[Federal Register Volume 63, Number 168 (Monday, August 31, 1998)]
[Proposed Rules]
[Pages 46180-46181]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-23335]


 ========================================================================
 Proposed Rules
                                                 Federal Register
 ________________________________________________________________________
 
 This section of the FEDERAL REGISTER contains notices to the public of 
 the proposed issuance of rules and regulations. The purpose of these 
 notices is to give interested persons an opportunity to participate in 
 the rule making prior to the adoption of the final rules.
 
 ========================================================================
 

  Federal Register / Vol. 63, No. 168 / Monday, August 31, 1998 / 
Proposed Rules  

[[Page 46180]]


=======================================================================
-----------------------------------------------------------------------

OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 890

RIN 3206-AI37


Federal Employees Health Benefits Program: Effective Dates

AGENCY: Office of Personnel Management.

ACTION: Proposed rule.

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

SUMMARY: The Office of Personnel Management (OPM) is issuing proposed 
regulations to change the existing Federal Employees Health Benefits 
(FEHB) Program regulations concerning the effective date for new 
enrollments made by employees during the annual open season. These 
regulations would also change the effective date of open season changes 
in enrollment made by employees, annuitants, former spouses and 
individuals enrolled under the temporary continuation of coverage (TCC) 
provisions of FEHB law. The proposed regulations would standardize the 
effective date of most of these new enrollments or changes in 
enrollment. This would make it easier for employing offices and health 
plan carriers to administer the Program and reduce the potential for 
error in determining effective dates.

DATES: Comments must be received on or before September 30, 1998.

ADDRESSES: Send written comments to Abby L. Block, Chief, Insurance 
Policy and Information Division, Retirement and Insurance Service, 
Office of Personnel Management, P.O. Box 57, Washington, DC 20044; or 
deliver to OPM, Room 3425, 1900 E Street NW., Washington, DC; or FAX to 
(202) 606-0633.

FOR FURTHER INFORMATION CONTACT: Jay D. Fritz (202) 606-0004.

SUPPLEMENTARY INFORMATION: The effective date of new enrollments by 
employees during the annual open season is specified in current 
regulations as the first day of the first pay period that begins in the 
next following year and which follows a pay period during any part of 
which the employee is in a pay status. For open season changes in 
enrollment by employees, annuitants, former spouses and individuals 
enrolled under TCC, the effective date is the first day of the first 
pay period that begins in January of the next following year. Under 
current regulations, the effective date for employee enrollments and 
changes in enrollment may be different each year based on which day in 
January is the first day of the pay period.
    These proposed regulations would adopt January 1st as the effective 
date for all open season new enrollments for employees in a pay status. 
For employees in a non-pay status, an open season new enrollment must 
continue to be effective on the first day of the first pay period that 
begins in the next year which follows a pay period during any part of 
which the employee is in a pay status. The effective date for these 
employees cannot be regulated as January 1st since they may not meet 
the requirement of being in a pay status prior to the January 1st 
effective date.
    These regulations would also adopt January 1st as the effective 
date for all open season changes in enrollment for employees, 
regardless of whether or not they are in a pay status, and for 
annuitants, former spouses, and individuals on TCC.
    We believe standardization of the effective date of new enrollments 
and changes in enrollment made during the annual open season would be 
consistent with the effective date of benefits changes under our 
contracts with participating carriers, and would simplify 
administration of the FEHB Program. With the effective date always 
being January 1st, there is less chance of employing offices making 
errors in either determining the effective date or forwarding an 
incorrect effective date to the health benefits carriers. Recordkeeping 
by the carriers would be simplified, resulting in less chance of error 
in entering data into their enrollment systems.
    The regulations would also bring a measure of uniformity to the 
Program as all enrollees would have the same effective date for their 
open season transactions regardless of their pay period. Under current 
regulations, the Federal agencies that operate with a pay period 
different from that used by most other agencies have different 
effective dates. This regulatory change would make it easier for 
enrollees since they would always know that they are covered by their 
new plan beginning January 1st.
    These proposed regulations do not affect government contributions 
or employee withholdings for health insurance premiums. Any change in 
the contributions or withholdings brought about by a new enrollment or 
change in enrollment made during the open season will continue to be 
effective beginning on the first day of the first pay period that 
begins in January of the next year. We are not requiring that employing 
offices prorate withholdings and contributions when the January 1st 
effective date is not at the beginning of a pay period as this would 
create an administrative burden for both the employing offices and the 
carriers.
    Under current regulations, when an individual makes an open season 
change from a plan with a deductible any covered expenses incurred from 
January 1st to the effective date of the open season change count 
towards the losing carrier's prior year deductible. Enrolled 
individuals and their family members are eligible for reimbursement by 
the losing carrier for covered expenses incurred during the current 
year if the prior year's deductible or family limit on deductibles had 
previously been met. Since these proposed regulations make January 1st 
the effective date for all open season changes in enrollment, this 
provision is no longer necessary. We are therefore removing the 
provision for deductible carryover (Sec. 890.201(a)(10)) from the 
current regulations.

Reduction of Comment Period for Proposed Rulemaking

    I have determined that the comment period will be thirty days 
because OPM must receive public comments on this new initiative as soon 
as possible in order to analyze them, work with interested parties, and 
publish a final regulation prior to the beginning of the 1999 Contract 
Year.

Regulatory Flexibility Act

    I certify that these regulations will not have a significant 
economic impact on a substantial number of small entities because they 
primarily affect administrative procedures for Federal

[[Page 46181]]

agencies and health benefits carriers that participate in the FEHB 
Program.

Executive Order 12866, Regulatory Review

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

List of Subjects in 5 CFR Part 890

    Administrative practice and procedure, Government employees, Health 
facilities, Health insurance, Health professions, Hostages, Iraq, 
Kuwait, Lebanon, Reporting and recordkeeping requirements, Retirement.

U.S. Office of Personnel Management.
Janice R. Lachance,
Director.

    Accordingly, OPM proposes to amend 5 CFR Part 890 as follows:

PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM

    1. The authority citation for part 890 continues to read as 
follows:

    Authority: 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), and 
11246 (b) and (c) of Pub. L. 105-33, 111 Stat. 251.


Sec. 890.201  [Amended]

    2. In Sec. 890.201, paragraph (a)(10) is removed and paragraph 
(a)(11) is redesignated as paragraph (a)(10).
    3. In Sec. 890.301, paragraph (f)(4) is revised to read as follows:


Sec. 890.301  Opportunities for employees to enroll or change 
enrollment; effective dates.

* * * * *
    (f) * * *
    (4)(i) An open season new enrollment for an employee in a pay 
status takes effect on the first day of January of the next year.
    (ii) An open season new enrollment for an employee in a non-pay 
status takes effect on the first day of the first pay period that 
begins in the next year and which follows a pay period during any part 
of which the employee is in a pay status.
    (iii) An open season change of enrollment takes effect on the first 
day of January of the next year.
* * * * *
    4. In Sec. 890.306, paragraph (f)(2) is revised to read as follows:


Sec. 890.306  Opportunities for annuitants to change enrollment or to 
reenroll; effective dates.

* * * * *
    (f) * * *
    (2) An open season reenrollment or change of enrollment takes 
effect on the first day of January of the next year.
* * * * *
    5. In Sec. 890.806, paragraph (f)(2) is revised to read as follows:


Sec. 890.806  Opportunities for former spouses to enroll and change 
enrollment; effective dates of enrollment.

* * * * *
    (f) * * *
    (2) An open season reenrollment or change of enrollment takes 
effect on the first day of January of the next year.
* * * * *
    6. In Sec. 890.1108, paragraph (e)(2) is revised to read as 
follows:


Sec. 890.1108  Opportunities to change enrollment; effective dates.

* * * * *
    (e) * * *
    (2) An open season change of enrollment takes effect on the first 
day of January of the next year.
* * * * *
[FR Doc. 98-23335 Filed 8-28-98; 8:45 am]
BILLING CODE 6325-01-P