Proposed Rule2021-22281
FEDVIP: Extension of Eligibility to Certain Employees on Temporary Appointments and Certain Employees on Seasonal and Intermittent Schedules; Enrollment Clarifications and Qualifying Life Events
Primary source
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Published
October 19, 2021
Issuing agencies
Personnel Management Office
Abstract
The Office of Personnel Management (OPM) is issuing a proposed rule to expand eligibility for enrollment in the Federal Employees Dental and Vision Insurance Program (FEDVIP) to additional categories of Federal employees. This proposed rule expands eligibility for FEDVIP to certain Federal employees on temporary appointments and certain employees on seasonal and intermittent schedules that became eligible for Federal Employees Health Benefits (FEHB) enrollment beginning in 2015. This rule also expands access to FEDVIP benefits to certain firefighters on temporary appointments and intermittent emergency response personnel who became eligible for FEHB coverage in 2012. This proposed rule also updates the provisions on enrollment for active duty service members who become eligible for FEDVIP as uniformed service retirees pursuant to the National Defense Authorization Act of 2017 (FY17 NDAA). In addition, this rule proposes to add qualifying life events (QLEs) for enrollees who may become eligible for and enroll in dental and/or vision services from the Department of Veterans Affairs (VA). Lastly, the rule also proposes technical corrections and clarifications to the part.
Full Text
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<title>Federal Register, Volume 86 Issue 199 (Tuesday, October 19, 2021)</title>
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[Federal Register Volume 86, Number 199 (Tuesday, October 19, 2021)]
[Proposed Rules]
[Pages 57764-57769]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-22281]
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Proposed Rules
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains notices to the public of
the proposed issuance of rules and regulations. The purpose of these
notices is to give interested persons an opportunity to participate in
the rule making prior to the adoption of the final rules.
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Federal Register / Vol. 86, No. 199 / Tuesday, October 19, 2021 /
Proposed Rules
[[Page 57764]]
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 894
RIN 3206-AN91
FEDVIP: Extension of Eligibility to Certain Employees on
Temporary Appointments and Certain Employees on Seasonal and
Intermittent Schedules; Enrollment Clarifications and Qualifying Life
Events
AGENCY: Office of Personnel Management.
ACTION: Notice of proposed rulemaking.
-----------------------------------------------------------------------
SUMMARY: The Office of Personnel Management (OPM) is issuing a proposed
rule to expand eligibility for enrollment in the Federal Employees
Dental and Vision Insurance Program (FEDVIP) to additional categories
of Federal employees. This proposed rule expands eligibility for FEDVIP
to certain Federal employees on temporary appointments and certain
employees on seasonal and intermittent schedules that became eligible
for Federal Employees Health Benefits (FEHB) enrollment beginning in
2015. This rule also expands access to FEDVIP benefits to certain
firefighters on temporary appointments and intermittent emergency
response personnel who became eligible for FEHB coverage in 2012. This
proposed rule also updates the provisions on enrollment for active duty
service members who become eligible for FEDVIP as uniformed service
retirees pursuant to the National Defense Authorization Act of 2017
(FY17 NDAA). In addition, this rule proposes to add qualifying life
events (QLEs) for enrollees who may become eligible for and enroll in
dental and/or vision services from the Department of Veterans Affairs
(VA). Lastly, the rule also proposes technical corrections and
clarifications to the part.
DATES: OPM must receive comments on or before December 20, 2021.
ADDRESSES: You may submit comments, identified by docket number and/or
Regulatory Information Number (RIN) and title, by the following method:
<bullet> Federal Rulemaking Portal: <a href="https://www.regulations.gov">https://www.regulations.gov</a>.
Follow the instructions for submitting comments.
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 <a href="https://www.regulations.gov">https://www.regulations.gov</a>
as they are received without change, including any personal identifiers
or contact information.
FOR FURTHER INFORMATION CONTACT: Julia Elam, Program Analyst, at
<a href="/cdn-cgi/l/email-protection#b5dfc0d9dcd49bd0d9d4d8f5dac5d89bd2dac3"><span class="__cf_email__" data-cfemail="6e041b02070f400b020f032e011e0340090118">[email protected]</span></a> or (202) 606-2128.
SUPPLEMENTARY INFORMATION:
Authority for This Rulemaking
FEDVIP was created as a result of the passage of the Federal
Employee Dental and Vision Benefits Enhancement Act of 2004, Public Law
108-496. This Act required OPM to make stand-alone dental and vision
insurance available to Federal employees, retirees, and their
dependents. As of August 3, 2021, FEDVIP has 5.4 million enrollees with
approximately 7.3 million covered individuals. FEDVIP is available to
eligible Federal civilian and U.S. Postal Service (USPS) employees,
retirees (annuitants), survivor annuitants, compensationers, and their
eligible family members (dependents); and certain TRICARE-eligible
individuals (TEIs) who are authorized under Section 715 of Public Law
114-328, on an enrollee-pay-all basis; there is no government
contribution toward premiums.
The program is administered by OPM in accordance with 5 U.S.C.
chapters 89A and 89B and implementing regulations (5 CFR part 894). The
authority to extend FEDVIP eligibility to additional groups of
employees falls under OPM's regulatory authority at 5 U.S.C. 8962 and 5
U.S.C. 8992 to determine eligibility of employees based on the nature
and type of employment.
Discussion of the Proposed Changes
Addition of Newly Eligible Groups
This rule will allow newly eligible individuals to enroll
themselves and their family members in FEDVIP. Under current FEDVIP
regulations at 5 CFR 894.302, Federal employees in certain positions
are not eligible to enroll in FEDVIP. This rule proposes to extend
eligibility to enroll in FEDVIP to certain temporary Federal employees,
and certain Federal employees on seasonal and intermittent schedules
who are eligible for the FEHB. Consistent with Internal Revenue Code
section 4980H, OPM expanded eligibility to enroll in the FEHB Program
to these categories of Federal employees who are expected to work 130
hours per month, for at least 90 days, at 79 FR 62325 (October 17,
2014). This proposed rule expands eligibility to enroll in FEDVIP to
this same group of employees under 5 CFR part 894 and allows them to
enroll in FEDVIP.
In addition, the rule would allow certain temporary employees of
the United States Postal Service (USPS) as well as certain USPS
employees on seasonal and intermittent schedules expected to work 130
hours per month, for at least 90 days, to enroll for FEDVIP coverage as
USPS does not offer separate dental and vision plans for this group.
Current FEDVIP regulations do not allow certain firefighters on
temporary appointments and intermittent emergency response personnel
for wildland fire protection to enroll. These employees are distinct
from the categories described above because they might not meet the
requirement of being expected to work 130 hours per calendar month for
90 days or more. In 2012, upon request by an employing agency,
eligibility to enroll in the FEHB Program was extended to employees in
positions that provide emergency response services for wildland fire
protection, and to employees performing similar types of emergency
response services if approved by OPM. This proposed rule similarly
provides these employees eligibility to enroll in FEDVIP.
OPM seeks comments on how this expanded group of certain employees
on temporary appointments and employees on seasonal and intermittent
schedules, as well as certain firefighters and intermittent emergency
response personnel, should first be offered an enrollment opportunity
upon issuance of the final rule. We have proposed that enrollments for
newly eligible employees would be accepted during a 60-day period from
the date of issuance of the final rule, after the employing
[[Page 57765]]
office notifies employees of their eligibility to enroll in a FEDVIP
plan. If an employee in this group is expected to work or does work 130
hours per calendar month for 90 days or more, then he or she is
eligible to enroll upon notification by his or her employing office. If
an employee is a firefighter or intermittent emergency response
personnel, he or she is eligible upon notification of his or her
employing office. Coverage will become effective for these newly
eligible groups pursuant to 5 CFR 894.504. Employing offices must
determine eligibility of new and current employees and upon determining
eligibility, promptly offer employees made eligible by this rule an
opportunity to enroll in FEDVIP so that coverage becomes effective upon
issuance of the final rule.
Enrollment of Active Duty Service Members Who Experience a Status
Change to Uniformed Services Retirees
This proposed rule clarifies when active duty service members who
become uniformed services retirees may enroll in FEDVIP outside of open
season. A sponsor on active duty becomes eligible for FEDVIP as a TEI,
pursuant to Public Law 108-496, when the individual becomes a uniformed
services retiree. Under current regulations at Sec. 894.501(b), an
individual may enroll within 60 days of becoming eligible. Under 5 CFR
894.504, the individual's enrollment is effective the first day of the
pay period following the one in which the Administrator receives the
enrollment. A sponsor who is on active duty that retires and becomes a
TEI could experience a 30-day break in coverage if that individual
enrolls when becoming eligible as a uniformed services retiree. OPM is
adding a new paragraph, 5 CFR 894.501(e) to allow these active duty
service members who will experience a status change to a uniformed
services retiree to enroll in FEDVIP beginning 31 days before the
service member loses other dental or vision coverage to 60 days after
becoming eligible to enroll. We are also amending 5 CFR 894.504(d) to
make the effective date for these individuals enrolling outside of open
season to be no earlier than the date the active duty service member
lost other coverage.
Addition of New QLEs and Technical Corrections
OPM is proposing to amend certain provisions in 5 CFR part 894 to
add qualifying life events for enrollees to cancel a FEDVIP enrollment
and decrease an enrollment type. During the 2018 Open Season and the
period for belated enrollments, OPM became aware of circumstances where
enrollees who are both TRICARE-eligible and a Federal employee, wanted
to cancel coverage because the enrollee or a dependent became eligible
for VA dental or vision services. OPM is proposing a new QLE for an
enrollee to cancel FEDVIP enrollment when the enrollee becomes eligible
for such services and for a decrease in enrollment type when a family
member who has been covered under an enrollment becomes eligible for VA
dental and or vision services.
In 5 CFR 894.511, OPM proposes to add a new paragraph (c) that adds
a QLE allowing a TEI sponsor to decrease an enrollment if a TEI family
member who is enrolled becomes deployed to active military duty.
Currently, this QLE in 5 CFR 894.511(b) only applies to Federal
employees, annuitants or compensationers. In addition, the rule
proposes to add a new paragraph (d) that adds a new QLE for an enrollee
to decrease an enrollment type if a covered family member becomes
eligible for dental or vision benefits from the VA.
In 5 CFR 894.601, OPM proposes a new paragraph (i) that addresses
when FEDVIP coverage stops if a sponsor becomes eligible to cancel an
enrollment outside of open season and elects to do so. If the sponsor
cancels a self plus one or self and family enrollment, the sponsor must
notify family members of changes in the enrollment. In 5 CFR 894.602,
OPM proposes to add a qualifying life event for an enrollee to cancel
their FEDVIP enrollment if the enrollee is determined to be eligible
for and enrolls in dental or vision benefits through the VA. If the
enrollee is a sponsor and cancels a self plus one or self and family
enrollment in a FEDVIP dental plan, the sponsor meets one of the
conditions in 5 CFR 894.309(a)(3)(iii), and must notify eligible family
members about the change in enrollment. Then, an eligible family member
would have to reenroll in a FEDVIP dental plan and cover all eligible
family members, pursuant to 5 CFR 894.815(b) and 5 CFR 894.806.
In addition, this proposed rule includes technical corrections.
These technical corrections include the following: Capitalization and
italicization of certain defined terms throughout 5 CFR part 894;
proposal to clarify that premium conversion applies to Federal
employees and to update the definition of stepchild in 5 CFR 894.101;
proposal to amend the reference to 5 CFR 890.102(c) in 5 CFR 894.302 so
that it refers instead to 5 CFR 890.102(c)(1) through (8); a proposal
to amend 5 CFR 894.201 to use the more inclusive terminology of
``enrollee'' instead of the terms ``employee'' and ``annuitant'' since
TEIs are also enrollees; and a proposal to remove 5 CFR 894.203 since
the situations for changing a family member under a self plus one
enrollment or changing to a self only enrollment are covered in 5 CFR
894.510 and 5 CFR 894.511. This rule also incorporates italicization of
defined terms in 5 CFR 894.502.
Expected Impact of Proposed Changes
While this rule expands the number of individuals who are
potentially eligible for FEDVIP, OPM does not believe this regulation
will have a large impact on the broader dental and vision insurance
markets. FEDVIP generally constitutes a smaller percentage of dental
and vision insurance carrier's overall books of business. OPM has
contracted with twelve dental carriers and five vision carriers to
offer plans under FEDVIP. There are currently twenty-three dental plan
options available across FEDVIP from these twelve dental carriers.
Within the five vision carriers, there are currently ten vision plan
options that are nationwide and internationally available to all
potential enrollees.
OPM estimates that as of June 2021 there are approximately 86,000
Federal employees in the impacted categories that are eligible for FEHB
that would also be eligible for FEDVIP under this proposed rule.
However, using FEHB Program eligibility as a proxy for FEDVIP
eligibility is limited since OPM cannot estimate the uptake of the
eligible population to enroll in FEDVIP. Since OPM does not have
extensive data on and cannot estimate the potential uptake of newly
eligible individuals to determine the impact of this regulation, we are
seeking comments on the following:
1. How will the regulation impact changes to enrollment in FEDVIP?
2. How will the allowance of new categories of employees impact
FEDVIP?
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 emphasizes the importance of quantifying both costs and
benefits, of reducing costs, of harmonizing rules, and of promoting
flexibility. A regulatory impact analysis must be prepared for major
rules with
[[Page 57766]]
economically significant effects of $100 million or more in any one
year. While this rule does not reach the economic effect of $100
million or more under Executive Order 12866, this rule has been
designated as a ``significant regulatory action,'' under Executive
Order 12866.
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.
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.
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.
This rule involves an OMB approved collection of information
subject to the PRA for the FEDVIP Enrollment System, known as BENEFEDS,
OMB Number: 3206-0272 but does not impose any new reporting or record-
keeping requirements subject to the Paperwork Reduction Act. The
systems of record notice for this collection is: <a href="https://www.opm.gov/information-management/privacy-policy/sorn/opm-sorn-central-1-civil-service-retirement-and-insurance-records.pdf">https://www.opm.gov/information-management/privacy-policy/sorn/opm-sorn-central-1-civil-service-retirement-and-insurance-records.pdf</a>.
List of Subjects in 5 CFR Part 894
Administrative practice and procedure, Government employees, Health
facilities, Health insurance, Health professions, Hostages, Iraq,
Kuwait, Lebanon, Military personnel, Reporting and recordkeeping
requirements, Retirement.
Office of Personnel Management.
Alexys Stanley,
Regulatory Affairs Analyst.
Accordingly, OPM proposes to amend 5 CFR part 894 as follows:
PART 894--FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM
0
1. The authority citation for part 894 continues to read as follows:
Authority: 5 U.S.C. 8962; 5 U.S.C. 8992; Subpart C also issued
under section 1 of Pub. L. 110-279, 122 Stat. 2604 (2 U.S.C. 2051);
and Sec. 894.601(b) also issued under Pub. L. 116-92, 133 Stat. 1198
(5 U.S.C. 8956 note).
Subpart A--Administration and General Provisions
0
2. Amend Sec. 894.101 by revising the definitions of ``Premium
conversion'' and ``Stepchild'' to read as follows:
Sec. 894.101 Definitions.
* * * * *
Premium conversion means the payment of FEDVIP premiums by an
employee using pre-tax dollars. See Sec. 892.102 of this chapter for a
discussion of how premium conversion works.
* * * * *
Stepchild means your spouse's child born within or outside marriage
or his or her adopted child. The child of your spouse shall continue to
be considered your stepchild after your divorce from your spouse or the
death of your spouse so long as the child continues to live with you in
a regular parent-child relationship.
* * * * *
0
3. Amend Sec. 894.105 by revising paragraphs (b) and (c) to read as
follows:
Sec. 894.105 Who may correct an error in my enrollment?
* * * * *
(b) OPM may order correction of an administrative error or other
noncompliance with FEDVIP rules in this part if it receives evidence
that it would be against equity (fairness) and good conscience not to
order the correction. Corrections are made at the discretion of OPM and
are not subject to review.
(c) If the correction gives you or a family member retroactive
coverage, you must pay the premiums for all periods of the retroactive
coverage. Retroactive premiums will not be on a pre-tax basis (they are
not subject to premium conversion).
Subpart B--Coverage and Types of Enrollment
0
4. Revise Sec. 894.201 to read as follows:
Sec. 894.201 What types of enrollments are available under FEDVIP?
FEDVIP has three types of enrollment:
(a) Self only, which covers only the enrollee;
(b) Self plus one, which covers the enrollee plus one family
member; and
(c) Self and family, which covers the enrollee and all family
members.
0
5. Amend Sec. 894.202 by revising the section heading to read as
follows:
Sec. 894.202 I am an enrollee; if I enroll for self plus one, may I
decide which family member to cover?
* * * * *
Sec. 894.203 [Removed]
0
6. Remove Sec. 894.203.
Sec. 894.204 [Redesignated as Sec. 894.203]
0
7. Redesignate Sec. 894.204 as Sec. 894.203.
0
8. Revise newly redesignated Sec. 894.203 to read as follows:
Sec. 894.203 May I be enrolled in more than one dental or vision plan
at a time?
You may be enrolled or be covered in a FEDVIP dental plan and a
separate FEDVIP vision plan at the same time. But no one may enroll or
be covered as a family member in a FEDVIP dental or vision plan if he
or she is covered under another person's FEDVIP dental or vision self
plus one or self and family enrollment, except as provided under Sec.
890.302(a)(2) through (4) of this chapter, with respect to dual
enrollments. If two parents of a TEI child are entitled to be a
sponsor, they must choose one parent to be the child's sponsor. Dual
enrollments of TEIs are permitted as provided under Sec. 890.302(a)(2)
of this chapter as applicable to TEI family members.
Subpart C--Eligibility
0
9. Amend Sec. 894.301 by:
0
a. Revising the section heading.
0
b. In paragraph (b), removing the word ``or'' at the end of the
paragraph.
0
c. In paragraph (c)(2), removing the period of the end of the paragraph
and adding ``; or'' in its place.
0
d. Adding paragraph (d).
The revision and addition read as follows:
[[Page 57767]]
Sec. 894.301 Am I eligible to enroll in FEDVIP as an employee?
* * * * *
(d) You are an employee in a position identified by OPM that
provides emergency response services for wildland fire protection
pursuant to 5 CFR 890.102(h); or you are an employee whose employing
agency performs similar types of emergency response services pursuant
to 5 CFR 890.102(i). OPM may limit the coverage of intermittent
employees to the periods of time during which they are in a pay status
pursuant to 5 CFR 890.102(i).
0
10. Amend Sec. 894.302 by:
0
a. Revising the introductory text.
0
b. Removing the undesignated paragraph following the introductory text.
0
c. In paragraph (e)(3):
0
i. Removing ``Sec. 316.401 and Sec. 316.403'' and adding ``Sec. Sec.
316.401 and 316.403'' in its place.
0
ii. Removing the word ``or'' at the end of the sentence.
0
d. In paragraph (e)(4), removing the period at the end of the sentence
and adding ``; or'' in its place.
0
e. Adding paragraph (e)(5).
0
f. Revising paragraphs (f) and (g).
0
g. Adding paragraphs (l) and (m).
The revisions and additions read as follows:
Sec. 894.302 What is an excluded position?
Excluded positions are described in 5 U.S.C. 8901(1)(i), (ii),
(iii), and (iv) and 5 CFR 890.102(c)(1) through (8). You are in an
excluded position if you are:
* * * * *
(e) * * *
(5) You are an employee working on a temporary appointment and if
you meet the conditions in 5 CFR 890.102(j), you are eligible to enroll
in a FEDVIP plan upon notification by your employing office.
(f) Expected to work fewer than six months in each year.
Exceptions: You are eligible if:
(1) You receive an appointment of at least one year's duration as
an Intern under 5 CFR 213.3402(a). To qualify, you must be expected to
be in a pay status for at least one-third of the total period of time
from the date of the first appointment to the completion of the work-
study program.
(2) You are an employee working on a seasonal schedule of less than
6 months in a year, and if you meet the conditions in 5 CFR 890.102(j),
you are eligible to enroll in a FEDVIP plan upon notification by your
employing office.
(g) An intermittent employee (a non-full-time employee without a
prearranged regular tour of duty). Exception: If you are an employee
working on an intermittent schedule and if you meet the conditions in 5
CFR 890.102(j), you are eligible to enroll in a FEDVIP plan upon
notification by your employing office.
* * * * *
(l) For purposes of this subpart, ``qualifying leave without pay
hours'' means hours of leave without pay for purposes of taking leave
under the Family and Medical Leave Act for performance of duty in the
Uniformed Services under the Uniformed Services Employment and
Reemployment Rights Act of 1994, 38 U.S.C. 4301 et seq., for receiving
medical treatment under Executive Order 5396 (July 7, 1930), and for
periods during which workers compensation is received under the Federal
Employees Compensation Act, 5 U.S.C. chapter 81. (m) Once an employee
is properly enrolled under paragraphs (e) through (g) of this section
and meets the conditions in 5 CFR 890.102(j), enrollment will not be
terminated, regardless of his or her actual work schedule or employer
expectations in subsequent years, unless the employee separates from
service, receives a new appointment (in which case eligibility will be
determined by the rules in this part applicable to the new
appointment), or otherwise meets one of the circumstances for
termination or cancellation of coverage in Sec. Sec. 894.601 and
894.602.
Subpart D--Cost of Coverage
0
11. Amend Sec. 894.403 by revising paragraphs (b)(3) and (4) to read
as follows:
Sec. 894.403 Are FEDVIP premiums paid on a pre-tax basis?
* * * * *
(b) * * *
(3) Your enrollment change was made effective retroactively which
resulted in additional premium withholdings, unless it is as a result
of birth or adoption of a child;
(4) You have been approved to pay premiums directly to the
Administrator; or
* * * * *
Subpart E--Enrollment and Changing Enrollment
0
12. Revise Sec. 894.501 to read as follows:
Sec. 894.501 When may I enroll?
You may enroll:
(a) During the annual open season;
(b) Within 60 days after you first become eligible as:
(1) A new employee;
(2) A previously ineligible employee who transfers to a covered
position;
(3) A new survivor annuitant, if not already covered under FEDVIP;
(4) A Federal employee or USPS employee working on a temporary
appointment as stated in Sec. 894.302(e)(5); a Federal employee or
USPS employee working on a seasonal schedule as stated in Sec.
894.302(f); or a Federal employee or USPS employee working on an
intermittent schedule as stated in Sec. 894.302(g);
(5) An employee in a position identified by OPM that provides
emergency response services for wildland fire protection pursuant to 5
CFR 890.102(h); or an employee whose employing agency performs similar
types of emergency response services pursuant to 5 CFR 890.102(i);
(6) A TEI certifying family member, but only if, on your first date
of eligibility to enroll, your sponsor is not a TEI or is deceased, or
for FEDVIP dental coverage, if your sponsor is defined at 5 CFR
890.309(a)(3)(iii); or
(7) A TEI former spouse;
(c) Within 60 days of when you return to Federal employment
following a break in service of at least 30 days;
(d) From 31 days before you or an eligible family member loses
other dental or vision coverage to 60 days after a QLE that allows you
to enroll;
(e) For a sponsor who becomes eligible as a TEI, from 31 days
before you lose other dental or vision coverage as an active duty
service member to 60 days after you become eligible to enroll as a
uniformed services retiree who is a TEI;
(f) From 31 days before you get married to 60 days after;
(g) Within 60 days after returning to Federal employment after
being on leave without pay if you did not have Federal dental or vision
coverage prior to going on leave without pay, or your coverage was
terminated or canceled during your period of leave without pay;
(h) Within 60 days of your annuity or compensation being restored
after having been terminated; or
(i) For a TEI, within 60 days of your uniformed services pay or
uniformed services retirement pay being restored after having been
reduced, forfeited, or terminated.
0
13. Amend Sec. 894.502 by revising paragraphs (b) through (d) to read
as follows:
Sec. 894.502 What are the Qualifying Life Events (QLEs) that allow
me to enroll or become covered in FEDVIP outside of open season?
* * * * *
(b) Your annuity or compensation is restored after having been
terminated;
[[Page 57768]]
(c) You return to pay status as an employee after being on leave
without pay due to deployment to active military duty;
(d) You are an employee and you get married;
* * * * *
0
14. Amend Sec. 894.504 by:
0
a. Redesignating paragraphs (d) and (e) as paragraphs (e) and (f).
0
b. Adding new paragraph (d).
0
c. Revising newly redesignated paragraphs (e) and (f).
The addition and revisions read as follows:
Sec. 894.504 When is my enrollment effective?
* * * * *
(d) Outside of open season, if you are an active duty service
member who becomes a uniformed services retiree (TEI) and enroll or are
enrolled 31 days before you lose other dental or vision coverage, your
enrollment is effective no earlier than the date you lost other
coverage.
(e) A QLE enrollment or change is effective the 1st day of the pay
period following the date of your QLE.
(f)(1) A belated open season enrollment or change is effective
retroactive to the date it would have been effective if you had made a
timely enrollment or request for a change.
(2) Any belated enrollment or change outside of open season that
goes beyond the allowable 60-day enrollment timeframe is effective
retroactive to the 1st day of the pay period following the one in which
you became newly eligible or the date of your QLE.
(3) You must pay any retroactive premiums due to a belated
enrollment or request for a change.
0
15. Amend Sec. 894.511 by adding paragraphs (c) and (d) to read as
follows:
Sec. 894.511 What are the QLEs that are consistent with decreasing my
type of enrollment?
* * * * *
(c) You are a sponsor and your TEI spouse deploys to active
military duty.
(d) You are an enrollee and your family member or TEI family member
becomes eligible for dental or vision benefits from the Department of
Veterans Affairs.
0
16. Revise Sec. 894.512 to read as follows:
Sec. 894.512 What happens if I leave Federal employment and then
return?
(a) Your FEDVIP coverage terminates at the end of the pay period in
which you separate from Government employment. Exception: If you
separate for retirement or while in receipt of workers' compensation as
defined in Sec. 894.701, your FEDVIP coverage continues.
(b)(1) If you return to Federal employment after a break in
employment of fewer than 30 days, and you were not previously enrolled
in FEDVIP, you may not enroll until the next open season or unless you
have a QLE that allows you to enroll.
(2) If you return to Federal employment after a break in service of
fewer than 30 days, and you were previously enrolled in FEDVIP, you may
reenroll in the same plan(s) and plan option and with the same type of
enrollment you had before you separated. Exceptions:
(i) If you were enrolled in a dental or vision plan with a
restricted geographic service area, and you have since moved out of the
plan's service area, you may change to a different dental or vision
plan that serves that area.
(ii) If you have since gained or lost an eligible family member,
you may change your type of enrollment consistent with the change in
the number of eligible family members.
(3) If you return to Federal employment as a new hire after a break
in service of 30 days or more, you may enroll if you were not
previously enrolled, change your dental or vision plan, or change your
type of enrollment.
Subpart F--Termination or Cancellation of Coverage
0
17. Amend Sec. 894.601 by adding paragraph (i) to read as follows:
Sec. 894.601 When does my FEDVIP coverage stop?
* * * * *
(i) If you are a sponsor and during the course of your enrollment,
you become eligible for dental or vision benefits from the Department
of Veterans Affairs, you may cancel your enrollment. Your cancellation
will become effective at the end of the pay period that you submit your
request pursuant to Sec. 894.602(c). If you cancel a self plus one or
self and family enrollment, as sponsor, pursuant to Sec. 894.815, you
must notify your family members of changes in your enrollment. You will
still be the sponsor but no longer the enrollee, and pursuant to Sec.
894.806, your family members would only be eligible for dental
coverage, and a TEI certifying family member would have to reenroll in
and cover all TEI family members for dental coverage only.
0
18. Revise Sec. 894.602 to read as follows:
Sec. 894.602 May I cancel my enrollment at any time?
Generally, an enrollee may only cancel an enrollment during an open
season. Exceptions: You may cancel your dental and/or vision enrollment
if:
(a) You are an employee and transfer to an eligible position with a
Federal agency that provides dental or vision coverage with 50 percent
or more employer-paid premiums and the employee enrolls in that
program.
(b) You are an employee and you or your spouse deploy to active
military duty.
(c) You are an enrollee and during the course of your enrollment,
you become eligible for and enroll in Department of Veterans Affairs
(VA) dental or vision benefits. If you are an enrollee who is a
sponsor, you must notify your family members of changes in your
enrollment pursuant to Sec. 894.815. Your family members will only be
eligible for FEDVIP dental coverage since you are a TEI-D who is not
enrolled in FEDVIP and receives VA dental services and meets one of the
conditions in Sec. 894.309(a)(3)(iii). See Sec. Sec. 894.806 and
894.815(b). Upon cancellation of the enrollment, you will still be the
sponsor but no longer the enrollee, and a TEI certifying family member
must reenroll in and cover all TEI family members for FEDVIP dental
coverage only and upon reenrollment may change from one dental plan to
another.
(d) Cancellations under paragraphs (a) and (b) of this section will
become effective at the end of the pay period that you submit your
request, and cancellations under paragraph (c) of this section will
become effective at the end of the pay period that your cancellation
was approved.
Subpart G--Annuitants and Compensationers
0
19. Amend Sec. 894.704 by revising the section heading to read as
follows:
Sec. 894.704 What happens if I retire from Federal employment and
then come back to work for the Federal Government?
* * * * *
Sec. Sec. 894.101, 894.301, 894.302, 894.308, 894.403, 894.404,
894.405, 894.406, 894.510, 894.601, 894.704, and 894.901 [Amended]
0
20. In addition to the amendments above to 5 CFR part 894, in the table
below, for each section indicated in the left column, remove the text
indicated in the middle column from wherever it appears, and add in its
place the text indicated in the right column:
[[Page 57769]]
----------------------------------------------------------------------------------------------------------------
Section Remove Add
----------------------------------------------------------------------------------------------------------------
Section 894.101 introductory text..... enrollee................. enrollee.
Section 894.101, definition of enrollee................. enrollee.
``Acquiring an eligible child'',
paragraph (4).
Section 894.101, definition of enrollee's............... enrollee's.
``Acquiring an eligible child'',
paragraph (6).
Section 894.101, definition of enrollee................. enrollee.
``Acquiring an eligible child'',
paragraph (6).
Section 894.101, definition of employee................. employee.
``Annuitant''.
Section 894.101, definition of employees................ employees.
``Annuitant''.
Section 894.101, definition of enrollee................. enrollee.
``Child'', paragraph (1)(iii).
Section 894.101, definition of employee................. employee.
``Covered position''.
Section 894.101, definition of enrollee................. enrollee.
``Dependent''.
Section 894.101, definition of employee additionally.... employee additionally.
``Employee''.
Section 894.101, definition of employee of the District. employee of the District.
``Employee''.
Section 894.101, definition of Administrator's.......... Administrator's.
``Enrollment reconsideration''.
Section 894.101, definition of enrollee................. enrollee.
``Recognized natural child''.
Section 894.101, definition of enrollee................. enrollee.
``Regular parent-child relationship''.
Section 894.301(c)(1)................. employee................. employee.
Section 894.302(d).................... employees................ employees.
Section 894.302(k)(1) and (2)......... employee................. employee.
Section 894.308(a) and (b) enrollee................. enrollee.
introductory text.
Section 894.308(b)(2)................. enrollee's............... enrollee's.
Section 894.308(b)(3)................. enrollee................. enrollee.
Section 894.403(a).................... employee................. employee.
Section 894.404....................... employees................ employees.
Section 894.405(a).................... Administrator............ Administrator.
Section 894.405(c).................... enrollee................. enrollee.
Section 894.406(c).................... enrollee................. enrollee.
Section 894.510(a) introductory text.. type of enrollment....... type of enrollment:
Section 894.510(c)(1)................. type of enrollment....... type of enrollment.
Section 894.601(b).................... enrollee................. enrollee.
Section 894.704(c).................... employee................. employee.
Section 894.901(a) and (b)............ enrollees................ enrollees.
----------------------------------------------------------------------------------------------------------------
[FR Doc. 2021-22281 Filed 10-18-21; 8:45 am]
BILLING CODE 6325-64-P
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</html>Indexed from Federal Register on October 19, 2021.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.