80_FR_55906 80 FR 55726 - Federal Employees Health Benefits Program Self Plus One Enrollment Type

80 FR 55726 - Federal Employees Health Benefits Program Self Plus One Enrollment Type

OFFICE OF PERSONNEL MANAGEMENT

Federal Register Volume 80, Issue 180 (September 17, 2015)

Page Range55726-55739
FR Document2015-23348

The United States Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations to add an additional enrollment type called ``self plus one'' for premium rating and family member eligibility purposes.

Federal Register, Volume 80 Issue 180 (Thursday, September 17, 2015)
[Federal Register Volume 80, Number 180 (Thursday, September 17, 2015)]
[Rules and Regulations]
[Pages 55726-55739]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-23348]


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OFFICE OF PERSONNEL MANAGEMENT

5 CFR Parts 890 and 892

RIN 3206-AN08


Federal Employees Health Benefits Program Self Plus One 
Enrollment Type

AGENCY: Office of Personnel Management.

ACTION: Final rule.

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SUMMARY: The United States Office of Personnel Management (OPM) is 
issuing a final rule to amend the Federal Employees Health Benefits 
(FEHB) Program regulations to add an additional enrollment type called 
``self plus one'' for premium rating and family member eligibility 
purposes.

DATES: This rule is effective September 17, 2015.

FOR FURTHER INFORMATION CONTACT: Chelsea Ruediger at 
[email protected] or (202) 606-0004.

SUPPLEMENTARY INFORMATION: The U.S. Office of Personnel Management 
(OPM) issued a Notice of Proposed Rulemaking on December 2, 2014 to 
amend title 5 of the Code of Federal Regulations parts 890 and 892 to 
include a self plus one enrollment type to comply with the 2013 
Bipartisan Budget Act. During the comment period on the proposed rule, 
OPM received 64 comments including 5 from Federal Employees Health 
Benefits (FEHB) Program carriers, 2 from employee organizations or 
unions, 1 from a carrier organization, and 56 from individuals, many of 
them enrollees in the FEHB Program. These comments are addressed below.

[[Page 55727]]

General Comments Regarding Self Plus One

    OPM received a variety of comments, mostly from FEHB enrollees, 
expressing excitement about the self plus one enrollment type. 
Commenters indicated that the enrollment type will benefit them 
personally and financially.
    One commenter requested justification for the implementation of the 
self plus one enrollment type and expressed concern over the level of 
complexity that this additional statutorily required enrollment type 
introduces to consumer choice in the FEHB Program. The commenter noted 
that under the current two-tier system, ``the typical enrollee . . . 
has a choice of about 20 plan options'' and projected that options 
available for families may double and premiums might vary greatly.
    OPM is updating 5 CFR parts 890 and 892 to comply with provisions 
of the 2013 Bipartisan Budget Act. This more closely aligns insurance 
offerings for Federal employees with those available in the commercial 
market and to more equitably spread costs among the enrollment types 
offered.
    OPM is aware that creation of a new enrollment tier may create 
additional complexity. However, this complexity is limited because the 
rule only introduces a new enrollment type. Benefits design will not 
differ from other enrollment types offered within the same plan option, 
which minimizes the complexity introduced by the rule. To alleviate 
potential concerns about complexity during the introductory year, Sec.  
892.207(d) has been amended in this final rule to include a one-time 
limited enrollment period to be held in early 2016. Final dates for the 
Limited Enrollment Period will be announced by OPM following the 
publication of this rule. During this period, enrollees will be allowed 
to decrease enrollment from self and family to self plus one. 
Enrollment changes made in conjunction with the limited enrollment 
period will be effective on the first day of the first pay period 
following the one in which the appropriate request is received by the 
employing office. Because enrollees who do not participate in premium 
conversion (pre-tax deduction of premiums), including annuitants, may 
decrease their enrollment at any time, this limited enrollment period 
is intended only for premium conversion participants. No new 
enrollments, changes in plan or plan option, or increases in enrollment 
will be allowed in conjunction with the limited enrollment period.
    In advance of Open Season each year, OPM, agencies and carriers 
inform employees and annuitants of their enrollment options and provide 
them with decision-making tools. Given the addition of the self plus 
one enrollment type, this communications strategy will be augmented for 
the 2015 Open Season. OPM communications will encourage enrollees to 
carefully review the options available to them for plan year 2016.
    An FEHB carrier requested clarification that ``enrollees will need 
to make a positive election through their agency or retirement office 
in order to switch from self only or self and family to self plus 
one.'' This statement is correct. Just as is the case under the current 
two-tier system, enrollees must inform their agency, either through an 
electronic or paper copy of the Standard Form 2809, when they increase 
or decrease coverage. Agencies are responsible for submitting this 
information to carriers. This requirement will be no different for self 
plus one.

Comments on Effective Dates

    Several commenters requested additional information about the 
timing of the implementation of the self plus one enrollment type. 
Others requested that OPM delay implementation by at least one year in 
order to conduct additional analysis. Another questioned the decision 
to implement the new self plus one enrollment option for plan year 
2016, as this date was not required by law.
    The effective date in this final rule has not been altered. The 
Bipartisan Budget Act was passed in 2013 and OPM has been working 
diligently to implement this statutory mandate within a reasonable 
timeframe. Enrollees who have been looking forward to this change will 
now be able to select a self plus one enrollment type during the 2015 
Open Season for effective dates in January of 2016.

Comments on Family Member Eligibility

    OPM received three comments about family member eligibility. Two 
commenters asked about the eligibility of domestic partners and 
cohabitating (unmarried) opposite sex couples. A third comment asked if 
a sibling could be covered.
    Family member eligibility is defined in title 5 U.S. Code section 
8901 and includes spouses and children up to age 26. As stated in the 
supplementary information of the proposed rule, family member 
eligibility guidelines remain the same as in place under the two tier 
system. Domestic partners, cohabitating (unmarried) couples, and 
siblings are not considered eligible family members under the law at 
this time.

Switching a Covered Family Member

    The proposed rule outlined the circumstances in which an enrollee 
with a self plus one enrollment would be allowed to switch their 
covered family member. Some commenters expressed concerns that these 
provisions might lead to adverse selection. OPM believes that adequate 
protection against adverse selection is provided in the manner in which 
Qualifying Life Events (QLEs) allowing such a change have been limited. 
Further, the general rule applies that the change must be consistent 
with the QLE experienced. The following chart, which was published with 
the proposed rule, clarifies which QLE codes will allow an enrollee to 
switch a covered family member outside of Open Season (definitions for 
each of the event codes can be found on the SF2809 at http://www.opm.gov/forms/pdf_fill/sf2809.pdf):

------------------------------------------------------------------------
                                           Permitted for the following
                 Change                            event codes
------------------------------------------------------------------------
            For Enrollees Participating in Premium Conversion
------------------------------------------------------------------------
Switch covered family member under a     1B, 1C, 1I, 1J, 1M, 1N, 1O, 1P,
 self plus one enrollment.                1Q, 1R
------------------------------------------------------------------------
  For Annuitants (decreases in enrollment type are allowed at any time)
------------------------------------------------------------------------
Switch covered family member under a     2A, 2B, 2F, 2G, 2H, 2I, 2J
 self plus one enrollment.
------------------------------------------------------------------------
   For Former Spouses Under the Spouse Equity Provision (decreases in
                enrollment type are allowed at any time)
------------------------------------------------------------------------
Switch covered family member under a     3B, 3C, 3F, 3G, 3H, 3I
 self plus one enrollment.
------------------------------------------------------------------------

[[Page 55728]]

 
    For Temporary Continuation of Coverage (TCC) for Eligible Former
  Employees, Former Spouses, and Children (decreases in enrollment type
                        are allowed at any time)
------------------------------------------------------------------------
Switch covered family member under a     4B, 4C, 4D, 4F, 4G, 4H
 self plus one enrollment.
------------------------------------------------------------------------
   For Employees Not Participating in Premium Conversion (decreases in
                enrollment type are allowed at any time)
------------------------------------------------------------------------
Switch covered family member under a     5B, 5C, 5F, 5G, 5H, 5I, 5J, 5N
 self plus one enrollment.
------------------------------------------------------------------------

    One carrier organization requested that OPM require a 30 day 
advance notice to carriers before allowing a switch in covered family 
member in order to prevent overpayments as well as verification of 
alternative health insurance for the family member being removed. OPM 
declines to make this change. It is expected that carriers will utilize 
current standard operating procedures to process the switching of a 
covered family member; generally changes are effective at the beginning 
of the next pay period after receipt by the agency.
    A commenter urged OPM to treat the switch as a cancellation for the 
family member who is being removed from the self plus one enrollment, 
thereby rendering the individual ineligible for the 31 day extension of 
coverage. Just as is the case under the two tier system, under Sec.  
890.401(a)(1) eligibility for the 31 day extension of coverage is 
provided for covered family members whose coverage is terminated other 
than by cancellation of the enrollment or discontinuance of the plan, 
in whole or in part. For family members, terminations are typically 
based on a loss of eligibility such as, in the case of a child, turning 
age 26; or, in the case of a spouse, a divorce. Cancellation is 
typically a voluntary election to no longer be covered under an FEHB 
plan, for example when a family member becomes eligible for other group 
coverage. Switching a covered family member may occur as the result of 
either a termination or a cancellation. Therefore, OPM declines to make 
this change.
    One commenter urged OPM to apply a blanket policy against 
discretionary retroactive switching of a covered family member. Section 
892.207(b) has been updated in the final rule to include switching a 
covered family member in order to accommodate this suggestion. 
Enrollment changes made under Sec.  892.207 are, in general, effective 
on the first day of the first pay period following the one in which the 
appropriate request is received by the employing office. In addition, 
paragraph (f)(2) has been added to Sec.  890.302 in the final rule to 
specify that the effective date for switching a covered family member 
will be prospective. A definition of the term ``switching a covered 
family member'' has also been added to Sec.  890.101.
    One commenter requested that OPM clarify that ``enrollees cannot 
switch the covered family member under the self plus one without a QLE 
to validate dependent eligibility.'' As described in the proposed rule, 
and supported in the final rule, enrollees must experience a QLE in 
order to switch their covered family member.
    One commenter requested additional information about how carriers 
will be notified of the designated covered family member under the self 
plus one enrollment. The Standard Form 2809 and electronic enrollment 
transmissions will be utilized just as they are currently to 
communicate enrollment information. Additionally, OPM is assessing 
other methods, including updating enrollment systems government-wide to 
allow for the transmittal of changes in the designated family member 
from agencies to carriers.
    One commenter asked that OPM require the capture of a Social 
Security Number for dependents. As this is outside the scope of this 
rule, we decline to comment at this time.

Qualifying Life Events (QLE)

    One commenter requested that OPM clarify whether or not enrollees 
must experience a QLE in order to decrease enrollment outside of Open 
Season. Under Sec.  892.208, enrollees who participate in premium 
conversion must experience a QLE in order to decrease enrollment 
outside of Open Season. Under Sec.  890.301(e), enrollees who do not 
participate in premium conversion may decrease enrollment at any time. 
This final rule has not altered these requirements.
    Another commenter requested that OPM clarify that ``retired federal 
employees/annuitants will have the option to change plans and/or 
enrollment types upon retirement, regardless of Medicare eligibility or 
age at the time of retirement.''
    Retirement is not a QLE and therefore no changes may be made based 
solely on retirement. Retirement is a change from one payroll office to 
another. After an individual is retired, under the provisions in Sec.  
890.301(e), they may decrease enrollment or cancel coverage at any 
time. QLEs are still required for increasing coverage or changing plans 
outside of Open Season.
    It was requested that OPM clarify the process for handling an 
annuitant who, upon experiencing the death of her spouse, forgets to 
decrease her enrollment to self only. As this question is beyond the 
scope of this regulation, OPM declines to comment at this time.
    Additional guidance was requested regarding carrier 
responsibilities to notify enrollees and agencies when a family member 
has aged out of eligibility or passed away. OPM encourages carriers to 
contact their enrollees when a child ages out or if they learn of the 
death of a covered family member in order to inform the enrollee of 
their QLE opportunity at that time.

Alternative Enrollment Types

    Four commenters suggested alternative enrollment types. One 
commenter suggested that OPM provide rates based on the number of 
family members enrolled. Another suggested an enrollment type available 
to only those enrolled in both FEHB and Medicare. A third commenter 
suggested that, instead of self plus one, OPM alter eligibility 
guidelines to allow spouses and dependents to enroll in their own right 
in self only enrollments. Finally, an FEHB carrier commented that OPM 
should implement a four-tier system: Self only, employee and spouse, 
employee and one non-spousal family member, and self and family. 
Commenters urged OPM to consider methods for encouraging or requiring 
Medicare enrollment. One suggested that OPM should consider reducing 
premiums for annuitants enrolled in Medicare as FEHB is the secondary 
payer. Another expressed concerns that the addition of the self plus 
one enrollment type would exacerbate an existing problem in which 
younger

[[Page 55729]]

enrollees subsidize higher cost annuitants.
    OPM is unable to implement these suggested changes. The FEHB 
statute only allows the following enrollment types: Self only, self 
plus one, and self and family. Any other enrollment types, including 
separate enrollment tiers for individuals enrolled in Medicare, would 
require legislative change.

Definition of Self Plus One

    OPM received four comments indicating that the definition of self 
plus one in the proposed rule, which does not preclude an individual 
with only one eligible family member from enrolling in self and family, 
has potentially negative consequences. These commenters indicated the 
definition, coupled with concerns that self plus one premiums and/or 
enrollee shares may rise above self and family premiums and/or enrollee 
shares, could result in revenue shortfall for carriers. They predicted 
that some consumers with only one eligible family member will likely 
select a self and family enrollment if the enrollee share is lower, 
leading to a financial loss for plans with higher claims costs for self 
plus one enrollments.
    Individual choice is, and always has been, one of the hallmarks of 
the FEHB Program. Before the addition of the self plus one enrollment 
type, individuals have been free to select a self only or self and 
family enrollment, regardless of whether or not they have eligible 
family members. In that tradition, the final rule adopts the proposed 
rule's provision, providing individuals the freedom to select among all 
three enrollment types available, regardless of the number of their 
eligible family members.
    One commenter requested that OPM use this opportunity to expressly 
state that all eligible family members are covered under a self and 
family enrollment. Current regulatory language, which has not been 
altered in this rule, already adequately expresses this. Section 
890.302(a)(1) states that an enrollment for self and family includes 
all family member who are eligible to be covered by the enrollment. 
Further, the definition of self and family, as added by this final rule 
states that self and family enrollment means an enrollment that covers 
the enrollee and all eligible family members.

Government Contribution Calculations

    The government contribution to premium is calculated based on 
weighted average of the subscription charges described in 5 U.S. Code 
section 8906. One commenter points out that most carriers are unable to 
predict the government contribution for their plans because they do not 
cover an adequate portion of the total market to estimate actual FEHB 
enrollment to determine the weighted average. Thus, many plans propose 
total premiums to OPM without a complete understanding of what the 
government and enrollee contributions will be, putting them at a 
disadvantage in a competitive market. Given the additional uncertainty 
for plan year 2016, with the addition of the self plus one enrollment 
type, the commenter requested that OPM provide carriers more 
flexibility to adjust final premium rates during the negotiation 
process after the government contribution has been calculated. OPM will 
adhere to standard operating procedures for plan year 2016 final rate 
negotiations.
    An FEHB carrier requested that OPM provide additional information 
to carriers concerning rate setting for plan year 2016. In addition, 
they cautioned OPM against applying the same government contribution 
for both self plus one and self and family enrollments for plan year 
2016 as this method might lead to increased ``unpredictability of which 
subscribers will choose which tier.'' Many commenters requested 
additional information about the weighted averages that would be used 
to determine the government contribution for plan year 2016.
    The 2013 Bipartisan Budget Act provides OPM with flexibility in the 
first year that self plus one is offered to ``determine the weighted 
average of the subscription charges that will be in effect for the 
contract year for enrollments for self plus one under such chapter 
based on an actuarial analysis.'' \1\ The weighted average is used to 
calculate the Government contribution, according to a formula set in 
statute (5 U.S.C. 8906). OPM takes a count of enrollments with 
Government contributions in March of each year (referred to in the 
following paragraphs as the ``March enrollment count''). This March 
enrollment count is used to determine the maximum Government 
contribution for the following plan year. For each enrollment type, OPM 
sums the product of the new premium and the March enrollment count for 
each option and divides the sum by the total number of individuals 
enrolled in that enrollment type.
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    \1\ Full text available at http://www.thefederalregister.org/fdsys/pkg/BILLS-113hjres59enr/pdf/BILLS-113hjres59enr.pdf.
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    Because we do not have self plus one data from our March 2015 
enrollment count, OPM has determined that it will use the 2015 self and 
family March enrollment count to calculate the weighted average for 
both the 2016 self plus one and self and family enrollment types. The 
weighted average for self plus one will be based on the 2016 self plus 
one premiums and the 2015 self and family March enrollment count. OPM 
provides rate-setting guidance to carriers on an annual basis. For the 
2016 plan year, OPM requested that carriers propose self plus one 
premiums that are no greater than self and family premiums.\2\ Although 
OPM does not expect this policy to change in the out years, the right 
to reevaluate is reserved.
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    \2\ United States Office of Personnel Management, Federal 
Employees Health Benefits Program Call Letter, Fiscal Year 2016, 
Issued March 13, 2015. https://www.opm.gov/healthcare-insurance/healthcare/carriers/2015/2015-02.pdf
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Rate-Setting and the Cost of Self Plus One

    Comments were received that indicated the addition of the self plus 
one enrollment type would translate into cost savings for enrollees 
with only one eligible family member. Commenters in this category 
praised OPM for implementing the new enrollment type. Other commenters 
expressed concerns about rate setting for the new self plus one 
enrollment type. In particular, a concern that self and family premiums 
would rise drastically in plan year 2016 in order to accommodate the 
new self plus one enrollment type. It was suggested that OPM impose a 
10% cap on such growth in the final rule, especially for the first year 
of implementation. Others expressed concerns about the differential 
between the three enrollment tiers. OPM was asked to clarify whether or 
not the enrollee share of a self plus one enrollment would be less than 
or exactly equal to two self only enrollments. One carrier projected 
that, although self plus one premiums might not rise above self and 
family premiums, the differential between the two would be negligible, 
calling into question the cost-benefit of such a change given the high 
administrative burden of implementation.
    Other commenters expressed concerns about actual claims costs. One 
highlighted the unique nature of the FEHB risk pool because the 
annuitant population is combined with the active employee population, 
indicating that many annuitants, who traditionally have higher claims 
costs, have only one eligible family member and therefore might make up 
the bulk of self plus one enrollees. Two commenters pointed out that 
HMO plans might be especially impacted. They expressed concerns that, 
if OPM were to require that self

[[Page 55730]]

plus one total premiums remain below self and family total premiums, 
the end result would be an even more dramatic increase for self and 
family enrollees. The commenter projected that this change would render 
some regional HMOs non-competitive, forcing them out of the FEHB 
market.
    The final rule does not set differentials between tiers, nor does 
it impose caps on premium growth. Under the three tier system, carriers 
will set rate differentials between tiers that are appropriate for the 
expected population, just as they do under the two tier system. An 
artificial cap is unwarranted because plans must set rates that reflect 
the costs of the population they will be covering. Further, enrollees 
have free choice to stay in their current plan or shop for a less 
expensive plan or option that meets their needs. Because the FEHB 
Program is market-based, artificial caps on premium are likely to cause 
adverse consequences such as inadequate rates for some products.
    One commenter requested that rate information be provided earlier 
than normally scheduled to provide individuals adequate time to analyze 
their options. Given the rate negotiation process outlined in Sec.  
890.501, OPM cannot set the government contribution before September 
1st for the following plan year.

Comments on the Regulatory Impact Analysis

    Commenters who discussed OPM's Regulatory Impact Analysis (RIA) in 
the proposed rule asked that OPM provide a more robust analysis for 
public comment. Four commenters suggested that the RIA provided in the 
proposed rule was insufficient under requirements outlined in the 
Administrative Procedures Act, Executive Order 12866, Executive Order 
13563, and the Congressional Review Act. They suggested a delay in 
implementation in order to conduct additional analysis, provide details 
to the public, and allow for an additional comment period. One 
commenter stated OPM had failed to properly justify the change and to 
explain the potential impacts on the FEHB Program. Multiple commenters 
disagreed with OPM's assertion that self plus one premiums would likely 
be lower than self and family. One commenter noted that the RIA failed 
to discuss the possibility of rate differentials between the enrollment 
types. The commenter suggested that all carriers should be required to 
maintain the same differentials between their plan tiers. The commenter 
requested an actuarial analysis of the method that will be utilized to 
determine the weighted average of all FEHB plans for plan year 2015.
    OPM believes the analysis provided in the proposed rule fulfills 
legal requirements. As noted in the proposed and reiterated in the 
final rule, this change is being implemented to comply with the 2013 
Bipartisan Budget Act. In addition, this change aligns insurance 
offerings with those available in the commercial market and more 
equitably spreads costs among the enrollment types offered.

Information Provided to Carriers

    Four commenters requested that we clarify information for carriers. 
One commenter asked OPM to release details, including the final rule, 
by March 31, 2015 to allow carriers ample time to prepare. Another 
commenter asked for additional details on enrollment and eligibility 
under the new self plus one enrollment type; however, provided no 
specific questions.
    One commenter asked that OPM clarify benefits structures including 
deductibles and out of pocket maximums. OPM addressed these issues 
through normal carrier communications including the annual call letter, 
carrier letters, and teleconferences. OPM utilizes several methods for 
communicating with carriers including, but not limited to carrier 
letters, brochure tools, and teleconferences. Some of the information 
requested during the public comment period either has already been 
released or is forthcoming via these alternative communication methods.

Systems Updates

    OPM received three comments relative to the systems updates 
required to implement the new self plus one enrollment type. One 
commenter also asked that the brochure template language be available 
early. Two commenters suggested that OPM improve processes by which 
dependent information is communicated to carriers. An employee 
organization noted that the number of enrollment changes in Open Season 
2015 is likely to far exceed the average Open Season and expressed 
concerns that the overall system would not be able to handle this 
increased number of enrollment changes.
    OPM has carefully and deliberately been reviewing, modifying, and 
testing internal systems to ensure that enrollee information is 
accurately collected and disseminated to carriers. In addition, 
numerous communications have been distributed on the required systems 
changes with agencies, carriers, and enrollment systems. We are 
confident that, through all of these efforts, all necessary systems 
updates will be completed in time for a smooth implementation of the 
self plus one enrollment type in plan year 2016.

Paperwork Reduction Act (PRA)

    OPM has reviewed this final rule for PRA implications and has 
determined that it does not apply to this section.

Regulatory Impact Analysis

    Executive Order 12866 and Executive Order 13563 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 that may 
have economically significant effects (i.e., effects of $100 million or 
more in at least one year). Given that there are approximately 8.2 
million members participating in the FEHB Program, including 
approximately one million two-person self and family enrollments, and 
participation involves hundreds of dollars per member per month, we 
cannot rule out the possibility that this final rule's changes to the 
FEHB Program will have effects that meet the threshold for economic 
significance. We do expect the overall federal budget impact of this 
final rule to be net neutral, though this is subject to uncertainty.
    The new enrollment tier will align FEHB Program offerings with the 
commercial market and serve to more equitably spread costs across 
different enrollment types; in other words, it will shift costs among 
program participants. For plan year 2016, OPM has required that that 
the self plus one enrollment type have total premiums no greater than 
self and family total premiums.

Current FEHB Enrollment Trends

    In plan year 2015 there were over 4 million FEHB contracts. This 
includes 1.89 million self only contracts (47%) and 2.13 million self 
and family contracts (53%).
    During a typical year, approximately 6% of FEHB enrollees change 
their enrollment by selecting a new plan option or a new enrollment 
type (approximately 8% of active employees and 4% of annuitants). 
However, as this is the first time the FEHB Program has experienced a 
large-scale programmatic change as the addition of a new enrollment 
type, it is expected that

[[Page 55731]]

movement will be greater in the coming years as enrollees learn more 
about their options.

Predicting Enrollment Trends Under the Three Tier System

    In order to estimate the impact of the addition of the self plus 
one enrollment type, OPM has conducted an analysis to predict the 
potential shift in enrollment that may occur.
    OPM determined that the following movement patterns were possible:
     FEHB eligible individuals who are currently not enrolled 
may choose to enroll in FEHB after self plus one becomes available.
     Current self only enrollees may choose to increase 
enrollment to include coverage for an eligible family member who is not 
currently covered under an FEHB enrollment.
     Current self only enrollees may choose to cancel coverage 
in order to be covered under a spouse or parent's self plus one FEHB 
enrollment.
     Current self and family enrollees with only one eligible 
family member may choose to decrease to a self plus one enrollment.
     Current self and family enrollees with two or more 
eligible family members may choose to decrease to a self plus one 
enrollment to cover only one of their eligible family members.
     Some FEHB enrollees in either self only or self and family 
may choose to cancel their enrollments.
     Enrollees in either self only or self and family may 
choose to remain in their current enrollment type.
    Based on available data and experience, OPM estimates that much of 
the movement that will occur will result in a shift from one enrollment 
type to another. There are a limited number of circumstances where the 
addition of the self plus one enrollment type may result in new FEHB 
enrollees or in enrollees leaving the program. It is difficult to 
estimate how many individuals may newly enroll in the program. Most 
employees who do not participate in the FEHB Program do so because they 
have access to other insurance options. This rule will not alter access 
to other insurance for FEHB eligible employees. Also, because OPM does 
not have government-wide eligible and covered family member data, it is 
not known exactly how many individuals are covered under self and 
family enrollments, nor is it known how many eligible family members 
exist but are not currently covered because the enrollee has chosen a 
self only enrollment.
    In order to learn more about potential movement between enrollment 
types, OPM requested data on covered enrollees and family members from 
carriers with the 2014 rate proposals. Carriers reported that over one 
million self and family contracts had only one dependent listed. Of 
those enrollments, approximately 60% were annuitants and 40% were 
active employees. While this number does not capture the universe of 
enrollees who may choose a self plus one enrollment, it does provide a 
starting place for estimating the potential movement between tiers.
    OPM also examined enrollment data for the Federal Employees Dental 
and Vision Insurance Program (FEDVIP). FEDVIP has offered self plus one 
as an enrollment option since its inception in 2007. There are 
currently approximately 2.7 million FEDVIP contracts. Of those, 41% are 
self only, 32% are self plus one, and 27% are self and family.
    Comparing FEHB and FEDVIP enrollment patterns may be illustrative 
because the pool of eligible individuals is roughly the same. Most 
FEDVIP enrollees are also eligible for FEHB. However, there are some 
key differences between the programs. First, family member eligibility 
guidelines are slightly different. Eligible children are covered under 
FEDVIP enrollments until the age of 22 whereas eligible children are 
covered under FEHB until the age of 26. Second, FEDVIP has lower 
participation as it is an employee-pay-all program with no government 
contribution towards the premium. In addition, benefits offered in 
standalone dental and vision programs are limited, and therefore, 
enrollee behavior and motivation based on those benefits would be 
different.
    Examining the types of movement that are possible and comparing 
FEHB enrollment trends with other programs provides only a limited view 
of the complex factors that affect enrollment decisions for enrollees. 
Enrollee choice and movement is an individualized decision based on the 
needs of the enrollee and their dependents. Self plus one uptake is 
dependent on a combination of factors including premiums, benefits 
structures, and the level of communication from agencies, carriers, and 
OPM about new enrollment options.
    For most enrollees, the enrollee share for self plus one will be 
lower than for self and family; however, it is possible that, because 
of the statutory formula used to calculate the government contribution, 
some plans may have a higher enrollee share for self plus one than for 
self and family. This will make it even more important for enrollees to 
review their enrollment options before selecting a plan and an 
enrollment type that meets their needs. OPM is implementing a robust 
communications strategy to ensure that as many enrollees as possible 
are aware of the new self plus one enrollment type.
    Plan design remains the same between enrollment types offered in 
the same plan option. Therefore, OPM expects that cognitive costs for 
enrollees would be relatively low. For those enrollees that do not 
typically reevaluate their enrollment every Open Season, the cognitive 
costs of a review of the plans, plan options, and enrollment types 
available may well be worth incurring, as they may discover better 
alternatives (though these improvements may represent transfers from 
other members of society, rather than benefits to society as whole). 
Ultimately, actual enrollment decisions cannot be predicted with 
precision. Further, it will likely take years for enrollment numbers to 
reach an equilibrium following this Program change.\3\
---------------------------------------------------------------------------

    \3\ As discussed in more detail elsewhere in this analysis, plan 
switching--in which federal employees and annuitants with one 
eligible family member gravitate toward plans with relatively low 
self plus one premiums and federal employees and annuitants with 
multiple eligible family members gravitate toward plans with 
relatively low self and family premiums--would lead to further 
changes in premiums, and several iterations of switching activity 
and premium adjustments may occur before the new equilibrium is 
reached. Moreover, because health insurance decisions tend to be 
characterized by inertia, the behavioral changes discussed here and 
throughout this analysis may be relatively rare when this rule is 
first implemented and then become more widespread over time, as 
turnover occurs in the federal workforce and there is an 
accumulation of qualifying life events that cause FEHB participants 
to reconsider their health insurance choices.
---------------------------------------------------------------------------

Cost Analysis

    OPM's Fiscal Year 2014 Congressional Budget Justification \4\ 
included a projection that the addition of the self plus one enrollment 
would have a net neutral impact on the Federal budget. This projection, 
based on FEHB carriers' relative costs and population

[[Page 55732]]

distributions, included the following assumptions:
---------------------------------------------------------------------------

    \4\ United States Office of Personnel Management, Congressional 
Budget Justification Performance Budget, Fiscal Year 2014, Submitted 
April 2013, available at https://www.opm.gov/about-us/budget-performance/budgets/congressional-budget-justification-fy2014.pdf. 
See also Congressional Budget Office, Cost Estimate, Bipartisan 
Budget Act of 2013, dated December 11, 2013, available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/Bipartisan%20Budget%20Act% 20of%202013.pdf. In estimating potential 
premium changes, OPM used data on FEHB enrollees' medical 
expenditures, while CBO used data on medical expenditures for the 
general population. Because of the large number of annuitants in the 
FEHB enrolled population, two-person FEHB enrollments tend to have 
higher costs than two-person enrollments in the nation as a whole, 
thus explaining some of the difference between OPM's and CBO's 
estimates.
---------------------------------------------------------------------------

     The average premium for self plus one coverage will be 
approximately 94% of the cost of existing self and family coverage.
     The average premium for self and family coverage will be 
approximately 107% of the cost of existing self and family coverage.
     33% of active employees with existing self and family will 
shift to self plus one coverage.
     Only 20% of annuitants with existing self and family 
coverage will retain that coverage (80% will shift to self plus one).
    As discussed above, there are several ways in which enrollees may 
choose to change their enrollment based on the addition of the self 
plus one enrollment type. The magnitudes of these changes (and the 
effects experienced by the government that depend on FEHB participants' 
behavior) would be correlated with the amount that participant premium 
contributions change. If, as shown above, self plus one premiums are 
only slightly lower than baseline self and family premiums, then two-
person families will have little incentive to transfer family members 
from other coverage to FEHB. Similarly, if self and family premiums 
increase only slightly as a result of this rule, then families larger 
than two people will have little incentive to switch some or all of 
their members from FEHB to other health insurance coverage. As a 
result, in this example, a change in the cost of the Program would be 
contingent, in part, upon the amount of switching into or out of FEHB 
from/to other health insurance.
    Current enrollees with self and family coverage who only have one 
dependent and choose to decrease enrollment to self plus one, will 
likely benefit from lower premiums. Those with more than one dependent 
covered under a self and family enrollment will likely incur higher 
premiums. A large percentage of annuitants who currently have self and 
family coverage would likely benefit from the lower total premiums of a 
self plus one enrollment type, resulting in score-able savings to the 
government because the government share of annuitant premiums will 
decrease.
    OPM estimated that, in total, savings for annuitants and the 
government would rise above $450 million in the first year of self plus 
one. Conversely, costs for non-Postal employees and the government 
would rise about $450 million for the same time frame. This converse 
relationship between costs associated with annuitants and employees 
continues into future year projections and results in the overall net-
neutral projection.
    Actual cost shifting cannot be measured until rate negotiations are 
finalized and enrollment changes take place. As enrollees shift from 
self only and self and family enrollments, OPM will closely monitor the 
effect on premiums. If premiums for active employees with two or more 
covered family members rise, there will be increasing costs to 
government agencies (assuming appropriation of necessary funds).\5\
---------------------------------------------------------------------------

    \5\ United States Office of Personnel Management, Congressional 
Budget Justification Performance Budget, Fiscal Year 2014, Submitted 
April 2013, available at https://www.opm.gov/about-us/budget-performance/budgets/congressional-budget-justification-fy2014.pdf. 
See also Congressional Budget Office, Cost Estimate, Bipartisan 
Budget Act of 2013, dated December 11, 2013, available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/Bipartisan%20Budget%20Act% 20of%202013.pdf.
---------------------------------------------------------------------------

    The impact of this final rule hinges upon the relative premiums for 
self plus one and self and family enrollment types. Because the self 
and family option includes coverage for a larger number of people, a 
natural assumption would be that premiums would be lower for a self 
plus one enrollment type than for a self and family enrollment type. 
For plan year 2016, OPM instructed carriers to propose total premiums 
for self plus one that were less than or equal to total premiums for 
self and family. In that case, several rule-induced outcomes are 
likely:
     Federal employees and annuitants who, in the absence of 
the rule, would choose self and family enrollment for themselves and 
either a spouse or a child would switch to a self plus one enrollment, 
resulting in lower total premium payments between employees, annuitants 
and the federal government.
     Federal employees and annuitants choosing self and family 
enrollment for themselves and at least two family members would 
experience an increase in premiums and therefore, in some cases, may 
choose to switch from FEHB to an alternative health insurance option. 
If all such families continued with FEHB participation, the government 
would experience an increase in premium payments that would (in theory) 
exactly offset the decreases associated with two-person families 
switching from self and family to self plus one enrollment; however, 
any switching away from FEHB would mitigate the premium increases 
experienced by the federal government, instead potentially leading to 
payment increases by any contributors to the newly-chosen insurance 
options (an obvious example would be the employer of a federal 
employee's or annuitant's spouse if that employer sponsors the newly-
chosen insurance).
     Federal employees and annuitants who, in the absence of 
the rule, would choose self only enrollment in spite of having a spouse 
who would be eligible for coverage under self and family enrollment may 
choose self plus one enrollment. This might occur if a self and family 
premium is greater than the combined premiums for a federal employee's 
self only enrollment and a spouse's self only enrollment in health 
insurance through his or her own non-federal employer, but the relevant 
FEHB self plus one premium is less than the combined premiums.\6\ In 
this type of scenario in which the federal employee's or annuitant's 
enrollment increases, the federal government would pay more in premiums 
(relative to a baseline in which this rule is not finalized) but the 
federal employee's or annuitant's family would pay less. Any 
contributors to the insurance in which the family member would be 
enrolled in the absence of the rule--such as the non-federal employer 
of the federal employee's spouse in the preceding example--would also 
pay less.
---------------------------------------------------------------------------

    \6\ Similarly, federal employees and annuitants who, in the 
absence of the rule, would choose not to participate in the FEHB 
Program may choose a self plus one enrollment. For example, this 
outcome might occur if the self plus one option available in the 
FEHB Program is less expensive than either a family or plus-one 
enrollment available via a federal employee's spouse or the combined 
premiums for the federal employee's self only enrollment and the 
spouse's self only enrollment.
---------------------------------------------------------------------------

    To the extent that new patterns of enrollment do not change how 
society uses its resources (i.e., amount or quality of medical services 
provided), then the effects described above would be transfers between 
members of society, rather than social costs or benefits.
    It is possible that two-person families are, on average, less 
healthy than larger families; indeed, multiple comments to the docket 
provided evidence that some plans' expenditures for two-person 
enrollments are higher than for enrollments with three or more total 
family members. For the 2016 plan year, because OPM has requested that 
carriers propose self plus one premiums no greater than self and family 
premiums, plans with this medical expenditure pattern will presumably 
set equal premiums for self plus one and self and family enrollment 
types. In the event that OPM does not repeat this request for future 
years, plans with higher average expenditures for two-person than for 
larger families will presumably set premiums higher for self plus one 
enrollment than for self and family

[[Page 55733]]

enrollment. If this pattern--in which self plus one premiums are 
greater than or equal to self and family premiums--held universally, 
the lack of premium decrease to give federal employees and annuitants 
an incentive to switch from self and family to self plus one enrollment 
would lead to the rule's enrollment impact being negligible.\7\ 
However, as indicated by docket submissions, relative expenditures on 
(and thus premiums for) two-person and larger enrollments differ across 
plans, and hence the effect of adding the self plus one option may be 
to increase switching between plans, as federal employees and 
annuitants with one eligible family member gravitate toward plans with 
relatively low self plus one premiums and federal employees and 
annuitants with multiple eligible family members gravitate toward plans 
with relatively low self and family premiums. Plan switching of this 
type would lead to further changes in premiums and several iterations 
of switching activity and premium adjustments may occur.
---------------------------------------------------------------------------

    \7\ This negligible-impact outcome may not occur if the 
government contribution, as determined by statutory formula, was 
such that enrollee contributions were lower for self plus one 
enrollments than for self and family enrollments even in cases where 
total premiums for self plus one enrollments were greater than or 
equal to total premiums for self and family enrollments.
---------------------------------------------------------------------------

    Additionally, the rule imposes implementation costs, such as the 
costs of systems updates, on FEHB-participating health insurance plans, 
federal agencies, and on OPM itself. These expenses are encompassed in 
existing workloads. OPM has no specific estimate for these costs, but 
expects them to be marginal.
    Though regulatory alternatives to this rule are limited due to the 
statutory mandate, OPM did consider delaying implementation of the rule 
until the 2017 plan year. OPM rejected this option for two reasons. 
First, delaying implementation will not provide additional information. 
Because OPM contracts with a number of carriers, proposed rates are 
proprietary and cannot be released publically without compromising 
confidential negotiation processes. Until first year negotiations are 
completed and enrollment changes occur, OPM would not have a precise 
understanding of the impact of the self plus one enrollment type on 
premiums.
    Second, implementation has already been delayed. After the passage 
of the 2013 Bipartisan Budget Act, the first year that implementation 
would have been possible was plan year 2015. OPM determined that this 
was not adequate time to implement the new enrollment type and chose to 
delay implementation until 2016. OPM, carriers, and Federal agencies 
are well into the implementation process. Rate negotiations between OPM 
and FEHB carriers have begun under the assumption that the 2016 plan 
year would include the self plus one enrollment type. Agencies and 
carriers are currently implementing the systems changes required to 
accommodate three tier enrollments. Delaying implementation would 
adversely impact the Federal benefits Open Season which is scheduled to 
begin in early November of this year.

Congressional Review Act

    OPM has determined that this regulatory action is not subject to 
the Congressional Review Act, 5 U.S.C. 801-08, because it relates to 
agency management and personnel. The program is not statutorily for 
general application but rather governs employment fringe benefits for 
Federal employees, annuitants and their families. Moreover, OPM has 
been statutorily granted discretion in terms of deciding how its 
actions may affect non-agency parties, such as carriers, by its 
authority to regulate enrollment. See, 5 U.S.C. 8905(a), 8905(g)(2), 
and 8913(b).

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 adds a self plus one enrollment tier to the current self only and 
self and family enrollment tiers under FEHB.

Executive Orders 13563 and 12866, Regulatory Review

    This rule has been reviewed by the Office of Management and Budget 
in accordance with Executive Orders 13563 and 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

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.

5 CFR Part 892

    Administrative practice and procedure, Government employees, Health 
insurance, Taxes, Wages.

U.S. Office of Personnel Management.
Beth F. Cobert,
Acting Director.

    Accordingly, OPM is amending title 5, Code of Federal Regulations 
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.


0
2. Amend Sec.  890.101 as follows:
0
a. By revising the definitions of ``Change the enrollment'' and 
``Covered family member.''
0
b. By adding the definitions of ``Decrease enrollment type,'' 
``Increase enrollment type,'' ``Self and family enrollment,'' ``Self 
only enrollment,'' ``Self plus one enrollment,'' and ``Switch a covered 
family member'' in alphabetical order.
    The revisions and additions read as follows:


Sec.  890.101  Definitions; time computations.

* * * * *
    Change the enrollment means to submit to the employing office an 
appropriate request electing a change of enrollment to a different plan 
or option, or to a different type of coverage (self only, self plus 
one, or self and family).
* * * * *
    Covered family member means a member of the family of an enrollee 
with a self plus one or self and family enrollment who meets the 
requirements of Sec. Sec.  890.302, 890.804, or 890.1106(a), as 
appropriate to the type of enrollee.
* * * * *
    Decrease enrollment type means a change in enrollment from self and 
family to self plus one or to self only or a change from self plus one 
to self only.
* * * * *
    Increase enrollment type means a change in enrollment from self 
only to self plus one or to self and family or a

[[Page 55734]]

change from self plus one to self and family.
* * * * *
    Self and family enrollment means an enrollment that covers the 
enrollee and all eligible family members.
    Self only enrollment means an enrollment that covers only the 
enrollee.
    Self plus one enrollment means an enrollment that covers the 
enrollee and one eligible family member.
* * * * *
    Switch a covered family member means, under a self plus one 
enrollment, to terminate or cancel the enrollment of the designated 
covered family member and designate another eligible family member for 
coverage.
* * * * *

0
3. Amend Sec.  890.201 by revising paragraph (a)(6) to read as follows:


Sec.  890.201  Minimum standards for health benefits plans.

    (a) * * *
    (6) Provide a standard rate structure that contains, for each 
option, one standard self only rate, one standard self plus one rate 
and one standard self and family rate.
* * * * *

0
4. Amend Sec.  890.301 by revising paragraphs (e), (f)(3), (g)(1) and 
(3), (h) heading and introductory text, (i) introductory text, (i)(1), 
and (m) to read as follows:


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

* * * * *
    (e) Decreasing enrollment type. (1) Subject to two exceptions, an 
employee may decrease enrollment type at any time. Exceptions:
    (i) An employee participating in health insurance premium 
conversion may decrease enrollment type during an open season or 
because of and consistent with a qualifying life event as defined in 
part 892 of this chapter.
    (ii) An employee who is subject to a court or administrative order 
as discussed in paragraph (g)(3) of this section may not decrease 
enrollment type in a way that eliminates coverage of a child identified 
in the order as long as the court or administrative order is still in 
effect and the employee has at least one child identified in the order 
who is still eligible under the FEHB Program, unless the employee 
provides documentation to the agency that he or she has other coverage 
for the child(ren). The employee may not elect self only as long as he 
or she has one child identified as covered, but may elect self plus 
one.
    (2) A decrease in enrollment type takes effect on the first day of 
the first pay period that begins after the date the employing office 
receives an appropriate request to change the enrollment, except that 
at the request of the enrollee and upon a showing satisfactory to the 
employing office that there was no family member eligible for coverage 
under the self plus one or self and family enrollment, or only one 
family member eligible for coverage under the self and family 
enrollment, as appropriate, the employing office may make the change 
effective on the first day of the pay period following the one in which 
there was, in the case of a self plus one enrollment, no family member 
or, in the case of a self and family enrollment, only one or no family 
member.
    (f) * * *
    (3) With one exception, during an open season, an eligible employee 
may enroll and an enrolled employee may decrease or increase enrollment 
type, may change from one plan or option to another, or may make any 
combination of these changes. Exception: An employee who is subject to 
a court or administrative order as discussed in paragraph (g)(3) of 
this section may not cancel his or her enrollment, decrease enrollment 
type, or change to a comprehensive medical plan that does not serve the 
area where his or her child or children live as long as the court or 
administrative order is still in effect, and the employee has at least 
one child identified in the order who is still eligible under the FEHB 
Program, unless the employee provides documentation to the agency that 
he or she has other coverage for the child(ren). The employee may not 
elect self only as long as he or she has one child identified as 
covered, but may elect self plus one.
* * * * *
    (g) Change in family status. (1) An eligible employee may enroll 
and an enrolled employee may decrease or increase enrollment type, 
change from one plan or option to another, or make any combination of 
these changes when the employee's family status changes, including a 
change in marital status or any other change in family status. The 
employee must enroll or change the enrollment within the period 
beginning 31 days before the date of the change in family status, and 
ending 60 days after the date of the change in family status.
* * * * *
    (3)(i) If an employing office receives a court or administrative 
order on or after October 30, 2000, requiring an employee to provide 
health benefits for his or her child or children, the employing office 
will determine if the employee has a self plus one or self and family 
enrollment, as appropriate, in a health benefits plan that provides 
full benefits in the area where the child or children live. If the 
employee does not have the required enrollment, the agency must notify 
him or her that it has received the court or administrative order and 
give the employee until the end of the following pay period to change 
his or her enrollment or provide documentation to the employing office 
that he or she has other coverage for the child or children. If the 
employee does not comply within these time frames, the employing office 
must enroll the employee involuntarily as stated in paragraph 
(g)(3)(ii) of this section.
    (ii) If the employee is not enrolled or does not enroll, the agency 
must enroll him or her for self plus one or self and family coverage, 
as appropriate, in the option that provides the lower level of coverage 
in the Service Benefit Plan. If the employee is enrolled but does not 
increase the enrollment type in a way that is sufficient to cover the 
child or children, the employing office must change the enrollment to 
self plus one or self and family, as appropriate, in the same option 
and plan, as long as the plan provides full benefits in the area where 
the child or children live. If the employee is enrolled in a 
comprehensive medical plan that does not serve the area in which the 
child or children live, the employing office must change the enrollment 
to self plus one or self and family, as appropriate, in the option that 
provides the lower level of coverage in the Service Benefit Plan.
* * * * *
    (h) Change in employment status. An eligible employee may enroll 
and an enrolled employee may decrease or increase enrollment type, 
change from one plan or option to another, or make any combination of 
these changes when the employee's employment status changes. Except as 
otherwise provided, an employee must enroll or change the enrollment 
within 60 days after the change in employment status. Employment status 
changes include, but are not limited to--
* * * * *
    (i) Loss of coverage under this part or under another group 
insurance plan. An eligible employee may enroll and an enrolled 
employee may decrease or increase enrollment type, change 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 loses coverage 
under this part or another group health benefits plan. Except as 
otherwise

[[Page 55735]]

provided, an employee must enroll or change the enrollment within the 
period beginning 31 days before the date of loss of coverage, and 
ending 60 days after the date of loss of coverage. Losses of coverage 
include, but are not limited to--
    (1) Loss of coverage under another FEHB enrollment due to the 
termination, cancellation, or a change to self plus one or to self 
only, of the covering enrollment.
* * * * *
    (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 decrease or increase enrollment type, change 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.

0
5. Amend Sec.  890.302 by revising paragraphs (a)(1), (a)(2)(ii), and 
(c) introductory text and adding paragraph (f) to read as follows:


Sec.  890.302  Coverage of family members.

    (a)(1) An enrollment for self plus one includes the enrollee and 
one eligible family member. An enrollment for self and family includes 
all family members who are eligible to be covered by the enrollment. 
Except as provided in paragraph (a)(2) of this section, no employee, 
former employee, annuitant, child, or former spouse may enroll or be 
covered as a family member if he or she is already covered under 
another person's self plus one or self and family enrollment in the 
FEHB Program.
    (2) * * *
    (ii) Exception. An individual described in paragraph (a)(2)(i) of 
this section may enroll if he or she or his or her eligible family 
members would otherwise not have access to coverage, in which case the 
individual may enroll in his or her own right for self only, self plus 
one, or self and family coverage, as appropriate. However, an eligible 
individual is entitled to receive benefits under only one enrollment 
regardless of whether he or she qualifies as a family member under a 
spouse's or parent's enrollment. To ensure that no person receives 
benefits under more than one enrollment, each enrollee must promptly 
notify the insurance carrier as to which person(s) will be covered 
under his or her enrollment. These individuals are not covered under 
the other enrollment. Examples include but are not limited to:
    (A) To protect the interests of married or legally separated 
Federal employees, annuitants, and their children, an employee or 
annuitant may enroll in his or her own right in a self only, self plus 
one, or self and family enrollment, as appropriate, even though his or 
her spouse also has a self plus one or self and family enrollment if 
the employee, annuitant, or his or her children live apart from the 
spouse and would otherwise not have access to coverage due to a service 
area restriction and the spouse refuses to change health plans.
    (B) When an employee who is under age 26 and covered under a 
parent's self plus one or self and family enrollment acquires an 
eligible family member, the employee may elect to enroll for self plus 
one or self and family coverage.
* * * * *
    (c) Child incapable of self-support. When an individual's 
enrollment for self plus one or self and family includes a child who 
has become 26 years of age and is incapable of self-support, the 
employing office must require such enrollee to submit a physician's 
certificate verifying the child's disability. The certificate must--
* * * * *
    (f) Switching a covered family member. (1) An enrollee with a self 
plus one enrollment may switch his or her covered family member during 
the annual Open Season, upon a change in family status, upon a change 
in coverage, or upon a change in eligibility, so long as switching a 
covered family member is consistent with the event that has taken 
place.
    (2) Switching a covered family member under a self plus one 
enrollment will be effective on the first day of the first pay period 
that begins after the date the employing office receives an appropriate 
request to switch the covered family member.

0
6. Amend Sec.  890.303 by revising paragraphs (c), (d)(2)(ii), and the 
heading of paragraph (d)(3) to read as follows:


Sec.  890.303  Continuation of enrollment.

* * * * *
    (c) On death. The enrollment of a deceased employee or annuitant 
who is enrolled for self plus one or self and family (as opposed to 
self only) is transferred automatically to his or her eligible survivor 
annuitant(s) covered by the enrollment, as applicable. For self and 
family, the enrollment is considered to be that of:
    (1) The survivor annuitant from whose annuity all or the greatest 
portion of the withholding for health benefits is made; or
    (2) The surviving spouse entitled to a basic employee death 
benefit. The enrollment covers members of the family of the deceased 
employee or annuitant. In those instances in which the annuity is split 
among surviving family members, multiple enrollments are allowed. A 
remarried spouse is not a member of the family of the deceased employee 
or annuitant unless annuity under section 8341 or 8442 of title 5, 
United States Code, continues after remarriage.
    (d) * * *
    (2) * * *
    (ii) If the surviving spouse of a deceased employee or annuitant is 
enrolled as an employee with a self plus one or self and family 
enrollment (or, if both the decedent and the surviving spouse were 
enrolled in a self only or self plus one enrollment) at the time the 
surviving spouse becomes a survivor annuitant and the surviving spouse 
is thereafter separated without entitlement to continued enrollment as 
a retiree, the surviving spouse is entitled to enroll as a survivor 
annuitant. The change from coverage as an employee to coverage as a 
survivor annuitant must be made within 30 days of separation from 
service.
* * * * *
    (3) Insurable interest survivor annuity. * * *
* * * * *

0
7. Amend Sec.  890.306 by revising paragraphs (e), (f)(1)(i), (g)(1), 
(l) introductory text, (l)(1), (n), and (r) to read as follows:


Sec.  890.306  When can annuitants or survivor annuitants change 
enrollment or reenroll and what are the effective dates?

* * * * *
    (e) Decreasing enrollment type. (1) With one exception, an 
annuitant may decrease enrollment type at any time. Exception: An 
annuitant who, as an employee, was subject to a court or administrative 
order as discussed in Sec.  890.301(g)(3) at the time he or she retired 
may not, after retirement, decrease enrollment type in a way that 
eliminates coverage of a child identified in the order as long as the 
court or administrative order is still in effect and the annuitant has 
at least one child identified in the order who is still eligible under 
the FEHB Program, unless the annuitant provides documentation to the 
retirement system that he or she has other coverage for the child or 
children. The annuitant may not elect

[[Page 55736]]

self only as long as he or she has one child identified as covered, but 
may elect self plus one.
    (2) A decrease in enrollment type takes effect on the first day of 
the first pay period that begins after the date the employing office 
receives an appropriate request to change the enrollment, except that 
at the request of the annuitant and upon a showing satisfactory to the 
employing office that there was no family member eligible for coverage 
under the self plus one or self and family enrollment, or only one 
family member eligible for coverage under the self and family 
enrollment, as appropriate, the employing office may make the change 
effective on the first day of the pay period following the one in which 
there was, in the case of a self plus one enrollment, no family member 
or, in the case of a self and family enrollment, only one or no family 
member.
    (f) * * *
    (1) * * *
    (i) With one exception, an enrolled annuitant may decrease or 
increase enrollment type, may change from one plan or option to 
another, or may make any combination of these changes. Exception: An 
annuitant who, as an employee, was subject to a court or administrative 
order as discussed in Sec.  890.301(g)(3) at the time he or she retired 
may not cancel or suspend his or her enrollment, decrease enrollment 
type in a way that eliminates coverage of a child identified in the 
order or change to a comprehensive medical plan that does not serve the 
area where his or her child or children live after retirement as long 
as the court or administrative order is still in effect and the 
annuitant has at least one child identified in the order who is still 
eligible under the FEHB Program, unless the annuitant provides 
documentation to the retirement system that he or she has other 
coverage for the child or children. The annuitant may not elect self 
only as long as he or she has one child identified as covered, but may 
elect self plus one.
* * * * *
    (g) Change in family status. (1) An enrolled former employee in 
receipt of an annuity may decrease or increase enrollment type, change 
from one plan or option to another, or make any combination of these 
changes when the annuitant's family status changes, including a change 
in marital status or any other change in family status. In the case of 
an enrolled survivor annuitant, a change in family status based on 
additional family members occurs only if the additional family members 
are family members of the deceased employee or annuitant. The annuitant 
must change the enrollment within the period beginning 31 days before 
the date of the change in family status, and ending 60 days after the 
date of the change in family status.
* * * * *
    (l) Loss of coverage under this part or under another group 
insurance plan. An annuitant who meets the requirements of paragraph 
(a) of this section, and who is not enrolled but is covered by another 
enrollment under this part may continue coverage by enrolling in his or 
her own name when the annuitant loses coverage under the other 
enrollment under this part. An enrolled annuitant may decrease or 
increase enrollment type, change from one plan or option to another, or 
make any combination of these changes when the annuitant or an eligible 
family member of the annuitant loses coverage under this part or under 
another group health benefits plan. Except as otherwise provided, an 
annuitant must enroll or change the enrollment within the period 
beginning 31 days before the date of loss of coverage and ending 60 
days after the date of loss of coverage. Losses of coverage include, 
but are not limited to--
    (1) Loss of coverage under another FEHB enrollment due to the 
termination, cancellation, or a change to self plus one or self only, 
of the covering enrollment;
* * * * *
    (n) Overseas post of duty. An annuitant may decrease or increase 
enrollment type, change from one plan or option to another, or make any 
combination of these changes within 60 days after the retirement or 
death of the employee on whose service title to annuity is based, if 
the employee was stationed at a post of duty outside a State of the 
United States or the District of Columbia at the time of retirement or 
death.
* * * * *
    (r) Sole survivor. When an employee or annuitant enrolled for self 
plus one or self and family dies, leaving a survivor annuitant who is 
entitled to continue the enrollment, and it is apparent from available 
records that the survivor annuitant is the sole survivor entitled to 
continue the enrollment, the office of the retirement system which is 
acting as employing office must decrease the enrollment to self only, 
effective on the commencing date of the survivor annuity. On request of 
the survivor annuitant made within 31 days after the first installment 
of annuity is paid, the office of the retirement system which is acting 
as employing office must rescind the action retroactive to the 
effective date of the change to self only, with corresponding 
adjustment in withholdings and contributions.
* * * * *

0
8. Amend Sec.  890.401 by revising paragraph (a)(1) to read as follows:


Sec.  890.401  Temporary extension of coverage and conversion.

    (a) Thirty-one day extension and conversion. (1) An enrollee whose 
enrollment is terminated other than by cancellation of the enrollment 
or discontinuance of the plan, in whole or part, and a covered family 
member whose coverage is terminated other than by cancellation of the 
enrollment or discontinuance of the plan, in whole or in part, is 
entitled to a 31-day extension of coverage for self only, self plus 
one, or self and family, as the case may be, without contributions by 
the enrollee or the Government, during which period he or she is 
entitled to exercise the right of conversion provided for by this part. 
The 31-day extension of coverage and the right of conversion for any 
person ends on the effective date of a new enrollment under this part 
covering the person.
* * * * *

0
9. Amend Sec.  890.501 by revising paragraphs (b) introductory text, 
(b)(2)(i), and (b)(3) to read as follows:


Sec.  890.501  Government contributions.

* * * * *
    (b) In accordance with the provisions of 5 U.S.C. 8906(a) which 
take effect with the contract year that begins in January 1999, OPM 
will determine the amounts representing the weighted average of 
subscription charges in effect for each contract year, for self only, 
self plus one, and self and family enrollments, as follows:
* * * * *
    (2) * * *
    (i) When a subscription charge for an upcoming contract year 
applies to a plan that is the result of a merger of two or more plans 
which contract separately with OPM during the determination year, or 
applies to a plan which will cease to offer two benefits options, OPM 
will combine the self only enrollments, the self plus one enrollments, 
and the self and family enrollments from the merging plans, or from a 
plan's benefits options, for purposes of weighting subscription charges 
in effect for the successor plan for the upcoming contract year.
* * * * *
    (3) After OPM weights each subscription charge as provided in

[[Page 55737]]

paragraph (b)(2) of this section, OPM will compute the total of 
subscription charges associated with self only enrollments, self plus 
one enrollments, and self and family enrollments, respectively. OPM 
will divide each subscription charge total by the total number of 
enrollments such amount represents to obtain the program-wide weighted 
average subscription charges for self only and for self plus one and 
self and family enrollments, respectively.
* * * * *

0
10. Amend Sec.  890.804 by revising paragraph (a) to read as follows:


Sec.  890.804  Coverage.

    (a) Type of enrollment. A former spouse who meets the requirements 
of Sec.  890.803 may elect coverage for self only, self plus one, or 
self and family. A self and family enrollment covers only the former 
spouse and all eligible children of both the former spouse and the 
employee, former employee, or employee annuitant, provided such 
children are not otherwise covered by a health plan under this part. A 
self plus one enrollment covers only the former spouse and one eligible 
child of both the former spouse and the employee, former employee, or 
employee annuitant, provided the child is not otherwise covered by a 
health plan under this part. A child must be under age 26 or incapable 
of self-support because of a mental or physical disability existing 
before age 26. No person may be covered by two enrollments.
* * * * *

0
11. Amend Sec.  890.806 by revising paragraphs (e), (f)(1)(i), (g)(1), 
(j) introductory text, and (j)(1) to read as follows:


Sec.  890.806  When can former spouses change enrollment or reenroll 
and what are the effective dates?

* * * * *
    (e) Decreasing enrollment type. (1) A former spouse may decrease 
enrollment type at any time.
    (2) A decrease in enrollment type takes effect on the first day of 
the first pay period that begins after the date the employing office 
receives an appropriate request to change the enrollment, except that 
at the request of the former spouse and upon a showing satisfactory to 
the employing office that there was no family member eligible for 
coverage under the self plus one or self and family enrollment, or only 
one family member eligible for coverage under the self and family 
enrollment, as appropriate, the employing office may make the change 
effective on the first day of the pay period following the one in which 
there was, in the case of a self plus one enrollment, no family member 
or, in the case of a self and family enrollment, only one or no family 
member.
    (f) * * *
    (1) * * *
    (i) An enrolled former spouse may decrease enrollment type, 
increase enrollment type provided the family member(s) to be covered 
under the enrollment is eligible for coverage under Sec.  890.804, 
change from one plan or option to another, or make any combination of 
these changes.
* * * * *
    (g) Change in family status. (1) An enrolled former spouse may 
increase enrollment type, change from one plan or option to another, or 
make any combination of these changes within the period beginning 31 
days before and ending 60 days after the birth or acquisition of a 
child who meets the eligibility requirements of Sec.  890.804.
* * * * *
    (j) Loss of coverage under this part or under another group 
insurance plan. An enrolled former spouse may decrease or increase 
enrollment type, change from one plan or option to another or make any 
combination of these changes when the former spouse or a child who 
meets the eligibility requirements under Sec.  890.804 loses coverage 
under another enrollment under this part or under another group health 
benefits plan. Except as otherwise provided, the former spouse must 
change the enrollment within the period beginning 31 days before the 
date of loss of coverage and ending 60 days after the date of loss of 
coverage, provided he or she continues to meet the eligibility 
requirements under Sec.  890.803. Losses of coverage include but are 
not limited to--
    (1) Loss of coverage under another FEHB enrollment due to the 
termination, cancellation, or a change to self plus one or self only, 
of the covering enrollment;
* * * * *

0
12. Amend Sec.  890.1103 by revising paragraphs (a)(2) and (3) to read 
as follows:


Sec.  890.1103  Eligibility.

    (a) * * *
    (2) Individuals whose coverage as children under the self plus one 
or self and family enrollment of an employee, former employee, or 
annuitant ends because they cease meeting the requirements for being 
considered covered family members. For the purpose of this section, 
children who are enrolled under this part as survivors of deceased 
employees or annuitants are considered to be children under a self plus 
one or self and family enrollment of an employee or annuitant at the 
time of the qualifying event.
    (3) Former spouses of employees, of former employees having 
continued self plus one or self and family coverage under this subpart, 
or of annuitants, if the former spouse would be eligible for continued 
coverage under subpart H of this part except for failure to meet the 
requirement of Sec.  890.803(a)(1) or (3) or the documentation 
requirements of Sec.  890.806(a), including former spouses who lose 
eligibility under subpart H within 36 months after termination of the 
marriage because they ceased meeting the requirement of Sec.  
890.803(a)(1) or (3).
* * * * *

0
13. Amend Sec.  890.1106 by revising paragraph (a) introductory text to 
read as follows:


Sec.  890.1106  Coverage.

    (a) Type of enrollment. An individual who enrolls under this 
subpart may elect coverage for self only, self plus one, or self and 
family.
* * * * *

0
14. Amend Sec.  890.1108 by revising paragraphs (d), (e)(1), (f)(1) and 
(2), (h) introductory text, and (h)(1) to read as follows:


Sec.  890.1108   Opportunities to change enrollment; effective dates.

* * * * *
    (d) Decreasing enrollment type. (1) An enrollee may decrease 
enrollment type at any time.
    (2) A decrease in enrollment type takes effect on the first day of 
the first pay period that begins after the date the employing office 
receives an appropriate request to change the enrollment, except that 
at the request of the enrollee and upon a showing satisfactory to the 
employing office that there was no family member eligible for coverage 
under the self plus one or self and family enrollment, or only one 
family member eligible for coverage under the self and family 
enrollment, as appropriate, the employing office may make the change 
effective on the first day of the pay period following the one in which 
there was, in the case of a self plus one enrollment, no family member 
or, in the case of a self and family enrollment, only one or no family 
member.
    (e) Open season. (1) During an open season as provided by Sec.  
890.301(f), an enrollee (except for a former spouse who is eligible for 
continued coverage

[[Page 55738]]

under Sec.  890.1103(a)(3)) may decrease or increase enrollment type, 
change from one plan or option to another, or make any combination of 
these changes. A former spouse who is eligible for continued coverage 
under Sec.  890.1103(a)(3) may change from one plan or option to 
another, but may not increase enrollment type unless the individual to 
be covered under the self plus one or self and family enrollment 
qualifies as a family member under Sec.  890.1106(a)(2).
* * * * *
    (f) Change in family status. (1) Except for a former spouse, an 
enrollee may decrease or increase enrollment type, change from one plan 
or option to another, or make any combination of these changes when the 
enrollee's family status changes, including a change in marital status 
or any other change in family status. The enrollee must change the 
enrollment within the period beginning 31 days before the date of the 
change in family status, and ending 60 days after the date of the 
change in family status.
    (2) A former spouse who is covered under this section may increase 
enrollment type, change from one plan or option to another, or make any 
combination of these changes within the period beginning 31 days before 
and ending 60 days after the birth or acquisition of a child who 
qualifies as a covered family member under Sec.  890.1106(a)(2).
* * * * *
    (h) Loss of coverage under this part or under another group 
insurance plan. An enrollee may decrease or increase enrollment type, 
change from one plan or option to another, or make any combination of 
these changes when the enrollee loses coverage under this part or a 
qualified family member of the enrollee loses coverage under this part 
or under another group health benefits plan. Except as otherwise 
provided, an enrollee must change the enrollment within the period 
beginning 31 days before the date of loss of coverage and ending 60 
days after the date of loss of coverage. Losses of coverage include, 
but are not limited to--
    (1) Loss of coverage under another FEHB enrollment due to the 
termination, cancellation, or change to self plus one or to self only, 
of the covering enrollment.
* * * * *

0
15. Amend Sec.  890.1202 by revising the definition of ``Covered family 
members'' to read as follows:


Sec.  890.1202   Definitions.

* * * * *
    Covered family members as it applies to individuals covered under 
this subpart has the same meaning as set forth in Sec.  890.101(a). For 
eligible survivors of individuals enrolled under this subpart, a self 
plus one enrollment covers only the survivor or former spouse and one 
eligible child of both the survivor or former spouse and hostage. A 
self and family enrollment covers only the survivor or former spouse 
and any eligible children of both the survivor or former spouse and 
hostage.
* * * * *

0
16. Amend Sec.  890.1203 by revising paragraph (b) to read as follows:


Sec.  890.1203   Coverage.

* * * * *
    (b) An individual who is covered under this subpart is covered 
under the Standard Option of the Service Benefit Plan. The individual 
has a self and family enrollment unless the U.S. Department of State 
determines that the individual is married and has no eligible children, 
or is unmarried and has one eligible child, in which case the 
individual is covered under a self plus one enrollment, or unless the 
U.S. Department of State determines that the individual is unmarried 
and has no eligible children, in which case the individual has a self 
only enrollment.
* * * * *

0
17. Amend Sec.  890.1205 by revising paragraphs (a) and (b) to read as 
follows:


Sec.  890.1205  Change in type of enrollment.

    (a) Individuals covered under this subpart or eligible survivors 
enrolled under this subpart may increase enrollment type if they 
acquire an eligible family member. The change may be made at the 
written request of the enrollee at any time after the family member is 
acquired. An increase in enrollment type under this paragraph (a) 
becomes effective on the 1st day of the pay period after the pay period 
during which the request is received by the U.S. Department of State, 
except that a change based on the birth or addition of a child as a new 
family member is effective on the 1st day of the pay period during 
which the child is born or otherwise becomes a new family member.
    (b) Individuals covered under this subpart or eligible survivors 
enrolled under this subpart may decrease enrollment type from a self 
and family enrollment when the last eligible family member (other than 
the enrollee) ceases to be a family member or only one family member 
remains; and may decrease enrollment type from a self plus one 
enrollment when no family member remains. The change may be made at the 
written request of the enrollee at any time after the last family 
member is lost and it becomes effective on the 1st day of the pay 
period after the pay period during which the request is received by the 
U.S. Department of State.
* * * * *

0
18. Amend Sec.  890.1209 by revising paragraph (c) to read as follows:


Sec.  890.1209   Responsibilities of the U.S. Department of State.

* * * * *
    (c) The U.S. Department of State must determine the number of 
eligible family members, if any, for the purpose of coverage under a 
self only, self plus one, or self and family enrollment as set forth in 
Sec.  890.1203(b). If the number of eligible family members of the 
individual cannot be determined, the U.S. Department of State must 
enroll the individual for self and family coverage.

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

0
19. 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.


0
20. In Sec.  892.101, the definition of ``Qualifying life event'' is 
amended by revising the introductory text and paragraphs (9) and (13) 
to read as follows:


Sec.  892.101  Definitions.

* * * * *
    Qualifying life event means an event that may permit changes to 
your FEHB enrollment as well as changes to your premium conversion 
election as described in Treasury regulations at 26 CFR 1.125-4. For 
purposes of determining whether a qualifying life event has occurred 
under this part, a stepchild who is the child of an employee's domestic 
partner as defined in part 890 of this chapter shall be treated as 
though the child were a dependent within the meaning of 26 CFR 1.125-4 
even if the child does not so qualify under such Treasury regulations. 
Such events include the following:
* * * * *
    (9) An employee becomes entitled to Medicare. (For change to self 
only, self plus one, cancellation, or change in premium conversion 
status see paragraph (11) of this definition.)
* * * * *
    (13) An employee or eligible family member becomes eligible for 
premium

[[Page 55739]]

assistance under Medicaid or a State Children's Health Insurance 
Program (CHIP). An eligible employee may enroll and an enrolled 
employee may decrease or increase enrollment type, change 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 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.

0
21. Amend Sec.  892.207 by revising paragraph (b) and adding paragraph 
(d) to read as follows:


Sec.  892.207  Can I make changes to my FEHB enrollment while I am 
participating in premium conversion?

* * * * *
    (b) However, if you are participating in premium conversion there 
are two exceptions: You must have a qualifying life event to decrease 
enrollment type, switch a covered family member, or to cancel FEHB 
coverage entirely. (See Sec. Sec.  892.209 and 892.210.) Your change in 
enrollment must be consistent with and correspond to your qualifying 
life event as described in Sec.  892.101. These limitations apply only 
to changes you may wish to make outside open season.
* * * * *
    (d) During the first plan year in which the self plus one 
enrollment type is available, OPM will administer a limited enrollment 
period for enrollees who participate in premium conversion. During this 
limited enrollment period, enrollees who participate in premium 
conversion will be allowed to decrease enrollment from self and family 
to self plus one during a time period determined by OPM. No other 
changes, including changes in plan or plan option or increases in 
enrollment, will be allowed. Enrollments will be effective on the first 
day of the first pay period following the one in which the appropriate 
request is received by the employing office.

0
22. Revise Sec.  892.208 to read as follows:


Sec.  892.208  Can I decrease my enrollment type at any time?

    If you are participating in premium conversion you may decrease 
your FEHB enrollment type under either of the following circumstances:
    (a) During the annual open season. A decrease in enrollment type 
made during the annual open season takes effect on the 1st day of the 
first pay period that begins in the next year.
    (b) Within 60 days after you have a qualifying life event. A 
decrease in enrollment type made because of a qualifying life event 
takes effect on the first day of the first pay period that begins after 
the date your employing office receives your appropriate request. Your 
change in enrollment must be consistent with and correspond to your 
qualifying life event. For example, if you get divorced and have no 
dependent children, changing to self only would be consistent with that 
qualifying life event. As another example, if both you and your spouse 
are Federal employees, and your youngest dependent turns age 26, 
changing from a self and family to a self plus one or two self only 
enrollments would be consistent and appropriate for that event.
    (c) If you are subject to a court or administrative order as 
discussed in Sec.  890.301(g)(3), you may not decrease enrollment type 
in a way that eliminates coverage of a child identified in the order as 
long as the court or administrative order is still in effect and you 
have at least one child identified in the order who is still eligible 
under the FEHB Program, unless you provide documentation to your agency 
that you have other coverage for your child or children. See also 
Sec. Sec.  892.207 and 892.209. If you are subject to a court or 
administrative order as discussed in Sec.  890.301(g)(3), you may not 
change your enrollment to self plus one as long as the court or 
administrative order is still in effect and you have more than one 
child identified in the order who is still eligible under the FEHB 
Program, unless you provide documentation to your agency that you have 
other coverage for your children. See also Sec. Sec.  892.207 and 
892.209.

[FR Doc. 2015-23348 Filed 9-16-15; 8:45 am]
BILLING CODE 6325-63-P



                                            55726            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                               (iii) Undercut host-country                           compelling political, safety, or security             fee to recipients of USAID grants,
                                            government ‘‘ownership’’ of                              concerns, or marking would have an                    cooperative agreements or other
                                            constitutions, laws, regulations,                        adverse impact in the cooperating                     assistance awards or subawards.
                                            policies, studies, assessments, reports,                 country. USAID recipients may request                 Additional costs associated with
                                            publications, surveys or audits, public                  waivers of the Marking Plan in whole or               marking requirements will be met by
                                            service announcements, or other                          in part, through the AOR. No marking                  USAID if reasonable, allowable, and
                                            communications better positioned as                      is required while a waiver                            allocable under 2 CFR part 200, subpart
                                            ‘‘by’’ or ‘‘from’’ a cooperating country                 determination is pending. The waiver                  E. The standard cost reimbursement
                                            ministry or government official.                         determination on safety or security                   provisions of the grant, cooperative
                                               (iv) Impair the functionality of an                   grounds must be made in consultation                  agreement, other assistance award or
                                            item, such as sterilized equipment or                    with U.S. Government security                         subaward must be followed when
                                            spare parts.                                             personnel if available, and must                      applying for reimbursement of
                                               (v) Incur substantial costs or be                     consider the same information that                    additional marking costs.
                                            impractical, such as items too small or                  applies to determinations of the safety                  (End of award term)
                                            other otherwise unsuited for individual                  and security of U.S. Government
                                            marking, such as food in bulk.                           employees in the cooperating country,                 Angelique M. Crumbly,
                                               (vi) Offend local cultural or social                  as well as any information supplied by                Agency Regulatory Official, U.S. Agency for
                                            norms, or be considered inappropriate                    the AOR or the recipient for whom the                 International Development.
                                            on such items as condoms, toilets, bed                   waiver is sought. When reviewing a                    [FR Doc. 2015–23419 Filed 9–16–15; 8:45 am]
                                            pans, or similar commodities.                            request for approval of a waiver, the                 BILLING CODE 6116–01–P
                                               (vii) Conflict with international law.                Principal Officer may review how
                                               (2) These exceptions are presumptive,                 program materials will be marked (if at
                                            not automatic and must be approved by                    all) if the USAID Identity is removed.
                                            the Agreement Officer. Apparently                        Approved waivers are not limited in                   OFFICE OF PERSONNEL
                                            successful applicants may request                        duration but are subject to Principal                 MANAGEMENT
                                            approval of one or more of the                           Officer review at any time due to
                                            presumptive exceptions, depending on                     changed circumstances. Approved                       5 CFR Parts 890 and 892
                                            the circumstances, in their Marking                      waivers ‘‘flow down’’ to recipients of
                                            Plan. The Agreement Officer will review                  subawards unless specified otherwise.                 RIN 3206–AN08
                                            requests for presumptive exceptions for                  Principal Officers may also authorize
                                            adequacy, along with the rest of the                     the removal of USAID markings already                 Federal Employees Health Benefits
                                            Marking Plan. When reviewing a request                   affixed if circumstances warrant.                     Program Self Plus One Enrollment
                                            for approval of a presumptive exception,                 Principal Officers’ determinations                    Type
                                            the Agreement Officer may review how                     regarding waiver requests are subject to
                                            program materials will be marked (if at                  appeal to the Principal Officer’s                     AGENCY:  Office of Personnel
                                            all) if the USAID identity is removed.                   cognizant Assistant Administrator.                    Management.
                                            Exceptions approved will apply to                        Recipients may appeal by submitting a                 ACTION: Final rule.
                                            subrecipients unless otherwise provided                  written request to reconsider the
                                            by USAID.                                                Principal Officer’s waiver determination              SUMMARY:   The United States Office of
                                               (i) In cases where the Marking Plan                   to the cognizant Assistant                            Personnel Management (OPM) is issuing
                                            has not been complied with, the                          Administrator.                                        a final rule to amend the Federal
                                            Agreement Officer will initiate                             (2) Non-retroactivity. Marking                     Employees Health Benefits (FEHB)
                                            corrective action. Such action may                       requirements apply to any obligation of               Program regulations to add an
                                            involve informing the recipient of a                     USAID funds for new awards as of                      additional enrollment type called ‘‘self
                                            USAID grant or cooperative agreement                     January 2, 2006. Marking requirements                 plus one’’ for premium rating and
                                            or other assistance award or subaward                    also will apply to new obligations under              family member eligibility purposes.
                                            of instances of noncompliance and                        existing awards, such as incremental                  DATES: This rule is effective September
                                            requesting that the recipient carry out                  funding actions, as of January 2, 2006,               17, 2015.
                                            its responsibilities as set forth in the                 when the total estimated cost of the
                                            Marking Plan and award. Major or                                                                               FOR FURTHER INFORMATION CONTACT:
                                                                                                     existing award has been increased by
                                            repeated non-compliance with the                                                                               Chelsea Ruediger at Chelsea.Ruediger@
                                                                                                     USAID or the scope of effort is changed
                                            Marking Plan will be governed by the                                                                           opm.gov or (202) 606–0004.
                                                                                                     to accommodate any costs associated
                                            uniform suspension and termination                       with marking. In the event a waiver is                SUPPLEMENTARY INFORMATION: The U.S.
                                            procedures set forth at 2 CFR 200.338                    rescinded, the marking requirements                   Office of Personnel Management (OPM)
                                            through 2 CFR 200.342, and 2 CFR                         will apply from the date forward that                 issued a Notice of Proposed Rulemaking
                                            700.14.                                                  the waiver is rescinded. In the event a               on December 2, 2014 to amend title 5 of
                                               (j)(1) Waivers. USAID Principal                       waiver is rescinded after the period of               the Code of Federal Regulations parts
                                            Officers, defined for purposes of this                   performance as defined in 2 CFR 200.77                890 and 892 to include a self plus one
                                            provision at § 700.1, may at any time                    but before closeout as defined in 2 CFR               enrollment type to comply with the
                                            after award waive in whole or in part                    200.16., the USAID mission or operating               2013 Bipartisan Budget Act. During the
                                            the USAID approved Marking Plan,                         unit with initial responsibility to                   comment period on the proposed rule,
                                            including USAID marking requirements                     administer the marking requirements                   OPM received 64 comments including 5
                                            for each USAID funded program,                           must make a cost benefit analysis as to               from Federal Employees Health Benefits
tkelley on DSK3SPTVN1PROD with RULES




                                            project, activity, public communication                  requiring USAID marking requirements                  (FEHB) Program carriers, 2 from
                                            or commodity, or in exceptional                          after the date of completion of the                   employee organizations or unions, 1
                                            circumstances may make a waiver by                       affected programs, projects, activities,              from a carrier organization, and 56 from
                                            region or country, if the Principal                      public communications or commodities.                 individuals, many of them enrollees in
                                            Officer determines that otherwise                           (k) The USAID Identity and other                   the FEHB Program. These comments are
                                            USAID required marking would pose                        guidance will be provided at no cost or               addressed below.


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                       55727

                                            General Comments Regarding Self Plus                      received by the employing office.                     Budget Act was passed in 2013 and
                                            One                                                       Because enrollees who do not                          OPM has been working diligently to
                                               OPM received a variety of comments,                    participate in premium conversion (pre-               implement this statutory mandate
                                            mostly from FEHB enrollees, expressing                    tax deduction of premiums), including                 within a reasonable timeframe.
                                            excitement about the self plus one                        annuitants, may decrease their                        Enrollees who have been looking
                                            enrollment type. Commenters indicated                     enrollment at any time, this limited                  forward to this change will now be able
                                            that the enrollment type will benefit                     enrollment period is intended only for                to select a self plus one enrollment type
                                            them personally and financially.                          premium conversion participants. No                   during the 2015 Open Season for
                                               One commenter requested                                new enrollments, changes in plan or                   effective dates in January of 2016.
                                            justification for the implementation of                   plan option, or increases in enrollment
                                                                                                                                                            Comments on Family Member
                                            the self plus one enrollment type and                     will be allowed in conjunction with the
                                                                                                                                                            Eligibility
                                            expressed concern over the level of                       limited enrollment period.
                                            complexity that this additional                             In advance of Open Season each year,                  OPM received three comments about
                                            statutorily required enrollment type                      OPM, agencies and carriers inform                     family member eligibility. Two
                                            introduces to consumer choice in the                      employees and annuitants of their                     commenters asked about the eligibility
                                            FEHB Program. The commenter noted                         enrollment options and provide them                   of domestic partners and cohabitating
                                            that under the current two-tier system,                   with decision-making tools. Given the                 (unmarried) opposite sex couples. A
                                            ‘‘the typical enrollee . . . has a choice                 addition of the self plus one enrollment              third comment asked if a sibling could
                                            of about 20 plan options’’ and projected                  type, this communications strategy will               be covered.
                                            that options available for families may                   be augmented for the 2015 Open                          Family member eligibility is defined
                                            double and premiums might vary                            Season. OPM communications will                       in title 5 U.S. Code section 8901 and
                                            greatly.                                                  encourage enrollees to carefully review               includes spouses and children up to age
                                               OPM is updating 5 CFR parts 890 and                    the options available to them for plan                26. As stated in the supplementary
                                            892 to comply with provisions of the                      year 2016.                                            information of the proposed rule, family
                                            2013 Bipartisan Budget Act. This more                       An FEHB carrier requested                           member eligibility guidelines remain
                                            closely aligns insurance offerings for                    clarification that ‘‘enrollees will need to           the same as in place under the two tier
                                            Federal employees with those available                    make a positive election through their                system. Domestic partners, cohabitating
                                            in the commercial market and to more                      agency or retirement office in order to               (unmarried) couples, and siblings are
                                            equitably spread costs among the                          switch from self only or self and family              not considered eligible family members
                                            enrollment types offered.                                 to self plus one.’’ This statement is                 under the law at this time.
                                               OPM is aware that creation of a new                    correct. Just as is the case under the
                                                                                                                                                            Switching a Covered Family Member
                                            enrollment tier may create additional                     current two-tier system, enrollees must
                                            complexity. However, this complexity is                   inform their agency, either through an                  The proposed rule outlined the
                                            limited because the rule only introduces                  electronic or paper copy of the Standard              circumstances in which an enrollee
                                            a new enrollment type. Benefits design                    Form 2809, when they increase or                      with a self plus one enrollment would
                                            will not differ from other enrollment                     decrease coverage. Agencies are                       be allowed to switch their covered
                                            types offered within the same plan                        responsible for submitting this                       family member. Some commenters
                                            option, which minimizes the                               information to carriers. This                         expressed concerns that these
                                            complexity introduced by the rule. To                     requirement will be no different for self             provisions might lead to adverse
                                            alleviate potential concerns about                        plus one.                                             selection. OPM believes that adequate
                                            complexity during the introductory                                                                              protection against adverse selection is
                                                                                                      Comments on Effective Dates
                                            year, § 892.207(d) has been amended in                                                                          provided in the manner in which
                                            this final rule to include a one-time                       Several commenters requested                        Qualifying Life Events (QLEs) allowing
                                            limited enrollment period to be held in                   additional information about the timing               such a change have been limited.
                                            early 2016. Final dates for the Limited                   of the implementation of the self plus                Further, the general rule applies that the
                                            Enrollment Period will be announced by                    one enrollment type. Others requested                 change must be consistent with the QLE
                                            OPM following the publication of this                     that OPM delay implementation by at                   experienced. The following chart, which
                                            rule. During this period, enrollees will                  least one year in order to conduct                    was published with the proposed rule,
                                            be allowed to decrease enrollment from                    additional analysis. Another questioned               clarifies which QLE codes will allow an
                                            self and family to self plus one.                         the decision to implement the new self                enrollee to switch a covered family
                                            Enrollment changes made in                                plus one enrollment option for plan year              member outside of Open Season
                                            conjunction with the limited enrollment                   2016, as this date was not required by                (definitions for each of the event codes
                                            period will be effective on the first day                 law.                                                  can be found on the SF2809 at http://
                                            of the first pay period following the one                   The effective date in this final rule               www.opm.gov/forms/pdf_fill/
                                            in which the appropriate request is                       has not been altered. The Bipartisan                  sf2809.pdf):

                                                                                    Change                                                          Permitted for the following event codes

                                                                                                  For Enrollees Participating in Premium Conversion

                                            Switch covered family member under a self plus one enrollment ...........              1B, 1C, 1I, 1J, 1M, 1N, 1O, 1P, 1Q, 1R

                                                                                      For Annuitants (decreases in enrollment type are allowed at any time)
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                                            Switch covered family member under a self plus one enrollment ...........              2A, 2B, 2F, 2G, 2H, 2I, 2J

                                                             For Former Spouses Under the Spouse Equity Provision (decreases in enrollment type are allowed at any time)

                                            Switch covered family member under a self plus one enrollment ...........              3B, 3C, 3F, 3G, 3H, 3I




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                                            55728            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                                                                   Change                                                          Permitted for the following event codes

                                                  For Temporary Continuation of Coverage (TCC) for Eligible Former Employees, Former Spouses, and Children (decreases in
                                                                                         enrollment type are allowed at any time)

                                            Switch covered family member under a self plus one enrollment ...........             4B, 4C, 4D, 4F, 4G, 4H

                                                         For Employees Not Participating in Premium Conversion (decreases in enrollment type are allowed at any time)

                                            Switch covered family member under a self plus one enrollment ...........             5B, 5C, 5F, 5G, 5H, 5I, 5J, 5N



                                               One carrier organization requested                    date for switching a covered family                      Retirement is not a QLE and therefore
                                            that OPM require a 30 day advance                        member will be prospective. A                         no changes may be made based solely
                                            notice to carriers before allowing a                     definition of the term ‘‘switching a                  on retirement. Retirement is a change
                                            switch in covered family member in                       covered family member’’ has also been                 from one payroll office to another. After
                                            order to prevent overpayments as well                    added to § 890.101.                                   an individual is retired, under the
                                            as verification of alternative health                       One commenter requested that OPM                   provisions in § 890.301(e), they may
                                            insurance for the family member being                    clarify that ‘‘enrollees cannot switch the            decrease enrollment or cancel coverage
                                            removed. OPM declines to make this                       covered family member under the self                  at any time. QLEs are still required for
                                            change. It is expected that carriers will                plus one without a QLE to validate                    increasing coverage or changing plans
                                            utilize current standard operating                       dependent eligibility.’’ As described in              outside of Open Season.
                                            procedures to process the switching of                   the proposed rule, and supported in the                  It was requested that OPM clarify the
                                            a covered family member; generally                       final rule, enrollees must experience a               process for handling an annuitant who,
                                            changes are effective at the beginning of                QLE in order to switch their covered                  upon experiencing the death of her
                                            the next pay period after receipt by the                 family member.                                        spouse, forgets to decrease her
                                            agency.                                                     One commenter requested additional                 enrollment to self only. As this question
                                               A commenter urged OPM to treat the                                                                          is beyond the scope of this regulation,
                                                                                                     information about how carriers will be
                                            switch as a cancellation for the family                                                                        OPM declines to comment at this time.
                                                                                                     notified of the designated covered
                                            member who is being removed from the                                                                              Additional guidance was requested
                                                                                                     family member under the self plus one
                                            self plus one enrollment, thereby                                                                              regarding carrier responsibilities to
                                                                                                     enrollment. The Standard Form 2809
                                            rendering the individual ineligible for                                                                        notify enrollees and agencies when a
                                                                                                     and electronic enrollment transmissions
                                            the 31 day extension of coverage. Just as                                                                      family member has aged out of
                                                                                                     will be utilized just as they are currently
                                            is the case under the two tier system,                                                                         eligibility or passed away. OPM
                                                                                                     to communicate enrollment
                                            under § 890.401(a)(1) eligibility for the                                                                      encourages carriers to contact their
                                                                                                     information. Additionally, OPM is
                                            31 day extension of coverage is                                                                                enrollees when a child ages out or if
                                                                                                     assessing other methods, including
                                            provided for covered family members                                                                            they learn of the death of a covered
                                                                                                     updating enrollment systems
                                            whose coverage is terminated other than                                                                        family member in order to inform the
                                                                                                     government-wide to allow for the
                                            by cancellation of the enrollment or                                                                           enrollee of their QLE opportunity at that
                                                                                                     transmittal of changes in the designated
                                            discontinuance of the plan, in whole or                                                                        time.
                                                                                                     family member from agencies to
                                            in part. For family members,
                                                                                                     carriers.                                             Alternative Enrollment Types
                                            terminations are typically based on a
                                            loss of eligibility such as, in the case of                 One commenter asked that OPM                          Four commenters suggested
                                            a child, turning age 26; or, in the case                 require the capture of a Social Security              alternative enrollment types. One
                                            of a spouse, a divorce. Cancellation is                  Number for dependents. As this is                     commenter suggested that OPM provide
                                            typically a voluntary election to no                     outside the scope of this rule, we                    rates based on the number of family
                                            longer be covered under an FEHB plan,                    decline to comment at this time.                      members enrolled. Another suggested
                                            for example when a family member                         Qualifying Life Events (QLE)                          an enrollment type available to only
                                            becomes eligible for other group                                                                               those enrolled in both FEHB and
                                            coverage. Switching a covered family                        One commenter requested that OPM                   Medicare. A third commenter suggested
                                            member may occur as the result of                        clarify whether or not enrollees must                 that, instead of self plus one, OPM alter
                                            either a termination or a cancellation.                  experience a QLE in order to decrease                 eligibility guidelines to allow spouses
                                            Therefore, OPM declines to make this                     enrollment outside of Open Season.                    and dependents to enroll in their own
                                            change.                                                  Under § 892.208, enrollees who                        right in self only enrollments. Finally,
                                               One commenter urged OPM to apply                      participate in premium conversion must                an FEHB carrier commented that OPM
                                            a blanket policy against discretionary                   experience a QLE in order to decrease                 should implement a four-tier system:
                                            retroactive switching of a covered                       enrollment outside of Open Season.                    Self only, employee and spouse,
                                            family member. Section 892.207(b) has                    Under § 890.301(e), enrollees who do                  employee and one non-spousal family
                                            been updated in the final rule to include                not participate in premium conversion                 member, and self and family.
                                            switching a covered family member in                     may decrease enrollment at any time.                  Commenters urged OPM to consider
                                            order to accommodate this suggestion.                    This final rule has not altered these                 methods for encouraging or requiring
                                            Enrollment changes made under                            requirements.                                         Medicare enrollment. One suggested
                                            § 892.207 are, in general, effective on                     Another commenter requested that                   that OPM should consider reducing
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                                            the first day of the first pay period                    OPM clarify that ‘‘retired federal                    premiums for annuitants enrolled in
                                            following the one in which the                           employees/annuitants will have the                    Medicare as FEHB is the secondary
                                            appropriate request is received by the                   option to change plans and/or                         payer. Another expressed concerns that
                                            employing office. In addition, paragraph                 enrollment types upon retirement,                     the addition of the self plus one
                                            (f)(2) has been added to § 890.302 in the                regardless of Medicare eligibility or age             enrollment type would exacerbate an
                                            final rule to specify that the effective                 at the time of retirement.’’                          existing problem in which younger


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                              55729

                                            enrollees subsidize higher cost                          government contribution for their plans                enrollment count to calculate the
                                            annuitants.                                              because they do not cover an adequate                  weighted average for both the 2016 self
                                              OPM is unable to implement these                       portion of the total market to estimate                plus one and self and family enrollment
                                            suggested changes. The FEHB statute                      actual FEHB enrollment to determine                    types. The weighted average for self
                                            only allows the following enrollment                     the weighted average. Thus, many plans                 plus one will be based on the 2016 self
                                            types: Self only, self plus one, and self                propose total premiums to OPM without                  plus one premiums and the 2015 self
                                            and family. Any other enrollment types,                  a complete understanding of what the                   and family March enrollment count.
                                            including separate enrollment tiers for                  government and enrollee contributions                  OPM provides rate-setting guidance to
                                            individuals enrolled in Medicare, would                  will be, putting them at a disadvantage                carriers on an annual basis. For the 2016
                                            require legislative change.                              in a competitive market. Given the                     plan year, OPM requested that carriers
                                            Definition of Self Plus One                              additional uncertainty for plan year                   propose self plus one premiums that are
                                                                                                     2016, with the addition of the self plus               no greater than self and family
                                               OPM received four comments                            one enrollment type, the commenter                     premiums.2 Although OPM does not
                                            indicating that the definition of self plus              requested that OPM provide carriers                    expect this policy to change in the out
                                            one in the proposed rule, which does                     more flexibility to adjust final premium               years, the right to reevaluate is reserved.
                                            not preclude an individual with only                     rates during the negotiation process
                                            one eligible family member from                                                                                 Rate-Setting and the Cost of Self Plus
                                                                                                     after the government contribution has                  One
                                            enrolling in self and family, has                        been calculated. OPM will adhere to
                                            potentially negative consequences.                       standard operating procedures for plan                    Comments were received that
                                            These commenters indicated the                           year 2016 final rate negotiations.                     indicated the addition of the self plus
                                            definition, coupled with concerns that                      An FEHB carrier requested that OPM                  one enrollment type would translate
                                            self plus one premiums and/or enrollee                   provide additional information to                      into cost savings for enrollees with only
                                            shares may rise above self and family                    carriers concerning rate setting for plan              one eligible family member.
                                            premiums and/or enrollee shares, could                   year 2016. In addition, they cautioned                 Commenters in this category praised
                                            result in revenue shortfall for carriers.                OPM against applying the same                          OPM for implementing the new
                                            They predicted that some consumers                       government contribution for both self                  enrollment type. Other commenters
                                            with only one eligible family member                     plus one and self and family                           expressed concerns about rate setting for
                                            will likely select a self and family                     enrollments for plan year 2016 as this                 the new self plus one enrollment type.
                                            enrollment if the enrollee share is lower,               method might lead to increased                         In particular, a concern that self and
                                            leading to a financial loss for plans with               ‘‘unpredictability of which subscribers                family premiums would rise drastically
                                            higher claims costs for self plus one                    will choose which tier.’’ Many                         in plan year 2016 in order to
                                            enrollments.                                             commenters requested additional                        accommodate the new self plus one
                                               Individual choice is, and always has                  information about the weighted averages                enrollment type. It was suggested that
                                            been, one of the hallmarks of the FEHB                   that would be used to determine the                    OPM impose a 10% cap on such growth
                                            Program. Before the addition of the self                 government contribution for plan year                  in the final rule, especially for the first
                                            plus one enrollment type, individuals                    2016.                                                  year of implementation. Others
                                            have been free to select a self only or                     The 2013 Bipartisan Budget Act                      expressed concerns about the
                                            self and family enrollment, regardless of                provides OPM with flexibility in the                   differential between the three
                                            whether or not they have eligible family                 first year that self plus one is offered to            enrollment tiers. OPM was asked to
                                            members. In that tradition, the final rule               ‘‘determine the weighted average of the                clarify whether or not the enrollee share
                                            adopts the proposed rule’s provision,                    subscription charges that will be in                   of a self plus one enrollment would be
                                            providing individuals the freedom to                     effect for the contract year for                       less than or exactly equal to two self
                                            select among all three enrollment types                  enrollments for self plus one under such               only enrollments. One carrier projected
                                            available, regardless of the number of                   chapter based on an actuarial                          that, although self plus one premiums
                                            their eligible family members.                           analysis.’’ 1 The weighted average is                  might not rise above self and family
                                               One commenter requested that OPM                      used to calculate the Government                       premiums, the differential between the
                                            use this opportunity to expressly state                  contribution, according to a formula set               two would be negligible, calling into
                                            that all eligible family members are                     in statute (5 U.S.C. 8906). OPM takes a                question the cost-benefit of such a
                                            covered under a self and family                          count of enrollments with Government                   change given the high administrative
                                            enrollment. Current regulatory language,                 contributions in March of each year                    burden of implementation.
                                            which has not been altered in this rule,                                                                           Other commenters expressed
                                                                                                     (referred to in the following paragraphs
                                            already adequately expresses this.                                                                              concerns about actual claims costs. One
                                                                                                     as the ‘‘March enrollment count’’). This
                                            Section 890.302(a)(1) states that an                                                                            highlighted the unique nature of the
                                                                                                     March enrollment count is used to
                                            enrollment for self and family includes                                                                         FEHB risk pool because the annuitant
                                                                                                     determine the maximum Government
                                            all family member who are eligible to be                                                                        population is combined with the active
                                                                                                     contribution for the following plan year.
                                            covered by the enrollment. Further, the                                                                         employee population, indicating that
                                                                                                     For each enrollment type, OPM sums
                                            definition of self and family, as added                                                                         many annuitants, who traditionally
                                                                                                     the product of the new premium and the
                                            by this final rule states that self and                                                                         have higher claims costs, have only one
                                                                                                     March enrollment count for each option
                                            family enrollment means an enrollment                                                                           eligible family member and therefore
                                                                                                     and divides the sum by the total number                might make up the bulk of self plus one
                                            that covers the enrollee and all eligible                of individuals enrolled in that
                                            family members.                                                                                                 enrollees. Two commenters pointed out
                                                                                                     enrollment type.                                       that HMO plans might be especially
                                            Government Contribution Calculations                        Because we do not have self plus one
                                                                                                                                                            impacted. They expressed concerns
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                                                                                                     data from our March 2015 enrollment
                                              The government contribution to                                                                                that, if OPM were to require that self
                                                                                                     count, OPM has determined that it will
                                            premium is calculated based on
                                                                                                     use the 2015 self and family March
                                            weighted average of the subscription                                                                              2 United States Office of Personnel Management,

                                            charges described in 5 U.S. Code section                                                                        Federal Employees Health Benefits Program Call
                                                                                                       1 Full text available at http://www.gpo.gov/fdsys/   Letter, Fiscal Year 2016, Issued March 13, 2015.
                                            8906. One commenter points out that                      pkg/BILLS-113hjres59enr/pdf/BILLS-                     https://www.opm.gov/healthcare-insurance/
                                            most carriers are unable to predict the                  113hjres59enr.pdf.                                     healthcare/carriers/2015/2015-02.pdf



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                                            55730            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                            plus one total premiums remain below                     utilized to determine the weighted                    changes with agencies, carriers, and
                                            self and family total premiums, the end                  average of all FEHB plans for plan year               enrollment systems. We are confident
                                            result would be an even more dramatic                    2015.                                                 that, through all of these efforts, all
                                            increase for self and family enrollees.                    OPM believes the analysis provided                  necessary systems updates will be
                                            The commenter projected that this                        in the proposed rule fulfills legal                   completed in time for a smooth
                                            change would render some regional                        requirements. As noted in the proposed                implementation of the self plus one
                                            HMOs non-competitive, forcing them                       and reiterated in the final rule, this                enrollment type in plan year 2016.
                                            out of the FEHB market.                                  change is being implemented to comply
                                              The final rule does not set                            with the 2013 Bipartisan Budget Act. In               Paperwork Reduction Act (PRA)
                                            differentials between tiers, nor does it                 addition, this change aligns insurance                  OPM has reviewed this final rule for
                                            impose caps on premium growth. Under                     offerings with those available in the                 PRA implications and has determined
                                            the three tier system, carriers will set                 commercial market and more equitably                  that it does not apply to this section.
                                            rate differentials between tiers that are                spreads costs among the enrollment                    Regulatory Impact Analysis
                                            appropriate for the expected population,                 types offered.
                                            just as they do under the two tier                                                                                Executive Order 12866 and Executive
                                                                                                     Information Provided to Carriers                      Order 13563 directs agencies to assess
                                            system. An artificial cap is unwarranted
                                            because plans must set rates that reflect                   Four commenters requested that we                  all costs and benefits of available
                                            the costs of the population they will be                 clarify information for carriers. One                 regulatory alternatives and, if regulation
                                            covering. Further, enrollees have free                   commenter asked OPM to release                        is necessary, to select regulatory
                                            choice to stay in their current plan or                  details, including the final rule, by                 approaches that maximize net benefits
                                            shop for a less expensive plan or option                 March 31, 2015 to allow carriers ample                (including potential economic,
                                            that meets their needs. Because the                      time to prepare. Another commenter                    environmental, public, health, and
                                            FEHB Program is market-based, artificial                 asked for additional details on                       safety effects, distributive impacts, and
                                            caps on premium are likely to cause                      enrollment and eligibility under the                  equity). A regulatory impact analysis
                                            adverse consequences such as                             new self plus one enrollment type;                    must be prepared for major rules that
                                            inadequate rates for some products.                      however, provided no specific                         may have economically significant
                                              One commenter requested that rate                      questions.                                            effects (i.e., effects of $100 million or
                                            information be provided earlier than                        One commenter asked that OPM                       more in at least one year). Given that
                                            normally scheduled to provide                            clarify benefits structures including                 there are approximately 8.2 million
                                            individuals adequate time to analyze                     deductibles and out of pocket                         members participating in the FEHB
                                            their options. Given the rate negotiation                maximums. OPM addressed these issues                  Program, including approximately one
                                            process outlined in § 890.501, OPM                       through normal carrier communications                 million two-person self and family
                                            cannot set the government contribution                   including the annual call letter, carrier             enrollments, and participation involves
                                            before September 1st for the following                   letters, and teleconferences. OPM                     hundreds of dollars per member per
                                            plan year.                                               utilizes several methods for                          month, we cannot rule out the
                                                                                                     communicating with carriers including,                possibility that this final rule’s changes
                                            Comments on the Regulatory Impact
                                                                                                     but not limited to carrier letters,                   to the FEHB Program will have effects
                                            Analysis
                                                                                                     brochure tools, and teleconferences.                  that meet the threshold for economic
                                              Commenters who discussed OPM’s                         Some of the information requested                     significance. We do expect the overall
                                            Regulatory Impact Analysis (RIA) in the                  during the public comment period                      federal budget impact of this final rule
                                            proposed rule asked that OPM provide                     either has already been released or is                to be net neutral, though this is subject
                                            a more robust analysis for public                        forthcoming via these alternative                     to uncertainty.
                                            comment. Four commenters suggested                       communication methods.                                   The new enrollment tier will align
                                            that the RIA provided in the proposed                                                                          FEHB Program offerings with the
                                            rule was insufficient under                              Systems Updates
                                                                                                                                                           commercial market and serve to more
                                            requirements outlined in the                               OPM received three comments                         equitably spread costs across different
                                            Administrative Procedures Act,                           relative to the systems updates required              enrollment types; in other words, it will
                                            Executive Order 12866, Executive Order                   to implement the new self plus one                    shift costs among program participants.
                                            13563, and the Congressional Review                      enrollment type. One commenter also                   For plan year 2016, OPM has required
                                            Act. They suggested a delay in                           asked that the brochure template                      that that the self plus one enrollment
                                            implementation in order to conduct                       language be available early. Two                      type have total premiums no greater
                                            additional analysis, provide details to                  commenters suggested that OPM                         than self and family total premiums.
                                            the public, and allow for an additional                  improve processes by which dependent
                                            comment period. One commenter stated                     information is communicated to                        Current FEHB Enrollment Trends
                                            OPM had failed to properly justify the                   carriers. An employee organization                       In plan year 2015 there were over 4
                                            change and to explain the potential                      noted that the number of enrollment                   million FEHB contracts. This includes
                                            impacts on the FEHB Program. Multiple                    changes in Open Season 2015 is likely                 1.89 million self only contracts (47%)
                                            commenters disagreed with OPM’s                          to far exceed the average Open Season                 and 2.13 million self and family
                                            assertion that self plus one premiums                    and expressed concerns that the overall               contracts (53%).
                                            would likely be lower than self and                      system would not be able to handle this                  During a typical year, approximately
                                            family. One commenter noted that the                     increased number of enrollment                        6% of FEHB enrollees change their
                                            RIA failed to discuss the possibility of                 changes.                                              enrollment by selecting a new plan
                                            rate differentials between the                             OPM has carefully and deliberately                  option or a new enrollment type
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                                            enrollment types. The commenter                          been reviewing, modifying, and testing                (approximately 8% of active employees
                                            suggested that all carriers should be                    internal systems to ensure that enrollee              and 4% of annuitants). However, as this
                                            required to maintain the same                            information is accurately collected and               is the first time the FEHB Program has
                                            differentials between their plan tiers.                  disseminated to carriers. In addition,                experienced a large-scale programmatic
                                            The commenter requested an actuarial                     numerous communications have been                     change as the addition of a new
                                            analysis of the method that will be                      distributed on the required systems                   enrollment type, it is expected that


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                             55731

                                            movement will be greater in the coming                   OPM requested data on covered                         that meets their needs. OPM is
                                            years as enrollees learn more about their                enrollees and family members from                     implementing a robust communications
                                            options.                                                 carriers with the 2014 rate proposals.                strategy to ensure that as many enrollees
                                                                                                     Carriers reported that over one million               as possible are aware of the new self
                                            Predicting Enrollment Trends Under the
                                                                                                     self and family contracts had only one                plus one enrollment type.
                                            Three Tier System                                        dependent listed. Of those enrollments,                  Plan design remains the same
                                               In order to estimate the impact of the                approximately 60% were annuitants                     between enrollment types offered in the
                                            addition of the self plus one enrollment                 and 40% were active employees. While                  same plan option. Therefore, OPM
                                            type, OPM has conducted an analysis to                   this number does not capture the                      expects that cognitive costs for enrollees
                                            predict the potential shift in enrollment                universe of enrollees who may choose a                would be relatively low. For those
                                            that may occur.                                          self plus one enrollment, it does provide             enrollees that do not typically
                                               OPM determined that the following                     a starting place for estimating the                   reevaluate their enrollment every Open
                                            movement patterns were possible:                         potential movement between tiers.                     Season, the cognitive costs of a review
                                               • FEHB eligible individuals who are                      OPM also examined enrollment data                  of the plans, plan options, and
                                            currently not enrolled may choose to                     for the Federal Employees Dental and                  enrollment types available may well be
                                            enroll in FEHB after self plus one                       Vision Insurance Program (FEDVIP).                    worth incurring, as they may discover
                                            becomes available.                                       FEDVIP has offered self plus one as an                better alternatives (though these
                                               • Current self only enrollees may                     enrollment option since its inception in              improvements may represent transfers
                                            choose to increase enrollment to include                 2007. There are currently approximately               from other members of society, rather
                                            coverage for an eligible family member                   2.7 million FEDVIP contracts. Of those,               than benefits to society as whole).
                                            who is not currently covered under an                    41% are self only, 32% are self plus                  Ultimately, actual enrollment decisions
                                            FEHB enrollment.                                         one, and 27% are self and family.                     cannot be predicted with precision.
                                               • Current self only enrollees may                        Comparing FEHB and FEDVIP                          Further, it will likely take years for
                                            choose to cancel coverage in order to be                 enrollment patterns may be illustrative               enrollment numbers to reach an
                                            covered under a spouse or parent’s self                  because the pool of eligible individuals              equilibrium following this Program
                                            plus one FEHB enrollment.                                is roughly the same. Most FEDVIP                      change.3
                                               • Current self and family enrollees                   enrollees are also eligible for FEHB.
                                            with only one eligible family member                     However, there are some key differences               Cost Analysis
                                            may choose to decrease to a self plus                    between the programs. First, family                     OPM’s Fiscal Year 2014 Congressional
                                            one enrollment.                                          member eligibility guidelines are                     Budget Justification 4 included a
                                               • Current self and family enrollees                   slightly different. Eligible children are             projection that the addition of the self
                                            with two or more eligible family                         covered under FEDVIP enrollments                      plus one enrollment would have a net
                                            members may choose to decrease to a                      until the age of 22 whereas eligible                  neutral impact on the Federal budget.
                                            self plus one enrollment to cover only                   children are covered under FEHB until                 This projection, based on FEHB carriers’
                                            one of their eligible family members.                    the age of 26. Second, FEDVIP has lower               relative costs and population
                                               • Some FEHB enrollees in either self                  participation as it is an employee-pay-
                                            only or self and family may choose to                    all program with no government                          3 As discussed in more detail elsewhere in this
                                            cancel their enrollments.                                contribution towards the premium. In                  analysis, plan switching—in which federal
                                               • Enrollees in either self only or self               addition, benefits offered in standalone              employees and annuitants with one eligible family
                                            and family may choose to remain in                       dental and vision programs are limited,               member gravitate toward plans with relatively low
                                            their current enrollment type.                                                                                 self plus one premiums and federal employees and
                                                                                                     and therefore, enrollee behavior and                  annuitants with multiple eligible family members
                                               Based on available data and                           motivation based on those benefits                    gravitate toward plans with relatively low self and
                                            experience, OPM estimates that much of                   would be different.                                   family premiums—would lead to further changes in
                                            the movement that will occur will result                    Examining the types of movement                    premiums, and several iterations of switching
                                            in a shift from one enrollment type to                   that are possible and comparing FEHB                  activity and premium adjustments may occur before
                                                                                                                                                           the new equilibrium is reached. Moreover, because
                                            another. There are a limited number of                   enrollment trends with other programs                 health insurance decisions tend to be characterized
                                            circumstances where the addition of the                  provides only a limited view of the                   by inertia, the behavioral changes discussed here
                                            self plus one enrollment type may result                 complex factors that affect enrollment                and throughout this analysis may be relatively rare
                                            in new FEHB enrollees or in enrollees                    decisions for enrollees. Enrollee choice              when this rule is first implemented and then
                                                                                                                                                           become more widespread over time, as turnover
                                            leaving the program. It is difficult to                  and movement is an individualized                     occurs in the federal workforce and there is an
                                            estimate how many individuals may                        decision based on the needs of the                    accumulation of qualifying life events that cause
                                            newly enroll in the program. Most                        enrollee and their dependents. Self plus              FEHB participants to reconsider their health
                                            employees who do not participate in the                  one uptake is dependent on a                          insurance choices.
                                                                                                                                                             4 United States Office of Personnel Management,
                                            FEHB Program do so because they have                     combination of factors including
                                                                                                                                                           Congressional Budget Justification Performance
                                            access to other insurance options. This                  premiums, benefits structures, and the                Budget, Fiscal Year 2014, Submitted April 2013,
                                            rule will not alter access to other                      level of communication from agencies,                 available at https://www.opm.gov/about-us/budget-
                                            insurance for FEHB eligible employees.                   carriers, and OPM about new                           performance/budgets/congressional-budget-
                                            Also, because OPM does not have                          enrollment options.                                   justification-fy2014.pdf. See also Congressional
                                                                                                                                                           Budget Office, Cost Estimate, Bipartisan Budget Act
                                            government-wide eligible and covered                        For most enrollees, the enrollee share             of 2013, dated December 11, 2013, available at
                                            family member data, it is not known                      for self plus one will be lower than for              http://www.cbo.gov/sites/default/files/cbofiles/
                                            exactly how many individuals are                         self and family; however, it is possible              attachments/Bipartisan%20Budget%20Act%
                                            covered under self and family                            that, because of the statutory formula                20of%202013.pdf. In estimating potential premium
                                                                                                                                                           changes, OPM used data on FEHB enrollees’
                                            enrollments, nor is it known how many                    used to calculate the government
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                                                                                                                                                           medical expenditures, while CBO used data on
                                            eligible family members exist but are                    contribution, some plans may have a                   medical expenditures for the general population.
                                            not currently covered because the                        higher enrollee share for self plus one               Because of the large number of annuitants in the
                                            enrollee has chosen a self only                          than for self and family. This will make              FEHB enrolled population, two-person FEHB
                                                                                                                                                           enrollments tend to have higher costs than two-
                                            enrollment.                                              it even more important for enrollees to               person enrollments in the nation as a whole, thus
                                               In order to learn more about potential                review their enrollment options before                explaining some of the difference between OPM’s
                                            movement between enrollment types,                       selecting a plan and an enrollment type               and CBO’s estimates.



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                                            55732            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                            distributions, included the following                    projections and results in the overall                of a federal employee’s or annuitant’s
                                            assumptions:                                             net-neutral projection.                               spouse if that employer sponsors the
                                               • The average premium for self plus                      Actual cost shifting cannot be                     newly-chosen insurance).
                                            one coverage will be approximately                       measured until rate negotiations are                     • Federal employees and annuitants
                                            94% of the cost of existing self and                     finalized and enrollment changes take                 who, in the absence of the rule, would
                                            family coverage.                                         place. As enrollees shift from self only              choose self only enrollment in spite of
                                               • The average premium for self and                    and self and family enrollments, OPM                  having a spouse who would be eligible
                                            family coverage will be approximately                    will closely monitor the effect on                    for coverage under self and family
                                            107% of the cost of existing self and                    premiums. If premiums for active                      enrollment may choose self plus one
                                            family coverage.                                         employees with two or more covered                    enrollment. This might occur if a self
                                               • 33% of active employees with                        family members rise, there will be                    and family premium is greater than the
                                            existing self and family will shift to self              increasing costs to government agencies               combined premiums for a federal
                                            plus one coverage.                                       (assuming appropriation of necessary                  employee’s self only enrollment and a
                                               • Only 20% of annuitants with                         funds).5                                              spouse’s self only enrollment in health
                                            existing self and family coverage will                      The impact of this final rule hinges               insurance through his or her own non-
                                            retain that coverage (80% will shift to                  upon the relative premiums for self plus              federal employer, but the relevant FEHB
                                            self plus one).                                          one and self and family enrollment                    self plus one premium is less than the
                                               As discussed above, there are several                 types. Because the self and family                    combined premiums.6 In this type of
                                            ways in which enrollees may choose to                    option includes coverage for a larger                 scenario in which the federal
                                            change their enrollment based on the                     number of people, a natural assumption                employee’s or annuitant’s enrollment
                                            addition of the self plus one enrollment                 would be that premiums would be                       increases, the federal government would
                                            type. The magnitudes of these changes                    lower for a self plus one enrollment type             pay more in premiums (relative to a
                                            (and the effects experienced by the                      than for a self and family enrollment                 baseline in which this rule is not
                                            government that depend on FEHB                           type. For plan year 2016, OPM                         finalized) but the federal employee’s or
                                            participants’ behavior) would be                         instructed carriers to propose total                  annuitant’s family would pay less. Any
                                            correlated with the amount that                          premiums for self plus one that were                  contributors to the insurance in which
                                            participant premium contributions                        less than or equal to total premiums for              the family member would be enrolled in
                                            change. If, as shown above, self plus one                self and family. In that case, several                the absence of the rule—such as the
                                            premiums are only slightly lower than                    rule-induced outcomes are likely:                     non-federal employer of the federal
                                            baseline self and family premiums, then                     • Federal employees and annuitants                 employee’s spouse in the preceding
                                            two-person families will have little                     who, in the absence of the rule, would                example—would also pay less.
                                            incentive to transfer family members                     choose self and family enrollment for                    To the extent that new patterns of
                                            from other coverage to FEHB. Similarly,                  themselves and either a spouse or a                   enrollment do not change how society
                                            if self and family premiums increase                     child would switch to a self plus one                 uses its resources (i.e., amount or
                                            only slightly as a result of this rule, then             enrollment, resulting in lower total                  quality of medical services provided),
                                            families larger than two people will                     premium payments between employees,                   then the effects described above would
                                            have little incentive to switch some or                  annuitants and the federal government.                be transfers between members of
                                            all of their members from FEHB to other                     • Federal employees and annuitants                 society, rather than social costs or
                                            health insurance coverage. As a result,                  choosing self and family enrollment for               benefits.
                                            in this example, a change in the cost of                 themselves and at least two family                       It is possible that two-person families
                                            the Program would be contingent, in                      members would experience an increase                  are, on average, less healthy than larger
                                            part, upon the amount of switching into                  in premiums and therefore, in some                    families; indeed, multiple comments to
                                            or out of FEHB from/to other health                      cases, may choose to switch from FEHB                 the docket provided evidence that some
                                            insurance.                                               to an alternative health insurance                    plans’ expenditures for two-person
                                               Current enrollees with self and family                option. If all such families continued                enrollments are higher than for
                                            coverage who only have one dependent                     with FEHB participation, the                          enrollments with three or more total
                                            and choose to decrease enrollment to                     government would experience an                        family members. For the 2016 plan year,
                                            self plus one, will likely benefit from                  increase in premium payments that                     because OPM has requested that carriers
                                            lower premiums. Those with more than                     would (in theory) exactly offset the                  propose self plus one premiums no
                                            one dependent covered under a self and                   decreases associated with two-person                  greater than self and family premiums,
                                            family enrollment will likely incur                      families switching from self and family               plans with this medical expenditure
                                            higher premiums. A large percentage of                   to self plus one enrollment; however,                 pattern will presumably set equal
                                            annuitants who currently have self and                   any switching away from FEHB would                    premiums for self plus one and self and
                                            family coverage would likely benefit                     mitigate the premium increases                        family enrollment types. In the event
                                            from the lower total premiums of a self                  experienced by the federal government,                that OPM does not repeat this request
                                            plus one enrollment type, resulting in                   instead potentially leading to payment                for future years, plans with higher
                                            score-able savings to the government                     increases by any contributors to the                  average expenditures for two-person
                                            because the government share of                          newly-chosen insurance options (an                    than for larger families will presumably
                                            annuitant premiums will decrease.                        obvious example would be the employer                 set premiums higher for self plus one
                                               OPM estimated that, in total, savings                                                                       enrollment than for self and family
                                            for annuitants and the government                          5 United States Office of Personnel Management,

                                            would rise above $450 million in the                     Congressional Budget Justification Performance          6 Similarly, federal employees and annuitants
                                                                                                     Budget, Fiscal Year 2014, Submitted April 2013,       who, in the absence of the rule, would choose not
                                            first year of self plus one. Conversely,
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                                                                                                     available at https://www.opm.gov/about-us/budget-     to participate in the FEHB Program may choose a
                                            costs for non-Postal employees and the                   performance/budgets/congressional-budget-             self plus one enrollment. For example, this outcome
                                            government would rise about $450                         justification-fy2014.pdf. See also Congressional      might occur if the self plus one option available in
                                            million for the same time frame. This                    Budget Office, Cost Estimate, Bipartisan Budget Act   the FEHB Program is less expensive than either a
                                                                                                     of 2013, dated December 11, 2013, available at        family or plus-one enrollment available via a
                                            converse relationship between costs                      http://www.cbo.gov/sites/default/files/cbofiles/      federal employee’s spouse or the combined
                                            associated with annuitants and                           attachments/Bipartisan%20Budget%20Act%                premiums for the federal employee’s self only
                                            employees continues into future year                     20of%202013.pdf.                                      enrollment and the spouse’s self only enrollment.



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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                         55733

                                            enrollment. If this pattern—in which                     until 2016. OPM, carriers, and Federal                5 CFR Part 892
                                            self plus one premiums are greater than                  agencies are well into the                              Administrative practice and
                                            or equal to self and family premiums—                    implementation process. Rate                          procedure, Government employees,
                                            held universally, the lack of premium                    negotiations between OPM and FEHB                     Health insurance, Taxes, Wages.
                                            decrease to give federal employees and                   carriers have begun under the
                                            annuitants an incentive to switch from                   assumption that the 2016 plan year                    U.S. Office of Personnel Management.
                                            self and family to self plus one                         would include the self plus one                       Beth F. Cobert,
                                            enrollment would lead to the rule’s                      enrollment type. Agencies and carriers                Acting Director.
                                            enrollment impact being negligible.7                     are currently implementing the systems                  Accordingly, OPM is amending title 5,
                                            However, as indicated by docket                          changes required to accommodate three                 Code of Federal Regulations as follows:
                                            submissions, relative expenditures on                    tier enrollments. Delaying
                                            (and thus premiums for) two-person and                   implementation would adversely impact                 PART 890—FEDERAL EMPLOYEES
                                            larger enrollments differ across plans,                  the Federal benefits Open Season which                HEALTH BENEFITS PROGRAM
                                            and hence the effect of adding the self                  is scheduled to begin in early November
                                            plus one option may be to increase                       of this year.                                         ■ 1. The authority citation for part 890
                                            switching between plans, as federal                                                                            continues to read as follows:
                                            employees and annuitants with one                        Congressional Review Act
                                                                                                                                                              Authority: 5 U.S.C. 8913; Sec. 890.301 also
                                            eligible family member gravitate toward                    OPM has determined that this                        issued under sec. 311 of Pub. L. 111–03, 123
                                            plans with relatively low self plus one                  regulatory action is not subject to the               Stat. 64; Sec. 890.111 also issued under
                                            premiums and federal employees and                       Congressional Review Act, 5 U.S.C.                    section 1622(b) of Pub. L. 104–106, 110 Stat.
                                            annuitants with multiple eligible family                 801–08, because it relates to agency                  521; Sec. 890.112 also issued under section
                                            members gravitate toward plans with                                                                            1 of Pub. L. 110–279, 122 Stat. 2604; 5 U.S.C.
                                                                                                     management and personnel. The
                                            relatively low self and family premiums.                                                                       8913; Sec. 890.803 also issued under 50
                                                                                                     program is not statutorily for general                U.S.C. 403p, 22 U.S.C. 4069c and 4069c–1;
                                            Plan switching of this type would lead                   application but rather governs                        subpart L also issued under sec. 599C of Pub.
                                            to further changes in premiums and                       employment fringe benefits for Federal                L. 101–513, 104 Stat. 2064, as amended; Sec.
                                            several iterations of switching activity                 employees, annuitants and their                       890.102 also issued under sections 11202(f),
                                            and premium adjustments may occur.                       families. Moreover, OPM has been                      11232(e), 11246(b) and (c) of Pub. L. 105–33,
                                               Additionally, the rule imposes                        statutorily granted discretion in terms of            111 Stat. 251; and section 721 of Pub. L. 105–
                                            implementation costs, such as the costs                  deciding how its actions may affect non-              261, 112 Stat. 2061.
                                            of systems updates, on FEHB-                             agency parties, such as carriers, by its
                                            participating health insurance plans,                                                                          ■  2. Amend § 890.101 as follows:
                                                                                                     authority to regulate enrollment. See, 5
                                            federal agencies, and on OPM itself.                                                                           ■  a. By revising the definitions of
                                                                                                     U.S.C. 8905(a), 8905(g)(2), and 8913(b).
                                            These expenses are encompassed in                                                                              ‘‘Change the enrollment’’ and ‘‘Covered
                                            existing workloads. OPM has no specific                  Regulatory Flexibility Act                            family member.’’
                                            estimate for these costs, but expects                                                                          ■ b. By adding the definitions of
                                                                                                        I certify that this regulation will not            ‘‘Decrease enrollment type,’’ ‘‘Increase
                                            them to be marginal.
                                                                                                     have a significant economic impact on                 enrollment type,’’ ‘‘Self and family
                                               Though regulatory alternatives to this
                                                                                                     a substantial number of small entities                enrollment,’’ ‘‘Self only enrollment,’’
                                            rule are limited due to the statutory
                                                                                                     because the regulation only adds a self               ‘‘Self plus one enrollment,’’ and
                                            mandate, OPM did consider delaying
                                                                                                     plus one enrollment tier to the current               ‘‘Switch a covered family member’’ in
                                            implementation of the rule until the
                                                                                                     self only and self and family enrollment              alphabetical order.
                                            2017 plan year. OPM rejected this
                                                                                                     tiers under FEHB.                                        The revisions and additions read as
                                            option for two reasons. First, delaying
                                            implementation will not provide                          Executive Orders 13563 and 12866,                     follows:
                                            additional information. Because OPM                      Regulatory Review
                                                                                                                                                           § 890.101   Definitions; time computations.
                                            contracts with a number of carriers,
                                            proposed rates are proprietary and                         This rule has been reviewed by the                  *     *      *     *    *
                                            cannot be released publically without                    Office of Management and Budget in                      Change the enrollment means to
                                            compromising confidential negotiation                    accordance with Executive Orders                      submit to the employing office an
                                            processes. Until first year negotiations                 13563 and 12866.                                      appropriate request electing a change of
                                            are completed and enrollment changes                     Federalism                                            enrollment to a different plan or option,
                                            occur, OPM would not have a precise                                                                            or to a different type of coverage (self
                                            understanding of the impact of the self                    We have examined this rule in                       only, self plus one, or self and family).
                                            plus one enrollment type on premiums.                    accordance with Executive Order 13132,                *     *      *     *    *
                                               Second, implementation has already                    Federalism, and have determined that                    Covered family member means a
                                            been delayed. After the passage of the                   this rule will not have any negative                  member of the family of an enrollee
                                            2013 Bipartisan Budget Act, the first                    impact on the rights, roles and                       with a self plus one or self and family
                                            year that implementation would have                      responsibilities of State, local, or tribal           enrollment who meets the requirements
                                            been possible was plan year 2015. OPM                    governments.                                          of §§ 890.302, 890.804, or 890.1106(a),
                                            determined that this was not adequate                    List of Subjects                                      as appropriate to the type of enrollee.
                                            time to implement the new enrollment                                                                           *     *      *     *    *
                                            type and chose to delay implementation                   5 CFR Part 890                                          Decrease enrollment type means a
                                                                                                       Administrative practice and                         change in enrollment from self and
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                                               7 This negligible-impact outcome may not occur

                                            if the government contribution, as determined by         procedure, Government employees,                      family to self plus one or to self only or
                                            statutory formula, was such that enrollee                Health facilities, Health insurance,                  a change from self plus one to self only.
                                            contributions were lower for self plus one               Health professions, Hostages, Iraq,                   *     *      *     *    *
                                            enrollments than for self and family enrollments
                                            even in cases where total premiums for self plus
                                                                                                     Kuwait, Lebanon, Military personnel,                    Increase enrollment type means a
                                            one enrollments were greater than or equal to total      Reporting and recordkeeping                           change in enrollment from self only to
                                            premiums for self and family enrollments.                requirements, Retirement.                             self plus one or to self and family or a


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                                            55734            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                            change from self plus one to self and                       (2) A decrease in enrollment type                  will determine if the employee has a self
                                            family.                                                  takes effect on the first day of the first            plus one or self and family enrollment,
                                            *      *     *    *    *                                 pay period that begins after the date the             as appropriate, in a health benefits plan
                                               Self and family enrollment means an                   employing office receives an                          that provides full benefits in the area
                                            enrollment that covers the enrollee and                  appropriate request to change the                     where the child or children live. If the
                                            all eligible family members.                             enrollment, except that at the request of             employee does not have the required
                                               Self only enrollment means an                         the enrollee and upon a showing                       enrollment, the agency must notify him
                                            enrollment that covers only the enrollee.                satisfactory to the employing office that             or her that it has received the court or
                                               Self plus one enrollment means an                     there was no family member eligible for               administrative order and give the
                                            enrollment that covers the enrollee and                  coverage under the self plus one or self              employee until the end of the following
                                            one eligible family member.                              and family enrollment, or only one                    pay period to change his or her
                                            *      *     *    *    *                                 family member eligible for coverage                   enrollment or provide documentation to
                                               Switch a covered family member                        under the self and family enrollment, as              the employing office that he or she has
                                            means, under a self plus one                             appropriate, the employing office may                 other coverage for the child or children.
                                            enrollment, to terminate or cancel the                   make the change effective on the first                If the employee does not comply within
                                            enrollment of the designated covered                     day of the pay period following the one               these time frames, the employing office
                                            family member and designate another                      in which there was, in the case of a self             must enroll the employee involuntarily
                                            eligible family member for coverage.                     plus one enrollment, no family member                 as stated in paragraph (g)(3)(ii) of this
                                            *      *     *    *    *                                 or, in the case of a self and family                  section.
                                            ■ 3. Amend § 890.201 by revising                         enrollment, only one or no family                        (ii) If the employee is not enrolled or
                                            paragraph (a)(6) to read as follows:                     member.                                               does not enroll, the agency must enroll
                                                                                                        (f) * * *                                          him or her for self plus one or self and
                                            § 890.201 Minimum standards for health                      (3) With one exception, during an                  family coverage, as appropriate, in the
                                            benefits plans.                                          open season, an eligible employee may                 option that provides the lower level of
                                              (a) * * *                                              enroll and an enrolled employee may                   coverage in the Service Benefit Plan. If
                                              (6) Provide a standard rate structure                  decrease or increase enrollment type,                 the employee is enrolled but does not
                                            that contains, for each option, one                      may change from one plan or option to                 increase the enrollment type in a way
                                            standard self only rate, one standard self               another, or may make any combination                  that is sufficient to cover the child or
                                            plus one rate and one standard self and                  of these changes. Exception: An                       children, the employing office must
                                            family rate.                                             employee who is subject to a court or                 change the enrollment to self plus one
                                            *     *     *     *      *                               administrative order as discussed in                  or self and family, as appropriate, in the
                                            ■ 4. Amend § 890.301 by revising                         paragraph (g)(3) of this section may not              same option and plan, as long as the
                                            paragraphs (e), (f)(3), (g)(1) and (3), (h)              cancel his or her enrollment, decrease                plan provides full benefits in the area
                                            heading and introductory text, (i)                       enrollment type, or change to a                       where the child or children live. If the
                                            introductory text, (i)(1), and (m) to read               comprehensive medical plan that does                  employee is enrolled in a
                                            as follows:                                              not serve the area where his or her child             comprehensive medical plan that does
                                                                                                     or children live as long as the court or              not serve the area in which the child or
                                            § 890.301 Opportunities for employees                    administrative order is still in effect,              children live, the employing office must
                                            who are not participants in premium
                                                                                                     and the employee has at least one child               change the enrollment to self plus one
                                            conversion to enroll or change enrollment;
                                            effective dates.                                         identified in the order who is still                  or self and family, as appropriate, in the
                                                                                                     eligible under the FEHB Program, unless               option that provides the lower level of
                                            *       *    *     *     *
                                                                                                     the employee provides documentation                   coverage in the Service Benefit Plan.
                                               (e) Decreasing enrollment type. (1)
                                                                                                     to the agency that he or she has other                *       *     *    *    *
                                            Subject to two exceptions, an employee
                                                                                                     coverage for the child(ren). The                         (h) Change in employment status. An
                                            may decrease enrollment type at any
                                                                                                     employee may not elect self only as long              eligible employee may enroll and an
                                            time. Exceptions:
                                               (i) An employee participating in                      as he or she has one child identified as              enrolled employee may decrease or
                                            health insurance premium conversion                      covered, but may elect self plus one.                 increase enrollment type, change from
                                            may decrease enrollment type during an                   *      *      *    *     *                            one plan or option to another, or make
                                            open season or because of and                               (g) Change in family status. (1) An                any combination of these changes when
                                            consistent with a qualifying life event as               eligible employee may enroll and an                   the employee’s employment status
                                            defined in part 892 of this chapter.                     enrolled employee may decrease or                     changes. Except as otherwise provided,
                                               (ii) An employee who is subject to a                  increase enrollment type, change from                 an employee must enroll or change the
                                            court or administrative order as                         one plan or option to another, or make                enrollment within 60 days after the
                                            discussed in paragraph (g)(3) of this                    any combination of these changes when                 change in employment status.
                                            section may not decrease enrollment                      the employee’s family status changes,                 Employment status changes include, but
                                            type in a way that eliminates coverage                   including a change in marital status or               are not limited to—
                                            of a child identified in the order as long               any other change in family status. The                *       *     *    *    *
                                            as the court or administrative order is                  employee must enroll or change the                       (i) Loss of coverage under this part or
                                            still in effect and the employee has at                  enrollment within the period beginning                under another group insurance plan. An
                                            least one child identified in the order                  31 days before the date of the change in              eligible employee may enroll and an
                                            who is still eligible under the FEHB                     family status, and ending 60 days after               enrolled employee may decrease or
                                            Program, unless the employee provides                    the date of the change in family status.              increase enrollment type, change from
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                                            documentation to the agency that he or                   *      *      *    *     *                            one plan or option to another, or make
                                            she has other coverage for the                              (3)(i) If an employing office receives a           any combination of these changes when
                                            child(ren). The employee may not elect                   court or administrative order on or after             the employee or an eligible family
                                            self only as long as he or she has one                   October 30, 2000, requiring an employee               member of the employee loses coverage
                                            child identified as covered, but may                     to provide health benefits for his or her             under this part or another group health
                                            elect self plus one.                                     child or children, the employing office               benefits plan. Except as otherwise


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                       55735

                                            provided, an employee must enroll or                     under his or her enrollment. These                       (1) The survivor annuitant from
                                            change the enrollment within the period                  individuals are not covered under the                 whose annuity all or the greatest portion
                                            beginning 31 days before the date of loss                other enrollment. Examples include but                of the withholding for health benefits is
                                            of coverage, and ending 60 days after                    are not limited to:                                   made; or
                                            the date of loss of coverage. Losses of                     (A) To protect the interests of married               (2) The surviving spouse entitled to a
                                            coverage include, but are not limited                    or legally separated Federal employees,               basic employee death benefit. The
                                            to—                                                      annuitants, and their children, an                    enrollment covers members of the
                                               (1) Loss of coverage under another                    employee or annuitant may enroll in his               family of the deceased employee or
                                            FEHB enrollment due to the                               or her own right in a self only, self plus            annuitant. In those instances in which
                                            termination, cancellation, or a change to                one, or self and family enrollment, as                the annuity is split among surviving
                                            self plus one or to self only, of the                    appropriate, even though his or her                   family members, multiple enrollments
                                            covering enrollment.                                     spouse also has a self plus one or self               are allowed. A remarried spouse is not
                                            *      *     *     *    *                                and family enrollment if the employee,                a member of the family of the deceased
                                               (m) An employee or eligible family                    annuitant, or his or her children live                employee or annuitant unless annuity
                                            member becomes eligible for premium                      apart from the spouse and would                       under section 8341 or 8442 of title 5,
                                            assistance under Medicaid or a State                     otherwise not have access to coverage                 United States Code, continues after
                                            Children’s Health Insurance Program                      due to a service area restriction and the             remarriage.
                                            (CHIP). An eligible employee may enroll                  spouse refuses to change health plans.                   (d) * * *
                                            and an enrolled employee may decrease                       (B) When an employee who is under                     (2) * * *
                                            or increase enrollment type, change                      age 26 and covered under a parent’s self                 (ii) If the surviving spouse of a
                                            from one plan or option to another, or                   plus one or self and family enrollment                deceased employee or annuitant is
                                            make any combination of these changes                    acquires an eligible family member, the               enrolled as an employee with a self plus
                                            when the employee or an eligible family                  employee may elect to enroll for self                 one or self and family enrollment (or, if
                                            member of the employee becomes                           plus one or self and family coverage.                 both the decedent and the surviving
                                            eligible for premium assistance under a                  *      *    *     *     *                             spouse were enrolled in a self only or
                                            Medicaid plan or CHIP. An employee                          (c) Child incapable of self-support.               self plus one enrollment) at the time the
                                            must enroll or change his or her                         When an individual’s enrollment for                   surviving spouse becomes a survivor
                                            enrollment within 60 days after the date                 self plus one or self and family includes             annuitant and the surviving spouse is
                                            the employee or family member is                         a child who has become 26 years of age                thereafter separated without entitlement
                                            determined to be eligible for assistance.                and is incapable of self-support, the                 to continued enrollment as a retiree, the
                                            ■ 5. Amend § 890.302 by revising                         employing office must require such                    surviving spouse is entitled to enroll as
                                            paragraphs (a)(1), (a)(2)(ii), and (c)                   enrollee to submit a physician’s                      a survivor annuitant. The change from
                                            introductory text and adding paragraph                   certificate verifying the child’s                     coverage as an employee to coverage as
                                            (f) to read as follows:                                  disability. The certificate must—                     a survivor annuitant must be made
                                                                                                     *      *    *     *     *                             within 30 days of separation from
                                            § 890.302   Coverage of family members.                     (f) Switching a covered family                     service.
                                               (a)(1) An enrollment for self plus one                member. (1) An enrollee with a self plus              *       *     *     *     *
                                            includes the enrollee and one eligible                   one enrollment may switch his or her                     (3) Insurable interest survivor annuity.
                                            family member. An enrollment for self                    covered family member during the                      * * *
                                            and family includes all family members                   annual Open Season, upon a change in                  *       *     *     *     *
                                            who are eligible to be covered by the                    family status, upon a change in                       ■ 7. Amend § 890.306 by revising
                                            enrollment. Except as provided in                        coverage, or upon a change in eligibility,            paragraphs (e), (f)(1)(i), (g)(1), (l)
                                            paragraph (a)(2) of this section, no                     so long as switching a covered family                 introductory text, (l)(1), (n), and (r) to
                                            employee, former employee, annuitant,                    member is consistent with the event that              read as follows:
                                            child, or former spouse may enroll or be                 has taken place.
                                            covered as a family member if he or she                     (2) Switching a covered family                     § 890.306 When can annuitants or survivor
                                            is already covered under another                         member under a self plus one                          annuitants change enrollment or reenroll
                                            person’s self plus one or self and family                enrollment will be effective on the first             and what are the effective dates?
                                            enrollment in the FEHB Program.                          day of the first pay period that begins               *      *    *     *     *
                                               (2) * * *                                             after the date the employing office                      (e) Decreasing enrollment type. (1)
                                               (ii) Exception. An individual                         receives an appropriate request to                    With one exception, an annuitant may
                                            described in paragraph (a)(2)(i) of this                 switch the covered family member.                     decrease enrollment type at any time.
                                            section may enroll if he or she or his or                ■ 6. Amend § 890.303 by revising                      Exception: An annuitant who, as an
                                            her eligible family members would                        paragraphs (c), (d)(2)(ii), and the                   employee, was subject to a court or
                                            otherwise not have access to coverage,                   heading of paragraph (d)(3) to read as                administrative order as discussed in
                                            in which case the individual may enroll                  follows:                                              § 890.301(g)(3) at the time he or she
                                            in his or her own right for self only, self                                                                    retired may not, after retirement,
                                            plus one, or self and family coverage, as                § 890.303    Continuation of enrollment.              decrease enrollment type in a way that
                                            appropriate. However, an eligible                        *      *    *     *     *                             eliminates coverage of a child identified
                                            individual is entitled to receive benefits                  (c) On death. The enrollment of a                  in the order as long as the court or
                                            under only one enrollment regardless of                  deceased employee or annuitant who is                 administrative order is still in effect and
                                            whether he or she qualifies as a family                  enrolled for self plus one or self and                the annuitant has at least one child
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                                            member under a spouse’s or parent’s                      family (as opposed to self only) is                   identified in the order who is still
                                            enrollment. To ensure that no person                     transferred automatically to his or her               eligible under the FEHB Program, unless
                                            receives benefits under more than one                    eligible survivor annuitant(s) covered by             the annuitant provides documentation
                                            enrollment, each enrollee must                           the enrollment, as applicable. For self               to the retirement system that he or she
                                            promptly notify the insurance carrier as                 and family, the enrollment is considered              has other coverage for the child or
                                            to which person(s) will be covered                       to be that of:                                        children. The annuitant may not elect


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                                            55736            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                            self only as long as he or she has one                   family members of the deceased                        which is acting as employing office
                                            child identified as covered, but may                     employee or annuitant. The annuitant                  must rescind the action retroactive to
                                            elect self plus one.                                     must change the enrollment within the                 the effective date of the change to self
                                               (2) A decrease in enrollment type                     period beginning 31 days before the date              only, with corresponding adjustment in
                                            takes effect on the first day of the first               of the change in family status, and                   withholdings and contributions.
                                            pay period that begins after the date the                ending 60 days after the date of the                  *     *     *     *     *
                                            employing office receives an                             change in family status.                              ■ 8. Amend § 890.401 by revising
                                            appropriate request to change the                        *      *     *     *    *                             paragraph (a)(1) to read as follows:
                                            enrollment, except that at the request of                   (l) Loss of coverage under this part or
                                            the annuitant and upon a showing                         under another group insurance plan. An                § 890.401 Temporary extension of
                                            satisfactory to the employing office that                annuitant who meets the requirements                  coverage and conversion.
                                            there was no family member eligible for                  of paragraph (a) of this section, and who               (a) Thirty-one day extension and
                                            coverage under the self plus one or self                 is not enrolled but is covered by another             conversion. (1) An enrollee whose
                                            and family enrollment, or only one                       enrollment under this part may                        enrollment is terminated other than by
                                            family member eligible for coverage                      continue coverage by enrolling in his or              cancellation of the enrollment or
                                            under the self and family enrollment, as                 her own name when the annuitant loses                 discontinuance of the plan, in whole or
                                            appropriate, the employing office may                    coverage under the other enrollment                   part, and a covered family member
                                            make the change effective on the first                   under this part. An enrolled annuitant                whose coverage is terminated other than
                                            day of the pay period following the one                  may decrease or increase enrollment                   by cancellation of the enrollment or
                                            in which there was, in the case of a self                type, change from one plan or option to               discontinuance of the plan, in whole or
                                            plus one enrollment, no family member                    another, or make any combination of                   in part, is entitled to a 31-day extension
                                            or, in the case of a self and family                     these changes when the annuitant or an                of coverage for self only, self plus one,
                                            enrollment, only one or no family                        eligible family member of the annuitant               or self and family, as the case may be,
                                            member.                                                  loses coverage under this part or under               without contributions by the enrollee or
                                               (f) * * *                                             another group health benefits plan.                   the Government, during which period
                                               (1) * * *                                             Except as otherwise provided, an                      he or she is entitled to exercise the right
                                               (i) With one exception, an enrolled                   annuitant must enroll or change the                   of conversion provided for by this part.
                                            annuitant may decrease or increase                       enrollment within the period beginning                The 31-day extension of coverage and
                                            enrollment type, may change from one                     31 days before the date of loss of                    the right of conversion for any person
                                            plan or option to another, or may make                   coverage and ending 60 days after the                 ends on the effective date of a new
                                            any combination of these changes.                        date of loss of coverage. Losses of                   enrollment under this part covering the
                                            Exception: An annuitant who, as an                       coverage include, but are not limited                 person.
                                            employee, was subject to a court or                      to—                                                   *     *      *     *      *
                                            administrative order as discussed in                        (1) Loss of coverage under another                 ■ 9. Amend § 890.501 by revising
                                            § 890.301(g)(3) at the time he or she                    FEHB enrollment due to the                            paragraphs (b) introductory text,
                                            retired may not cancel or suspend his or                 termination, cancellation, or a change to             (b)(2)(i), and (b)(3) to read as follows:
                                            her enrollment, decrease enrollment                      self plus one or self only, of the covering
                                            type in a way that eliminates coverage                   enrollment;                                           § 890.501   Government contributions.
                                            of a child identified in the order or                    *      *     *     *    *                             *     *     *     *     *
                                            change to a comprehensive medical                           (n) Overseas post of duty. An                        (b) In accordance with the provisions
                                            plan that does not serve the area where                  annuitant may decrease or increase                    of 5 U.S.C. 8906(a) which take effect
                                            his or her child or children live after                  enrollment type, change from one plan                 with the contract year that begins in
                                            retirement as long as the court or                       or option to another, or make any                     January 1999, OPM will determine the
                                            administrative order is still in effect and              combination of these changes within 60                amounts representing the weighted
                                            the annuitant has at least one child                     days after the retirement or death of the             average of subscription charges in effect
                                            identified in the order who is still                     employee on whose service title to                    for each contract year, for self only, self
                                            eligible under the FEHB Program, unless                  annuity is based, if the employee was                 plus one, and self and family
                                            the annuitant provides documentation                     stationed at a post of duty outside a                 enrollments, as follows:
                                            to the retirement system that he or she                  State of the United States or the District            *     *     *     *     *
                                            has other coverage for the child or                      of Columbia at the time of retirement or                (2) * * *
                                            children. The annuitant may not elect                    death.                                                  (i) When a subscription charge for an
                                            self only as long as he or she has one                   *      *     *     *    *                             upcoming contract year applies to a
                                            child identified as covered, but may                        (r) Sole survivor. When an employee                plan that is the result of a merger of two
                                            elect self plus one.                                     or annuitant enrolled for self plus one               or more plans which contract separately
                                            *      *     *    *      *                               or self and family dies, leaving a                    with OPM during the determination
                                               (g) Change in family status. (1) An                   survivor annuitant who is entitled to                 year, or applies to a plan which will
                                            enrolled former employee in receipt of                   continue the enrollment, and it is                    cease to offer two benefits options, OPM
                                            an annuity may decrease or increase                      apparent from available records that the              will combine the self only enrollments,
                                            enrollment type, change from one plan                    survivor annuitant is the sole survivor               the self plus one enrollments, and the
                                            or option to another, or make any                        entitled to continue the enrollment, the              self and family enrollments from the
                                            combination of these changes when the                    office of the retirement system which is              merging plans, or from a plan’s benefits
                                            annuitant’s family status changes,                       acting as employing office must                       options, for purposes of weighting
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                                            including a change in marital status or                  decrease the enrollment to self only,                 subscription charges in effect for the
                                            any other change in family status. In the                effective on the commencing date of the               successor plan for the upcoming
                                            case of an enrolled survivor annuitant,                  survivor annuity. On request of the                   contract year.
                                            a change in family status based on                       survivor annuitant made within 31 days                *     *     *     *     *
                                            additional family members occurs only                    after the first installment of annuity is               (3) After OPM weights each
                                            if the additional family members are                     paid, the office of the retirement system             subscription charge as provided in


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                       55737

                                            paragraph (b)(2) of this section, OPM                    day of the pay period following the one               are enrolled under this part as survivors
                                            will compute the total of subscription                   in which there was, in the case of a self             of deceased employees or annuitants are
                                            charges associated with self only                        plus one enrollment, no family member                 considered to be children under a self
                                            enrollments, self plus one enrollments,                  or, in the case of a self and family                  plus one or self and family enrollment
                                            and self and family enrollments,                         enrollment, only one or no family                     of an employee or annuitant at the time
                                            respectively. OPM will divide each                       member.                                               of the qualifying event.
                                            subscription charge total by the total                      (f) * * *                                            (3) Former spouses of employees, of
                                            number of enrollments such amount                           (1) * * *                                          former employees having continued self
                                            represents to obtain the program-wide                       (i) An enrolled former spouse may                  plus one or self and family coverage
                                            weighted average subscription charges                    decrease enrollment type, increase                    under this subpart, or of annuitants, if
                                            for self only and for self plus one and                  enrollment type provided the family                   the former spouse would be eligible for
                                            self and family enrollments,                             member(s) to be covered under the                     continued coverage under subpart H of
                                            respectively.                                            enrollment is eligible for coverage under             this part except for failure to meet the
                                            *     *     *    *      *                                § 890.804, change from one plan or                    requirement of § 890.803(a)(1) or (3) or
                                                                                                     option to another, or make any                        the documentation requirements of
                                            ■ 10. Amend § 890.804 by revising
                                                                                                     combination of these changes.                         § 890.806(a), including former spouses
                                            paragraph (a) to read as follows:
                                                                                                     *       *    *     *     *                            who lose eligibility under subpart H
                                            § 890.804   Coverage.                                       (g) Change in family status. (1) An                within 36 months after termination of
                                              (a) Type of enrollment. A former                       enrolled former spouse may increase                   the marriage because they ceased
                                            spouse who meets the requirements of                     enrollment type, change from one plan                 meeting the requirement of
                                            § 890.803 may elect coverage for self                    or option to another, or make any                     § 890.803(a)(1) or (3).
                                            only, self plus one, or self and family.                 combination of these changes within the               *     *     *     *     *
                                            A self and family enrollment covers                      period beginning 31 days before and                   ■ 13. Amend § 890.1106 by revising
                                            only the former spouse and all eligible                  ending 60 days after the birth or                     paragraph (a) introductory text to read
                                            children of both the former spouse and                   acquisition of a child who meets the                  as follows:
                                            the employee, former employee, or                        eligibility requirements of § 890.804.
                                            employee annuitant, provided such                        *       *    *     *     *                            § 890.1106   Coverage.
                                            children are not otherwise covered by a                     (j) Loss of coverage under this part or              (a) Type of enrollment. An individual
                                            health plan under this part. A self plus                 under another group insurance plan. An                who enrolls under this subpart may
                                            one enrollment covers only the former                    enrolled former spouse may decrease or                elect coverage for self only, self plus
                                            spouse and one eligible child of both the                increase enrollment type, change from                 one, or self and family.
                                            former spouse and the employee, former                   one plan or option to another or make                 *     *     *     *     *
                                            employee, or employee annuitant,                         any combination of these changes when                 ■ 14. Amend § 890.1108 by revising
                                            provided the child is not otherwise                      the former spouse or a child who meets                paragraphs (d), (e)(1), (f)(1) and (2), (h)
                                            covered by a health plan under this part.                the eligibility requirements under                    introductory text, and (h)(1) to read as
                                            A child must be under age 26 or                          § 890.804 loses coverage under another                follows:
                                            incapable of self-support because of a                   enrollment under this part or under
                                            mental or physical disability existing                   another group health benefits plan.                   § 890.1108 Opportunities to change
                                            before age 26. No person may be                          Except as otherwise provided, the                     enrollment; effective dates.
                                            covered by two enrollments.                              former spouse must change the                         *      *    *     *      *
                                            *     *     *     *      *                               enrollment within the period beginning                   (d) Decreasing enrollment type. (1) An
                                            ■ 11. Amend § 890.806 by revising
                                                                                                     31 days before the date of loss of                    enrollee may decrease enrollment type
                                            paragraphs (e), (f)(1)(i), (g)(1), (j)                   coverage and ending 60 days after the                 at any time.
                                            introductory text, and (j)(1) to read as                 date of loss of coverage, provided he or                 (2) A decrease in enrollment type
                                            follows:                                                 she continues to meet the eligibility                 takes effect on the first day of the first
                                                                                                     requirements under § 890.803. Losses of               pay period that begins after the date the
                                            § 890.806 When can former spouses                        coverage include but are not limited                  employing office receives an
                                            change enrollment or reenroll and what are               to—                                                   appropriate request to change the
                                            the effective dates?                                        (1) Loss of coverage under another                 enrollment, except that at the request of
                                            *     *     *     *     *                                FEHB enrollment due to the                            the enrollee and upon a showing
                                              (e) Decreasing enrollment type. (1) A                  termination, cancellation, or a change to             satisfactory to the employing office that
                                            former spouse may decrease enrollment                    self plus one or self only, of the covering           there was no family member eligible for
                                            type at any time.                                        enrollment;                                           coverage under the self plus one or self
                                              (2) A decrease in enrollment type                      *       *    *     *     *                            and family enrollment, or only one
                                            takes effect on the first day of the first               ■ 12. Amend § 890.1103 by revising                    family member eligible for coverage
                                            pay period that begins after the date the                paragraphs (a)(2) and (3) to read as                  under the self and family enrollment, as
                                            employing office receives an                             follows:                                              appropriate, the employing office may
                                            appropriate request to change the                                                                              make the change effective on the first
                                            enrollment, except that at the request of                § 890.1103    Eligibility.                            day of the pay period following the one
                                            the former spouse and upon a showing                       (a) * * *                                           in which there was, in the case of a self
                                            satisfactory to the employing office that                  (2) Individuals whose coverage as                   plus one enrollment, no family member
                                            there was no family member eligible for                  children under the self plus one or self              or, in the case of a self and family
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                                            coverage under the self plus one or self                 and family enrollment of an employee,                 enrollment, only one or no family
                                            and family enrollment, or only one                       former employee, or annuitant ends                    member.
                                            family member eligible for coverage                      because they cease meeting the                           (e) Open season. (1) During an open
                                            under the self and family enrollment, as                 requirements for being considered                     season as provided by § 890.301(f), an
                                            appropriate, the employing office may                    covered family members. For the                       enrollee (except for a former spouse
                                            make the change effective on the first                   purpose of this section, children who                 who is eligible for continued coverage


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                                            55738            Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations

                                            under § 890.1103(a)(3)) may decrease or                     Covered family members as it applies                member remains. The change may be
                                            increase enrollment type, change from                     to individuals covered under this                     made at the written request of the
                                            one plan or option to another, or make                    subpart has the same meaning as set                   enrollee at any time after the last family
                                            any combination of these changes. A                       forth in § 890.101(a). For eligible                   member is lost and it becomes effective
                                            former spouse who is eligible for                         survivors of individuals enrolled under               on the 1st day of the pay period after the
                                            continued coverage under                                  this subpart, a self plus one enrollment              pay period during which the request is
                                            § 890.1103(a)(3) may change from one                      covers only the survivor or former                    received by the U.S. Department of
                                            plan or option to another, but may not                    spouse and one eligible child of both the             State.
                                            increase enrollment type unless the                       survivor or former spouse and hostage.                *     *     *     *    *
                                            individual to be covered under the self                   A self and family enrollment covers                   ■ 18. Amend § 890.1209 by revising
                                            plus one or self and family enrollment                    only the survivor or former spouse and                paragraph (c) to read as follows:
                                            qualifies as a family member under                        any eligible children of both the
                                            § 890.1106(a)(2).                                         survivor or former spouse and hostage.                § 890.1209 Responsibilities of the U.S.
                                            *      *    *     *     *                                 *     *     *     *     *                             Department of State.
                                              (f) Change in family status. (1) Except                 ■ 16. Amend § 890.1203 by revising                    *      *    *    *      *
                                            for a former spouse, an enrollee may                      paragraph (b) to read as follows:                        (c) The U.S. Department of State must
                                            decrease or increase enrollment type,                                                                           determine the number of eligible family
                                            change from one plan or option to                         § 890.1203    Coverage.                               members, if any, for the purpose of
                                            another, or make any combination of                       *      *    *    *      *                             coverage under a self only, self plus one,
                                            these changes when the enrollee’s                            (b) An individual who is covered                   or self and family enrollment as set forth
                                            family status changes, including a                        under this subpart is covered under the               in § 890.1203(b). If the number of
                                            change in marital status or any other                     Standard Option of the Service Benefit                eligible family members of the
                                            change in family status. The enrollee                     Plan. The individual has a self and                   individual cannot be determined, the
                                            must change the enrollment within the                     family enrollment unless the U.S.                     U.S. Department of State must enroll the
                                            period beginning 31 days before the date                  Department of State determines that the               individual for self and family coverage.
                                            of the change in family status, and                       individual is married and has no
                                            ending 60 days after the date of the                      eligible children, or is unmarried and                PART 892—FEDERAL FLEXIBLE
                                            change in family status.                                  has one eligible child, in which case the             BENEFITS PLAN: PRE-TAX PAYMENT
                                              (2) A former spouse who is covered                      individual is covered under a self plus               OF HEALTH BENEFITS PREMIUMS
                                            under this section may increase                           one enrollment, or unless the U.S.                    ■  19. The authority citation for part 892
                                            enrollment type, change from one plan                     Department of State determines that the               is revised to read as follows:
                                            or option to another, or make any                         individual is unmarried and has no
                                            combination of these changes within the                   eligible children, in which case the                    Authority: 5 U.S.C. 8913; 5 U.S.C.
                                            period beginning 31 days before and                       individual has a self only enrollment.                1103(a)(7); 26 U.S.C. 125.
                                            ending 60 days after the birth or                         *      *    *    *      *                             ■ 20. In § 892.101, the definition of
                                            acquisition of a child who qualifies as                   ■ 17. Amend § 890.1205 by revising
                                                                                                                                                            ‘‘Qualifying life event’’ is amended by
                                            a covered family member under                             paragraphs (a) and (b) to read as follows:            revising the introductory text and
                                            § 890.1106(a)(2).                                                                                               paragraphs (9) and (13) to read as
                                            *      *    *     *     *                                 § 890.1205    Change in type of enrollment.           follows:
                                              (h) Loss of coverage under this part or                    (a) Individuals covered under this
                                                                                                                                                            § 892.101   Definitions.
                                            under another group insurance plan. An                    subpart or eligible survivors enrolled
                                            enrollee may decrease or increase                         under this subpart may increase                       *      *    *     *    *
                                            enrollment type, change from one plan                     enrollment type if they acquire an                       Qualifying life event means an event
                                            or option to another, or make any                         eligible family member. The change may                that may permit changes to your FEHB
                                            combination of these changes when the                     be made at the written request of the                 enrollment as well as changes to your
                                            enrollee loses coverage under this part                   enrollee at any time after the family                 premium conversion election as
                                            or a qualified family member of the                       member is acquired. An increase in                    described in Treasury regulations at 26
                                            enrollee loses coverage under this part                   enrollment type under this paragraph (a)              CFR 1.125–4. For purposes of
                                            or under another group health benefits                    becomes effective on the 1st day of the               determining whether a qualifying life
                                            plan. Except as otherwise provided, an                    pay period after the pay period during                event has occurred under this part, a
                                            enrollee must change the enrollment                       which the request is received by the                  stepchild who is the child of an
                                            within the period beginning 31 days                       U.S. Department of State, except that a               employee’s domestic partner as defined
                                            before the date of loss of coverage and                   change based on the birth or addition of              in part 890 of this chapter shall be
                                            ending 60 days after the date of loss of                  a child as a new family member is                     treated as though the child were a
                                            coverage. Losses of coverage include,                     effective on the 1st day of the pay                   dependent within the meaning of 26
                                            but are not limited to—                                   period during which the child is born or              CFR 1.125–4 even if the child does not
                                              (1) Loss of coverage under another                      otherwise becomes a new family                        so qualify under such Treasury
                                            FEHB enrollment due to the                                member.                                               regulations. Such events include the
                                            termination, cancellation, or change to                      (b) Individuals covered under this                 following:
                                            self plus one or to self only, of the                     subpart or eligible survivors enrolled                *      *    *     *    *
                                            covering enrollment.                                      under this subpart may decrease                          (9) An employee becomes entitled to
                                            *      *    *     *     *                                 enrollment type from a self and family                Medicare. (For change to self only, self
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                                            ■ 15. Amend § 890.1202 by revising the                    enrollment when the last eligible family              plus one, cancellation, or change in
                                            definition of ‘‘Covered family members’’                  member (other than the enrollee) ceases               premium conversion status see
                                            to read as follows:                                       to be a family member or only one                     paragraph (11) of this definition.)
                                                                                                      family member remains; and may                        *      *    *     *    *
                                            § 890.1202       Definitions.                             decrease enrollment type from a self                     (13) An employee or eligible family
                                            *      *     *         *        *                         plus one enrollment when no family                    member becomes eligible for premium


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                                                             Federal Register / Vol. 80, No. 180 / Thursday, September 17, 2015 / Rules and Regulations                                           55739

                                            assistance under Medicaid or a State                        (b) Within 60 days after you have a                (Actinidia deliciosa and Actinidia
                                            Children’s Health Insurance Program                      qualifying life event. A decrease in                  chinensis) from Chile as eligible for
                                            (CHIP). An eligible employee may enroll                  enrollment type made because of a                     importation into the United States
                                            and an enrolled employee may decrease                    qualifying life event takes effect on the             subject to a systems approach. Under
                                            or increase enrollment type, change                      first day of the first pay period that                this systems approach, the fruit will
                                            from one plan or option to another, or                   begins after the date your employing                  have to be grown in a place of
                                            make any combination of these changes                    office receives your appropriate request.             production that is registered with the
                                            when the employee or an eligible family                  Your change in enrollment must be                     Government of Chile and certified as
                                            member of the employee becomes                           consistent with and correspond to your                having a low prevalence of Brevipalpus
                                            eligible for premium assistance under a                  qualifying life event. For example, if                chilensis. The fruit will have to undergo
                                            Medicaid plan or a State Children’s                      you get divorced and have no                          pre-harvest sampling at the registered
                                            Health Insurance Program. An employee                    dependent children, changing to self                  production site. Following post-harvest
                                            must enroll or change his or her                         only would be consistent with that                    processing, the fruit will have to be
                                            enrollment within 60 days after the date                 qualifying life event. As another                     inspected in Chile at an approved
                                            the employee or family member is                         example, if both you and your spouse                  inspection site. Each consignment of
                                            determined to be eligible for assistance.                are Federal employees, and your                       fruit will have to be accompanied by a
                                            ■ 21. Amend § 892.207 by revising                        youngest dependent turns age 26,                      phytosanitary certificate with an
                                            paragraph (b) and adding paragraph (d)                   changing from a self and family to a self             additional declaration stating that the
                                            to read as follows:                                      plus one or two self only enrollments                 fruit had been found free of Brevipalpus
                                                                                                     would be consistent and appropriate for               chilensis based on field and
                                            § 892.207 Can I make changes to my FEHB                                                                        packinghouse inspections. This rule
                                                                                                     that event.
                                            enrollment while I am participating in                                                                         allows for the safe importation of kiwi
                                            premium conversion?
                                                                                                        (c) If you are subject to a court or
                                                                                                     administrative order as discussed in                  from Chile using mitigation measures
                                            *      *    *     *      *                               § 890.301(g)(3), you may not decrease                 other than fumigation with methyl
                                               (b) However, if you are participating                                                                       bromide.
                                                                                                     enrollment type in a way that eliminates
                                            in premium conversion there are two
                                                                                                     coverage of a child identified in the                 DATES: Effective October 19, 2015.
                                            exceptions: You must have a qualifying
                                                                                                     order as long as the court or                         FOR FURTHER INFORMATION CONTACT: Ms.
                                            life event to decrease enrollment type,
                                                                                                     administrative order is still in effect and           Claudia Ferguson, Senior Regulatory
                                            switch a covered family member, or to
                                                                                                     you have at least one child identified in             Policy Specialist, Regulatory
                                            cancel FEHB coverage entirely. (See
                                                                                                     the order who is still eligible under the             Coordination and Compliance, PPQ,
                                            §§ 892.209 and 892.210.) Your change in
                                                                                                     FEHB Program, unless you provide                      APHIS, 4700 River Road Unit 133,
                                            enrollment must be consistent with and
                                                                                                     documentation to your agency that you                 Riverdale, MD 20737–1236; (301) 851–
                                            correspond to your qualifying life event
                                                                                                     have other coverage for your child or                 2352.
                                            as described in § 892.101. These
                                                                                                     children. See also §§ 892.207 and                     SUPPLEMENTARY INFORMATION:
                                            limitations apply only to changes you
                                                                                                     892.209. If you are subject to a court or
                                            may wish to make outside open season.                                                                          Background
                                                                                                     administrative order as discussed in
                                            *      *    *     *      *                               § 890.301(g)(3), you may not change                      Under the regulations in ‘‘Subpart-
                                               (d) During the first plan year in which               your enrollment to self plus one as long              Fruits and Vegetables’’ (7 CFR 319.56–
                                            the self plus one enrollment type is                     as the court or administrative order is               1 through 319.56–73, referred to below
                                            available, OPM will administer a                         still in effect and you have more than                as the regulations), the Animal and
                                            limited enrollment period for enrollees                  one child identified in the order who is              Plant Health Inspection Service (APHIS)
                                            who participate in premium conversion.                   still eligible under the FEHB Program,                of the U.S. Department of Agriculture
                                            During this limited enrollment period,                   unless you provide documentation to                   prohibits or restricts the importation of
                                            enrollees who participate in premium                     your agency that you have other                       fruits and vegetables into the United
                                            conversion will be allowed to decrease                   coverage for your children. See also                  States from certain parts of the world to
                                            enrollment from self and family to self                  §§ 892.207 and 892.209.                               prevent plant pests from being
                                            plus one during a time period                                                                                  introduced into and spread within the
                                                                                                     [FR Doc. 2015–23348 Filed 9–16–15; 8:45 am]
                                            determined by OPM. No other changes,                                                                           United States.
                                                                                                     BILLING CODE 6325–63–P
                                            including changes in plan or plan                                                                                 On October 16, 2014, we published in
                                            option or increases in enrollment, will                                                                        the Federal Register (79 FR 62055–
                                            be allowed. Enrollments will be                                                                                62058, Docket No. APHIS–2014–0002) a
                                            effective on the first day of the first pay              DEPARTMENT OF AGRICULTURE
                                                                                                                                                           proposal 1 to amend the regulations by
                                            period following the one in which the                                                                          listing kiwi (Actinidia deliciosa and
                                            appropriate request is received by the                   Animal and Plant Health Inspection
                                                                                                     Service                                               Actinidia chinensis) from Chile as
                                            employing office.                                                                                              eligible for importation into the United
                                            ■ 22. Revise § 892.208 to read as                                                                              States under the same systems approach
                                                                                                     7 CFR Part 319
                                            follows:                                                                                                       as baby kiwi from Chile, which are
                                                                                                     [Docket No. APHIS–2014–0002]                          eligible for importation under the
                                            § 892.208 Can I decrease my enrollment
                                            type at any time?                                        RIN 0579–AD98                                         conditions in § 319.56–53. We also
                                               If you are participating in premium                                                                         prepared a commodity import
                                                                                                     Importation of Kiwi From Chile Into the               evaluation document (CIED) titled
                                            conversion you may decrease your
                                                                                                     United States                                         ‘‘Importation of Fresh Fruits of Kiwi
                                            FEHB enrollment type under either of
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                                            the following circumstances:                                                                                   (Actinidia deliciosa and Actinidia
                                                                                                     AGENCY:  Animal and Plant Health
                                               (a) During the annual open season. A                                                                        chinensis) from Chile into the United
                                                                                                     Inspection Service, USDA.
                                            decrease in enrollment type made                         ACTION: Final rule.                                     1 To view the proposed rule, supporting
                                            during the annual open season takes                                                                            documents, and the comments we received, go to
                                            effect on the 1st day of the first pay                   SUMMARY:  We are amending the fruits                  http://www.regulations.gov/
                                            period that begins in the next year.                     and vegetables regulations to list kiwi               #!docketDetail;D=APHIS-2014-0002.



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Document Created: 2015-12-15 09:34:25
Document Modified: 2015-12-15 09:34:25
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionFinal rule.
DatesThis rule is effective September 17, 2015.
ContactChelsea Ruediger at [email protected] or (202) 606-0004.
FR Citation80 FR 55726 
RIN Number3206-AN08
CFR Citation5 CFR 890
5 CFR 892
CFR AssociatedAdministrative Practice and Procedure; Government Employees; Health Facilities; Health Insurance; Health Professions; Hostages; Iraq; Kuwait; Lebanon; Military Personnel; Reporting and Recordkeeping Requirements; Retirement; Taxes and Wages

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