OPM Seeks Comments on Proposed Rulemaking on Eligibility Expansion Under Federal Employees Health Benefits Program

Targeted News Service

WASHINGTON, July 29 -- The U.S. Office of Personnel Management published the following proposed rule in the Federal Register:

Federal Employees Health Benefits Program Expansion of Eligibility to Certain Employees on Temporary Appointments and Certain Employees on Seasonal and Intermittent Schedules

A Proposed Rule by the Personnel Management Office on 07/29/2014

Publication Date: Tuesday, July 29, 2014

Agency: Office of Personnel Management

Dates: OPM must receive comments on or before August 28, 2014.

Comments Close: 08/28/2014

Entry Type: Proposed Rule

Action: Notice of proposed rulemaking.

Document Citation: 79 FR 43969

Page: 43969 -43972 (4 pages)

CFR: 5 CFR 890

RIN: 3206-AM86

Document Number: 2014-17806

Shorter URL: https://federalregister.gov/a/2014-17806

Action

Notice Of Proposed Rulemaking.

Summary

The United States Office of Personnel Management (OPM) is issuing a proposed rule that would expand eligibility for enrollment under the Federal Employees Health Benefits (FEHB) Program to certain temporary, seasonal, and intermittent employees who are identified as full-time employees. This regulation would make FEHB coverage available to these newly eligible employees no later than January 2015.

DATES:

OPM must receive comments on or before August 28, 2014.

ADDRESSES:

Send written comments to Louise Yinug, Senior Policy Analyst, Planning and Policy Analysis, U.S. Office of Personnel Management, Room 3415, 1900 E Street NW., Washington, DC; or FAX to (202) 606-0036 Attn: Louise Yinug. You may also submit comments using the Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions for submitting comments.

FOR FURTHER INFORMATION CONTACT:

Louise Yinug, Senior Policy Analyst at (202) 606-0004.

SUPPLEMENTARY INFORMATION:

OPM is proposing to expand eligibility for coverage under the Federal Employees Health Benefits (FEHB) Program to certain temporary, seasonal, and intermittent Federal employees who are expected to work full-time schedules within the meaning of section 4980H of the Internal Revenue Code (IRC) for at least 90 days.

This proposed rule would expand eligibility by authorizing enrollment in a FEHB health plan for certain Federal employees on temporary appointments and certain employees working on seasonal and intermittent schedules. Currently, most employees on temporary appointments become eligible for FEHB coverage after completing one year of current continuous employment and, once eligible for coverage, do not receive an employer contribution to premium. Employees working on seasonal schedules for less than six months in a year and those working intermittent schedules are excluded from eligibility regardless of the work hours for which they are expected to be scheduled. Some limited exceptions were made to these exclusions for temporary firefighters and emergency response workers in 5 CFR 890.102(h) and (i).

Under this proposed regulation, employees on temporary appointments, employees on seasonal schedules who will be working less than six months per year, and employees working intermittent schedules would be eligible to enroll in a FEHB health plan if the employee is expected to work a full-time schedule of 130 or more hours in a calendar month. If the employing office expects the employee to work at least 90 days, the employee is eligible to enroll upon notification of the employee's eligibility by the employing office. If the employing office expects the employee to work fewer than 90 days, the employee will be eligible to enroll after the completion of a 90 day waiting period. Temporary, seasonal, and intermittent employees who are expected to work a schedule of less than 130 hours in a calendar month would not be eligible to enroll in a FEHB health plan. Temporary, seasonal, and intermittent employees for whom the expectation of hours of employment changes from less than 130 hours per calendar month to 130 hours or more per calendar month would become eligible to enroll in an FEHB health plan as described above.

The change in eligibility for coverage set forth in this proposed regulation is intended to ensure, to the greatest extent practicable, that full-time employees, within the meaning of section 4980H of the IRC and Treasury regulations thereunder (79 FR 8544, February 12, 2014) are eligible to enroll in FEHB. IRC section 4980H, enacted as part of the Affordable Care Act, defines a full-time employee as, with respect to any month, an employee who is employed on average at least 30 hours of service per week (IRC section 4980H(c)(4)). Under the IRC section 4980H regulations a full-time employee means, with respect to any calendar month, an employee who is employed at least 130 hours of service in that month.

This proposed rule would allow newly eligible employees (employees on an appointment limited to one year and employees working on a seasonal or intermittent schedule) to initially enroll under the FEHB program with a Government contribution to premium if they are expected to be employed on a full-time schedule and are expected to work for at least 90 days.

Some temporary employees who have completed one year of continuous employment are already eligible for FEHB coverage but without a Government contribution to premium. This proposed rule would allow these employees to enroll in a FEHB plan under 5 CFR 890.102(j) (with a Government contribution to premium) if the employee is determined by his or her employing office to be newly eligible for FEHB coverage under this regulation.

Enrollments for employees newly eligible pursuant to this rule would be accepted during a 60-day period after the employing office notifies employees of their eligibility to enroll in a FEHB health plan. Coverage will become effective as provided for by 5 CFR 890.301. Employing offices must promptly determine eligibility of new and current employees and upon determining eligibility, promptly offer employees an opportunity to enroll in the FEHB Program so that coverage becomes effective no later than January 2015.

While this proposed regulation would expand FEHB coverage to new categories of Federal employees, there are other employers who are entitled to purchase FEHB coverage for their own employees or whose employees are otherwise entitled to enroll in FEHB coverage. These other employers may have made or are planning to make other arrangements to provide health insurance for their temporary, seasonal, and intermittent employees. Accordingly, the OPM Director may waive application of this proposed rule when the employer of an individual not covered by 5 U.S.C. 8901(1)(A) demonstrates to OPM that these expansion requirements would have an adverse impact on the employer's need for self-governance. We expect such instances to be rare.

[*Federal RegisterVJ 2014-07-29]

For more information about Targeted News Service products and services, please contact: Myron Struck, editor, Targeted News Service LLC, Springfield, Va., 703/304-1897; [email protected]; http://targetednews.com.

TNS 22VistaJ-140729 gv-1170353