[Federal Register Volume 87, Number 220 (Wednesday, November 16, 2022)]
[Rules and Regulations]
[Pages 68595-68599]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-24849]



 ========================================================================
 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. 
 
 ========================================================================
 

  Federal Register / Vol. 87, No. 220 / Wednesday, November 16, 2022 / 
Rules and Regulations  

[[Page 68595]]



OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 875

RIN 3206-AO21


Enhancing Stability and Flexibility for the Federal Long Term 
Care Insurance Program (FLTCIP)--Abbreviated Underwriting, Applications 
for FLTCIP Coverage, and Technical Corrections

AGENCY: Office of Personnel Management.

ACTION: Final rule.

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

SUMMARY: The Office of Personnel Management (OPM) is issuing a final 
regulation to support enhancing stability and flexibility in FLTCIP by 
amending when abbreviated underwriting will be offered to prospective 
enrollees and finalizing rules for the suspension of applications for 
coverage and the requirements around any such suspension periods. OPM 
is also finalizing technical corrections for the sake of clarity and to 
remove redundancies. This final rule adopts the proposed regulations 
with one technical change correcting the provision related to the 
Federal appeals board that is delegated the authority to resolve 
contract disputes between the Carrier and OPM. Finally, OPM may 
effectuate a suspension period after publication of this final rule 
with a separate document in the Federal Register.

DATES: Effective on November 16, 2022. OPM will publish a separate 
document announcing the effective date of a suspension period in the 
Federal Register.

FOR FURTHER INFORMATION CONTACT: Dyan Dyttmer, Senior Policy Analyst, 
[email protected], (202) 936-0152.

SUPPLEMENTARY INFORMATION: On June 3, 2022, OPM published proposed 
regulations (87 FR 33653), which proposed amendments to 5 CFR part 875 
to support FLTCIP stability and flexibility by amending when 
abbreviated underwriting will be offered to prospective enrollees and 
proposing rules for the suspension of applications for coverage and the 
requirements around any such suspension periods. OPM also proposed 
technical corrections for the sake of clarity and to remove 
redundancies. Finally, with the publication of the proposed rule, OPM 
provided notice of an anticipated suspension period.
    The comment period for the proposed rule closed on July 5, 2022. 
OPM received three comments from individuals on the proposed rule, and 
a Federal appeals board contacted us regarding OPM's delegation of 
authority to resolve contract disputes in 5 CFR 875.109. A summary of 
the comments OPM received follows, along with our responses to the 
comments and a technical change OPM is making to the final rule in 
response to the comments.

Responses to Comments on the Proposed Rule

    One commenter questioned OPM's authority to authorize a suspension 
period and to change the 60-day abbreviated underwriting period allowed 
to newly eligible active workforce members and spouses. The commenter 
asserted that OPM lacked authority to suspend applications based on the 
statutory language in 5 U.S.C. 9002(a) which states that OPM shall 
establish and administer the FLTCIP for which eligible individuals may 
obtain long term care insurance coverage. The commenter stated that the 
statutory construct should be interpreted to mean that OPM must offer 
eligible individuals an opportunity to enroll in the FLTCIP. Another 
commenter questioned OPM's authority to suspend applications for a 
period, as this would reduce premiums received from enrollees prevented 
from enrolling and therefore increase premiums for those already 
enrolled.
    OPM disagrees with these comments and concludes that it has the 
authority to institute these changes to FLTCIP. OPM's authority to 
establish and administer the Program brings with it the obligation to 
oversee the Program's functioning and to protect both current and 
prospective enrollees, as well as the health of the Program as a whole. 
OPM has authority under 5 U.S.C. 9008 to prescribe regulations to 
effectuate this authority, including to create through regulation the 
ability to suspend applications for coverage, with notice and for a 
reasonable period of time, when necessary for the proper administration 
of the Program. It is also within OPM's authority to alter through 
regulation the circumstances under which abbreviated underwriting may 
be offered. As OPM explained in the preamble of the proposed rule, the 
purpose of creating through regulation the ability to suspend 
applications is to protect eligible individuals from applying to enroll 
when OPM has determined that underwriting processes may need revisions 
or when the current premium rates offered to new applicants may not 
reasonably and equitably reflect the cost of the benefits as required 
under 5 U.S.C. 9003(b)(2). Finally, OPM acknowledges that if FLTCIP is 
suspended for a period this would prevent currently eligible and newly 
eligible individuals from applying for coverage during the suspension, 
and individuals may have to wait to apply after the suspension period 
or seek alternative coverage. As explained in the preamble of the 
proposed rule, the number of potential new enrollees would be small. 
OPM will only suspend applications when it is in the best interest of 
the Program, as required by this final rule.
    One commenter stated that the proposed rule is arbitrary and 
capricious under the Administrative Procedure Act because OPM stated in 
the preamble that it considered the Notice of Proposed rulemaking to 
serve as the notice required under the proposed 5 CFR 875.110(b), which 
is being finalized in this final rule. OPM is clarifying that the 
proposed rule served as notice to the public that OPM intends to 
suspend FLTCIP applications and establishes the process for suspension, 
amends abbreviated underwriting rules, and modifies the regulations. 
OPM is clarifying that these actions, including the process for 
suspension as proposed in 5 CFR 875.110, will be effectuated after 
publication of the final rule, not after the proposed rule as the 
commenter stated.
    One commenter questioned whether OPM consulted with the Secretaries 
of the uniformed services before promulgating the rule as required by 5 
U.S.C. 9008(c). OPM fulfilled the

[[Page 68596]]

requirement of consultation through the inter-agency review process 
before it published the proposed rule.
    All three of the commenters expressed general concerns about the 
manner in which OPM administers FLTCIP. They suggested that OPM should 
act in a fashion similar to state insurance regulators, such as by 
adopting standards set by the National Association of Insurance 
Commissioners (NAIC) for long term care insurance rate increases, 
conducting public rate hearings, and taking expert and enrollee 
testimony. They also suggested that OPM should be more transparent in 
its operation of the Program, such as by making public its 
communications with the FLTCIP Carrier. Finally, one commenter 
suggested that OPM should require the FLTCIP Carrier and administrator 
to be more transparent regarding their operations, such as by 
publishing quarterly reports with information about pay-outs, expenses, 
reserves, and investment mix.
    OPM acknowledges the importance of transparency and consumer 
protections for FLTCIP enrollees. OPM complies with consumer 
protections in the FLTCIP statute and the Health Insurance Portability 
and Accountability Act of 1996, including by providing a contingent 
benefit upon lapse, inflation protection options, portability, and 
guaranteed renewability (except when enrollees fail to pay their 
premiums). As part of contracting, OPM and the FLTCIP Carrier agree to 
specific requirements for the insurer to follow, including certain NAIC 
model standards. While OPM will consider these comments in its future 
administration of the Program, the comments are outside the scope of 
this rule and require no further response.
    The Armed Services Board of Contract Appeals (ASBCA) also contacted 
OPM seeking clarification regarding the appropriate board of contract 
appeals to resolve contract disputes between OPM and the FLTCIP 
Carrier. The ASBCA correctly noted that although OPM's regulations 
currently identified the ASBCA as the board of contract appeals with 
jurisdiction, the National Defense Authorization Act for Fiscal Year 
2006 created the Civilian Board of Contract Appeals (CBCA) and 
specified the jurisdiction of the ASBCA and CBCA. As an executive 
agency, OPM contract disputes are within the jurisdiction of the CBCA 
pursuant to 41 U.S.C. 7105(b). OPM is making a technical correction 
that updates our regulations to reflect that the CBCA, not the ASBCA, 
will resolve contract disputes related to FLTCIP.

Notice of Suspension Period

    OPM will issue a separate Federal Register document announcing the 
beginning date and anticipated length of any suspension period at least 
30 days before the suspension period starts.

Changes From Proposed Rule

    OPM has made a change to the final rule to clarify 5 CFR 875.110. 
The proposed rule included the process for suspending applications for 
FLTCIP coverage after publication of a document in the Federal 
Register. The proposed rule also included a process for extending such 
a suspension. The final rule clarifies that each extension to the 
suspension period is limited to 24 months. Each extension will be based 
on current information supporting OPM's conclusion that continuing the 
suspension is in the best interest of the Program, and each extension 
will require publication in the Federal Register.
    OPM has made one technical correction to this final rule. This 
final rule clarifies in 5 CFR 875.109 that the Civilian Board of 
Contract Appeals has jurisdiction to resolve contract disputes related 
to FLTCIP. Except for the change above and this technical correction, 
OPM is issuing this final rule with no other changes.

Expected Impact of the Final Rule

    The changes in this final rule, including underwriting changes and 
any future suspensions of applications for FLTCIP coverage, will not 
affect current FLTCIP enrollees. Individuals already enrolled in FLTCIP 
will retain their coverage as long as they continue to pay premiums. 
The changes impact new enrollment and are expected to impose no more 
than de minimus administrative costs to Federal agencies since FLTCIP 
is an enrollee-pay-all program, and there is no Government contribution 
toward enrollee premiums.
    OPM expects that the rule will not result in a significant impact 
on the eligible or newly eligible population. Approximately 6,000 
eligible individuals enroll in FLTCIP annually, which is less than 0.1% 
of 11 million eligible federal and military actives and annuitants (not 
including spouses and other qualified relatives who are also eligible). 
This low percentage mirrors the low uptake for purchasing long term 
care insurance (LTCI) in the broader LTC market. According to a 
Treasury Report of the Federal Interagency Task Force on Long-Term Care 
Insurance, sales of new LTCI policies have declined since the early 
2000s, as numerous insurers decided to exit the market due to the poor 
financial performance of the product line; and low take-up rates for 
LTCI appear to stem in part from low demand for these products.\1\ The 
report identifies factors influencing demand including: substitutes for 
private LTCI such as Medicaid; unpaid care or the ability to receive 
informal care from family; a desire to leave assets to heirs can 
suppress demand because people may be motivated to postpone consumption 
and save money; lack of information and awareness about LTC costs and 
the ways to finance those costs; lack of trust in insurers; and 
premiums, costs, and loads.\2\
---------------------------------------------------------------------------

    \1\ U.S. Department of the Treasury, ``Long-Term Care Insurance: 
Recommendations for Improvement of Regulation.'' Report of the 
Federal Interagency Task Force on Long-Term Care Insurance, August 
2020, https://home.treasury.gov/system/files/136/Report-Federal-Interagency-Task-Force-Long-TermCare-Insurance.pdf.
    \2\ See footnote 1.
---------------------------------------------------------------------------

    Since less than 0.1% of the eligible population annually enroll in 
FLTCIP, based on this trend and market trends, it is unlikely that 
newly eligible individuals would have a high demand for LTCI during a 
suspension of applications. Further, there are other options for 
eligible individuals to plan for LTC needs. Some other options to plan 
for LTC needs during a suspension period include the following: saving 
for future needs by setting aside funds to invest in a 401(k), an IRA, 
or a non-retirement investment account; investing in a long-term care 
annuity; purchasing a ``combination'' or ``hybrid'' product that 
combines a life insurance policy with a LTC rider; or purchasing a 
short-term care insurance policy.

Indirect Effects on Other Parties

    OPM does not believe this regulation will have a large impact on 
the broader LTCI market. Approximately 6,000 eligible individuals 
enroll in FLTCIP annually, which is less than 0.1% of the eligible 
population. At an average premium of $125 per month or $1,500 per year, 
the forgone annual premium for new enrollees would total less than $10 
million per year during any FLTCIP enrollment suspension. As discussed 
above, affected individuals would likely pursue substitute savings and 
insurance products during a suspension period. OPM estimates that the 
magnitude of the forgone $10 million on other parties, such as LTC 
insurers in the LTCI market, would be quite small compared to the 
larger LTCI market.

[[Page 68597]]

Benefits of the Final Rule

    This final rule establishes provisions for OPM to suspend 
applications to FLTCIP when it is in the best interest of the program; 
for example, in order to allow for adjustment to underwriting processes 
or to reprice premium rates after a review of actuarial assumptions. 
The rule aims to protect eligible individuals from applying to enroll 
when it has been determined that underwriting processes may need 
revisions or when the current premium rates may not reflect the cost of 
the benefits provided due to market volatility and changes to 
projections about future costs. This allows OPM and the FLTCIP carrier 
to agree on underwriting changes or new premium rates that reasonably 
and equitably reflect the cost of the benefits provided as required by 
the FLTCIP statute.

Executive Orders 12866 and 13563

    Executive Orders 12866 and 13563 direct 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). 
Executive Order 13563 emphasizes the importance of quantifying both 
costs and benefits and of reducing costs, harmonizing rules, and 
promoting flexibility. This rule has been designated as a significant, 
but not economically significant, regulatory action under Executive 
Order 12866.

Congressional Review Act

    This rule is not a major rule under 5 U.S.C. 804(2). Subtitle E of 
the Small Business Regulatory Enforcement Fairness Act of 1996 
(codified at 5 U.S.C. 801-808), also known as the Congressional Review 
Act or CRA, generally provides that before a rule may take effect, the 
agency promulgating the rule must submit a rule report, which includes 
a copy of the rule, to each House of the Congress and to the 
Comptroller General of the United States. A major rule under the CRA 
cannot take effect until 60 days after it is published in the Federal 
Register.

Paperwork Reduction Act

    Notwithstanding any other provision of law, no person is required 
to respond to, nor shall any person be subject to a penalty for failure 
to comply with, a collection of information subject to the requirements 
of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.) (PRA) 
unless that collection of information displays a currently valid Office 
of Management and Budget (OMB) Control Number.

Regulatory Flexibility Act

    I certify that this regulation will not have a significant economic 
impact on a substantial number of small entities.

Federalism

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

List of Subjects in 5 CFR Part 875

    Administration and general provisions, Eligibility, Cost, and 
Coverage.

Office of Personnel Management.
Stephen Hickman,
Federal Register Liaison.

    Accordingly, OPM amends 5 CFR part 875 as follows:

PART 875--FEDERAL LONG TERM CARE INSURANCE PROGRAM

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

    Authority:  5 U.S.C. 9008; Pub. L. 116-92, 133 Stat. 1198 (5 
U.S.C. 8956 note).

Subpart A--Administration and General Provisions

0
2. Amend Sec.  875.101 by revising the definitions of ``Carrier'', 
``Eligible individual'', and ``Free look'' and adding in alphabetical 
order a definition for ``Special application period'' to read as 
follows:


Sec.  875.101   Definitions.

* * * * *
    Carrier means a ``qualified carrier'' as defined in section 9001 of 
title 5, United States Code, with which OPM has contracted to provide 
long term care insurance coverage under this section. A Carrier may 
designate one or more administrators to perform some of its 
obligations.
* * * * *
    Eligible individual means an employee, annuitant, member of the 
uniformed services, retired member of the uniformed services or 
qualified relative, as defined in section 9001 of title 5, United 
States Code.
* * * * *
    Free look means that within 30 days after you are approved for 
coverage and receive the Benefit Booklet, you may cancel that coverage 
if you are not satisfied with it and receive a refund of any premium 
you paid for that coverage. It will be as if the coverage was never 
issued.
* * * * *
    Special application period is a period in which active workforce 
members and their spouses may apply based on abbreviated underwriting. 
Such application periods will be provided for pursuant to OPM's 
authority in section 9008 of title 5, United States Code.
* * * * *

0
3. Revise Sec.  875.102 to read as follows:


Sec.  875.102   Where do I send benefit claims?

    You must submit your benefit claims to the FLTCIP Carrier.
0
4. Amend Sec.  875.107 by removing ``and'' at the end of paragraph (b), 
removing the semicolon and adding a period at the end of paragraph (c) 
and adding a semicolon in its place, and adding paragraphs (d) and (e).
    The additions read as follows:


Sec.  875.107   What are OPM's responsibilities as regulator under this 
Program?

* * * * *
    (d) Suspending applications for FLTCIP coverage, including coverage 
increases as specified in Sec.  875.110; and
    (e) Holding special application periods as specified in Sec.  
875.402.

0
5. Revise Sec.  875.109 to read as follows:


Sec.  875.109   Which board of contract appeals has jurisdiction for 
resolving contract disputes between OPM and the Carrier?

    For purposes of applying chapter 71 of title 41 to disputes arising 
between OPM and the Carrier, the Civilian Board of Contract Appeals has 
jurisdiction to decide an appeal relative to such a dispute.

0
6. Add Sec.  875.110 to read as follows:


Sec.  875.110   May OPM suspend applications for FLTCIP coverage?

    (a) OPM may suspend applications for FLTCIP coverage, including 
coverage increases, when OPM determines that a suspension is in the 
best interest of the Program.
    (b) OPM will issue a document in the Federal Register with the 
effective date of the suspension period, during which no applications 
for FLTCIP coverage will be accepted. The effective date will be 
determined at the discretion of the Director and will be at least 30 
days after the publication date of the document.
    (c) The duration of the suspension period, as determined at the 
discretion of the Director and not to exceed 24 months unless 
subsequently extended, will be announced in a document published in the 
Federal Register.

[[Page 68598]]

    (d) At least 30 days before the end of the suspension period, OPM 
may issue a document in the Federal Register announcing an extension of 
the suspension period when OPM determines that such extension is in the 
best interest of the Program. The duration of any extension to the 
suspension period will not exceed 24 months, unless subsequently 
extended by additional periods of suspension, each not to exceed 24 
months.

Subpart B--Eligibility

0
7. Revise Sec.  875.203 to read as follows:


Sec.  875.203   Am I eligible if I separated under the FERS MRA+10 
provision?

    If you have separated from service under the FERS Minimum 
Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 
8412(g), and have postponed receiving an annuity under that provision, 
you are eligible to apply for coverage as an annuitant under this part.

0
8. Amend Sec.  875.204 by revising paragraph (c) to read as follows:


Sec.  875.204   Am I eligible as a member of the uniformed services?

* * * * *
    (c) You are not eligible to apply for coverage solely because you 
belong to the Individual Ready Reserve. The Individual Ready Reserves 
includes Reservists who are assigned to a Voluntary Training Unit in 
the Naval Reserve and Category E in the Air Force Reserve.


Sec.  875.206   [Removed and Reserved]

0
9. Remove and reserve Sec.  875.206.

0
10. Revise Sec.  875.207 to read as follows:


Sec.  875.207   What happens if I am in nonpay status during a special 
application period?

    (a) If you return to pay status from nonpay status during a special 
application period, you have 60 days from the date of your return, or 
until the end of the special application period, whichever gives you 
more time, to apply for coverage pursuant to the rules of that special 
application period.
    (b) If you return to pay status from nonpay status within 180 days 
after the end of the special application period, you have 60 days from 
the date of your return to apply for coverage pursuant to the rules of 
that special application period.
    (c) Paragraphs (a) and (b) of this section apply only when you have 
been in nonpay status for more than one-half of a special application 
period, unless you went into nonpay status for a reason beyond your 
control.

0
11. Amend Sec.  875.209 by revising paragraph (a) to read as follows:


Sec.  875.209   How do I demonstrate that I am eligible to apply for 
coverage?

    (a) When you submit your application for coverage, you must make 
known your status as a member of an eligible group. If you are a 
qualified relative, you need to provide identifying information about 
the workforce member who makes you an eligible individual.
* * * * *

0
12. Amend Sec.  875.210 by revising paragraph (b)(1) to read as 
follows:


Sec.  875.210   What happens if I become ineligible after I submit an 
application?

* * * * *
    (b) * * *
    (1) When you are involuntarily separated from Federal civilian 
service (except for misconduct) or from the uniformed services (except 
for a dishonorable discharge); or, when you are the qualified relative 
of a workforce member who has been involuntarily separated from Federal 
civilian service (except for misconduct) or from the uniformed services 
(except for a dishonorable discharge).
* * * * *

0
13. Revise Sec.  875.211 to read as follows:


Sec.  875.211   What happens if my eligibility status changes after I 
submit my application?

    (a) If you applied as an active workforce member, and you retire or 
separate from service after you submit an application for coverage, but 
before your coverage becomes effective, you must notify the Carrier of 
this change.
    (b) If you applied with abbreviated underwriting during a special 
application period as an active workforce member or the spouse of an 
active workforce member, and the active workforce member retires or 
separates from service before your coverage becomes effective, you must 
reapply based on your new eligibility status.

0
14. Revise Sec.  875.213 to read as follows:


Sec.  875.213   May I apply as a qualified relative if I am the 
domestic partner of an employee or annuitant?

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

Subpart D--Coverage

0
15. Revise Sec.  875.401 to read as follows:


Sec.  875.401   How do I apply for coverage?

    To apply for coverage, you must complete the application in a form 
appropriate for your eligibility status as prescribed by the Carrier 
and approved by OPM.

0
16. Revise Sec.  875.402 to read as follows:


Sec.  875.402   When will open seasons be held?

    (a) There are no regularly scheduled open seasons for long term 
care insurance. OPM may have special application periods in which 
active workforce members and their spouses may apply based on 
abbreviated underwriting.
    (b) In situations where OPM determines that it is appropriate to 
have a special application period, OPM will announce any such period 
via publication of a document in the Federal Register. The document 
will include the requirements for eligible applicants during the 
special application period.

0
17. Revise Sec.  875.403 to read as follows:


Sec.  875.403   When may I apply for coverage?

    If you are an eligible individual, you may apply at any time 
outside of a suspension period described in Sec.  875.110. You will be 
subject to full underwriting requirements. The only exceptions to the 
full underwriting requirements are described in Sec.  875.402. You may 
apply as a qualified relative of a workforce member even if the 
workforce member does not apply for coverage.

0
18. Revise Sec.  875.404 to read as follows:


Sec.  875.404   What is the effective date of coverage?

    (a)(1) The effective dates of coverage under special application 
period enrollments will be announced in a document published in the 
Federal Register that announces special application period dates.
    (2) If you are an active workforce member or the spouse of an 
active workforce member and you are applying for coverage during a 
special application period, the workforce member must be

[[Page 68599]]

actively at work at least 1 day during the calendar week immediately 
before the week which contains your coverage effective date for your 
coverage to become effective. You must inform the Carrier if you do not 
meet this requirement. In the event you do not meet this requirement, 
the Carrier will issue you a revised effective date, which will be the 
1st day of the next month. The workforce member also must meet the 
actively at work requirement for any revised effective date for 
coverage to become effective, or you will be issued another revised 
effective date in the same manner.
    (b) If you enroll at any time outside of a special application 
period, your coverage effective date is the 1st day of the month after 
the date your application is approved.

0
19. Revise Sec.  875.405 to read as follows:


Sec.  875.405   May a spouse, domestic partner, or other qualified 
relative of a workforce member apply for coverage?

    A spouse, domestic partner, or other qualified relative of a 
workforce member may apply for coverage with full underwriting at any 
time following the marriage or commencing date of the domestic 
partnership, outside of a suspension period as described in Sec.  
875.110.

0
20. Amend Sec.  875.406 by revising paragraph (a)(1) to read as 
follows:


Sec.  875.406   May I change my coverage?

    (a) * * *
    (1) At any time outside of a suspension period described in Sec.  
875.110, you may apply to increase your coverage with full 
underwriting.
* * * * *

0
21. Revise Sec.  875.410 to read as follows:


Sec.  875.410   May I continue my coverage when I leave Federal or 
military service?

    If you are an active workforce member, your coverage will 
automatically continue when you leave active service, as long as the 
Carrier continues to receive the required premium when due.

0
22. Revise Sec.  875.413 to read as follows:


Sec.  875.413   Is it possible to have coverage reinstated?

    (a) Under certain circumstances, your coverage can be reinstated. 
The Carrier will reinstate your coverage if it receives proof 
satisfactory to it, within 6 months from the date of the written notice 
of termination, that you suffered from a cognitive impairment or loss 
of functional capacity, before the grace period ended, that caused you 
to miss making premium payments. In that event, you will not be 
required to submit to underwriting. Your coverage will be reinstated 
retroactively to the termination date but you must pay back premiums 
for that period. The premium will be the same as it was prior to 
termination.
    (b) If your coverage has terminated because you did not pay 
premiums or because you requested cancellation, the Carrier may 
reinstate your coverage within 12 months from the date of the written 
notice of termination at your request. You will be required to reapply 
based on full underwriting, and the Carrier will determine whether you 
are still insurable. If you are insurable, your coverage will be 
reinstated retroactively to the termination date and you must pay back 
premiums for that period. The premium will be the same as it was prior 
to termination.

[FR Doc. 2022-24849 Filed 11-14-22; 8:45 am]
BILLING CODE 6325-63-P