81_FR_87129 81 FR 86898 - Removal of Eligible Family Members From Existing Self and Family Enrollments

81 FR 86898 - Removal of Eligible Family Members From Existing Self and Family Enrollments

OFFICE OF PERSONNEL MANAGEMENT

Federal Register Volume 81, Issue 231 (December 1, 2016)

Page Range86898-86900
FR Document2016-28787

This action would amend Federal Employees Health Benefits (FEHB) Program rules. This proposed rule is in response to enrollee requests to remove family members from existing enrollments. The intended effect of this action is to allow certain eligible family members to be removed from self and family or self plus one enrollments.

Federal Register, Volume 81 Issue 231 (Thursday, December 1, 2016)
[Federal Register Volume 81, Number 231 (Thursday, December 1, 2016)]
[Proposed Rules]
[Pages 86898-86900]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-28787]



[[Page 86897]]

Vol. 81

Thursday,

No. 231

December 1, 2016

Part III





 Office of Personnel Management





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





5 CFR Part 890





Removal of Eligible Family Members From Existing Self and Family 
Enrollments; Proposed Rule

Federal Register / Vol. 81 , No. 231 / Thursday, December 1, 2016 / 
Proposed Rules

[[Page 86898]]


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

OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 890

RIN 3206-AN43


Removal of Eligible Family Members From Existing Self and Family 
Enrollments

AGENCY: Office of Personnel Management (OPM).

ACTION: Proposed rule.

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

SUMMARY: This action would amend Federal Employees Health Benefits 
(FEHB) Program rules. This proposed rule is in response to enrollee 
requests to remove family members from existing enrollments. The 
intended effect of this action is to allow certain eligible family 
members to be removed from self and family or self plus one 
enrollments.

DATES: Comments are due on or before January 30, 2017.

ADDRESSES: Send written comments to Padma Shah, Senior Policy Analyst, 
Planning and Policy Analysis, U.S. Office of Personnel Management, Room 
4316, 1900 E Street NW., Washington, DC. You may also submit comments 
identified by the RIN number stated above using the Federal eRulemaking 
Portal (http://www.regulations.gov). Follow the instructions for 
submitting comments.

FOR FURTHER INFORMATION CONTACT: Padma Shah at (202) 606-0004.

SUPPLEMENTARY INFORMATION:

I. Background

    Currently under 5 CFR 890.302, all eligible family members are 
covered under a self and family enrollment. Subject to a temporary 
extension of coverage and conversion, a family member's coverage 
terminates on the day he or she ceases to be an eligible family member, 
as provided by 5 CFR 890.304. Existing regulations allow enrollees to 
change enrollment from self and family to self plus one or self only 
based on a qualifying life event or during Open Season. However, there 
is no provision in the existing regulations addressing the voluntary 
removal of an eligible covered family member under an existing self and 
family or self plus one enrollment.
    The Office of Personnel Management has experienced a number of 
requests to remove eligible family members since OPM implementated FEHB 
coverage for children up to age 26 for plan year 2011 pursuant to the 
Patient Protection and Affordable Care Act, Public Law 111-148, as 
amended by the Health Care and Education Reconciliation Act, Public Law 
111-152 (the Affordable Care Act). In accordance with this law, OPM 
issued guidance to FEHB carriers in Carrier Letter No. 2010-18 and to 
agency benefit officers in Benefits Administration Letter No. 2010-201. 
In these guidance documents, OPM advised that for the upcoming plan 
year and beyond married children were eligible for coverage without 
dependency requirements, residency requirements, or requirements that a 
child be a student or have prior or current insurance coverage under 
their parent's FEHB Program enrollment. On October 30, 2013, OPM 
published a final rule codifying this change in eligibility in 5 CFR 
890.302 (78 FR 64873).
    With the extension of FEHB coverage to children up to age 26, 
including the addition of coverage for married and non-dependent 
children, there are more circumstances where eligible family members 
have their own coverage and are either not in need of coverage under a 
parent's FEHB self and family enrollment or do not wish to be covered 
under that enrollment. In addition, some FEHB-enrolled parents do not 
wish to provide health insurance coverage for their adult children. In 
light of the number of FEHB enrollees who have communicated to us that 
they do not wish to maintain coverage for their adult child and adult 
children who have communicated that they want to be removed from their 
parent's FEHB self and family enrollment, OPM has re-examined its 
previous policy not to allow removal of eligible family members under 
any circumstances. Our review of this issue also indicated that there 
may be circumstances where covered spouses would also seek to be 
removed from an existing enrollment. Accordingly, this proposed change 
attempts to provide appropriate removal opportunities for covered 
family members, including spouses and adult children. Though the 
availability of the new self plus one enrollment type will alleviate 
this issue somewhat, we anticipate that enrollees may still wish to 
remove family members from existing enrollments, especially in 
situations where there are more than three family members covered under 
a self and family enrollment.

II. Discussion of the Proposed Rule

    The Office of Personnel Management proposes to add a new paragraph, 
5 CFR 890.308(h), that allows eligible family members to be removed 
from a self and family or a self plus one enrollment in certain limited 
circumstances. A request for removal under this proposed rule can be 
submitted and effectuated anytime during the plan year if the 
individual provides all needed documentation. The proposed rule also 
includes amendments to Sec.  890.302 requiring that proof of family 
member eligibility must be provided upon request by a carrier, 
employing office, or OPM and updating paragraph numbering. For more 
information on these changes, see proposed rule Federal Employees 
Health Benefits Program: Removal of Ineligible Individuals from 
Existing Enrollments, publishing elsewhere in this issue of the Federal 
Register.
    In a majority of cases, there appears to be no detriment to an 
eligible family member covered under a self and family or a self plus 
one enrollment, even if the family member has other coverage. Health 
insurance plans can coordinate coverage and provide what, in most 
cases, amounts to more generous benefits to a family member who has 
double coverage. However, in a minority of circumstances, it may be 
beneficial for a family member to be removed from an enrollment. For 
example, if a family member covered under an FEHB enrollment is 
eligible for their own employer's high deductible health plan with a 
health savings account, under Internal Revenue Service (IRS) 
regulations, the family member may not be able to take advantage of the 
employer's offer unless he or she is not covered under another health 
plan. Accordingly, the regulation proposes to allow spouses and adult 
children to be removed from a self and family or a self plus one 
enrollment if certain requirements are met.
    In the case of a self plus one enrollment, it would, in most cases, 
be beneficial for the enrollee to decrease his or her enrollment to a 
self only enrollment or cancel the enrollment in accordance with Sec.  
890.302 for a family member to no longer be covered. Similarly, in the 
case of a self and family enrollment with two eligible family members, 
it would in most cases be beneficial for the enrollee to decrease to a 
self plus one enrollment. However, if the enrollee is enrolled in 
premium conversion, IRS rules would prohibit the decrease in or 
cancellation of the enrollment mid-year in the absence of a qualifying 
life event. Therefore, the regulation allows an enrollee or a family 
member to choose removal with no decrease in enrollment at any time 
mid-year.
    This regulation also addresses situations where an enrollee has 
more than two eligible family members covered under a self and family 
enrollment, and one of the eligible family members may wish to no 
longer

[[Page 86899]]

be covered under the enrollment. For example, a self and family 
enrollment may cover an enrollee's spouse, one minor child and one 
adult child. The adult child may wish to stop coverage under the 
enrollee's self and family enrollment due to the availability of other 
employer-sponsored coverage, while the enrollee's spouse and minor 
child have no other access to coverage. In this example, the adult 
child can be removed from the existing self and family enrollment.
    In contemplating circumstances for removal, OPM sought to balance 
the interests of eligible family members with the interests of FEHB 
enrollees. For example, under this proposed rule, spouses may be 
removed if both the enrollee and the spouse provide a notarized request 
for removal to their agency. This ensures that both the enrollee and 
family member are aware of and agree to the request and avoids agencies 
receiving conflicting requests as to whether a spouse should be covered 
where the spouses disagree, for instance where they are nearing or 
seeking divorce.
    Adult children may be removed from a self plus one or self and 
family enrollment by the enrollee without the consent of the child if 
the enrollee provides proof that the child is no longer a dependent. 
Consistent with the Affordable Care Act, the proposed rule 
``continue[s] to make [FEHB] coverage available for an adult child'' 
but permits an enrollee to reject the offer of coverage for adult 
children who are no longer dependents. OPM plans to provide 
subregulatory guidance defining how an individual may demonstrate that 
a child is no longer a dependent.
    Adult children who request removal from a self and family or self 
plus one enrollment will be removed if the child submits a notarized 
request for removal. OPM recognizes that with the extension of coverage 
to married and non-dependent children to age 26, there are more 
eligible adult children covered under the program who have their own 
independent means for obtaining health insurance coverage or who wish 
for other reasons, such as an interest in privacy, not to be covered 
under their parent's enrollment. However, under the proposed rule, 
minor children may not be removed from an enrollment without a court 
order to protect the interests of children who are not yet at an age 
where they are ready to be responsible for their own health insurance 
coverage.

Submissions of Requests

    To submit a notarized request for removal, the proposed rule 
instructs that the request must be submitted to the employing agency 
and that the effective date of the removal be the first day of the pay 
period following the agency's approval of the request. When an enrollee 
requesting removal of an adult child has submitted proof that the adult 
child is no longer a dependent, the proposed effective date is the 
first day of the second pay period following the agency's approval of 
the request. This proposed effective date gives a child being removed 
without his or her consent a pay period to receive notice of the 
removal and to procure other health coverage.
    If an eligible family member is removed from an enrollment, he or 
she may only regain coverage under the applicable self plus one or self 
and family enrollment during the annual Open Season or within 60 days 
of the eligible family member losing other coverage. Enrollees must 
provide the written consent of the family member and demonstrate their 
continued eligibility as a spouse or child under this section. This 
proposed policy avoids family members making multiple changes 
throughout the plan year and allows FEHB carriers to properly 
administer needed services. OPM will publish subregulatory guidance 
through a Benefits Administration Letter providing specific guidance to 
agencies on processes for removals.
    Family members removed under this proposed regulation will not be 
eligible for temporary extension of coverage and conversion under Sec.  
890.401 or temporary continuation of coverage (TCC) under Sec.  
890.1103. The FEHB governing statute does not allow removed family 
members to be eligible for TCC or a temporary extension of coverage and 
conversion as such removal does not result in the child ceasing to meet 
the requirements for being considered a child within the meaning of 5 
U.S.C. 8905a and 8901(1).
    Regulatory Impact Analysis: OPM has examined the impact of this 
proposed rule as required by Executive Order 12866 and Executive Order 
13563, which directs agencies to assess all costs and benefits of 
available regulatory alternatives and, if regulation is necessary, to 
select regulatory approaches that maximize net benefits (including 
potential economic, environmental, public, health, and safety effects, 
distributive impacts, and equity). A regulatory impact analysis must be 
prepared for major rules with economically significant effects of $100 
million or more in any one year. This rule is not considered a major 
rule because it provides a process for removal of erroneously enrolled 
eligible family members from self and family enrollments, which we do 
not estimate to have widespread applicability under the FEHB Program.

Regulatory Flexibility Act

    The Regulatory Flexibility Act of 1980 (Pub. L. 96-354) (RFA) 
establishes ``as a principle of regulatory issuance that agencies shall 
endeavor, consistent with the objectives of the rule and of applicable 
statutes, to fit regulatory and informational requirements to the scale 
of the businesses, organizations, and governmental jurisdictions 
subject to regulation.'' To achieve this principle, agencies are 
required to solicit and consider flexible regulatory proposals and to 
explain the rationale for their actions to assure that such proposals 
are given serious consideration.'' The RFA covers a widerange of small 
entities, including small businesses, not-for-profit organizations, and 
small governmental jurisdictions.
    Agencies must perform a review to determine whether a rule will 
have a significant economic impact on a substantial number of small 
entities. If the agency determines that it will, the agency must 
prepare a regulatory flexibility analysis as described in the RFA. I 
certify that this regulation will not have a significant economic 
impact on a substantial number of small entities because the regulation 
only affects health insurance benefits of Federal employees and 
annuitants.

Regulatory Review

    This rule has been reviewed by the Office of Management and Budget 
in accordance with Executive Orders 13563 and 12866.

Federalism

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

Paperwork Reduction Act

    The Paperwork Reduction Act of 1995 (44 U.S.C. chapter 3507(d); see 
5 CFR part 1320) requires that the U.S. Office of Management and Budget 
(OMB) approve all collections of information by a Federal agency from 
the public before they can be implemented. Respondents are not required 
to respond to any collection of information unless it displays a 
current valid OMB control number. OPM is not proposing any additional 
collections in this rule.

[[Page 86900]]

List of Subjects on 5 CFR Part 890

    Administrative practice and procedure, Government employees, Health 
insurance.

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

    For the reasons set forth in the preamble, OPM proposes to amend 
Part 890 of Title 5 of the 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 101, 104 Stat. 
2064, as amended; Sec. 890.102 also issued under sections 11202(f), 
11232(e), 11246(b) and (c) of Pub. L. 105-33, 111 Stat. 251; and 
section 721 of Pub. L. 105-261, 112 Stat. 2061; Pub. L. 111-148, as 
amended by Pub. L. 111-152.

0
2. Amend Sec.  890.302 by revising paragraph (a)(1) 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 section 890.308(h). Proof of family member 
eligibility may be required, and must be provided upon request, to the 
carrier, the employing office or OPM. 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.
* * * * *
0
3. Amend Sec.  890.308 by adding paragraph (h) to read as follows:


Sec.  890.308   Disenrollment.

* * * * *
    (h) Removal from Enrollment: Eligible Family Members. (1) An 
eligible family member may be removed from a self plus one or a self 
and family enrollment if a request is submitted to the employing office 
for approval in the following circumstances:
    (i) In the case of a spouse, if the enrollee and his or her spouse 
provide a notarized request for removal.
    (ii) In the case of a child who has reached the age of majority in 
the child's state of residence (the enrollee's state of residence if 
the child's is not known), if the enrollee provides proof that the 
child is no longer his or her dependent. The enrollee shall also 
provide the last known contact information for the child.
    (iii) In the case of a child who has reached the age of majority in 
the child's state of residence, if the child provides a notarized 
request for removal.
    (2) For removals under paragraphs (h)(1)(i) and (h)(1)(iii) of this 
section, the effective date is the first day of the pay period 
following the date that the request is approved by the employing 
office. For removals under paragraph (h)(1)(ii), the effective date is 
the first day of the second pay period following the date the request 
is approved by the employing office.
    (3) The family member's removal under this paragraph is considered 
a cancellation under Sec.  890.304(d) and removed family members are 
not eligible for temporary extension of coverage and conversion under 
section 890.401or temporary continuation of coverage under Sec.  
809.1103 of this chapter.
    (4) If an eligible family member is removed under this paragraph, 
he or she may only regain coverage under the applicable self plus one 
or self and family enrollment if requested by the enrollee during the 
annual open season or within 60 days of the family member losing other 
health insurance coverage. The enrollee must also provide written 
consent to reinstatement of coverage from the family member and 
demonstrate eligibility of the spouse or child as a family member.
    (5) If an employing office approves a request for removal, the 
employing office must notify the enrollee and the carrier of the 
removal immediately. For removals under paragraph (h)(1)(ii) of this 
section, the employing office must also immediately notify the child of 
the removal using the last known contact provided by the enrollee.

[FR Doc. 2016-28787 Filed 11-30-16; 8:45 am]
 BILLING CODE 6325-63-P



                                                     86898                Federal Register / Vol. 81, No. 231 / Thursday, December 1, 2016 / Proposed Rules

                                                     OFFICE OF PERSONNEL                                     Law 111–152 (the Affordable Care Act).                anytime during the plan year if the
                                                     MANAGEMENT                                              In accordance with this law, OPM                      individual provides all needed
                                                                                                             issued guidance to FEHB carriers in                   documentation. The proposed rule also
                                                     5 CFR Part 890                                          Carrier Letter No. 2010–18 and to                     includes amendments to § 890.302
                                                     RIN 3206–AN43                                           agency benefit officers in Benefits                   requiring that proof of family member
                                                                                                             Administration Letter No. 2010–201. In                eligibility must be provided upon
                                                     Removal of Eligible Family Members                      these guidance documents, OPM                         request by a carrier, employing office, or
                                                     From Existing Self and Family                           advised that for the upcoming plan year               OPM and updating paragraph
                                                     Enrollments                                             and beyond married children were                      numbering. For more information on
                                                                                                             eligible for coverage without                         these changes, see proposed rule
                                                     AGENCY:  Office of Personnel                            dependency requirements, residency                    Federal Employees Health Benefits
                                                     Management (OPM).                                       requirements, or requirements that a                  Program: Removal of Ineligible
                                                     ACTION: Proposed rule.                                  child be a student or have prior or                   Individuals from Existing Enrollments,
                                                                                                             current insurance coverage under their                publishing elsewhere in this issue of the
                                                     SUMMARY:    This action would amend                     parent’s FEHB Program enrollment. On                  Federal Register.
                                                     Federal Employees Health Benefits                       October 30, 2013, OPM published a                        In a majority of cases, there appears
                                                     (FEHB) Program rules. This proposed                     final rule codifying this change in                   to be no detriment to an eligible family
                                                     rule is in response to enrollee requests                eligibility in 5 CFR 890.302 (78 FR                   member covered under a self and family
                                                     to remove family members from existing                  64873).                                               or a self plus one enrollment, even if the
                                                     enrollments. The intended effect of this                   With the extension of FEHB coverage                family member has other coverage.
                                                     action is to allow certain eligible family              to children up to age 26, including the               Health insurance plans can coordinate
                                                     members to be removed from self and                     addition of coverage for married and                  coverage and provide what, in most
                                                     family or self plus one enrollments.                    non-dependent children, there are more                cases, amounts to more generous
                                                     DATES: Comments are due on or before                    circumstances where eligible family                   benefits to a family member who has
                                                     January 30, 2017.                                       members have their own coverage and                   double coverage. However, in a minority
                                                     ADDRESSES: Send written comments to                     are either not in need of coverage under              of circumstances, it may be beneficial
                                                     Padma Shah, Senior Policy Analyst,                      a parent’s FEHB self and family                       for a family member to be removed from
                                                     Planning and Policy Analysis, U.S.                      enrollment or do not wish to be covered               an enrollment. For example, if a family
                                                     Office of Personnel Management, Room                    under that enrollment. In addition,                   member covered under an FEHB
                                                     4316, 1900 E Street NW., Washington,                    some FEHB-enrolled parents do not                     enrollment is eligible for their own
                                                     DC. You may also submit comments                        wish to provide health insurance                      employer’s high deductible health plan
                                                     identified by the RIN number stated                     coverage for their adult children. In                 with a health savings account, under
                                                     above using the Federal eRulemaking                     light of the number of FEHB enrollees                 Internal Revenue Service (IRS)
                                                     Portal (http://www.regulations.gov).                    who have communicated to us that they                 regulations, the family member may not
                                                     Follow the instructions for submitting                  do not wish to maintain coverage for                  be able to take advantage of the
                                                     comments.                                               their adult child and adult children who              employer’s offer unless he or she is not
                                                                                                             have communicated that they want to be                covered under another health plan.
                                                     FOR FURTHER INFORMATION CONTACT:                        removed from their parent’s FEHB self                 Accordingly, the regulation proposes to
                                                     Padma Shah at (202) 606–0004.                           and family enrollment, OPM has re-                    allow spouses and adult children to be
                                                     SUPPLEMENTARY INFORMATION:                              examined its previous policy not to                   removed from a self and family or a self
                                                     I. Background                                           allow removal of eligible family                      plus one enrollment if certain
                                                                                                             members under any circumstances. Our                  requirements are met.
                                                        Currently under 5 CFR 890.302, all                   review of this issue also indicated that                 In the case of a self plus one
                                                     eligible family members are covered                     there may be circumstances where                      enrollment, it would, in most cases, be
                                                     under a self and family enrollment.                     covered spouses would also seek to be                 beneficial for the enrollee to decrease
                                                     Subject to a temporary extension of                     removed from an existing enrollment.                  his or her enrollment to a self only
                                                     coverage and conversion, a family                       Accordingly, this proposed change                     enrollment or cancel the enrollment in
                                                     member’s coverage terminates on the                     attempts to provide appropriate removal               accordance with § 890.302 for a family
                                                     day he or she ceases to be an eligible                  opportunities for covered family                      member to no longer be covered.
                                                     family member, as provided by 5 CFR                     members, including spouses and adult                  Similarly, in the case of a self and
                                                     890.304. Existing regulations allow                     children. Though the availability of the              family enrollment with two eligible
                                                     enrollees to change enrollment from self                new self plus one enrollment type will                family members, it would in most cases
                                                     and family to self plus one or self only                alleviate this issue somewhat, we                     be beneficial for the enrollee to decrease
                                                     based on a qualifying life event or                     anticipate that enrollees may still wish              to a self plus one enrollment. However,
                                                     during Open Season. However, there is                   to remove family members from existing                if the enrollee is enrolled in premium
                                                     no provision in the existing regulations                enrollments, especially in situations                 conversion, IRS rules would prohibit
                                                     addressing the voluntary removal of an                  where there are more than three family                the decrease in or cancellation of the
                                                     eligible covered family member under                    members covered under a self and                      enrollment mid-year in the absence of a
                                                     an existing self and family or self plus                family enrollment.                                    qualifying life event. Therefore, the
                                                     one enrollment.                                                                                               regulation allows an enrollee or a family
                                                                                                             II. Discussion of the Proposed Rule
mstockstill on DSK3G9T082PROD with PROPOSALS2




                                                        The Office of Personnel Management                                                                         member to choose removal with no
                                                     has experienced a number of requests to                    The Office of Personnel Management                 decrease in enrollment at any time mid-
                                                     remove eligible family members since                    proposes to add a new paragraph, 5 CFR                year.
                                                     OPM implementated FEHB coverage for                     890.308(h), that allows eligible family                  This regulation also addresses
                                                     children up to age 26 for plan year 2011                members to be removed from a self and                 situations where an enrollee has more
                                                     pursuant to the Patient Protection and                  family or a self plus one enrollment in               than two eligible family members
                                                     Affordable Care Act, Public Law 111–                    certain limited circumstances. A request              covered under a self and family
                                                     148, as amended by the Health Care and                  for removal under this proposed rule                  enrollment, and one of the eligible
                                                     Education Reconciliation Act, Public                    can be submitted and effectuated                      family members may wish to no longer


                                                VerDate Sep<11>2014   17:15 Nov 30, 2016   Jkt 241001   PO 00000   Frm 00002   Fmt 4701   Sfmt 4702   E:\FR\FM\01DEP2.SGM   01DEP2


                                                                          Federal Register / Vol. 81, No. 231 / Thursday, December 1, 2016 / Proposed Rules                                          86899

                                                     be covered under the enrollment. For                    the employing agency and that the                     enrollments, which we do not estimate
                                                     example, a self and family enrollment                   effective date of the removal be the first            to have widespread applicability under
                                                     may cover an enrollee’s spouse, one                     day of the pay period following the                   the FEHB Program.
                                                     minor child and one adult child. The                    agency’s approval of the request. When
                                                                                                                                                                   Regulatory Flexibility Act
                                                     adult child may wish to stop coverage                   an enrollee requesting removal of an
                                                     under the enrollee’s self and family                    adult child has submitted proof that the                 The Regulatory Flexibility Act of 1980
                                                     enrollment due to the availability of                   adult child is no longer a dependent, the             (Pub. L. 96–354) (RFA) establishes ‘‘as a
                                                     other employer-sponsored coverage,                      proposed effective date is the first day              principle of regulatory issuance that
                                                     while the enrollee’s spouse and minor                   of the second pay period following the                agencies shall endeavor, consistent with
                                                     child have no other access to coverage.                 agency’s approval of the request. This                the objectives of the rule and of
                                                     In this example, the adult child can be                 proposed effective date gives a child                 applicable statutes, to fit regulatory and
                                                     removed from the existing self and                      being removed without his or her                      informational requirements to the scale
                                                     family enrollment.                                      consent a pay period to receive notice                of the businesses, organizations, and
                                                        In contemplating circumstances for                   of the removal and to procure other                   governmental jurisdictions subject to
                                                     removal, OPM sought to balance the                      health coverage.                                      regulation.’’ To achieve this principle,
                                                     interests of eligible family members                       If an eligible family member is                    agencies are required to solicit and
                                                     with the interests of FEHB enrollees.                   removed from an enrollment, he or she                 consider flexible regulatory proposals
                                                     For example, under this proposed rule,                  may only regain coverage under the
                                                                                                                                                                   and to explain the rationale for their
                                                     spouses may be removed if both the                      applicable self plus one or self and
                                                                                                                                                                   actions to assure that such proposals are
                                                     enrollee and the spouse provide a                       family enrollment during the annual
                                                                                                                                                                   given serious consideration.’’ The RFA
                                                     notarized request for removal to their                  Open Season or within 60 days of the
                                                                                                                                                                   covers a widerange of small entities,
                                                     agency. This ensures that both the                      eligible family member losing other
                                                                                                                                                                   including small businesses, not-for-
                                                     enrollee and family member are aware                    coverage. Enrollees must provide the
                                                                                                                                                                   profit organizations, and small
                                                     of and agree to the request and avoids                  written consent of the family member
                                                                                                                                                                   governmental jurisdictions.
                                                     agencies receiving conflicting requests                 and demonstrate their continued
                                                     as to whether a spouse should be                        eligibility as a spouse or child under                   Agencies must perform a review to
                                                     covered where the spouses disagree, for                 this section. This proposed policy                    determine whether a rule will have a
                                                     instance where they are nearing or                      avoids family members making multiple                 significant economic impact on a
                                                     seeking divorce.                                        changes throughout the plan year and                  substantial number of small entities. If
                                                        Adult children may be removed from                   allows FEHB carriers to properly                      the agency determines that it will, the
                                                     a self plus one or self and family                      administer needed services. OPM will                  agency must prepare a regulatory
                                                     enrollment by the enrollee without the                  publish subregulatory guidance through                flexibility analysis as described in the
                                                     consent of the child if the enrollee                    a Benefits Administration Letter                      RFA. I certify that this regulation will
                                                     provides proof that the child is no                     providing specific guidance to agencies               not have a significant economic impact
                                                     longer a dependent. Consistent with the                 on processes for removals.                            on a substantial number of small entities
                                                     Affordable Care Act, the proposed rule                     Family members removed under this                  because the regulation only affects
                                                     ‘‘continue[s] to make [FEHB] coverage                   proposed regulation will not be eligible              health insurance benefits of Federal
                                                     available for an adult child’’ but permits              for temporary extension of coverage and               employees and annuitants.
                                                     an enrollee to reject the offer of coverage             conversion under § 890.401 or
                                                     for adult children who are no longer                    temporary continuation of coverage                    Regulatory Review
                                                     dependents. OPM plans to provide                        (TCC) under § 890.1103. The FEHB                        This rule has been reviewed by the
                                                     subregulatory guidance defining how an                  governing statute does not allow                      Office of Management and Budget in
                                                     individual may demonstrate that a child                 removed family members to be eligible                 accordance with Executive Orders
                                                     is no longer a dependent.                               for TCC or a temporary extension of                   13563 and 12866.
                                                        Adult children who request removal                   coverage and conversion as such
                                                     from a self and family or self plus one                 removal does not result in the child                  Federalism
                                                     enrollment will be removed if the child                 ceasing to meet the requirements for
                                                     submits a notarized request for removal.                being considered a child within the                     The Office of Personnel Management
                                                     OPM recognizes that with the extension                  meaning of 5 U.S.C. 8905a and 8901(1).                has examined this proposed rule in
                                                     of coverage to married and non-                            Regulatory Impact Analysis: OPM has                accordance with Executive Order 13132,
                                                     dependent children to age 26, there are                 examined the impact of this proposed                  Federalism. The agency has determined
                                                     more eligible adult children covered                    rule as required by Executive Order                   that this proposed rule will not have
                                                     under the program who have their own                    12866 and Executive Order 13563,                      any negative impact on the rights, roles,
                                                     independent means for obtaining health                  which directs agencies to assess all costs            and responsibilities of State, local, or
                                                     insurance coverage or who wish for                      and benefits of available regulatory                  Tribal governments.
                                                     other reasons, such as an interest in                   alternatives and, if regulation is                    Paperwork Reduction Act
                                                     privacy, not to be covered under their                  necessary, to select regulatory
                                                     parent’s enrollment. However, under the                 approaches that maximize net benefits                    The Paperwork Reduction Act of 1995
                                                     proposed rule, minor children may not                   (including potential economic,                        (44 U.S.C. chapter 3507(d); see 5 CFR
                                                     be removed from an enrollment without                   environmental, public, health, and                    part 1320) requires that the U.S. Office
mstockstill on DSK3G9T082PROD with PROPOSALS2




                                                     a court order to protect the interests of               safety effects, distributive impacts, and             of Management and Budget (OMB)
                                                     children who are not yet at an age where                equity). A regulatory impact analysis                 approve all collections of information
                                                     they are ready to be responsible for their              must be prepared for major rules with                 by a Federal agency from the public
                                                     own health insurance coverage.                          economically significant effects of $100              before they can be implemented.
                                                                                                             million or more in any one year. This                 Respondents are not required to respond
                                                     Submissions of Requests                                 rule is not considered a major rule                   to any collection of information unless
                                                       To submit a notarized request for                     because it provides a process for                     it displays a current valid OMB control
                                                     removal, the proposed rule instructs                    removal of erroneously enrolled eligible              number. OPM is not proposing any
                                                     that the request must be submitted to                   family members from self and family                   additional collections in this rule.


                                                VerDate Sep<11>2014   17:15 Nov 30, 2016   Jkt 241001   PO 00000   Frm 00003   Fmt 4701   Sfmt 4702   E:\FR\FM\01DEP2.SGM   01DEP2


                                                     86900                Federal Register / Vol. 81, No. 231 / Thursday, December 1, 2016 / Proposed Rules

                                                     List of Subjects on 5 CFR Part 890                      member eligibility may be required, and               effective date is the first day of the pay
                                                       Administrative practice and                           must be provided upon request, to the                 period following the date that the
                                                     procedure, Government employees,                        carrier, the employing office or OPM.                 request is approved by the employing
                                                     Health insurance.                                       Except as provided in paragraph (a)(2)                office. For removals under paragraph
                                                                                                             of this section, no employee, former                  (h)(1)(ii), the effective date is the first
                                                       U.S. Office of Personnel Management.                  employee, annuitant, child, or former                 day of the second pay period following
                                                     Beth F. Cobert,                                         spouse may enroll or be covered as a                  the date the request is approved by the
                                                     Acting Director.                                        family member if he or she is already                 employing office.
                                                       For the reasons set forth in the                      covered under another person’s self plus                 (3) The family member’s removal
                                                     preamble, OPM proposes to amend Part                    one or self and family enrollment in the              under this paragraph is considered a
                                                     890 of Title 5 of the Code of Federal                   FEHB Program.                                         cancellation under § 890.304(d) and
                                                     Regulations as follows:                                 *     *     *     *    *                              removed family members are not
                                                                                                             ■ 3. Amend § 890.308 by adding                        eligible for temporary extension of
                                                     PART 890—FEDERAL EMPLOYEES                              paragraph (h) to read as follows:
                                                     HEALTH BENEFITS PROGRAM                                                                                       coverage and conversion under section
                                                                                                             § 890.308    Disenrollment.                           890.401or temporary continuation of
                                                     ■ 1. The authority citation for part 890                *       *     *     *     *                           coverage under § 809.1103 of this
                                                     continues to read as follows:                              (h) Removal from Enrollment: Eligible              chapter.
                                                        Authority: 5 U.S.C. 8913; Sec 890.301 also           Family Members. (1) An eligible family                   (4) If an eligible family member is
                                                     issued under sec. 311 of Pub. L. 111–03, 123            member may be removed from a self                     removed under this paragraph, he or she
                                                     Stat. 64; Sec. 890.111 also issued under                plus one or a self and family enrollment              may only regain coverage under the
                                                     section 1622(b) of Pub. L. 104–106, 110 Stat.           if a request is submitted to the                      applicable self plus one or self and
                                                     521; Sec. 890.112 also issued under section             employing office for approval in the                  family enrollment if requested by the
                                                     1 of Pub. L. 110–279, 122 Stat. 2604; 5 U.S.C.
                                                                                                             following circumstances:                              enrollee during the annual open season
                                                     8913; Sec. 890.803 also issued under 50
                                                     U.S.C. 403p, 22 U.S.C. 4069c and 4069c–1;
                                                                                                                (i) In the case of a spouse, if the                or within 60 days of the family member
                                                     subpart L also issued under sec. 599C of 101,           enrollee and his or her spouse provide                losing other health insurance coverage.
                                                     104 Stat. 2064, as amended; Sec. 890.102 also           a notarized request for removal.                      The enrollee must also provide written
                                                     issued under sections 11202(f), 11232(e),                  (ii) In the case of a child who has                consent to reinstatement of coverage
                                                     11246(b) and (c) of Pub. L. 105–33, 111 Stat.           reached the age of majority in the                    from the family member and
                                                     251; and section 721 of Pub. L. 105–261, 112            child’s state of residence (the enrollee’s            demonstrate eligibility of the spouse or
                                                     Stat. 2061; Pub. L. 111–148, as amended by              state of residence if the child’s is not              child as a family member.
                                                     Pub. L. 111–152.                                        known), if the enrollee provides proof
                                                                                                                                                                      (5) If an employing office approves a
                                                     ■ 2. Amend § 890.302 by revising                        that the child is no longer his or her
                                                                                                                                                                   request for removal, the employing
                                                     paragraph (a)(1) to read as follows:                    dependent. The enrollee shall also
                                                                                                                                                                   office must notify the enrollee and the
                                                                                                             provide the last known contact
                                                     § 890.302   Coverage of family members.                                                                       carrier of the removal immediately. For
                                                                                                             information for the child.
                                                       (a)(1) An enrollment for self plus one                                                                      removals under paragraph (h)(1)(ii) of
                                                                                                                (iii) In the case of a child who has
                                                     includes the enrollee and one eligible                                                                        this section, the employing office must
                                                                                                             reached the age of majority in the
                                                     family member. An enrollment for self                                                                         also immediately notify the child of the
                                                                                                             child’s state of residence, if the child
                                                     and family includes all family members                                                                        removal using the last known contact
                                                                                                             provides a notarized request for
                                                     who are eligible to be covered by the                                                                         provided by the enrollee.
                                                                                                             removal.
                                                     enrollment except as provided in                           (2) For removals under paragraphs                  [FR Doc. 2016–28787 Filed 11–30–16; 8:45 am]
                                                     section 890.308(h). Proof of family                     (h)(1)(i) and (h)(1)(iii) of this section, the        BILLING CODE 6325–63–P
mstockstill on DSK3G9T082PROD with PROPOSALS2




                                                VerDate Sep<11>2014   17:15 Nov 30, 2016   Jkt 241001   PO 00000   Frm 00004   Fmt 4701   Sfmt 9990   E:\FR\FM\01DEP2.SGM   01DEP2



Document Created: 2018-02-14 09:00:42
Document Modified: 2018-02-14 09:00:42
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionProposed rule.
DatesComments are due on or before January 30, 2017.
ContactPadma Shah at (202) 606-0004.
FR Citation81 FR 86898 
RIN Number3206-AN43
CFR AssociatedAdministrative Practice and Procedure; Government Employees and Health Insurance

2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR