[Federal Register Volume 64, Number 62 (Thursday, April 1, 1999)]
[Rules and Regulations]
[Page 15633]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-8011]
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Rules and Regulations
Federal Register
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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
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Federal Register / Vol. 64, No. 62 / Thursday, April 1, 1999 / Rules
and Regulations
[[Page 15633]]
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OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN 3206-AI33
Federal Employees Health Benefits Program: Contributions and
Withholdings
AGENCY: Office of Personnel Management.
ACTION: Final rule.
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SUMMARY: The Office of Personnel Management (OPM) is issuing final
regulations under the Federal Employees Health Benefits (FEHB) law that
specify procedures for OPM's annual determination of the weighted
average of subscription charges, for self only and for self and family
FEHB enrollments respectively. The determinations are a requirement
under recent amendments to the FEHB law that authorize a new method for
adjusting Government contributions toward health plan enrollment
charges. Effective with the FEHB contract year that begins in January
1999, the Government contribution generally amounts to 72 percent of
the weighted average of subscription charges in effect for self only
and for self and family enrollments respectively.
DATES: This final regulation is effective May 3, 1999.
FOR FURTHER INFORMATION CONTACT:
Bonnie R. Rose (202) 606-0004.
SUPPLEMENTARY INFORMATION: On August 28, 1998, OPM published interim
regulations in the Federal Register (63 FR 45933) that amended 5 CFR
890.501, in paragraphs (a) and (b), to provide for the administration
of a new Government contribution formula under the Federal Employees
Health Benefits (FEHB) law.
The Balanced Budget Act of 1997, approved on August 5, 1997 (Pub.
L. 105-33, sec. 7002, 111 Stat. 662), amended the FEHB law to authorize
a new Government contribution formula effective on the first day of the
contract year that begins in January 1999. In place of the ``Big-6''
formula, which evolved under FEHB law during the early 1970's, the new
formula bases Government contributions on the program-wide weighted
average costs, for self only and for self and family enrollments,
respectively.
The Big-6 formula provided a Government contribution for eligible
enrollees in any FEHB plan or option equal to the lesser of: (1) 60
percent of the simple average of self only or self and family
enrollment charges for the highest level of benefits offered under six
large plans described in law, or (2) 75 percent of charges for the
particular plan an individual elects to enroll in. The intent of the
new FEHB contribution formula, which is referred to as the ``Fair
Share'' formula, is to maintain a consistent level of Government
contributions, as a percent of the total program costs, regardless of
the configuration of participating health plans or FEHB enrollment
patterns.
The Fair Share formula requires a determination by the Office of
Personnel Management (OPM) in advance of each contract year of the
weighted average of subscription charges that will be in effect during
the year under all FEHB plans, for self only and for self and family
types of enrollment, respectively. For employees and annuitants
generally, the law provides a Government contribution equal to the
lesser of: (1) 72 percent of the amount OPM determines is the program-
wide weighted average of subscription charges for the type of
enrollment the individual selects, or (2) 75 percent of the
subscription charge for a particular plan (5 U.S.C. 8906 (a) and (b)).
The FEHB law, as amended, is very clear regarding the methodology
for determining the program-wide weighted average of subscription
charges in cases where health plans continue participation from year to
year. OPM's regulations explain how we intend to treat individual plans
for purposes of determining the program-wide weighted average of
subscription charges when the conditions of a plan's FEHB participation
change from one year to the next, including cases in which plans enter
the FEHB Program, cease participation, or merge with another FEHB plan,
and cases in which a health maintenance organization alters its
previous rating structure.
Also, the interim regulation deleted outdated provisions in
paragraph 5 CFR 890.501(b), and the reference to paragraph (b) in 5 CFR
890.501(a), which reflected FEHB law prior to 1974 amendments to the
Government contribution formula (Pub. L. 93-246, section 1, 88 Stat.
3).
We received no comments on the interim rule.
Regulatory Flexibility Act
I certify that these regulations will not have a significant
economic impact on a substantial number of small entities because the
regulations only affect Federal Government contributions toward
enrollment costs under the Federal Employees Health Benefits 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.
Office of Personnel Management.
Janice R. Lachance,
Director.
Accordingly, under authority of 5 U.S.C. 8913, OPM is adopting its
interim regulation amending 5 CFR part 890 as published on August 28,
1998 (63 FR 45933), as a final rule without change.
[FR Doc. 99-8011 Filed 3-31-99; 8:45 am]
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