Date of birth.
    3. Social Security Number.
    4. Name and address of employing agency or retirement system.
    5. Reasonable specification of the requested information.
    6. The address to which the information should be sent.
    7. Signature.
    Individuals requesting access must also comply with OPM's Privacy 
Act regulations regarding verification of identity and access to 
records (5 CFR part 297).
    Enrollees who request access to their records will have access to 
the entirety of their record, to include information about all covered 
individuals who are part of their enrollment record. Family members of 
the enrollee who request access to their records have access only to 
their own information and not to that of the enrollee or other covered 
family members.

CONTESTING RECORD PROCEDURES:
    Individuals wishing to request amendment of records about them may 
do so by writing to the Office of Personnel Management, Office of the 
Executive Secretariat, Privacy, and Information Management--FOIA, 1900 
E Street NW, Washington, DC 20415-7900 or by emailing [email protected]; 
ATTN: Healthcare and Insurance. Requests for amendment of records 
should include the words ``PRIVACY ACT AMENDMENT REQUEST'' in capital 
letters at the top of the request letter; if emailed include those 
words in the subject line. Individuals must furnish the following 
information for their records to be located:
    1. Full name, including any former name, and address.
    2. Date of birth.
    3. Social Security Number.
    4. Name and address of employing agency or retirement system.
    5. Precise identification of the information to be amended.
    6. Signature.
    Individuals requesting amendment must also comply with OPM's 
Privacy Act regulations regarding verification of identity and access 
to records (5 CFR part 297).
    OPM may refer amendment requests to employing agencies, retirement 
systems, and FEHB Carriers because they may be the ultimate source of 
FEHB enrollment records.

NOTIFICATION PROCEDURES:
    See ``Record Access Procedure.''

EXEMPTIONS PROMULGATED FOR THE SYSTEM:
    None.

HISTORY:
    OPM/Central-23, ``FEHB Program Enrollment Records, 86 FR 6377 
(January 21, 2021), 87 FR 5874 (February 2, 2022).''

[FR Doc. 2024-20061 Filed 9-5-24; 8:45 am]
BILLING CODE 6325-67-P