> **FEHB Program Carrier Letter U.S. Office of Personnel Management**

### All Carriers Office of Insurance Programs

> **Letter No. 1999-008 Date: February 9, 1999**
>
> Fee-for-service \[ 8 \] Experience-rated HMO \[ 8 \] Community-rated
> \[ 8 \]
>
> **SUBJECT:** **FEHB Reporting Requirements**

The enclosed summary of routine reports required of Federal Employees
Health Benefits (FEHB) carriers replaces the summary in Carrier Letter
97-13. This summary reflects recent changes to your routine reporting
requirements, as follows:

>  Conformed experience-rated plan financial reports to the Audit
> Guide.
>
>  Discontinued Table 2. (But report disenrollment data with Table 1.)
>
>  Discontinued the supplemental literature certification. (But
> requirements still apply.)
>
>  Changed the customer satisfaction survey.
>
>  Began a pilot project for FACCT reporting.
>
>  Discontinued the HMO report to Office of Insurance Programs on
> certain debarred providers. (But still report to the Office of the
> Inspector General on other debarred providers.)
>
>  Began a pilot project for Small, Small Disadvantaged and Women-Owned
> Small Business Subcontracting Plan.
>
>  Discontinued the Certification of Procurement Integrity.
>
> In addition, we will substantially change or discontinue the quality
> assurance performance standards report before the January 31, 2000,
> report is due. And we will soon revise Table 1 to include
> disenrollment data formerly reported on Table 2.
>
> We will not send you a summary every year; instead, we will write to
> you when we change a report and will include a current summary in the
> *FEHB Carrier Handbook* each time we revise it*.*
>
> Thank you for your attention to submitting timely and accurate reports
> on your FEHB business. Reporting is an important factor in determining
> an experience-rated carrier's service charge and evaluating a
> community-rated carrier's compliance with the new performance
> incentive program.
>
> For more information about this letter, contact Agnes Kalland
> (<akalland@opm.gov>). If you have questions about a report included in
> the summary or need a copy of a carrier letter (CL) referenced in the
> "Guidance" column, contact your OPM contract representative or email
> the person shown as the contact for the given report.

Sincerely,

\[signed\]

Frank D. Titus

Assistant Director

for Insurance Programs

> Enclosure

+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 1 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Annual        |       |     |      |         |      |          |   |
| Accounting      |       |     |      |         |      |          |   |
| Statement**     |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \-              | A     | Exp | Nov  | C       | CL   | F        |   |
| [Estimat        | nnual | -ra | 4    | ontract | 9    | inancial |   |
| ed]{.underline} |       | ted |      | \'1.7   | 8-42 | Mgmt     |   |
| Summary         |       |     |      |         |      | Di       |   |
| Statement of    |       |     |      | C       |      | v/Arsers |   |
| FEHBP           |       |     |      | ontract |      |          |   |
| Operations (see |       |     |      | \'3.2   |      | (*SC     |   |
| below)          |       |     |      |         |      | Arsers@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| *               | A     | Exp | Dec  | C       | CL   | F        |   |
| *AAS**\--Annual | nnual | -ra | 15   | ontract | 9    | inancial |   |
| Accounting      |       | ted |      | \'1.7   | 8-42 | Mgmt     |   |
| Statement       |       |     |      |         |      | Di       |   |
|                 |       |     |      | C       |      | v/Arsers |   |
| (Fiscal Year    |       |     |      | ontract |      |          |   |
| Accounting      |       |     |      | \'3.2   |      | (*SC     |   |
| Statement:)     |       |     |      |         |      | Arsers@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Summary      |       |     |      |         |      |          |   |
| Statement of    |       |     |      |         |      |          |   |
| FEHBP           |       |     |      |         |      |          |   |
| Operations      |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- FEHBP        |       |     |      |         |      |          |   |
| Balance Sheet   |       |     |      |         |      |          |   |
| as of 9/30      |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Consolidated |       |     |      |         |      |          |   |
| Statement of    |       |     |      |         |      |          |   |
| FEHBP Cash      |       |     |      |         |      |          |   |
| Flows           |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule 1   |       |     |      |         |      |          |   |
| \-- Health      |       |     |      |         |      |          |   |
| Benefits        |       |     |      |         |      |          |   |
| Charges Paid    |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Financial**   | A     | Exp | Mar  | C       | CL   | F        |   |
| Reporting       | nnual | -ra | 31   | ontract | 9    | inancial |   |
| Package:        |       | ted |      | \'1.7,  | 8-42 | Mgmt     |   |
|                 |       |     |      |         |      | Di       |   |
|                 |       |     |      | \'3.2,  |      | v/Arsers |   |
|                 |       |     |      | and     |      |          |   |
|                 |       |     |      | \'3.10  |      | (*SC     |   |
|                 |       |     |      |         |      | Arsers@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 1BHealth        |       |     |      |         |      |          |   |
| Benefit Charges |       |     |      |         |      |          |   |
| Paid            |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 2-Health        |       |     |      |         |      |          |   |
| Benefit Charges |       |     |      |         |      |          |   |
| Accrued but     |       |     |      |         |      |          |   |
| Unpaid          |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 3               |       |     |      |         |      |          |   |
| -Administrative |       |     |      |         |      |          |   |
| Expenses        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 3-A             |       |     |      |         |      |          |   |
| ddendum-Carrier |       |     |      |         |      |          |   |
| Cost            |       |     |      |         |      |          |   |
| Containment     |       |     |      |         |      |          |   |
| Expenses        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+

+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 2 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 3A-Supplemental |       |     |      |         |      |          |   |
| Schedule -      |       |     |      |         |      |          |   |
| Other Expenses  |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 3B-Vendor Cost  |       |     |      |         |      |          |   |
| Containment     |       |     |      |         |      |          |   |
| Expenses        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 3C              |       |     |      |         |      |          |   |
| -Reconciliation |       |     |      |         |      |          |   |
| of              |       |     |      |         |      |          |   |
| Administrative  |       |     |      |         |      |          |   |
| Expenses        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 4-Prior Period  |       |     |      |         |      |          |   |
| Adjustments     |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Schedule     |       |     |      |         |      |          |   |
| 5-Status of     |       |     |      |         |      |          |   |
| Reserves        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Additional   |       |     |      |         |      |          |   |
| Required        |       |     |      |         |      |          |   |
| Financial and   |       |     |      |         |      |          |   |
| Statistical     |       |     |      |         |      |          |   |
| Information     |       |     |      |         |      |          |   |
| (background)    |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Certified    |       |     |      |         |      |          |   |
| Financial       |       |     |      |         |      |          |   |
| Statements for  |       |     |      |         |      |          |   |
| the Most        |       |     |      |         |      |          |   |
| Current Fiscal  |       |     |      |         |      |          |   |
| Year            |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Audit         | A     | Exp | With | C       | CL   | F        |   |
| report** on     | nnual | -ra | AAC  | ontract | 9    | inancial |   |
| audit of the    | w/AAC | ted |      | \'1.7,  | 8-42 | Mgmt     |   |
| fiscal year     |       | pl  |      |         |      | Di       |   |
| accounting      |       | ans |      | \'3.2,  |      | v/Arsers |   |
| statement       |       | t   |      | and     |      |          |   |
|                 |       | hat |      | \'3.10  |      | (*SC     |   |
|                 |       | e   |      |         |      | Arsers@o |   |
|                 |       | lec |      |         |      | pm.gov*) |   |
|                 |       | ted |      |         |      |          |   |
|                 |       | to  |      |         |      |          |   |
|                 |       | p   |      |         |      |          |   |
|                 |       | rov |      |         |      |          |   |
|                 |       | ide |      |         |      |          |   |
|                 |       | an  |      |         |      |          |   |
|                 |       | au  |      |         |      |          |   |
|                 |       | dit |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Report on     | A     | Exp | With | C       | CL   | F        |   |
| compliance**    | nnual | -ra | AAC  | ontract | 9    | inancial |   |
| with laws,      |       | ted |      | \'1.7,  | 8-42 | Mgmt     |   |
| regulations and | w/AAC | pl  |      |         |      | Di       |   |
| internal        |       | ans |      | \'3.2,  | and  | v/Arsers |   |
| controls        |       | s   |      | and     |      |          |   |
|                 |       | ubj |      | \'3.10  | CL   | (*SC     |   |
|                 |       | ect |      |         | 9    | Arsers@o |   |
|                 |       | to  |      |         | 8-30 | pm.gov*) |   |
|                 |       | Ap  |      |         |      |          |   |
|                 |       | rim |      |         |      |          |   |
|                 |       | ary |      |         |      |          |   |
|                 |       | cov |      |         |      |          |   |
|                 |       | era |      |         |      |          |   |
|                 |       | ge@ |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+

+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 3 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Other         |       |     |      |         |      |          |   |
| Financial       |       |     |      |         |      |          |   |
| Reports**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **CPA report**  | A     | All | 90   | C       | CL   | F        |   |
| (2 copies) \--  | nnual |     | days | ontract | 98   | inancial |   |
| most recent     |       |     | a    | \'1.7,  | -005 | Mgmt     |   |
|                 |       |     | fter |         |      | Di       |   |
|                 |       |     | c    | \'3.2,  | CL   | v/Arsers |   |
|                 |       |     | arri | and     | 98   |          |   |
|                 |       |     | er's | \'3.10  | -042 | (*SCA    |   |
|                 |       |     | FY   |         |      | rsers@op |   |
|                 |       |     |      |         |      | m.gov*)) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Annual Paid     | A     | FFS | Mar  | C       | Of   | Ofc of   |   |
| Claims Report   | nnual |     | 31   | ontract | fice | Actua    |   |
|                 |       |     |      | \'1.7   | of   | ry/Simon |   |
|                 |       |     |      |         | Act  |          |   |
|                 |       |     |      |         | uary | (*S      |   |
|                 |       |     |      |         | Inst | VSimon@o |   |
|                 |       |     |      |         | ruct | pm.gov*) |   |
|                 |       |     |      |         | ions |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Incurred Claims | A     | BC  | Dec  | C       | Of   | Ofc of   |   |
| Report          | nnual | BS, | 31   | ontract | fice | Actua    |   |
|                 |       | MH  |      | \'1.7   | of   | ry/Simon |   |
|                 |       | BP, |      |         | Act  |          |   |
|                 |       | GE  |      |         | uary | (*S      |   |
|                 |       | HA, |      |         | Inst | VSimon@o |   |
|                 |       | NA  |      |         | ruct | pm.gov*) |   |
|                 |       | LC, |      |         | ions |          |   |
|                 |       | A   |      |         |      |          |   |
|                 |       | PWU |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Monthly         | Mo    | FFS | 15   | C       | Of   | Ofc of   |   |
| Incurred Claims | nthly |     | days | ontract | fice | Actua    |   |
|                 |       |     | a    | \'1.7   | of   | ry/Simon |   |
|                 |       |     | fter |         | Act  |          |   |
|                 |       |     | end  |         | uary | (*S      |   |
|                 |       |     | of   |         | Inst | VSimon@o |   |
|                 |       |     | m    |         | ruct | pm.gov*) |   |
|                 |       |     | onth |         | ions |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Premium       |       |     |      |         |      |          |   |
| Payment**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| TFS Form 3881 B | At    | All | As   | C       | FMD  | F        |   |
| Payment         | app   |     | dire | ontract | inst | inancial |   |
| Information     | roval |     | cted | \'3.1   | ruct | Mgmt     |   |
| Form            |       |     |      |         | ions | Di       |   |
|                 |       |     |      |         |      | v/Arsers |   |
|                 |       |     |      |         |      |          |   |
|                 |       |     |      |         |      | (*SC     |   |
|                 |       |     |      |         |      | Arsers@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Change of       | When  | All | As   | C       | FMD  | F        |   |
| Financial       | appli |     | dire | ontract | inst | inancial |   |
| Institution     | cable |     | cted | \'3.1   | ruct | Mgmt     |   |
|                 |       |     |      |         | ions | Di       |   |
|                 |       |     |      |         |      | v/Arsers |   |
|                 |       |     |      |         |      |          |   |
|                 |       |     |      |         |      | (*SC     |   |
|                 |       |     |      |         |      | Arsers@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Enrollment    |       |     |      |         |      |          |   |
| Reporting**     |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Table        | A     | All | Apr  | C       | CL   | OIP/IPE  |   |
| 1-Summary of    | nnual |     | 15   | ontract | 9    | D/Hodges |   |
| FEHBP           |       |     |      | \'1.7   | 8-42 |          |   |
| Enrollment      |       |     |      |         |      | (*       |   |
| (Include        |       |     |      |         | CL   | Hodges@o |   |
| disenrollment   |       |     |      |         | 98-0 | pm.gov*) |   |
| data formerly   |       |     |      |         | 05-A |          |   |
| on Table 2)     |       |     |      |         |      |          |   |
|                 |       |     |      |         | CL   |          |   |
|                 |       |     |      |         | 98   |          |   |
|                 |       |     |      |         | -012 |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| \- Table        | N/A   | N/A | N/A  | N/A     | [d   | OIP/IPE  |   |
| 2-Summary of    |       |     |      |         | isco | D/Hodges |   |
| Open Season     |       |     |      |         | ntin |          |   |
| Transactions    |       |     |      |         | ued] | (*       |   |
|                 |       |     |      |         | {.sm | Hodges@o |   |
| > ([discontinue |       |     |      |         | allc | pm.gov*) |   |
| d]{.smallcaps}) |       |     |      |         | aps} |          |   |
|                 |       |     |      |         | \    |          |   |
|                 |       |     |      |         | --CL |          |   |
|                 |       |     |      |         | 98-0 |          |   |
|                 |       |     |      |         | 05-A |          |   |
|                 |       |     |      |         | \--  |          |   |
|                 |       |     |      |         | CL98 |          |   |
|                 |       |     |      |         | -012 |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 4 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Rate          |       |     |      |         |      |          |   |
| Related**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Rate Proposal   | A     | A   | May  | C       | CL   | Ofc of   |   |
| (includes       | nnual | ll; | 31   | ontract | 9    | Actuar   |   |
| several tables  |       | by  |      | \'3.2   | 8-16 | y/Kichak |   |
| and reports)    |       | R   |      |         |      |          |   |
|                 |       | ate |      |         |      | (*NH     |   |
|                 |       | t   |      |         |      | Kichak@o |   |
|                 |       | ype |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Set of          | A     | All | Dec  | C       | CL   | Ofc of   |   |
| Enrollment and  | nnual |     | 31   | ontract | 9    | Actuary/ |   |
| Demographic     |       |     |      | \'1.7   | 5-32 | McKnight |   |
| Data via mag    |       |     |      |         |      |          |   |
| tape or 3480    |       |     |      |         | CL   | (*mc     |   |
| compatible      |       |     |      |         | 9    | knight@o |   |
| cartridge       |       |     |      |         | 3-04 | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Rate            | A     | C   | A    | C       | CL   | Ofc of   |   |
| Reconciliation  | nnual | -ra | pril | ontract | 9    | Actuary/ |   |
| Request         |       | ted | 30   | \'3.2   | 8-10 | McKnight |   |
| (includes       |       |     |      |         |      |          |   |
| several tables  |       |     |      |         |      | (*mc     |   |
| and reports)    |       |     |      |         |      | knight@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Utilization     | A     | C   | May  | C       | Call | Ofc of   |   |
| Data per 1,000  | nnual | -ra | 31   | ontract | Le   | Actuar   |   |
| Members         |       | ted |      | \'1.7   | tter | y/Kichak |   |
|                 |       |     |      |         |      |          |   |
|                 |       |     |      |         |      | (*NH     |   |
|                 |       |     |      |         |      | Kichak@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Benefit       |       |     |      |         |      |          |   |
| Proposals and   |       |     |      |         |      |          |   |
| Brochure        |       |     |      |         |      |          |   |
| Production**    |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Plan            | Annua | All | May  | C       | Call | OIP/ICD/ |   |
| Contracting     | l/not |     | 3    | ontract | le   | contract |   |
| Officials Form  | less  |     | 1/as | \'1.7   | tter | rep      |   |
|                 | than  |     | ne   |         |      |          |   |
|                 | a     |     | eded |         |      |          |   |
|                 | nnual |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Plan       | As    | All | As   | C       | Cont | OIP/ICD/ |   |
| Address Form    | up    |     | ne   | ontract | ract | contract |   |
|                 | dates |     | eded | \'1.7   | rep  | rep      |   |
|                 | are   |     |      |         |      |          |   |
|                 | n     |     |      |         |      |          |   |
|                 | eeded |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Brochure   | A     | All | Sept | C       | CL   | OIP/ICD/ |   |
| Quantity Form   | nnual |     | 15   | ontract | 9    | contract |   |
|                 |       |     |      | \'1.13  | 8-37 | rep      |   |
|                 |       |     |      |         | (    |          |   |
|                 |       |     |      |         | Broc |          |   |
|                 |       |     |      |         | hure |          |   |
|                 |       |     |      |         | Pro  |          |   |
|                 |       |     |      |         | duct |          |   |
|                 |       |     |      |         | ion) |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB            | N/A   | N   | N/A  | C       | [d   | OIP/ICD/ |   |
| Supplemental    |       | one |      | ontract | isco | contract |   |
| Literature      |       | C   |      | \'1.13  | ntin | rep      |   |
| Certification - |       | ert |      |         | ued] |          |   |
| ([discontinu    |       | ify |      |         | {.sm |          |   |
| ed]{.smallcaps} |       |     |      |         | allc |          |   |
| but             |       |     |      |         | aps} |          |   |
| requirements    |       |     |      |         | c    |          |   |
| still apply)    |       |     |      |         | erti |          |   |
|                 |       |     |      |         | fica |          |   |
|                 |       |     |      |         | tion |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+

+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 5 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Satis         |       |     |      |         |      |          |   |
| faction/Quality |       |     |      |         |      |          |   |
| Assessment**    |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Customer        | A     | All | Jun  | C       | CL   | OIP/IPE  |   |
| Satisfaction    | nnual | exc | 15   | ontract | 9    | D/Pierce |   |
| Survey Results  |       | ept |      | \'1.9   | 8-45 |          |   |
| (CAHPS)         |       | sm  |      |         |      | (*R      |   |
|                 |       | all |      |         | CL   | Pierce@o |   |
|                 |       | pl  |      |         | 98   | pm.gov*) |   |
|                 |       | ans |      |         | -45A |          |   |
|                 |       | (l  |      |         |      |          |   |
|                 |       | ess |      |         |      |          |   |
|                 |       | t   |      |         |      |          |   |
|                 |       | han |      |         |      |          |   |
|                 |       | 500 |      |         |      |          |   |
|                 |       | F   |      |         |      |          |   |
|                 |       | EHB |      |         |      |          |   |
|                 |       | e   |      |         |      |          |   |
|                 |       | nro |      |         |      |          |   |
|                 |       | lle |      |         |      |          |   |
|                 |       | es) |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FACCT (pilot)   | A     | 4   | Va   | C       | A    | OIP/IP   |   |
|                 | nnual | Ca  | ries | ontract | gree | ID/Block |   |
|                 |       | rri |      | \'1.9   | ment |          |   |
|                 |       | ers |      |         |      | (*       |   |
|                 |       |     |      |         |      | ABlock@o |   |
|                 |       | (   |      |         |      | pm.gov*) |   |
|                 |       | for |      |         |      |          |   |
|                 |       | pil |      |         |      |          |   |
|                 |       | ot) |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Quality         | A     | All | Jan  | C       | \    | OIP/IPE  |   |
| assurance       | nnual |     | 31   | ontract | -\-- | D/Hodges |   |
| performance     |       |     |      | \'1.9   |      |          |   |
| standards       |       |     |      |         |      | (Hodges@ |   |
|                 |       |     |      |         |      | opm.gov) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Other         |       |     |      |         |      |          |   |
| Reports**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Carrier    | S     | All | Apr  | C       | OIG  | Ofc of   |   |
| Debarment       | emi-a |     | 15   | ontract | Inst | I        |   |
| ActionsB        | nnual |     |      | \'2.7   | ruct | nspector |   |
|                 |       |     | Oct  |         | ions | G        |   |
| (providers      |       |     | 15   |         |      | en/Smith |   |
| excluded after  |       |     |      |         |      |          |   |
| 1/29/92)        |       |     |      |         |      | (*J      |   |
|                 |       |     |      |         |      | LSmith@o |   |
|                 |       |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Carrier    | A     | FFS | Mar  | Annual  | CL   | OIP/IPED |   |
| Debarment       | nnual |     | 31   | appropr | 9    | /Kalland |   |
| ActionsB        |       |     |      | iations | 3-01 |          |   |
|                 |       |     |      |         |      | (*AK     |   |
| (providers      |       |     |      |         | CL   | alland@o |   |
| excluded before |       |     |      |         | 9    | pm.gov*) |   |
| 1/29/92)        |       |     |      |         | 3-20 |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Carrier    | A     | HMO | N/A  | \-\--   | [d   | OIP/IPED |   |
| Debarment       | nnual |     |      |         | isco | /Kalland |   |
| ActionsB        |       |     |      |         | ntin |          |   |
|                 |       |     |      |         | ued] | (*AK     |   |
| (providers      |       |     |      |         | {.sm | alland@o |   |
| excluded before |       |     |      |         | allc | pm.gov*) |   |
| 1/29/92)        |       |     |      |         | aps} |          |   |
|                 |       |     |      |         |      |          |   |
| \[HMO report    |       |     |      |         |      |          |   |
| [discontinued   |       |     |      |         |      |          |   |
| ]{.smallcaps}\] |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Fraud and abuse | S     | All | Jan  | C       | CL   | O        |   |
| cases report    | emi-a |     | 31   | ontract | 9    | IP/IPED/ |   |
|                 | nnual |     |      | \'1.9   | 1-10 | Saunders |   |
|                 |       |     | Jul  |         |      |          |   |
|                 |       |     | 31   |         | CL   | (*MS     |   |
|                 |       |     |      |         | 9    | aunder@o |   |
|                 |       |     |      |         | 3-32 | pm.gov*) |   |
|                 |       |     |      |         |      |          |   |
|                 |       |     |      |         | CL   |          |   |
|                 |       |     |      |         | 9    |          |   |
|                 |       |     |      |         | 4-02 |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+

+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORTS       |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | * |
| FEHB CARRIERS** |       |     |      |         |      |          | 6 |
|                 |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Pilot         |       |     |      |         |      |          |   |
| Project**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Small, Small    | A     | 7   | Jun  | C       | OPM  | OIP/IPI  |   |
| Disadvantaged   | nnual | pi  | 15   | ontract | Inst | D/Mercer |   |
| and Women-Owned |       | lot |      |         | ruct |          |   |
| Small Business  |       | p   |      | A       | ions | (*MA     |   |
| Subcontracting  |       | roj |      | ppendix |      | Mercer@o |   |
| Plan            |       | ect |      | F       | 4/   | pm.gov*) |   |
|                 |       | ca  |      |         | 9/96 |          |   |
|                 |       | rri |      |         |      |          |   |
|                 |       | ers |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Subcontracting  | S     | 7   | Apr  | Same    | OPM  | OIP/IPI  |   |
| Report for      | emi-a | pi  | 30   |         | Inst | D/Mercer |   |
| Individual      | nnual | lot |      |         | ruct |          |   |
| Contracts (SF   |       | p   | Oct  |         | ions | (*MA     |   |
| 294)            |       | roj | 30   |         |      | Mercer@o |   |
|                 |       | ect |      |         | 4/   | pm.gov*) |   |
|                 |       | ca  |      |         | 9/96 |          |   |
|                 |       | rri |      |         |      |          |   |
|                 |       | ers |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Summary         | A     | 7   | Oct  | Same    | OPM  | OIP/IPI  |   |
| Subcontract     | nnual | pi  | 30   |         | Inst | D/Mercer |   |
| Report (SF 295) |       | lot |      |         | ruct |          |   |
|                 |       | p   |      |         | ions | (*MA     |   |
|                 |       | roj |      |         |      | Mercer@o |   |
|                 |       | ect |      |         | 4/   | pm.gov*) |   |
|                 |       | ca  |      |         | 9/96 |          |   |
|                 |       | rri |      |         |      |          |   |
|                 |       | ers |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Agreements    |       |     |      |         |      |          |   |
| and             |       |     |      |         |      |          |   |
| C               |       |     |      |         |      |          |   |
| ertifications** |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Agreement re    | 1^st^ | All | As   | OPM-HHS | An   | OIP/IPED |   |
| Release of      | year; |     | dire | Ag      | nual | /Kalland |   |
| Medicare Data   | then  |     | cted | reement | Le   |          |   |
|                 | when  |     |      |         | tter | (*AK     |   |
|                 | appli |     |      |         |      | alland@o |   |
|                 | cable |     |      |         |      | pm.gov*) |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Certification   | At    | All | Be   | C       | Cont | OIP/ICD/ |   |
| re Disclosure   | app   |     | fore | ontract | ract | contract |   |
| of Lobbying     | roval |     | appr | \'5.45  | rep  | rep      |   |
| Activities      |       |     | oval |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| OMB SF LLL,     | When  | All | As   | C       | Cont | OIP/ICD/ |   |
| Disclosure of   | appli |     | ne   | ontract | ract | contract |   |
| Lobbying        | cable |     | eded | \'5.45  | rep  | rep      |   |
| Activities      |       |     |      |         |      |          |   |
| (relates to     |       |     |      |         |      |          |   |
| certification)  |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Certification   | At    | All | Be   | C       | Cont | OIP/ICD/ |   |
| re Drug-Free    | app   |     | fore | ontract | ract | contract |   |
| Workplace       | roval |     | appr | \'5.25  | rep  | rep      |   |
|                 |       |     | oval |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Certification   | N/A   | N/A | N/A  | N/A     | [d   | OIP/IPI  |   |
| of Procurement  |       |     |      |         | isco | D/Mercer |   |
| Integrity       |       |     |      |         | ntin |          |   |
| ([discontinue   |       |     |      |         | ued] | (M       |   |
| d]{.smallcaps}) |       |     |      |         | {.sm | AMercer@ |   |
|                 |       |     |      |         | allc | opm.gov) |   |
|                 |       |     |      |         | aps} |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+