80 FR 66785 - Federal Long Term Care Insurance Program Eligibility Changes

OFFICE OF PERSONNEL MANAGEMENT

Federal Register Volume 80, Issue 210 (October 30, 2015)

The United States Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Long Term Care Insurance Program (FLTCIP) regulation to expand eligibility to apply for coverage under the Program. This rule expands the definition of ``qualified relative'' to include opposite-sex domestic partners of Federal and U.S. Postal Service employees, annuitants, members of the uniformed services, and retired members of the uniformed services. In addition, this rule provides that adult children of domestic partners will be considered one of the types of individuals comprising the statutory term ``qualified relative'' who may apply for FLTCIP coverage.

[Federal Register Volume 80, Number 210 (Friday, October 30, 2015)]
[Rules and Regulations]
[Pages 66785-66787]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-27381]



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Federal Register / Vol. 80, No. 210 / Friday, October 30, 2015 / 
Rules and Regulations

[[Page 66785]]



OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 875

RIN 3206-AN05


Federal Long Term Care Insurance Program Eligibility Changes

AGENCY: U.S. Office of Personnel Management.

ACTION: Final rule.

-----------------------------------------------------------------------

SUMMARY: The United States Office of Personnel Management (OPM) is 
issuing a final rule to amend the Federal Long Term Care Insurance 
Program (FLTCIP) regulation to expand eligibility to apply for coverage 
under the Program. This rule expands the definition of ``qualified 
relative'' to include opposite-sex domestic partners of Federal and 
U.S. Postal Service employees, annuitants, members of the uniformed 
services, and retired members of the uniformed services. In addition, 
this rule provides that adult children of domestic partners will be 
considered one of the types of individuals comprising the statutory 
term ``qualified relative'' who may apply for FLTCIP coverage.

DATES: Effective November 30, 2015.

FOR FURTHER INFORMATION CONTACT: Ronald Brown, Policy Analyst, (202) 
606-0004, or by email to [email protected].

SUPPLEMENTARY INFORMATION: On November 13, 2014, OPM published proposed 
regulations in the Federal Register (79 FR 67377--67379) to (1) Expand 
the definition of ``qualified relative'' under 5 U.S.C. 9001(5)(D) to 
include both same-sex and opposite-sex domestic partners of Federal and 
U.S. Postal Service employees and annuitants and members and retired 
members of the uniformed services; (2) expand the definition of 
``qualified relative'' to include adult children of domestic partners 
of Federal and U.S. Postal Service employees and annuitants, and 
members and retired members of the uniformed services; (3) allow the 
workforce member or his or her domestic partner to provide notice to 
the employing office if at any time between the time of application and 
the time coverage is scheduled to go into effect, any of the conditions 
for a domestic partnership are no longer met, in which case a domestic 
partnership is deemed terminated; (4) require domestic partners to 
provide documentation to establish that they meet the criteria for 
domestic partnership; (5) clarify that once coverage has begun, 
termination of a domestic partnership does not terminate a domestic 
partner's insurance coverage as long as the Carrier continues to 
receive the required premium when due; and (6) make other technical 
conforming amendments to the FLTCIP rules in connection with the 
extension of coverage to domestic partners and to adult children of 
domestic partners.
    Comments were requested to be received on or before January 12, 
2015. After reviewing the comments received OPM is issuing the final 
regulation as proposed.

Analysis of and Response to Public Comments

    We received three comments on the proposed rule. All commenters 
expressed support for the proposed rule that extends important coverage 
to domestic partners and to children of domestic partners under the 
FLTCIP. One commenter approved the wording of the proposed rule with no 
suggested changes and this comment is not addressed. Below, please find 
our response to the remaining two comments we received.
    Comment: The commenter had concerns as to the wording or the 
implications of this expansion primarily concerning states that do not 
recognize domestic partnerships, and requested to know how eligibility 
would be treated for qualified partners in states that do not recognize 
domestic partnerships. The commenter requested to know whether a couple 
that is considered, and could register as a domestic partnership in one 
state would be deemed ineligible in a state that does not recognize and 
does not register domestic partnerships or whether this would prohibit 
same-sex partnerships in states that prevent same-sex marriage. This 
commenter also noted that the FLTCIP regulation explains that one would 
not be deemed eligible if related in a way that would prohibit legal 
marriage in the U.S. jurisdiction in which the domestic partnership was 
formed and requested further clarification of how would this impact 
same-sex domestic partnerships in states that prevent same-sex 
marriage.
    Response: The proposed and final regulations expand the definition 
of ``qualified relative'' to cover all individuals who are domestic 
partners (both same-sex and opposite-sex) of Federal and U.S. Postal 
Service employees, annuitants, members of the uniformed services, and 
retired members of the uniformed services no matter their state of 
residence. The regulation allows coverage for individuals who certify 
to their employing office that they meet the criteria in the regulatory 
definition of domestic partnership. The requirement in paragraph 
(v)(ii) of the definition of domestic partnership does not prevent 
those who reside in states that prohibit same-sex marriage to register 
as domestic partners. The requirement is meant to prevent those who are 
related by blood to certify to a domestic partnership as determined by 
their state of residence. This requirement already applies to same-sex 
domestic partners who can currently apply for coverage.
    Comment: The commenter recommended that we amend the proposed 
rulemaking to ensure that all children of same-sex parents are eligible 
to access FLTCIP Benefits, regardless of their parents' ability to 
marry. The commenter stated that this can be achieved by redefining an 
eligible child to include the child of a person standing in loco 
parentis, where in loco parentis means those persons with day-to-day 
responsibilities to care for and financially support a child, and with 
whom a biological or legal relationship is not necessary.
    Response: The proposed rule clarifies that OPM intends for children 
of domestic partners to be treated the same as currently eligible 
individuals. The eligibility of the stepchild does not depend upon the 
parent's ability to marry. The FLTCIP regulation provides that a 
``stepchild,'' as defined in the proposed rule, may qualify for FLTCIP 
coverage as a qualified relative, if all eligibility requirements are 
met. The

[[Page 66786]]

stepchild must be the child of the spouse or domestic partner of an 
employee, annuitant, member of the uniformed services, or retired 
member of the uniformed services. The stepchild(ren) may apply for 
coverage even if the employee does not apply, and his or her 
eligibility for FLTICP coverage is determined independent of the 
workforce member's ability to marry.

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 additional groups to the list of groups eligible to apply for 
coverage under the FLTCIP. The FLTCIP is a voluntary, self-pay, 
benefits program with no Government contribution.

Executive Order 12866, Regulatory Review

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

Federalism

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

List of Subjects in 5 CFR Part 875

    Administrative practice and procedure, Employee benefit plans, 
Government contracts, Government employees, health insurance, military 
personnel, organization and functions, Retirement.

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

    Accordingly, OPM is amending 5 CFR part 875 as follows:

PART 875--FEDERAL LONG TERM CARE INSURANCE PROGRAM

0
1. The authority citation for 5 CFR part 875 continues to read as 
follows:

    Authority: 5 U.S.C. 9008.

Subpart A--Administration and General Provisions

0
2. Section 875.101 is amended by revising the definitions of ``domestic 
partner'' and ``domestic partnership'' and by adding in alphabetical 
order a definition of ``stepchild(ren)'' to read as follows:


Sec.  875.101  Definitions.

* * * * *
    Domestic partner is defined as a person in a domestic partnership 
with an employee, annuitant, member of the uniformed services, or 
retired member of the uniformed services.
    Domestic partnership means:
    (1) A committed relationship between two adults, of the opposite 
sex or same sex, in which the partners--
    (i) Are each other's sole domestic partner and intend to remain so 
indefinitely;
    (ii) Maintain a common residence, and intend to continue to do so 
(or would maintain a common residence but for an assignment abroad or 
other employment-related, financial, or similar obstacle);
    (iii) Are at least 18 years of age and mentally competent to 
consent to a contract;
    (iv) Share responsibility for a significant measure of each other's 
financial obligations;
    (v) Are not married or joined in a civil union to anyone else;
    (vi) Are not a domestic partner of anyone else;
    (vii) Are not related in a way that would prohibit legal marriage 
in the U.S. jurisdiction in which the domestic partnership was formed;
    (viii) Provide documentation demonstrating fulfillment of the 
requirements of paragraphs (1)(i) through (vii) of this definition as 
prescribed by OPM; and
    (ix) Certify that they understand that willful falsification of the 
documentation described in paragraph (1)(viii) of this definition may 
lead to disciplinary action and the recovery of the cost of benefits 
received related to such falsification and may constitute a criminal 
violation under 18 U.S.C. 1001.
    (2) You or your domestic partner must notify the employing office 
if at any time between the time of application and the time coverage is 
scheduled to go into effect, any of the conditions listed in paragraphs 
(1)(i) through (vii) of this definition are no longer met, in which 
case a domestic partnership is deemed terminated. Such notification 
must be made as soon as possible, but in no event later than thirty 
calendar days after such conditions are no longer met.
* * * * *
    Stepchild(ren), as set forth in section 9001 of title 5, United 
States Code, means the child(ren) of the spouse or domestic partner of 
an employee, annuitant, member of the uniformed services, or retired 
member of the uniformed services.
* * * * *

Subpart B--Eligibility

0
3. Section 875.208 is revised to read as follows:


Sec.  875.208  May I apply as a qualified relative if the person on 
whom I am basing my eligibility status has died?

    You may not apply as a qualified relative if the workforce member 
on whom you are basing your qualified relative status died prior to the 
time you apply for coverage, unless you are receiving a survivor 
annuity as the spouse or an insurable interest annuity as the domestic 
partner of a deceased workforce member. In this case, your adult 
children and your current spouse or domestic partner are also 
considered to be qualified relatives.
0
4. In Sec.  875.213, paragraph (a) is revised to read as follows:


Sec.  875.213  May I apply as a qualified relative if I am the domestic 
partner of a workforce member?

    (a) You may apply for coverage as a qualified relative if you are a 
domestic partner, as described in Sec.  875.101 of this chapter. As 
prescribed by OPM, you will be required to provide documentation to 
demonstrate that you meet these requirements, and you must submit to 
full underwriting requirements. However, as explained in Sec.  875.210 
of this chapter, if you lose your status as a domestic partner, and 
therefore a qualified relative, before your coverage goes into effect, 
you are no longer eligible for FLTCIP coverage.
* * * * *

Subpart D--Coverage

0
5. Section 875.405 is revised to read as follows:


Sec.  875.405  If I marry, may my new spouse apply for coverage; if I 
become a domestic partner, may my new domestic partner apply for 
coverage; and may other qualified relatives apply for coverage?

    (a) Marriage. (1) If you are an active workforce member and you 
have married, your spouse is eligible to submit an application for 
coverage under this section within 60 days from the date of your 
marriage and will be subject to the underwriting requirements in force 
for the spouses of active workforce members during the most recent open 
season. You, however, are not eligible for abbreviated underwriting 
because of your marriage. You, your spouse, or both you and your spouse 
may apply for coverage during this 60-day period, but full underwriting 
will be required for you. After 60 days from the date of your marriage, 
you and/or your spouse may still apply for

[[Page 66787]]

coverage but will be subject to full underwriting.
    (2) If you are an active workforce member and you have entered into 
a domestic partnership, your domestic partner is eligible to submit an 
application for coverage under this section at any time from the 
commencing date of your domestic partnership and will be subject to 
full underwriting requirements. You are not eligible for abbreviated 
underwriting because of your domestic partnership. You, your domestic 
partner, or both you and your domestic partner may apply for coverage 
at any time, but full underwriting will be required for both of you.
    (b) Domestic partnership. The new spouse or domestic partner of an 
annuitant or retired member of the uniformed services may apply for 
coverage with full underwriting at any time following the marriage or 
commencing date of the domestic partnership.
    (c) Other qualified relatives. Other qualified relative(s) of a 
workforce member may apply for coverage with full underwriting at any 
time following the marriage or commencing date of the domestic 
partnership.

0
6. In Sec.  875.412, the introductory text is revised and paragraph (e) 
is added to read as follows:


Sec.  875.412  When will my coverage terminate?

    Except as provided in paragraph (e) of this section, your coverage 
will terminate on the earliest of the following dates:
* * * * *
    (e) Termination of a domestic partnership does not terminate 
insurance coverage as long as the Carrier continues to receive the 
required premium when due.

[FR Doc. 2015-27381 Filed 10-29-15; 8:45 am]
BILLING CODE 6325-63-P