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Proposed Rule

Federal Employees Health Benefits Acquisition Regulations: Self Plus One and Contract Matrix Update

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Start Preamble

AGENCY:

Office of Personnel Management.

ACTION:

Proposed rule.

SUMMARY:

The Office of Personnel Management (OPM) is issuing this Start Printed Page 12570proposed rule to update its regulations concerning “self plus one” and the contract matrix. OPM is updating the Federal Employees Health Benefits Acquisition Regulations (FEHBAR) to include a recently added enrollment type called “self plus one” to the carrier advertising instructions and also provides notice to interested stakeholders that we are updating and clarifying the contract clause matrix.

DATES:

OPM must receive comments by May 2, 2019.

ADDRESSES:

You may submit comments identified by docket number and/or Regulatory Information Number (RIN) and title, by the following method:

All submissions received must include the agency name and docket number or RIN for this document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing at http://www.regulations.gov as they are received without change, including any personal identifiers or contact information.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Michael W. Kaszynski, Senior Policy Analyst, at Michael.Kaszynski@opm.gov or 202-606-1994.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

This proposed regulation amends the FEHBAR to list a “self plus one” enrollment type in the carrier advertising instructions so that carriers will be required to list all current enrollment types when advertising their health plans enrollment codes and premium rates to enrollees. This change is a technical correction and does not alter current FEHB family member eligibility guidelines.

This proposed regulation also provides notice to interested stakeholders that we are updating and clarifying the contract clause matrix. Annually, OPM determines which FAR and FEHBAR contract clauses are applicable to FEHB carrier contracts and we include the appropriate clauses in the carrier contracts. We also publish clauses and clause headings in the FEHBAR in order to give the clauses legal regulatory authority. This gives new carriers joining the FEHB Program the benefit of seeing OPM's required clauses in regulation for consideration prior to submitting an application for participation in the FEHB Program. This proposed regulation brings the contract clause matrix in line with the current Federal Acquisition Regulations (FAR) and FEHBAR contract clauses used in all Federal Employees Health Benefits (FEHB) Program carrier contracts.

Section 706 of the Bipartisan Budget Act of 2013 amended chapter 89 of title 5 United States Code (U.S.C) by adding a self plus one enrollment type for Federal employees and annuitants under the FEHB Program. The self plus one enrollment type became available during the 2015 Open Season for the 2016 plan year and was codified in a final rule at https://www.federalregister.gov/​documents/​2015/​09/​17/​2015-23348/​federal-employees-health-benefits-program-self-plus-one-enrollment-type. A self plus one enrollment covers the enrollee and one eligible family member, designated by the enrollee. Eligible family members under a self plus one enrollment include a spouse or eligible child as set forth in § 890.302 of title 5 CFR.

OPM manages the FEHB program which is executed with contractors managing and providing the FEHB benefits to government employees. This rule proposes to update the Federal Employee Health Benefits Acquisition Regulations (FEHBAR) to implement the “self plus one” program via FEHB contracts, and make the FEHB contract clauses consistent with current FAR and FEHBAR clause requirements. Specifically, the regulation amends the FEHBAR at 48 CFR part 1603 to list a self plus one enrollment type in the advertising instructions. OPM considers this change a technical correction as it does not change the operational requirements of the FEHB program and does not alter current FEHB family member eligibility guidelines.

This regulation also provides notice to interested stakeholders that we are updating the contract clause matrix at 48 CFR 1652.370. This will bring the matrix in line with current FAR and FEHBAR contract clauses used in all FEHB Program carrier contracts. The matrix at FEHBAR section 1652.370 lists the FAR and FEHBAR clauses to be used in contracts based on cost analysis and contracts based on a combination of cost and price analysis. Carriers must comply with all matrix clauses during their participation in the FEHB Program. Certain contract clauses are mandatory for FEHB contracts and others are used only when made applicable by pertinent sections of the FAR or FEHBAR. This regulation updates the matrix to include all current contract clauses.

Regulatory Impact Analysis

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, distribute impacts, and equity). Executive Order 13563 also emphasizes the importance of quantifying both costs and benefits, of reducing costs, of harmonizing rules, and of promoting flexibility. This rule is not a significant regulatory action under E.O. 12866.

Reducing Regulation and Controlling Regulatory Costs

This proposed rule is not expected to be an E.O. 13771 regulatory action because this proposed rule is not significant under E.O. 12866.

Regulatory Flexibility Act

The Office of Personnel Management certifies that this rule 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.

Civil Justice Reform

This regulation meets the applicable standard set forth in Executive Order 12988.

Unfunded Mandates Reform Act of 1995

This rule will not result in the expenditure by state, local, and tribal governments, in the aggregate, or by the private sector, of $100 million or more in any year and it will not significantly or uniquely affect small governments. Therefore, no actions were deemed necessary under the provisions of the Unfunded Mandates Reform Act of 1995.

Congressional Review Act

This action pertains to agency management, personnel, and organization and does not substantially affect the rights or obligations of no agency parties and, accordingly, is not a “rule” as that term is used by the Congressional Review Act (Subtitle E of the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA). Therefore, the reporting requirement of 5 U.S.C. 801 does not apply.

Paperwork Reduction Act

Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a Start Printed Page 12571penalty 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.

This rule involves an OMB approved collection of information subject to the PRA Health Benefits Election, SF 2809, OMB no. 3206-0160. The public reporting burden for this collection is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The total burden hour estimate for this form is 9,000 hours. The systems of record notice for this collection is: OPM SORN GOVT-1 General Personnel Records and OPM SORN CENTRAL-18-Federal Employees Health Benefits Program Claims Data Warehouse.

Start List of Subjects

List of Subjects in 48 CFR Parts 1603 and 1652

  • Government employees
  • Government procurement
  • Health insurance
  • Reporting and recordkeeping requirements
End List of Subjects Start Signature

Office of Personnel Management.

Alexys Stanley,

Regulatory Affairs Analyst.

End Signature

Accordingly, OPM is proposing to amend title 48, Code of Federal Regulations, parts 1603 and 1652 as follows:

Start Part

PART 1603—IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST

End Part Start Amendment Part

1. The authority citation for part 1603 continues to read as follows:

End Amendment Part Start Authority

Authority: 5 U.S.C. 8913; 40 U.S.C. 486(c); 48 CFR 1.301.

End Authority Start Amendment Part

2. Section 1603.7002 paragraph (e) is revised to read as follows:

End Amendment Part
Additional guidelines.
* * * * *

(e) Not give instructions on enrollment. Statements on enrollment procedures, requirements, or eligibility shall be limited to those such as: To sign up, fill out a Health Benefits Election Form (Standard Form 2809) from your personnel office indicating the enrollment you want or use your agency's electronic enrollment system:

The enrollment codes for (plan's name) are:

Self Only _Enrollment Code _

Self Plus One _Enrollment Code _

Self and Family _Enrollment Code _

The form must then be returned to your personnel office before the (date) deadline. Your (plan's name) coverage will begin the first pay period in January, (year). If you are a retired Federal employee and need forms, contact the Office of Personnel Management, 1900 E Street NW, Attn: Retirement Benefits Branch, Washington, DC 20415 or visit www.opm.gov/​forms.

Start Part

PART 1652—CONTRACT CLAUSES

End Part Start Amendment Part

3. The authority citation for part 1652 continues to read as follows:

End Amendment Part Start Authority

Authority: 5 U.S.C. 8913; 40 U.S.C. 486(c); 48 CFR 1.301.

End Authority Start Amendment Part

4. Section 1652.370 is revised as follows

End Amendment Part
Use of the matrix.

(a) The matrix in this section lists the FAR and FEHBAR clauses to be used with contracts based on cost analysis and contracts based on a combination of cost and price analysis. Carriers shall submit initial applications and requests for renewals on the basis that the new contract or contract renewal will include the clauses indicated.

(b) Certain contract clauses are mandatory for FEHBP contracts. Other clauses are to be used only when made applicable by pertinent sections of the FAR or FEHBAR. An “M” in the “Use Status” column indicates that the clause is mandatory. An “A” indicates that the clause is to be used only when the applicable conditions are met.

(c) Clauses are incorporated in the contract either in full text or by reference. If the full text is to be used, the matrix indicates a “T”. If the clause is incorporated by reference, the matrix indicates an “R”.

FEHBP Clause Matrix

ClauseTitleUse statusUse with experience rated contractsUse with community rate contracts
FAR 52.202-1DefinitionsMTT
FAR 52.203-3GratuitiesMTT
FAR 52.203-5Covenant Against Contingent FeesMTT
FAR 52.203-7Anti-Kickback ProceduresMTT
FAR 52.203-12Limitation on Payments to Influence Certain Federal TransactionsMTT
FAR 52.203-13Contractor Code of Business Ethics and ConductMTT
FAR 52.203-17Contractor Employee Whistleblower Rights and Requirement to Inform Employees of Whistleblower RightsMTT
FAR 52.203-19Prohibition Requiring Internal Confidentiality Agreements or StatementsMTT
FAR 52.204-7System For Rewards ManagementMTT
FAR 52.204-9Personnel Identity Verification of Contractor PersonnelMTT
FAR 52.204-21Basic Safeguarding of Contractor Information SystemsMTT
FAR 52.209-9Updates of Publically Available Information Regarding Responsibility MattersMTT
1652.203-70Misleading, Deceptive, or Unfair AdvertisingMTT
1652.204-70Contractor Records RetentionMTT
1652.204-71Coordination of BenefitsMTT
1652.204-72Filing Health Benefit Claims/Court Review of Disputed ClaimsMTT
1652.204-73Taxpayer Identification NumberMTT
1652.204-74Large Provider AgreementsMT
Start Printed Page 12572
FAR 52.209-6Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for DebarmentMTT
FAR 52.215-2Audit & Records—NegotiationMTT
FAR 52.215-10Price Reduction for Defective Cost or Pricing DataMT
FAR 52.215-12Subcontractor Certified Cost or Pricing DataMT
FAR 52.215-15Pension Adjustments and Asset ReversionsMT
FAR 52.215-18Reversion or Adjustment of Plans for Postretirement Benefits (PRB) Other Than PensionsMT
1652.215-70Rate Reduction for Defective Pricing or Defective Cost or Pricing DataMTT
1652.215-71Investment IncomeMT
1652.216-70Accounting and Price AdjustmentMT
1652.216-71Accounting and Allowable CostMT
FAR 52.219-8Utilization of Small Business ConcernsMTT
FAR 52.222-1Notice to the Government of Labor DisputesMTT
FAR 52.222-3Convict LaborMTT
FAR 52.222-4Contract Work Hours and Safety Standards Act—Overtime CompensationMTT
FAR 52.222-21Prohibition of Segregated FacilitiesMTT
FAR 52.222-26Equal OpportunityMTT
FAR 52.222-29Notification of Visa DenialATT
FAR 52.222-35Equal Opportunity for VeteransMTT
FAR 52.222-36Equal Opportunity for Workers With DisabilitiesMTT
FAR 52.222-37Employment Reports on VeteransMTT
FAR 52.222-50Combating Trafficking in PersonsMTT
FAR 52.222.54Employment Eligibility VerificationMTT
1652.222-70Notice of Significant EventsMTT
FAR 52.223-6Drug-Free WorkplaceATT
FAR 52.223-18Encouraging Contractor Policies to Ban Text Messaging While DrivingMTT
1652.224-70Confidentiality of RecordsMTT
FAR 52.227-1Authorization and ConsentMTT
FAR 52.227-2Notice and Assistance Regarding Patent and Copyright InfringementMTT
FAR 52.229-4Federal, State and Local Taxes (State and local AdjustmentsMTT
1652.229-70Taxes—Foreign Negotiated Benefits ContractsATT
FAR 52.232-8Discounts for Prompt PaymentMTT
FAR 52.232-17InterestMTT
FAR 52.232-23Assignment of ClaimsATT
FAR 52.232-33Payment by Electronic Funds Transfer—System for Awards ManagementMTT
1652.232-70Payments—Community-Rated ContractsAT
1652.232-71Payments—Experience-Rated ContractsAT
1652.232-72Non-Commingling of FEHBP FundsMT
1652.232-73Approval for Assignment of ClaimsMTT
FAR 52.233-1DisputesMTT
FAR 52.233-4Applicable Law for Breach of Contract ClaimMTT
FAR 52.239-1Privacy or Security SafeguardsMTT
FAR 52.242-1Notice of Intent to Disallow CostsMT
FAR 52.242-3Penalties for Unallowable CostsMT
FAR 52.242-13BankruptcyMTT
1652.243-70Changes—Negotiated Benefits ContractsMTT
FAR 52.244-5Competition in SubcontractingMT
FAR 52.244-6Subcontracts for Commercial ItemsMT
1652.244-70SubcontractsMT
1652.245-70Government Property (Negotiated Benefits Contracts)MTT
FAR 52.246-25Limitation of Liability—ServicesMT
1652.246-70FEHB InspectionMTT
FAR 52.247-63Preference for U.S.-Flag Air CarriersMTT
1652.249-70Renewal and Withdrawal of ApprovalMTT
1652.249-71FEHBP Termination for Convenience of the Government—Negotiated Benefits ContractsMTT
1652.249-72FEHBP Termination for Default—Negotiated Benefits ContractsMTT
FAR 52.251-1Government Supply SourcesAT
FAR 52.252-4Alterations in ContractATT
FAR 52.252-6Authorized Deviations in ClausesMTT
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[FR Doc. 2019-06223 Filed 4-1-19; 8:45 am]

BILLING CODE 6325-38-P