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

Published date02 April 2019
Citation84 FR 12569
Record Number2019-06223
SectionProposed rules
CourtPersonnel Management Office
Federal Register, Volume 84 Issue 63 (Tuesday, April 2, 2019)
[Federal Register Volume 84, Number 63 (Tuesday, April 2, 2019)]
                [Proposed Rules]
                [Pages 12569-12573]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2019-06223]
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                OFFICE OF PERSONNEL MANAGEMENT
                48 CFR Parts 1603 and 1652
                RIN 3206-AN56
                Federal Employees Health Benefits Acquisition Regulations: Self
                Plus One and Contract Matrix Update
                AGENCY: Office of Personnel Management.
                ACTION: Proposed rule.
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                SUMMARY: The Office of Personnel Management (OPM) is issuing this
                [[Page 12570]]
                proposed 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:
                 Federal Rulemaking Portal: http://www.regulations.gov.
                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 http://www.regulations.gov as they are
                received without change, including any personal identifiers or contact
                information.
                FOR FURTHER INFORMATION CONTACT: Michael W. Kaszynski, Senior Policy
                Analyst, at [email protected] or 202-606-1994.
                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 Sec. 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
                [[Page 12571]]
                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 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.
                List of Subjects in 48 CFR Parts 1603 and 1652
                 Government employees, Government procurement, Health insurance,
                Reporting and recordkeeping requirements.
                 Office of Personnel Management.
                Alexys Stanley,
                Regulatory Affairs Analyst.
                 Accordingly, OPM is proposing to amend title 48, Code of Federal
                Regulations, parts 1603 and 1652 as follows:
                PART 1603--IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF
                INTEREST
                0
                1. The authority citation for part 1603 continues to read as follows:
                 Authority: 5 U.S.C. 8913; 40 U.S.C. 486(c); 48 CFR 1.301.
                0
                2. Section 1603.7002 paragraph (e) is revised to read as follows:
                1603.7002 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.
                PART 1652--CONTRACT CLAUSES
                0
                3. The authority citation for part 1652 continues to read as follows:
                 Authority: 5 U.S.C. 8913; 40 U.S.C. 486(c); 48 CFR 1.301.
                0
                4. Section 1652.370 is revised as follows
                1652.370 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
                ----------------------------------------------------------------------------------------------------------------
                 Use with Use with
                 Clause Title Use status experience community rate
                 rated contracts contracts
                ----------------------------------------------------------------------------------------------------------------
                FAR 52.202-1................. Definitions................... M T T
                FAR 52.203-3................. Gratuities.................... M T T
                FAR 52.203-5................. Covenant Against Contingent M T T
                 Fees.
                FAR 52.203-7................. Anti-Kickback Procedures...... M T T
                FAR 52.203-12................ Limitation on Payments to M T T
                 Influence Certain Federal
                 Transactions.
                FAR 52.203-13................ Contractor Code of Business M T T
                 Ethics and Conduct.
                FAR 52.203-17................ Contractor Employee M T T
                 Whistleblower Rights and
                 Requirement to Inform
                 Employees of Whistleblower
                 Rights.
                FAR 52.203-19................ Prohibition Requiring Internal M T T
                 Confidentiality Agreements or
                 Statements.
                FAR 52.204-7................. System For Rewards Management. M T T
                FAR 52.204-9................. Personnel Identity M T T
                 Verification of Contractor
                 Personnel.
                FAR 52.204-21................ Basic Safeguarding of M T T
                 Contractor Information
                 Systems.
                FAR 52.209-9................. Updates of Publically M T T
                 Available Information
                 Regarding Responsibility
                 Matters.
                1652.203-70.................. Misleading, Deceptive, or M T T
                 Unfair Advertising.
                1652.204-70.................. Contractor Records Retention.. M T T
                1652.204-71.................. Coordination of Benefits...... M T T
                1652.204-72.................. Filing Health Benefit Claims/ M T T
                 Court Review of Disputed
                 Claims.
                1652.204-73.................. Taxpayer Identification Number M T T
                1652.204-74.................. Large Provider Agreements..... M T
                [[Page 12572]]
                
                FAR 52.209-6................. Protecting the Government's M T T
                 Interest When Subcontracting
                 With Contractors Debarred,
                 Suspended, or Proposed for
                 Debarment.
                FAR 52.215-2................. Audit & Records--Negotiation.. M T T
                FAR 52.215-10................ Price Reduction for Defective M T
                 Cost or Pricing Data.
                FAR 52.215-12................ Subcontractor Certified Cost M T
                 or Pricing Data.
                FAR 52.215-15................ Pension Adjustments and Asset M T
                 Reversions.
                FAR 52.215-18................ Reversion or Adjustment of M T
                 Plans for Postretirement
                 Benefits (PRB) Other Than
                 Pensions.
                1652.215-70.................. Rate Reduction for Defective M T T
                 Pricing or Defective Cost or
                 Pricing Data.
                1652.215-71.................. Investment Income............. M T
                1652.216-70.................. Accounting and Price M ............... T
                 Adjustment.
                1652.216-71.................. Accounting and Allowable Cost. M T
                FAR 52.219-8................. Utilization of Small Business M T T
                 Concerns.
                FAR 52.222-1................. Notice to the Government of M T T
                 Labor Disputes.
                FAR 52.222-3................. Convict Labor................. M T T
                FAR 52.222-4................. Contract Work Hours and Safety M T T
                 Standards Act--Overtime
                 Compensation.
                FAR 52.222-21................ Prohibition of Segregated M T T
                 Facilities.
                FAR 52.222-26................ Equal Opportunity............. M T T
                FAR 52.222-29................ Notification of Visa Denial... A T T
                FAR 52.222-35................ Equal Opportunity for Veterans M T T
                FAR 52.222-36................ Equal Opportunity for Workers M T T
                 With Disabilities.
                FAR 52.222-37................ Employment Reports on Veterans M T T
                FAR 52.222-50................ Combating Trafficking in M T T
                 Persons.
                FAR 52.222.54................ Employment Eligibility M T T
                 Verification.
                1652.222-70.................. Notice of Significant Events.. M T T
                FAR 52.223-6................. Drug-Free Workplace........... A T T
                FAR 52.223-18................ Encouraging Contractor M T T
                 Policies to Ban Text
                 Messaging While Driving.
                1652.224-70.................. Confidentiality of Records.... M T T
                FAR 52.227-1................. Authorization and Consent..... M T T
                FAR 52.227-2................. Notice and Assistance M T T
                 Regarding Patent and
                 Copyright Infringement.
                FAR 52.229-4................. Federal, State and Local Taxes M T T
                 (State and local Adjustments.
                1652.229-70.................. Taxes--Foreign Negotiated A T T
                 Benefits Contracts.
                FAR 52.232-8................. Discounts for Prompt Payment.. M T T
                FAR 52.232-17................ Interest...................... M T T
                FAR 52.232-23................ Assignment of Claims.......... A T T
                FAR 52.232-33................ Payment by Electronic Funds M T T
                 Transfer--System for Awards
                 Management.
                1652.232-70.................. Payments--Community-Rated A ............... T
                 Contracts.
                1652.232-71.................. Payments--Experience-Rated A T
                 Contracts.
                1652.232-72.................. Non-Commingling of FEHBP Funds M T
                1652.232-73.................. Approval for Assignment of M T T
                 Claims.
                FAR 52.233-1................. Disputes...................... M T T
                FAR 52.233-4................. Applicable Law for Breach of M T T
                 Contract Claim.
                FAR 52.239-1................. Privacy or Security Safeguards M T T
                FAR 52.242-1................. Notice of Intent to Disallow M T
                 Costs.
                FAR 52.242-3................. Penalties for Unallowable M T
                 Costs.
                FAR 52.242-13................ Bankruptcy.................... M T T
                1652.243-70.................. Changes--Negotiated Benefits M T T
                 Contracts.
                FAR 52.244-5................. Competition in Subcontracting. M T
                FAR 52.244-6................. Subcontracts for Commercial M T
                 Items.
                1652.244-70.................. Subcontracts.................. M T
                1652.245-70.................. Government Property M T T
                 (Negotiated Benefits
                 Contracts).
                FAR 52.246-25................ Limitation of Liability-- M T
                 Services.
                1652.246-70.................. FEHB Inspection............... M T T
                FAR 52.247-63................ Preference for U.S.-Flag Air M T T
                 Carriers.
                1652.249-70.................. Renewal and Withdrawal of M T T
                 Approval.
                1652.249-71.................. FEHBP Termination for M T T
                 Convenience of the
                 Government--Negotiated
                 Benefits Contracts.
                1652.249-72.................. FEHBP Termination for Default-- M T T
                 Negotiated Benefits Contracts.
                FAR 52.251-1................. Government Supply Sources..... A T
                FAR 52.252-4................. Alterations in Contract....... A T T
                FAR 52.252-6................. Authorized Deviations in M T T
                 Clauses.
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                [[Page 12573]]
                [FR Doc. 2019-06223 Filed 4-1-19; 8:45 am]
                 BILLING CODE 6325-38-P
                

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