II 

Calendar No. 499 

118TH CONGRESS 

2D SESSION S. 4035 

[Report No. 118–220] 

To require the Director of the Office of Personnel Management to take 

certain actions with respect to the health insurance program carried 

out under chapter 89 of title 5, United States Code, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 21, 2024 

Mr. SCOTT of Florida (for himself and Mr. CARPER) introduced the following 

bill; which was read twice and referred to the Committee on Homeland 

Security and Governmental Affairs 

SEPTEMBER 10, 2024 

Reported by Mr. PETERS, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To require the Director of the Office of Personnel Management to take certain actions with respect to the health 

insurance program carried out under chapter 89 of title 

5, United States Code, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘FEHB Protection 

3 Act’’. 

4 SEC. 2. FEHB IMPROVEMENTS. 

5 (a) DEFINITIONS.—In this section: 

6 (1) DIRECTOR.—The term ‘‘Director’’ means 

7 the Director of the Office of Personnel Management. 

8 (2) EMPLOYING OFFICE.—The term ‘‘employing 

9 office’’ has the meaning given the term in section 

10 890.101(a) of title 5, Code of Federal Regulations, 

11 or any successor regulation. 

12 (3) HEALTH BENEFITS PLAN; MEMBER OF

13 FAMILY.—The terms ‘‘health benefits plan’’ and 

14 ‘‘member of family’’ have the meanings given those 

15 terms in section 8901 of title 5, United States Code. 

16 (4) OPEN SEASON.—The term ‘‘open season’’ 

17 means an open season described in section 

18 890.301(f) of title 5, Code of Federal Regulations, 

19 or any successor regulation. 

20 (5) PROGRAM.—The term ‘‘Program’’ means 

21 the health insurance program carried out under 

22 chapter 89 of title 5, United States Code, including 

23 the program carried out under section 8903c of that 

24 title. 

25 (6) QUALIFYING LIFE EVENT.—The term 

26 ‘‘qualifying life event’’ has the meaning given the 


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1 term in section 892.101 of title 5, Code of Federal 

2 Regulations, or any successor regulation. 

3 (b) VERIFICATION REQUIREMENTS.—Beginning on 

4 the date that is 180 days after the date of enactment of 

5 this Act, the Director shall require each employing office 

6 to verify— 

7 (1) the veracity of any qualifying life event 

8 through which an enrollee in the Program seeks to 

9 add a member of family with respect to the enrollee 

10 to a health benefits plan under the Program; and 

11 (2) that, when an enrollee in the Program seeks 

12 to add a member of family with respect to the en13 rollee to the health benefits plan of the enrollee 

14 under the Program during any open season, the in15 dividual so added is actually a member of family 

16 with respect to the enrollee. 

17 (c) FRAUD RISK ASSESSMENT.—In any fraud risk 

18 assessment conducted with respect to the Program on or 

19 after the date of enactment of this Act, the Director shall 

20 include an assessment of individuals who are enrolled in, 

21 or covered under, a health benefits plan under the Pro22 gram even though those individuals are not eligible to be 

23 so enrolled or covered. 

24 (d) FAMILY MEMBER ELIGIBILITY VERIFICATION

25 AUDIT.— 


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1 (1) IN GENERAL.—During the 5-year period be2 ginning on the date of enactment of this Act, the Di3 rector shall conduct a comprehensive audit regarding 

4 members of family— 

5 (A) who are covered under an enrollment 

6 in a health benefits plan under the Program; 

7 and 

8 (B) with respect to whom the basis for the 

9 eligibility for the coverage described in subpara10 graph (A) has not been verified. 

11 (2) CONTENTS.—In conducting the audit re12 quired under paragraph (1), the Director shall re13 view marriage certificates, birth certificates, and 

14 other appropriate documents that are necessary to 

15 determine eligibility to enroll in a health benefits 

16 plan under the Program. 

17 (e) DISENROLLMENT OR REMOVAL.—Beginning on 

18 the date of enactment of this Act, the Director may 

19 disenroll or remove from enrollment any individual en20 rolled in, or covered under, a health benefits plan under 

21 the Program if the Director determines that such indi22 vidual is not eligible to be so enrolled or covered. 

23 SECTION 1. SHORT TITLE. 

24 This Act may be cited as the ‘‘FEHB Protection Act’’. 


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1 SEC. 2. FEHB IMPROVEMENTS. 

2 (a) DEFINITIONS.—In this section: 

3 (1) APPROPRIATE COMMITTEES OF CONGRESS.— 

4 The term ‘‘appropriate committees of Congress’’ 

5 means— 

6 (A) the Committee on Homeland Security 

7 and Governmental Affairs of the Senate; 

8 (B) the Committee on Appropriations of the 

9 Senate; 

10 (C) the Committee on Oversight and Ac11 countability of the House of Representatives; and 

12 (D) the Committee on Appropriations of the 

13 House of Representatives. 

14 (2) DIRECTOR.—The term ‘‘Director’’ means the 

15 Director of the Office of Personnel Management. 

16 (3) EMPLOYING OFFICE.—The term ‘‘employing 

17 office’’ has the meaning given the term in section 

18 890.101(a) of title 5, Code of Federal Regulations, or 

19 any successor regulation. 

20 (4) HEALTH BENEFITS PLAN; MEMBER OF FAM21 ILY.—The terms ‘‘health benefits plan’’ and ‘‘member 

22 of family’’ have the meanings given those terms in 

23 section 8901 of title 5, United States Code. 

24 (5) OPEN SEASON.—The term ‘‘open season’’ 

25 means an open season described in section 890.301(f) 


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1 of title 5, Code of Federal Regulations, or any suc2 cessor regulation. 

3 (6) PROGRAM.—The term ‘‘Program’’ means the 

4 health insurance program carried out under chapter 

5 89 of title 5, United States Code, including the pro6 gram carried out under section 8903c of that title. 

7 (7) QUALIFYING LIFE EVENT.—The term ‘‘quali8 fying life event’’ has the meaning given the term in 

9 section 892.101 of title 5, Code of Federal Regula10 tions, or any successor regulation. 

11 (b) VERIFICATION REQUIREMENTS.—Not later than 1 

12 year after the date of enactment of this Act, the Director 

13 shall issue regulations and implement a process to require 

14 each employing office to verify— 

15 (1) the veracity of any qualifying life event 

16 through which an enrollee in the Program seeks to 

17 add a member of family with respect to the enrollee 

18 to a health benefits plan under the Program; and 

19 (2) that, when an enrollee in the Program seeks 

20 to add a member of family with respect to the enrollee 

21 to the health benefits plan of the enrollee under the 

22 Program, including during any open season, the indi23 vidual so added is actually a member of family with 

24 respect to the enrollee. 


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1 (c) FRAUD RISK ASSESSMENT.—In any fraud risk as2 sessment conducted with respect to the Program on or after 

3 the date of enactment of this Act, the Director shall include 

4 an assessment of individuals who are enrolled in, or covered 

5 under, a health benefits plan under the Program even 

6 though those individuals are not eligible to be so enrolled 

7 or covered. 

8 (d) FAMILY MEMBER ELIGIBILITY VERIFICATION

9 AUDIT.— 

10 (1) IN GENERAL.—During the 3-year period be11 ginning on the date that is 1 year after the date of 

12 enactment of this Act, the Director, in coordination 

13 with the head of each employing office, shall conduct 

14 a comprehensive audit regarding members of family 

15 who are enrolled in, or covered under, a health bene16 fits plan under the Program. 

17 (2) CONTENTS.—In conducting the audit re18 quired under paragraph (1), the Director, in coordi19 nation with the head of each employing office, shall 

20 review marriage certificates, birth certificates, and 

21 other appropriate documents that are necessary to de22 termine eligibility to enroll in, or be covered under, 

23 a health benefits plan under the Program. 

24 (3) REPORTS.— 


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1 (A) IN GENERAL.—Not later than 180 days 

2 after the date on which the 3-year period de3 scribed in paragraph (1) begins, and once every 

4 180 days thereafter until the end of that 3-year 

5 period, the Director shall submit to the appro6 priate committees of Congress a report regarding 

7 the status of the audit required under that para8 graph. 

9 (B) CONTENTS.—Each report required 

10 under subparagraph (A) shall include, for the pe11 riod covered by the report— 

12 (i) the number of members of family 

13 who were reviewed under the audit con14 ducted under paragraph (1), including the 

15 number of those individuals found during 

16 the audit to be ineligible to be enrolled in, 

17 or covered under, a health benefits plan 

18 under the Program; 

19 (ii) the number of members of family 

20 who disenrolled from a health benefits plan, 

21 and the number of members of family who 

22 reduced the amount of coverage under a 

23 health benefits plan, under the Program be24 fore the end of a coverage year; and 


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1 (iii) any other information that the 

2 Director determines to be relevant. 

3 (e) DISENROLLMENT OR REMOVAL.—Not later than 

4 180 days after the date of enactment of this Act, the Direc5 tor shall develop a process through which any individual 

6 enrolled in, or covered under, a health benefits plan under 

7 the Program who is not eligible to be so enrolled or covered 

8 shall be disenrolled or removed from enrollment with respect 

9 to that health benefits plan. 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
Calendar No. 499 

118TH CONGRESS 

2D SESSION S. 4035 

[Report No. 118–220] 

A BILL 

To require the Director of the Office of Personnel 

and for other purposes. under chapter 89 of title 5, United States Code, to the health insurance program carried out Management to take certain actions with respect 

SEPTEMBER 10, 2024 

Reported with an amendment 


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