[Federal Register: January 17, 2007 (Volume 72, Number 10)]
[Rules and Regulations]
[Page 1911-1912]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr17ja07-1]
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Rules and Regulations
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains regulatory documents
having general applicability and legal effect, most of which are keyed
to and codified in the Code of Federal Regulations, which is published
under 50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by the Superintendent of Documents.
Prices of new books are listed in the first FEDERAL REGISTER issue of each
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[[Page 1911]]
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN 3206-AK95
Federal Employees Health Benefits Program: Discontinuance of
Health Plan in an Emergency
AGENCY: Office of Personnel Management.
ACTION: Final Regulation.
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SUMMARY: The Office of Personnel Management (OPM) is issuing a final
rule to amend the Federal Employees Health Benefits (FEHB) regulations
regarding discontinuance of a health plan to include situations in
which a health plan becomes incapacitated, either temporarily or
permanently, as the result of a disaster.
EFFECTIVE DATE: February 16, 2007.
FOR FURTHER INFORMATION CONTACT: For further information contact Edward
M. DeHarde, Center for Employee and Family Support Policy, Strategic
Human Resources Policy Division, Office of Personnel Management, 1900 E
Street, NW., Washington, DC 20415; or call him at 202-606-0004.
SUPPLEMENTARY INFORMATION: OPM currently has regulations dealing with
the discontinuance of a health plan in whole or part. The regulations
apply when a plan goes out of business or withdraws from the FEHB
Program. Enrollees in such plans are notified that they need to change
plans. The regulations also allow the automatic transfer of the
enrollment of annuitants who do not change plans.
In light of the devastation wrought by Hurricane Katrina, OPM has
expanded the discontinuation of a health plan to include situations in
which a plan becomes incapable of providing services, either on a
permanent or temporary basis, because of a disaster. In such a
situation enrollees are now allowed to change health plans. However,
depending on the nature of the disaster, it may not be possible to
locate enrollees to notify them of the need to change health plans. To
ensure there is no loss of coverage, any enrollee who is not able to
make a change in these circumstances will be transferred automatically
to the standard option of the nationwide Blue Cross and Blue Shield
Service Benefit Plan. To the extent practical, OPM will work together
with carriers and agencies to notify affected individual employees, and
OPM will make general notification or announcement on its Web site.
Invoking the provisions of these final regulations will be at OPM's
discretion. OPM will provide whatever notification is feasible, if a
disaster necessitates enrollment changes under these provisions.
It should be noted that, although one of the regulatory sections
being amended, Sec. 890.301, refers to employees who do not
participate in premium conversion, under the premium conversion
regulations at Sec. 892.207 these provisions would also apply to
employees who do participate in premium conversion.
A proposed rule was published to amend 5 CFR part 890 in the
Federal Register at 71 FR 11287, March 7, 2006. OPM requested comments
by May 8, 2006. We received one comment by that date, from an FEHB
Program carrier. The issues raised by this commenter are discussed
below.
The commenter suggested the regulations are unfair to affected
carriers as it could force them to incur lost revenue; the commenter
indicated that the proposed regulations do not define terms such as
incapacitated, discontinuance, and disaster; the commenter suggested
that the regulations do not provide a clear process for OPM to make
determinations, enforce rules or communicate with members and plans;
and the commenter suggested that the regulations give overly broad
discretion to OPM.
The intent of the regulations is that Federal employees can receive
coverage for services in the event of a disaster, even if the
employee's health plan is incapable of providing coverage. The
regulations do not affect any health plan that could still provide
benefit coverage to affected enrollees. Loss of coverage due to the
discontinuation of a health plan is a longstanding part of FEHB Program
regulations. The proposed rule adds discontinuation due to disaster to
the list of possible causes for the discontinuation of a health plan.
Under existing regulations, annuitants who do not change health
plans when a plan is discontinued are deemed to have enrolled in the
nationwide Blue Cross and Blue Shield Service Benefit Plan; however,
employees who do not change health plans are deemed to have cancelled
their coverage. Under the new rule, employees receive the same
protection as annuitants when their health plan is discontinued due to
disaster. This will ensure that no enrollee loses coverage because of a
disaster. The rule requires wide latitude in its application since no
one can accurately predict disaster or its aftermath. OPM is committed
to protecting the health and safety of the Federal workforce.
Therefore, for the reasons supplied in the proposed rule, we are
adopting the proposed rule as the final rule without change.
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 affects health benefits of Federal employees and retirees.
Executive Order 12866, Regulatory Review
This rule has been reviewed by the Office of Management and Budget
in accordance with Executive Order 12866.
Lists of Subjects in 5 CFR Part 890
Administrative practice and procedure, Government employees, Health
facilities, Health insurance, Health professions, Hostages, Iraq,
Kuwait, Lebanon, Military personnel, Reporting and recordkeeping
requirements, Retirement.
U.S. Office of Personnel Management.
Linda M. Springer,
Director.
0
Accordingly, OPM is amending part 890 of title 5, Code of Federal
Regulations as follows:
[[Page 1912]]
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. 890.303 also issued under 50
U.S.C. 403p, 22 U.S.C. 4069c and 4069c-1; subpart L also issued
under sec. 599 C of Pub. L 101-513, 104 Stat. 2064, as amended;
Sec. 890.102 also issued under sections 11202(f), 11232(e), and
11246(b) and (c) of Pub. L. 105-33, 111 Stat. 251; and section 721
of Pub. L. 105-261, 112 Stat. 2061 unless otherwise noted.
0
2. In Sec. 890.301 add new paragraph (i)(4)(iv) to read as follows:
Sec. 890.301 Opportunities for employees who are not participants in
premium conversion to enroll or change enrollment; effective dates.
* * * * *
(i) * * *
(4) * * *
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, an employee must change the enrollment
within 60 days of the disaster, as announced by OPM. If an employee
does not change the enrollment within the time frame announced by OPM,
the employee will be considered to be enrolled in the standard option
of the Blue Cross and Blue Shield Service Benefit Plan. The effective
date of enrollment changes under this provision will be set by OPM when
it makes the announcement allowing such changes.
* * * * *
0
3. In Sec. 890.306 add new paragraph (1)(4)(v) to read as follows:
Sec. 890.306 When can annuitants or survivor annuitants change
enrollment or reenroll and what are the effective dates?
* * * * *
(1) * * *
(4) * * *
(v) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, an annuitant must change the
enrollment within 60 days of the disaster, as announced by OPM. If an
annuitant does not change the enrollment within the time frame
announced by OPM, the annuitant will be considered to be enrolled in
the standard option of the Blue Cross and Blue Shield Service Benefit
Plan. The effective date of enrollment changes under this provision
will be set by OPM when it makes the announcement allowing such
changes.
* * * * *
0
4. In Sec. 890.806 add new paragraph (j)(4)(iv) to read as follows:
Sec. 890.806 When can former spouses change enrollment or reenroll
and what are the effective dates?
* * * * *
(j) * * *
(4) * * *
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, the former spouse must change the
enrollment within 60 days of the disaster, as announced by OPM. If the
former spouse does not change the enrollment within the time frame
announced by OPM, the former spouse will be considered to be enrolled
in the standard option of the Blue Cross and Blue Shield Service
Benefit Plan. The effective date of enrollment changes under this
provision will be set by OPM when it makes the announcement allowing
such changes.
* * * * *
0
5. In Sec. 890.1108 add new paragraph (h)(4)(iv) to read as follows:
Sec. 890.1108 Opportunities to change enrollment; effective dates.
* * * * *
(h) * * *
(4) * * *
(iv) If the discontinuance of the plan, whether permanent or
temporary, is due to a disaster, the enrollee must change the
enrollment within 60 days of the disaster, as announced by OPM. If the
enrollee does not change the enrollment within the time frame announced
by OPM, the enrollee will be considered to be enrolled in the standard
option of the Blue Cross and Blue Shield Service Benefit Plan. The
effective date of enrollment changes under this provision will be set
by OPM when it makes the announcement allowing such changes.
* * * * *
[FR Doc. E7-533 Filed 1-16-07; 8:45 am]
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