Subpart A - Administration and General Provisions

§ 890.101 - Definitions; time computations.

§ 890.102 - Coverage.

§ 890.103 - Correction of errors.

§ 890.104 - Initial decision and reconsideration on enrollment.

§ 890.105 - Filing claims for payment or service.

§ 890.106 - Carrier entitlement to pursue subrogation and reimbursement recoveries.

§ 890.107 - Court review.

§ 890.108 - Will OPM waive requirements for continued coverage during retirement?

§ 890.109 - Exclusion of certain periods of eligibility when determining continued coverage during retirement.

§ 890.110 - Enrollment reconciliation.

§ 890.111 - Continuation of eligibility for former Federal employees of the Civilian Marksmanship Program.

§ 890.112 - Continuation of coverage for certain Senate Restaurants employees.

§ 890.113 - Designation of FEHB Program services as emergency services under the Antideficiency Act.

§ 890.114 - Surprise billing and transparency.

§ 890.115 - Special provisions for Postal Service employees, Postal Service annuitants, and their eligible family members.

Subpart B - Health Benefits Plans

§ 890.201 - Minimum standards for health benefits plans.

§ 890.202 - Minimum standards for health benefits carriers.

§ 890.203 - Application for approval of, and proposal of amendments to, health benefit plans.

§ 890.204 - Withdrawal of approval of health benefits plans or carriers.

§ 890.205 - Nonrenewal of contracts of health benefits plans.

Subpart C - Enrollment

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

§ 890.302 - Coverage of family members.

§ 890.303 - Continuation of enrollment.

§ 890.304 - Termination of enrollment.

§ 890.305 - Reinstatement of enrollment after military service.

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

§ 890.307 - Waiver or suspension of annuity or compensation.

§ 890.308 - Disenrollment and removal from enrollment.

Subpart D - Temporary Extension of Coverage and Conversion

§ 890.401 - Temporary extension of coverage and conversion.

Subpart E - Contributions and Withholdings

§ 890.501 - Government contributions.

§ 890.502 - Withholdings, contributions, LWOP, premiums, and direct premium payment.

§ 890.503 - Reserves.

§ 890.504 - Disposition of contingency reserves upon reorganization or merger of plans.

§ 890.505 - Recurring premium payments to carriers.

Subpart F - Transfers From Retired Federal Employees Health Benefits Program

§ 890.601 - Coverage.

§ 890.602 - Opportunity to change enrollment.

§ 890.603 - Effective date.

§ 890.604 - [Reserved]

§ 890.605 - Persons confined on effective date.

Subpart G - XXX

§ 890.701 - Definitions.

§ 890.702 - Payment to any licensed practitioner.

Subpart H - Benefits for Former Spouses

§ 890.801 - Introduction.

§ 890.802 - Definition.

§ 890.803 - Who may enroll.

§ 890.804 - Coverage.

§ 890.805 - Application time limitations.

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

§ 890.807 - When do enrollments terminate, cancel or suspend?

§ 890.808 - Employing office responsibilities.

Subpart I - Limit on Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments

§ 890.901 - Purpose.

§ 890.902 - Definition.

§ 890.903 - Covered services.

§ 890.904 - Determination of FEHB benefit payment.

§ 890.905 - Limits on inpatient hospital and physician charges.

§ 890.906 - Retired enrolled individuals coinsurance payments.

§ 890.907 - Effective dates.

§ 890.908 - Notification of HHS.

§ 890.909 - End-of-year settlements.

§ 890.910 - Provider information.

Subpart J - Administrative Sanctions Imposed Against Health Care Providers

Civil Monetary Penalties and Financial Assessments

§ 890.1060 - Purpose and scope of civil monetary penalties and assessments.

§ 890.1061 - Bases for penalties and assessments.

§ 890.1062 - Deciding whether to impose penalties and assessments.

§ 890.1063 - Maximum amounts of penalties and assessments.

§ 890.1064 - Determining the amounts of penalties and assessments to be imposed on a provider.

§ 890.1065 - Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments.

§ 890.1066 - Notice of proposed penalties and assessments.

§ 890.1067 - Provider contests of proposed penalties and assessments.

§ 890.1068 - Effect of not contesting proposed penalties and assessments.

§ 890.1069 - Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments.

§ 890.1070 - Deciding contests of proposed penalties and assessments.

§ 890.1071 - Further appeal rights after final decision to impose penalties and assessments.

§ 890.1072 - Collecting penalties and assessments.

Reinstatement

§ 890.1051 - Applying for reinstatement when period of debarment expires.

§ 890.1052 - Reinstatements without application.

§ 890.1053 - Table of procedures and effective dates for reinstatements.

§ 890.1054 - Agencies and entities to be notified of reinstatements.

§ 890.1055 - Contesting a denial of reinstatement.

Notifying Outside Parties About Debarment and Suspension Actions

§ 890.1044 - Entities notified of OPM-issued debarments and suspensions.

§ 890.1045 - Informing persons covered by FEHBP about debarment or suspension of their provider.

Exceptions to the Effect of Debarments

§ 890.1046 - Effect of debarment or suspension on payments for services furnished in emergency situations.

§ 890.1047 - Special rules for institutional providers.

§ 890.1048 - Waiver of debarment for a provider that is the sole source of health care services in a community.

Permissive Debarments

§ 890.1011 - Bases for permissive debarments.

§ 890.1012 - Time limits for OPM to initiate permissive debarments.

§ 890.1013 - Deciding whether to propose a permissive debarment.

§ 890.1014 - Notice of proposed permissive debarment.

§ 890.1015 - Minimum and maximum length of permissive debarments.

§ 890.1016 - Aggravating and mitigating factors used to determine the length of permissive debarments.

§ 890.1017 - Determining length of debarment based on revocation or suspension of a provider's professional licensure.

§ 890.1018 - Determining length of debarment for an entity owned or controlled by a sanctioned provider.

§ 890.1019 - Determining length of debarment based on ownership or control of a sanctioned entity.

§ 890.1020 - Determining length of debarment based on false, wrongful, or deceptive claims.

§ 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

§ 890.1022 - Contesting proposed permissive debarments.

§ 890.1023 - Information considered in deciding a contest.

§ 890.1024 - Standard and burden of proof for deciding contests.

§ 890.1025 - Cases where additional fact-finding is not required.

§ 890.1026 - Procedures if a fact-finding proceeding is not required.

§ 890.1027 - Cases where an additional fact-finding proceeding is required.

§ 890.1028 - Conducting a fact-finding proceeding.

§ 890.1029 - Deciding a contest after a fact-finding proceeding.

Suspension

§ 890.1030 - Effect of a suspension.

§ 890.1031 - Grounds for suspension.

§ 890.1032 - Length of suspension.

§ 890.1033 - Notice of suspension.

§ 890.1034 - Counting a period of suspension as part of a subsequent debarment.

§ 890.1035 - Provider contests of suspensions.

§ 890.1036 - Information considered in deciding a contest.

§ 890.1037 - Cases where additional fact-finding is not required.

§ 890.1038 - Deciding a contest without additional fact-finding.

§ 890.1039 - Cases where additional fact-finding is required.

§ 890.1040 - Conducting a fact-finding proceeding.

§ 890.1041 - Deciding a contest after a fact-finding proceeding.

Mandatory Debarments

§ 890.1004 - Bases for mandatory debarments.

§ 890.1005 - Time limits for OPM to initiate mandatory debarments.

§ 890.1006 - Notice of proposed mandatory debarment.

§ 890.1007 - Minimum length of mandatory debarments.

§ 890.1008 - Mandatory debarment for longer than the minimum length.

§ 890.1009 - Contesting proposed mandatory debarments.

§ 890.1010 - Debarring official's decision of contest.

Special Exceptions to Protect Covered Persons

§ 890.1049 - Claims for non-emergency items or services furnished by a debarred or suspended provider.

§ 890.1050 - Exception to a provider's debarment for an individual enrollee.

Effect of Debarment

§ 890.1042 - Effective dates of debarments.

§ 890.1043 - Effect of debarment on a provider.

General Provisions and Definitions

§ 890.1001 - Scope and purpose.

§ 890.1002 - Use of terminology.

§ 890.1003 - Definitions.

§§ 890.1007--890.1009 - [Reserved]

Subpart K - Temporary Continuation of Coverage

§ 890.1101 - Purpose.

§ 890.1102 - Definitions.

§ 890.1103 - Eligibility.

§ 890.1104 - Notification by agency.

§ 890.1105 - Initial election of temporary continuation of coverage; application time limitations and effective dates.

§ 890.1106 - Coverage.

§ 890.1107 - Length of temporary continuation of coverage.

§ 890.1108 - Opportunities to change enrollment; effective dates.

§ 890.1109 - Premium payments.

§ 890.1110 - Termination of enrollment or coverage.

§ 890.1111 - Employing office responsibilities.

§ 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

§ 890.1113 - The administrative charge.

Subpart L - Benefits for United States Hostages in Iraq and Kuwait and United States Hostages Captured in Lebanon

§ 890.1201 - Purpose.

§ 890.1202 - Definitions.

§ 890.1203 - Coverage.

§ 890.1204 - Effective date of coverage.

§ 890.1205 - Change in type of enrollment.

§ 890.1206 - Cancellation of coverage.

§ 890.1207 - Termination of coverage.

§ 890.1208 - Premiums.

§ 890.1209 - Responsibilities of the U.S. Department of State.

§ 890.1210 - Reconsideration and appeal rights.

Subpart M - Department of Defense Federal Employees Health Benefits Program Demonstration Project

§ 890.1301 - Purpose.

§ 890.1302 - Duration.

§ 890.1303 - Eligibility.

§ 890.1304 - Enrollment.

§ 890.1305 - Termination and cancellation.

§ 890.1306 - Government premium contributions.

§ 890.1307 - Data collection.

§ 890.1308 - Carrier participation.

Subpart N - Federal Employees Health Benefits For Employees of Certain Indian Tribal Employers

§ 890.1401 - Purpose.

§ 890.1402 - Definitions and deemed references.

§ 890.1403 - Tribal employer purchase of FEHB requires current deposit of premium payment and timely payment of administrative fee.

§ 890.1404 - Tribal employer election and agreement to purchase FEHB.

§ 890.1405 - Tribal employees eligible for enrollment.

§ 890.1406 - Correction of enrollment errors.

§ 890.1407 - Enrollment process; effective dates.

§ 890.1408 - Change in enrollment type, plan, or option.

§ 890.1409 - Cancellation of coverage or decreases in enrollment.

§ 890.1410 - Termination of enrollment and 31-day temporary extension of coverage; and conversion to individual policy.

§ 890.1411 - Temporary Continuation of Coverage (TCC).

§ 890.1412 - Non-pay status, insufficient pay, or change to ineligible position.

§ 890.1413 - Premiums and administrative fee.

§ 890.1414 - Responsibilities of the tribal employer.

§ 890.1415 - Reconsideration of enrollment and eligibility decisions and appeal rights.

§ 890.1416 - Filing claims for payment or service and court review.

§ 890.1417 - No continuation of FEHB enrollment into retirement from employment with a tribal employer.

§ 890.1418 - No continuation of FEHB enrollment in compensationer status past 365 days.

Subpart P - Postal Service Health Benefits Program

§ 890.1601 - Purpose.

§ 890.1602 - Definitions and deemed references.

§ 890.1603 - Eligibility for the Postal Service Health Benefits Program.

§ 890.1604 - Medicare enrollment requirement for certain Postal Service annuitants and eligible family members.

§ 890.1605 - Enrollment in the initial contract year.

§ 890.1606 - Opportunities to enroll, change enrollment, or reenroll; effective dates.

§ 890.1607 - Initial decision and reconsideration.

§ 890.1608 - Disenrollment, removal, termination, cancellation, and suspension.

§ 890.1609 - Temporary extension of coverage, conversion, or temporary continuation of coverage.

§ 890.1610 - Minimum standards for PSHB Program plans and Carriers.

§ 890.1611 - Withdrawal of approval of health benefits plan or carrier.

§ 890.1612 - Information sharing.

§ 890.1613 - Postal Service contract year beginning date, Medicare late enrollment penalty, calculations for the Postal Service Retiree Health Benefits Fund, and clarification of statutory terms.

§ 890.1614 - Other administrative provisions.

§ 890.1615 - Crediting separate reserves for PSHB.

§ 890.1616 - Medicare Part D.