Rule2022-24849
Enhancing Stability and Flexibility for the Federal Long Term Care Insurance Program (FLTCIP)-Abbreviated Underwriting, Applications for FLTCIP Coverage, and Technical Corrections
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 16, 2022
Effective
November 16, 2022
Issuing agencies
Personnel Management Office
Abstract
The Office of Personnel Management (OPM) is issuing a final regulation to support enhancing stability and flexibility in FLTCIP by amending when abbreviated underwriting will be offered to prospective enrollees and finalizing rules for the suspension of applications for coverage and the requirements around any such suspension periods. OPM is also finalizing technical corrections for the sake of clarity and to remove redundancies. This final rule adopts the proposed regulations with one technical change correcting the provision related to the Federal appeals board that is delegated the authority to resolve contract disputes between the Carrier and OPM. Finally, OPM may effectuate a suspension period after publication of this final rule with a separate document in the Federal Register.
Full Text
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<title>Federal Register, Volume 87 Issue 220 (Wednesday, November 16, 2022)</title>
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[Federal Register Volume 87, Number 220 (Wednesday, November 16, 2022)]
[Rules and Regulations]
[Pages 68595-68599]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-24849]
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Rules and Regulations
Federal Register
________________________________________________________________________
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
under 50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by the Superintendent of Documents.
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Federal Register / Vol. 87, No. 220 / Wednesday, November 16, 2022 /
Rules and Regulations
[[Page 68595]]
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 875
RIN 3206-AO21
Enhancing Stability and Flexibility for the Federal Long Term
Care Insurance Program (FLTCIP)--Abbreviated Underwriting, Applications
for FLTCIP Coverage, and Technical Corrections
AGENCY: Office of Personnel Management.
ACTION: Final rule.
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SUMMARY: The Office of Personnel Management (OPM) is issuing a final
regulation to support enhancing stability and flexibility in FLTCIP by
amending when abbreviated underwriting will be offered to prospective
enrollees and finalizing rules for the suspension of applications for
coverage and the requirements around any such suspension periods. OPM
is also finalizing technical corrections for the sake of clarity and to
remove redundancies. This final rule adopts the proposed regulations
with one technical change correcting the provision related to the
Federal appeals board that is delegated the authority to resolve
contract disputes between the Carrier and OPM. Finally, OPM may
effectuate a suspension period after publication of this final rule
with a separate document in the Federal Register.
DATES: Effective on November 16, 2022. OPM will publish a separate
document announcing the effective date of a suspension period in the
Federal Register.
FOR FURTHER INFORMATION CONTACT: Dyan Dyttmer, Senior Policy Analyst,
<a href="/cdn-cgi/l/email-protection#c0a4b9a1aeeea4b9b4b4ada5b280afb0adeea7afb6"><span class="__cf_email__" data-cfemail="fd99849c93d39984898990988fbd928d90d39a928b">[email protected]</span></a>, (202) 936-0152.
SUPPLEMENTARY INFORMATION: On June 3, 2022, OPM published proposed
regulations (87 FR 33653), which proposed amendments to 5 CFR part 875
to support FLTCIP stability and flexibility by amending when
abbreviated underwriting will be offered to prospective enrollees and
proposing rules for the suspension of applications for coverage and the
requirements around any such suspension periods. OPM also proposed
technical corrections for the sake of clarity and to remove
redundancies. Finally, with the publication of the proposed rule, OPM
provided notice of an anticipated suspension period.
The comment period for the proposed rule closed on July 5, 2022.
OPM received three comments from individuals on the proposed rule, and
a Federal appeals board contacted us regarding OPM's delegation of
authority to resolve contract disputes in 5 CFR 875.109. A summary of
the comments OPM received follows, along with our responses to the
comments and a technical change OPM is making to the final rule in
response to the comments.
Responses to Comments on the Proposed Rule
One commenter questioned OPM's authority to authorize a suspension
period and to change the 60-day abbreviated underwriting period allowed
to newly eligible active workforce members and spouses. The commenter
asserted that OPM lacked authority to suspend applications based on the
statutory language in 5 U.S.C. 9002(a) which states that OPM shall
establish and administer the FLTCIP for which eligible individuals may
obtain long term care insurance coverage. The commenter stated that the
statutory construct should be interpreted to mean that OPM must offer
eligible individuals an opportunity to enroll in the FLTCIP. Another
commenter questioned OPM's authority to suspend applications for a
period, as this would reduce premiums received from enrollees prevented
from enrolling and therefore increase premiums for those already
enrolled.
OPM disagrees with these comments and concludes that it has the
authority to institute these changes to FLTCIP. OPM's authority to
establish and administer the Program brings with it the obligation to
oversee the Program's functioning and to protect both current and
prospective enrollees, as well as the health of the Program as a whole.
OPM has authority under 5 U.S.C. 9008 to prescribe regulations to
effectuate this authority, including to create through regulation the
ability to suspend applications for coverage, with notice and for a
reasonable period of time, when necessary for the proper administration
of the Program. It is also within OPM's authority to alter through
regulation the circumstances under which abbreviated underwriting may
be offered. As OPM explained in the preamble of the proposed rule, the
purpose of creating through regulation the ability to suspend
applications is to protect eligible individuals from applying to enroll
when OPM has determined that underwriting processes may need revisions
or when the current premium rates offered to new applicants may not
reasonably and equitably reflect the cost of the benefits as required
under 5 U.S.C. 9003(b)(2). Finally, OPM acknowledges that if FLTCIP is
suspended for a period this would prevent currently eligible and newly
eligible individuals from applying for coverage during the suspension,
and individuals may have to wait to apply after the suspension period
or seek alternative coverage. As explained in the preamble of the
proposed rule, the number of potential new enrollees would be small.
OPM will only suspend applications when it is in the best interest of
the Program, as required by this final rule.
One commenter stated that the proposed rule is arbitrary and
capricious under the Administrative Procedure Act because OPM stated in
the preamble that it considered the Notice of Proposed rulemaking to
serve as the notice required under the proposed 5 CFR 875.110(b), which
is being finalized in this final rule. OPM is clarifying that the
proposed rule served as notice to the public that OPM intends to
suspend FLTCIP applications and establishes the process for suspension,
amends abbreviated underwriting rules, and modifies the regulations.
OPM is clarifying that these actions, including the process for
suspension as proposed in 5 CFR 875.110, will be effectuated after
publication of the final rule, not after the proposed rule as the
commenter stated.
One commenter questioned whether OPM consulted with the Secretaries
of the uniformed services before promulgating the rule as required by 5
U.S.C. 9008(c). OPM fulfilled the
[[Page 68596]]
requirement of consultation through the inter-agency review process
before it published the proposed rule.
All three of the commenters expressed general concerns about the
manner in which OPM administers FLTCIP. They suggested that OPM should
act in a fashion similar to state insurance regulators, such as by
adopting standards set by the National Association of Insurance
Commissioners (NAIC) for long term care insurance rate increases,
conducting public rate hearings, and taking expert and enrollee
testimony. They also suggested that OPM should be more transparent in
its operation of the Program, such as by making public its
communications with the FLTCIP Carrier. Finally, one commenter
suggested that OPM should require the FLTCIP Carrier and administrator
to be more transparent regarding their operations, such as by
publishing quarterly reports with information about pay-outs, expenses,
reserves, and investment mix.
OPM acknowledges the importance of transparency and consumer
protections for FLTCIP enrollees. OPM complies with consumer
protections in the FLTCIP statute and the Health Insurance Portability
and Accountability Act of 1996, including by providing a contingent
benefit upon lapse, inflation protection options, portability, and
guaranteed renewability (except when enrollees fail to pay their
premiums). As part of contracting, OPM and the FLTCIP Carrier agree to
specific requirements for the insurer to follow, including certain NAIC
model standards. While OPM will consider these comments in its future
administration of the Program, the comments are outside the scope of
this rule and require no further response.
The Armed Services Board of Contract Appeals (ASBCA) also contacted
OPM seeking clarification regarding the appropriate board of contract
appeals to resolve contract disputes between OPM and the FLTCIP
Carrier. The ASBCA correctly noted that although OPM's regulations
currently identified the ASBCA as the board of contract appeals with
jurisdiction, the National Defense Authorization Act for Fiscal Year
2006 created the Civilian Board of Contract Appeals (CBCA) and
specified the jurisdiction of the ASBCA and CBCA. As an executive
agency, OPM contract disputes are within the jurisdiction of the CBCA
pursuant to 41 U.S.C. 7105(b). OPM is making a technical correction
that updates our regulations to reflect that the CBCA, not the ASBCA,
will resolve contract disputes related to FLTCIP.
Notice of Suspension Period
OPM will issue a separate Federal Register document announcing the
beginning date and anticipated length of any suspension period at least
30 days before the suspension period starts.
Changes From Proposed Rule
OPM has made a change to the final rule to clarify 5 CFR 875.110.
The proposed rule included the process for suspending applications for
FLTCIP coverage after publication of a document in the Federal
Register. The proposed rule also included a process for extending such
a suspension. The final rule clarifies that each extension to the
suspension period is limited to 24 months. Each extension will be based
on current information supporting OPM's conclusion that continuing the
suspension is in the best interest of the Program, and each extension
will require publication in the Federal Register.
OPM has made one technical correction to this final rule. This
final rule clarifies in 5 CFR 875.109 that the Civilian Board of
Contract Appeals has jurisdiction to resolve contract disputes related
to FLTCIP. Except for the change above and this technical correction,
OPM is issuing this final rule with no other changes.
Expected Impact of the Final Rule
The changes in this final rule, including underwriting changes and
any future suspensions of applications for FLTCIP coverage, will not
affect current FLTCIP enrollees. Individuals already enrolled in FLTCIP
will retain their coverage as long as they continue to pay premiums.
The changes impact new enrollment and are expected to impose no more
than de minimus administrative costs to Federal agencies since FLTCIP
is an enrollee-pay-all program, and there is no Government contribution
toward enrollee premiums.
OPM expects that the rule will not result in a significant impact
on the eligible or newly eligible population. Approximately 6,000
eligible individuals enroll in FLTCIP annually, which is less than 0.1%
of 11 million eligible federal and military actives and annuitants (not
including spouses and other qualified relatives who are also eligible).
This low percentage mirrors the low uptake for purchasing long term
care insurance (LTCI) in the broader LTC market. According to a
Treasury Report of the Federal Interagency Task Force on Long-Term Care
Insurance, sales of new LTCI policies have declined since the early
2000s, as numerous insurers decided to exit the market due to the poor
financial performance of the product line; and low take-up rates for
LTCI appear to stem in part from low demand for these products.\1\ The
report identifies factors influencing demand including: substitutes for
private LTCI such as Medicaid; unpaid care or the ability to receive
informal care from family; a desire to leave assets to heirs can
suppress demand because people may be motivated to postpone consumption
and save money; lack of information and awareness about LTC costs and
the ways to finance those costs; lack of trust in insurers; and
premiums, costs, and loads.\2\
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\1\ U.S. Department of the Treasury, ``Long-Term Care Insurance:
Recommendations for Improvement of Regulation.'' Report of the
Federal Interagency Task Force on Long-Term Care Insurance, August
2020, <a href="https://home.treasury.gov/system/files/136/Report-Federal-Interagency-Task-Force-Long-TermCare-Insurance.pdf">https://home.treasury.gov/system/files/136/Report-Federal-Interagency-Task-Force-Long-TermCare-Insurance.pdf</a>.
\2\ See footnote 1.
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Since less than 0.1% of the eligible population annually enroll in
FLTCIP, based on this trend and market trends, it is unlikely that
newly eligible individuals would have a high demand for LTCI during a
suspension of applications. Further, there are other options for
eligible individuals to plan for LTC needs. Some other options to plan
for LTC needs during a suspension period include the following: saving
for future needs by setting aside funds to invest in a 401(k), an IRA,
or a non-retirement investment account; investing in a long-term care
annuity; purchasing a ``combination'' or ``hybrid'' product that
combines a life insurance policy with a LTC rider; or purchasing a
short-term care insurance policy.
Indirect Effects on Other Parties
OPM does not believe this regulation will have a large impact on
the broader LTCI market. Approximately 6,000 eligible individuals
enroll in FLTCIP annually, which is less than 0.1% of the eligible
population. At an average premium of $125 per month or $1,500 per year,
the forgone annual premium for new enrollees would total less than $10
million per year during any FLTCIP enrollment suspension. As discussed
above, affected individuals would likely pursue substitute savings and
insurance products during a suspension period. OPM estimates that the
magnitude of the forgone $10 million on other parties, such as LTC
insurers in the LTCI market, would be quite small compared to the
larger LTCI market.
[[Page 68597]]
Benefits of the Final Rule
This final rule establishes provisions for OPM to suspend
applications to FLTCIP when it is in the best interest of the program;
for example, in order to allow for adjustment to underwriting processes
or to reprice premium rates after a review of actuarial assumptions.
The rule aims to protect eligible individuals from applying to enroll
when it has been determined that underwriting processes may need
revisions or when the current premium rates may not reflect the cost of
the benefits provided due to market volatility and changes to
projections about future costs. This allows OPM and the FLTCIP carrier
to agree on underwriting changes or new premium rates that reasonably
and equitably reflect the cost of the benefits provided as required by
the FLTCIP statute.
Executive Orders 12866 and 13563
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, distributive impacts, and equity).
Executive Order 13563 emphasizes the importance of quantifying both
costs and benefits and of reducing costs, harmonizing rules, and
promoting flexibility. This rule has been designated as a significant,
but not economically significant, regulatory action under Executive
Order 12866.
Congressional Review Act
This rule is not a major rule under 5 U.S.C. 804(2). Subtitle E of
the Small Business Regulatory Enforcement Fairness Act of 1996
(codified at 5 U.S.C. 801-808), also known as the Congressional Review
Act or CRA, generally provides that before a rule may take effect, the
agency promulgating the rule must submit a rule report, which includes
a copy of the rule, to each House of the Congress and to the
Comptroller General of the United States. A major rule under the CRA
cannot take effect until 60 days after it is published in the Federal
Register.
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.
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.
List of Subjects in 5 CFR Part 875
Administration and general provisions, Eligibility, Cost, and
Coverage.
Office of Personnel Management.
Stephen Hickman,
Federal Register Liaison.
Accordingly, OPM amends 5 CFR part 875 as follows:
PART 875--FEDERAL LONG TERM CARE INSURANCE PROGRAM
0
1. The authority citation for part 875 continues to read as follows:
Authority: 5 U.S.C. 9008; Pub. L. 116-92, 133 Stat. 1198 (5
U.S.C. 8956 note).
Subpart A--Administration and General Provisions
0
2. Amend Sec. 875.101 by revising the definitions of ``Carrier'',
``Eligible individual'', and ``Free look'' and adding in alphabetical
order a definition for ``Special application period'' to read as
follows:
Sec. 875.101 Definitions.
* * * * *
Carrier means a ``qualified carrier'' as defined in section 9001 of
title 5, United States Code, with which OPM has contracted to provide
long term care insurance coverage under this section. A Carrier may
designate one or more administrators to perform some of its
obligations.
* * * * *
Eligible individual means an employee, annuitant, member of the
uniformed services, retired member of the uniformed services or
qualified relative, as defined in section 9001 of title 5, United
States Code.
* * * * *
Free look means that within 30 days after you are approved for
coverage and receive the Benefit Booklet, you may cancel that coverage
if you are not satisfied with it and receive a refund of any premium
you paid for that coverage. It will be as if the coverage was never
issued.
* * * * *
Special application period is a period in which active workforce
members and their spouses may apply based on abbreviated underwriting.
Such application periods will be provided for pursuant to OPM's
authority in section 9008 of title 5, United States Code.
* * * * *
0
3. Revise Sec. 875.102 to read as follows:
Sec. 875.102 Where do I send benefit claims?
You must submit your benefit claims to the FLTCIP Carrier.
0
4. Amend Sec. 875.107 by removing ``and'' at the end of paragraph (b),
removing the semicolon and adding a period at the end of paragraph (c)
and adding a semicolon in its place, and adding paragraphs (d) and (e).
The additions read as follows:
Sec. 875.107 What are OPM's responsibilities as regulator under this
Program?
* * * * *
(d) Suspending applications for FLTCIP coverage, including coverage
increases as specified in Sec. 875.110; and
(e) Holding special application periods as specified in Sec.
875.402.
0
5. Revise Sec. 875.109 to read as follows:
Sec. 875.109 Which board of contract appeals has jurisdiction for
resolving contract disputes between OPM and the Carrier?
For purposes of applying chapter 71 of title 41 to disputes arising
between OPM and the Carrier, the Civilian Board of Contract Appeals has
jurisdiction to decide an appeal relative to such a dispute.
0
6. Add Sec. 875.110 to read as follows:
Sec. 875.110 May OPM suspend applications for FLTCIP coverage?
(a) OPM may suspend applications for FLTCIP coverage, including
coverage increases, when OPM determines that a suspension is in the
best interest of the Program.
(b) OPM will issue a document in the Federal Register with the
effective date of the suspension period, during which no applications
for FLTCIP coverage will be accepted. The effective date will be
determined at the discretion of the Director and will be at least 30
days after the publication date of the document.
(c) The duration of the suspension period, as determined at the
discretion of the Director and not to exceed 24 months unless
subsequently extended, will be announced in a document published in the
Federal Register.
[[Page 68598]]
(d) At least 30 days before the end of the suspension period, OPM
may issue a document in the Federal Register announcing an extension of
the suspension period when OPM determines that such extension is in the
best interest of the Program. The duration of any extension to the
suspension period will not exceed 24 months, unless subsequently
extended by additional periods of suspension, each not to exceed 24
months.
Subpart B--Eligibility
0
7. Revise Sec. 875.203 to read as follows:
Sec. 875.203 Am I eligible if I separated under the FERS MRA+10
provision?
If you have separated from service under the FERS Minimum
Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C.
8412(g), and have postponed receiving an annuity under that provision,
you are eligible to apply for coverage as an annuitant under this part.
0
8. Amend Sec. 875.204 by revising paragraph (c) to read as follows:
Sec. 875.204 Am I eligible as a member of the uniformed services?
* * * * *
(c) You are not eligible to apply for coverage solely because you
belong to the Individual Ready Reserve. The Individual Ready Reserves
includes Reservists who are assigned to a Voluntary Training Unit in
the Naval Reserve and Category E in the Air Force Reserve.
Sec. 875.206 [Removed and Reserved]
0
9. Remove and reserve Sec. 875.206.
0
10. Revise Sec. 875.207 to read as follows:
Sec. 875.207 What happens if I am in nonpay status during a special
application period?
(a) If you return to pay status from nonpay status during a special
application period, you have 60 days from the date of your return, or
until the end of the special application period, whichever gives you
more time, to apply for coverage pursuant to the rules of that special
application period.
(b) If you return to pay status from nonpay status within 180 days
after the end of the special application period, you have 60 days from
the date of your return to apply for coverage pursuant to the rules of
that special application period.
(c) Paragraphs (a) and (b) of this section apply only when you have
been in nonpay status for more than one-half of a special application
period, unless you went into nonpay status for a reason beyond your
control.
0
11. Amend Sec. 875.209 by revising paragraph (a) to read as follows:
Sec. 875.209 How do I demonstrate that I am eligible to apply for
coverage?
(a) When you submit your application for coverage, you must make
known your status as a member of an eligible group. If you are a
qualified relative, you need to provide identifying information about
the workforce member who makes you an eligible individual.
* * * * *
0
12. Amend Sec. 875.210 by revising paragraph (b)(1) to read as
follows:
Sec. 875.210 What happens if I become ineligible after I submit an
application?
* * * * *
(b) * * *
(1) When you are involuntarily separated from Federal civilian
service (except for misconduct) or from the uniformed services (except
for a dishonorable discharge); or, when you are the qualified relative
of a workforce member who has been involuntarily separated from Federal
civilian service (except for misconduct) or from the uniformed services
(except for a dishonorable discharge).
* * * * *
0
13. Revise Sec. 875.211 to read as follows:
Sec. 875.211 What happens if my eligibility status changes after I
submit my application?
(a) If you applied as an active workforce member, and you retire or
separate from service after you submit an application for coverage, but
before your coverage becomes effective, you must notify the Carrier of
this change.
(b) If you applied with abbreviated underwriting during a special
application period as an active workforce member or the spouse of an
active workforce member, and the active workforce member retires or
separates from service before your coverage becomes effective, you must
reapply based on your new eligibility status.
0
14. Revise Sec. 875.213 to read as follows:
Sec. 875.213 May I apply as a qualified relative if I am the
domestic partner of an employee or annuitant?
You may apply for coverage as a qualified relative if you are a
domestic partner, as described in Sec. 875.101. As prescribed by OPM,
you will be required to provide documentation to demonstrate that you
meet these requirements, and you must submit to full underwriting
requirements. However, as explained in Sec. 875.210, if you lose your
status as a domestic partner, and therefore status as a qualified
relative, before your coverage goes into effect, you are no longer
eligible for FLTCIP coverage.
Subpart D--Coverage
0
15. Revise Sec. 875.401 to read as follows:
Sec. 875.401 How do I apply for coverage?
To apply for coverage, you must complete the application in a form
appropriate for your eligibility status as prescribed by the Carrier
and approved by OPM.
0
16. Revise Sec. 875.402 to read as follows:
Sec. 875.402 When will open seasons be held?
(a) There are no regularly scheduled open seasons for long term
care insurance. OPM may have special application periods in which
active workforce members and their spouses may apply based on
abbreviated underwriting.
(b) In situations where OPM determines that it is appropriate to
have a special application period, OPM will announce any such period
via publication of a document in the Federal Register. The document
will include the requirements for eligible applicants during the
special application period.
0
17. Revise Sec. 875.403 to read as follows:
Sec. 875.403 When may I apply for coverage?
If you are an eligible individual, you may apply at any time
outside of a suspension period described in Sec. 875.110. You will be
subject to full underwriting requirements. The only exceptions to the
full underwriting requirements are described in Sec. 875.402. You may
apply as a qualified relative of a workforce member even if the
workforce member does not apply for coverage.
0
18. Revise Sec. 875.404 to read as follows:
Sec. 875.404 What is the effective date of coverage?
(a)(1) The effective dates of coverage under special application
period enrollments will be announced in a document published in the
Federal Register that announces special application period dates.
(2) If you are an active workforce member or the spouse of an
active workforce member and you are applying for coverage during a
special application period, the workforce member must be
[[Page 68599]]
actively at work at least 1 day during the calendar week immediately
before the week which contains your coverage effective date for your
coverage to become effective. You must inform the Carrier if you do not
meet this requirement. In the event you do not meet this requirement,
the Carrier will issue you a revised effective date, which will be the
1st day of the next month. The workforce member also must meet the
actively at work requirement for any revised effective date for
coverage to become effective, or you will be issued another revised
effective date in the same manner.
(b) If you enroll at any time outside of a special application
period, your coverage effective date is the 1st day of the month after
the date your application is approved.
0
19. Revise Sec. 875.405 to read as follows:
Sec. 875.405 May a spouse, domestic partner, or other qualified
relative of a workforce member apply for coverage?
A spouse, domestic partner, or other qualified relative of a
workforce member may apply for coverage with full underwriting at any
time following the marriage or commencing date of the domestic
partnership, outside of a suspension period as described in Sec.
875.110.
0
20. Amend Sec. 875.406 by revising paragraph (a)(1) to read as
follows:
Sec. 875.406 May I change my coverage?
(a) * * *
(1) At any time outside of a suspension period described in Sec.
875.110, you may apply to increase your coverage with full
underwriting.
* * * * *
0
21. Revise Sec. 875.410 to read as follows:
Sec. 875.410 May I continue my coverage when I leave Federal or
military service?
If you are an active workforce member, your coverage will
automatically continue when you leave active service, as long as the
Carrier continues to receive the required premium when due.
0
22. Revise Sec. 875.413 to read as follows:
Sec. 875.413 Is it possible to have coverage reinstated?
(a) Under certain circumstances, your coverage can be reinstated.
The Carrier will reinstate your coverage if it receives proof
satisfactory to it, within 6 months from the date of the written notice
of termination, that you suffered from a cognitive impairment or loss
of functional capacity, before the grace period ended, that caused you
to miss making premium payments. In that event, you will not be
required to submit to underwriting. Your coverage will be reinstated
retroactively to the termination date but you must pay back premiums
for that period. The premium will be the same as it was prior to
termination.
(b) If your coverage has terminated because you did not pay
premiums or because you requested cancellation, the Carrier may
reinstate your coverage within 12 months from the date of the written
notice of termination at your request. You will be required to reapply
based on full underwriting, and the Carrier will determine whether you
are still insurable. If you are insurable, your coverage will be
reinstated retroactively to the termination date and you must pay back
premiums for that period. The premium will be the same as it was prior
to termination.
[FR Doc. 2022-24849 Filed 11-14-22; 8:45 am]
BILLING CODE 6325-63-P
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