[Federal Register Volume 80, Number 4 (Wednesday, January 7, 2015)]
[Proposed Rules]
[Pages 929-931]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-30636]


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OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 890

RIN 3206-AN07


Federal Employees Health Benefits Program: Enrollment Options 
Following the Termination of a Plan or Plan Option

AGENCY: Office of Personnel Management.

ACTION: Proposed rule.

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SUMMARY: The U.S. Office of Personnel Management (OPM) is issuing a 
proposed rule to amend the Federal Employees Health Benefits (FEHB) 
Program regulations regarding enrollment options following the 
termination of a plan or plan option.

DATES: OPM must receive comments on or before March 9, 2015.

ADDRESSES: Send written comments to Chelsea Ruediger, Planning and 
Policy Analysis, U.S. Office of Personnel Management, Room 4312, 1900 E 
Street NW., Washington, DC 20415. You may also submit comments using 
the Federal eRulemaking Portal: http://www.regulations.gov. Follow the 
instructions for submitting comments.

FOR FURTHER INFORMATION CONTACT: Chelsea Ruediger at (202) 606-0004.

SUPPLEMENTARY INFORMATION: When a plan or plan option in the Federal 
Employees Health Benefits (FEHB) Program terminates, OPM provides the 
enrollees of that plan or plan option a time period in which they may 
elect to enroll in a new plan or plan option. This proposed rule 
clarifies the actions that OPM and employing agencies may take when an 
enrollee fails to make an enrollment election during the time period 
provided.
    Current regulation ends an employee's enrollment in the FEHB 
Program if he or she fails to make an enrollment election during the 
time period provided by OPM following a plan termination. This proposed 
regulation amends 5 CFR 890.301 to require the employing office to 
enroll automatically these employees into the lowest-cost nationwide 
plan option based on the enrollee share of the cost of a self only 
enrollment. Under the proposed regulation, a plan will not be 
considered the lowest-cost nationwide plan option if it is a High 
Deductible Health Plan (HDHP) or if it requires a membership fee or an 
association fee.
    For annuitants, current regulation provides that individuals who 
fail to make an enrollment election during the time provided by OPM 
following a plan termination shall be considered to be enrolled in the 
option of the Blue Cross and Blue Shield Service Benefit Plan that OPM 
determines most closely approximates the terminated plan. The proposed 
regulation amends 5 CFR 890.306 to provide that these annuitants will 
be enrolled into the lowest-cost nationwide plan option that is 
available to the individual based on the same criteria listed above.
    Current regulation provides that when a plan discontinuation occurs 
due to a disaster, employees and annuitants who fail to make an 
enrollment election within 60 days of the disaster, as announced by 
OPM, shall be considered to be enrolled in the Standard Option of the 
Blue Cross and Blue Shield Service Benefit Plan. The proposed rule 
amends the regulation to provide that these individuals will be 
enrolled into the lowest-cost nationwide plan option that is available 
to the individual based on the same criteria listed above. It also 
provides belated enrollment authority for individuals who, for causes 
beyond

[[Page 930]]

their control, are unable to make enrollment changes and are enrolled 
in the lowest-cost nationwide plan.
    Since 2004, OPM has allowed up to three plan options under a plan. 
See 69 FR 31721. Accordingly, the proposed rule also updates outdated 
language in 5 CFR 890.301 and 890.306 that considers the termination of 
a plan option under a plan with a total of only two plan options. Under 
the proposed rule, when two or more plan options remain after a 
different plan option is terminated, the employing office will enroll 
the employee in the lowest-cost remaining plan option that is not an 
HDHP.
    Conforming edits have been made to 5 CFR 890.806 for former spouses 
and 5 CFR 890.1108 for enrollees in temporary continuation of coverage 
status.
    We are seeking comment on these provisions.

Paperwork Reduction Act (PRA)

    OPM has reviewed this proposed rule for PRA implications and have 
determined that it does not apply to this action.

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. After completing this analysis, OPM has determined that this rule 
is not considered a major rule.

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 impacts options available for FEHB enrollees when the plan or plan 
option in which they are enrolled terminates.

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 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.
Katherine Archuleta,
Director.
    Accordingly, OPM proposes to amend title 5, Code of Federal 
Regulations, part 890 as follows:

PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM

0
1. The authority citation for part 890 continues to read as follows:

    Authority:  5 U.S.C. 8913; Sec. 890.301 also issued under sec. 
311 of Pub. L. 111-03, 123 Stat. 64; Sec. 890.111 also issued under 
section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec. 890.112 also 
issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 U.S.C. 
8913; Sec. 890.803 also issued under 50 U.S.C. 403p, 22 U.S.C. 4069c 
and 4069c-1; subpart L also issued under sec. 599C of Pub. L. 101-
513, 104 Stat. 2064, as amended; Sec. 890.102 also issued under 
sections 11202(f), 11232(e), 11246 (b) and (c) of Pub. L. 105-33, 
111 Stat. 251; and section 721 of Pub. L. 105-261, 112 Stat. 2061; 
Pub. L. 111-148, as amended by Pub. L. 111-152.

0
2. Amend Sec.  890.301 by revising paragraphs (i)(4)(ii), (iii), and 
(iv) and adding paragraphs (i)(4)(v) and (n) 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) * * *
    (ii) If the whole plan is discontinued, an employee who does not 
change the enrollment within the time set in paragraph (i)(4)(i) of 
this section will be enrolled in the lowest-cost nationwide plan 
option, as defined in paragraph (n) of this section;
    (iii) If one or more options of a plan are discontinued, an 
employee who does not change the enrollment will be enrolled in the 
remaining option of the plan, or in the case of a plan with two or more 
options remaining, the lowest-cost remaining option that is not a High 
Deductible Health Plan (HDHP).
    (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 enrolled in the lowest-cost nationwide plan 
option, as defined in paragraph (n) of this section. The effective date 
of enrollment changes under this provision will be set by OPM when it 
makes the announcement allowing such changes;
    (v) An employee who is unable, for causes beyond his or her 
control, to make an enrollment change within the 60 days following a 
disaster and is, as a result, enrolled in the lowest-cost nationwide 
plan as defined in paragraph (n) of this section, may request a belated 
enrollment into the plan of his or her choice subject to the 
requirements of paragraph (c) of this section.
* * * * *
    (n) OPM will annually determine the lowest-cost nationwide plan 
option calculated based on the enrollee share of the cost of a self 
only enrollment. The plan option identified may not be a High 
Deductible Health Plan (HDHP) or an option from a health benefits plan 
that charges an association or membership fee.
0
3. Amend Sec.  890.306 by revising paragraphs (l)(4)(ii), (iii), (iv), 
and (v) and adding paragraph (l)(4)(vi) to read as follows:


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

* * * * *
    (l) * * *
    (4) * * *
    (ii) If a plan discontinues all of its existing options, an 
annuitant who does not change his or her enrollment is deemed to have 
enrolled in the lowest-cost nationwide plan option, as defined in Sec.  
890.301(n); except when the annuity is insufficient to pay the 
withholdings, then paragraph (q) of this section applies.
    (iii) If one or more options of a plan are discontinued, an 
annuitant who does not change the enrollment will be enrolled in the 
remaining option of the plan, or in the case of a plan with two or more 
options remaining, the lowest-cost remaining option that is not a High 
Deductible Health Plan (HDHP). In the event that the annuity is 
insufficient to pay the withholdings, then paragraph (q) of this 
section applies;
    (iv) After an involuntary enrollment under paragraph (l)(4)(ii) or 
(iii) of this section becomes effective, the annuitant may change the 
enrollment to another option of the plan into which he or she

[[Page 931]]

was enrolled or another health plan of his or her choice retroactively 
within 90-days after OPM advises the annuitant of the new enrollment;
    (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 enrolled in the lowest-cost 
nationwide plan option, as defined in Sec.  890.301(n). The effective 
date of enrollment changes under this provision will be set by OPM when 
it makes the announcement allowing such changes;
    (vi) An annuitant who is unable, for causes beyond his or her 
control, to make an enrollment change within the 60 days following a 
disaster and is, as a result, enrolled in the lowest-cost nationwide 
plan as defined in Sec.  890.301(n), may request a belated enrollment 
into the plan of his or her choice subject to the requirements of 
paragraph (c) of this section.
* * * * *
0
4. Amend Sec.  890.806 by revising paragraphs (j)(4)(ii), (iii), and 
(iv) and adding paragraph (j)(4)(v) to read as follows:


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

* * * * *
    (j) * * *
    (4) * * *
    (ii) If the whole plan is discontinued, a former spouse who does 
not change the enrollment within the time set will be enrolled in the 
lowest-cost nationwide plan option, as defined in Sec.  890.301(n);
    (iii) If one or more options of a plan are discontinued, a former 
spouse who does not change the enrollment will be enrolled in the 
remaining option of the plan, or in the case of a plan with two or more 
options remaining, the lowest-cost remaining option that is not a High 
Deductible Health Plan (HDHP);
    (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 a 
former spouse does not change the enrollment within the time frame 
announced by OPM, the former spouse will be enrolled in the lowest-cost 
nationwide plan option, as defined in Sec.  890.301(n). The effective 
date of enrollment changes under this provision will be set by OPM when 
it makes the announcement allowing such changes;
    (v) A former spouse who is unable, for causes beyond his or her 
control, to make an enrollment change within the 60 days following a 
disaster and is, as a result, enrolled in the lowest-cost nationwide 
plan as defined in Sec.  890.301(n), may request a belated enrollment 
into the plan of his or her choice subject to the requirements of 
paragraph (c) of this section.
* * * * *
0
5. Amend Sec.  890.1108 by revising paragraphs (h)(4)(ii), (iii), and 
(iv) and adding paragraph (h)(4)(v) to read as follows:


Sec.  890.1108  Opportunities to change enrollment; effective dates.

* * * * *
    (h) * * *
    (4) * * *
    (ii) If the whole plan is discontinued, an enrollee who does not 
change the enrollment within the time set will be enrolled in the 
lowest-cost nationwide plan option, as defined in Sec.  890.301(n);
    (iii) If one or more options of a plan are discontinued, an 
enrollee who does not change the enrollment will enrolled in the 
remaining option of the plan, or in the case of a plan with two or more 
options remaining, the lowest-cost remaining option that is not a High 
Deductible Health Plan (HDHP);
    (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 enrolled in the lowest-cost nationwide 
plan option, as defined in Sec.  890.301(n). The effective date of 
enrollment changes under this provision will be set by OPM when it 
makes the announcement allowing such changes;
    (v) An enrollee who is unable, for causes beyond his or her 
control, to make an enrollment change within the 60 days following a 
disaster and is, as a result, enrolled in the lowest-cost nationwide 
plan as defined in Sec.  890.301(n), may request a belated enrollment 
into the plan of his or her choice subject to the requirements of 
paragraph (c) of this section.
* * * * *
[FR Doc. 2014-30636 Filed 1-6-15; 8:45 am]
BILLING CODE 6325-63-P