[Federal Register Volume 87, Number 107 (Friday, June 3, 2022)]
[Proposed Rules]
[Pages 33653-33658]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-11720]


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Proposed Rules
                                                Federal Register
________________________________________________________________________

This section of the FEDERAL REGISTER contains notices to the public of 
the proposed issuance of rules and regulations. The purpose of these 
notices is to give interested persons an opportunity to participate in 
the rule making prior to the adoption of the final rules.

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Federal Register / Vol. 87, No. 107 / Friday, June 3, 2022 / Proposed 
Rules

[[Page 33653]]



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: Notice of proposed rulemaking.

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SUMMARY: The Office of Personnel Management (OPM) is proposing 
amendments to support FLTCIP program 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 
is also proposing technical corrections for the sake of clarity and to 
remove redundancies. Finally, with the publication of this rule, OPM is 
also providing notice of an anticipated suspension period.

DATES: OPM must receive comments on or before July 5, 2022.

ADDRESSES: You may submit comments, identified by docket number and/or 
Regulatory Information Number (RIN) and title, by the following method:
    [ssquf] 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: Julia Elam, Supervisory Analyst, 
<a href="/cdn-cgi/l/email-protection#b3d9c6dfdad29dd6dfd2def3dcc3de9dd4dcc5"><span class="__cf_email__" data-cfemail="b8d2cdd4d1d996ddd4d9d5f8d7c8d596dfd7ce">[email protected]</span></a>, (202) 606-1560.

SUPPLEMENTARY INFORMATION: 

Background

    The Federal Long Term Care Insurance Program (FLTCIP) was created 
as a result of the enactment of the Long Term Care Security Act of 
2000, Public Law 106-265 (``the FLTCIP statute''). This Act required 
OPM to make long term care (LTC) benefits available to Federal 
employees, annuitants, active and retired members of the uniformed 
services, and the qualified relatives of these individuals. As of 
September 2021, FLTCIP has approximately 267,000 enrollees.
    FLTCIP is administered by OPM in accordance with 5 U.S.C. chapter 
90 and implementing regulations (5 CFR part 875). FLTCIP is an 
enrollee-pay-all program; there is no Government contribution toward 
premiums. Pursuant to 5 U.S.C. 9008, OPM has authority to administer 
the FLTCIP and is proposing changes, including to the use of 
abbreviated underwriting and suspension of applications for coverage, 
as a part of our administrative functions. More information on the 
program can be found at LTCFEDS.com.

Discussion of the Changes

Changes to the Use of Abbreviated Underwriting

    Underwriting is the process of reviewing medical and health-related 
information furnished in an insurance application process to determine 
if an applicant presents what an insurance carrier considers an 
acceptable level of risk. Under current regulations at 5 CFR 875.101 
full underwriting is the more comprehensive type of underwriting under 
FLTCIP which requires an applicant to answer many questions about their 
health status to enable the Carrier to determine whether the 
application will be approved. It may also include a review of the 
applicant's medical records, a phone interview, or an in-home 
interview. Under the regulations, abbreviated underwriting in FLTCIP 
asks fewer questions about an applicant's health status than with full 
underwriting to enable the Carrier to determine whether the application 
for coverage will be approved. It may also include a review of the 
applicant's medical records, a phone interview, or an in-home 
interview.
    While eligible individuals may apply for FLTCIP coverage at any 
time with full underwriting, current rules also provide a 60-day 
abbreviated underwriting period to newly eligible active workforce 
members and their spouses. An individual becomes newly eligible as an 
active workforce member when they enter a position that conveys 
eligibility, enter a position that conveys eligibility from a position 
that did not convey eligibility, or return to active service after a 
break in service of at least 180 days to a position that conveys 
eligibility. However, experience has shown that the 60-day abbreviated 
underwriting period for newly eligible active workforce members and 
spouses is not well-suited to FLTCIP. FLTCIP enrollment is much more 
common later in one's career than when someone is newly hired. 
According to a Treasury Report of the Federal Interagency Task Force on 
Long-Term Care Insurance, people typically purchase long term care 
insurance (LTCI) in their 50s or 60s, and then hold the insurance while 
paying premiums for a lengthy period.\1\ Since the inception of FLTCIP, 
only approximately 8% of FLTCIP applicants have applied during the 60-
day abbreviated underwriting period. The remaining 92% of FLTCIP 
applicants have applied during an open season or with full 
underwriting.
---------------------------------------------------------------------------

    \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, https://home.treasury.gov/system/files/136/Report-Federal-Interagency-Task-Force-Long-Term-Care-Insurance.pdf.
---------------------------------------------------------------------------

    The proposed changes would eliminate the 60-day abbreviated 
underwriting period, but not remove abbreviated underwriting entirely 
from the FLTCIP application process. Instead, OPM would continue to 
announce in the Federal Register any period during which active 
workforce members and spouses may apply with abbreviated underwriting, 
as OPM has done with open seasons in the past. To use more accurate 
terminology that reflects the underwritten nature of the benefit, and 
to reduce confusion between a FLTCIP abbreviated underwriting 
opportunity and the annual Federal Benefits Open Season, OPM is 
proposing to change the name of any such period to a ``special 
application period'' rather than an

[[Page 33654]]

``open season.'' Each future special application period may offer its 
own underwriting rules. Individual agencies will provide notice to 
their Federal employees of any special application period.

Suspension of Applications for FLTCIP Coverage

    Current rules permit eligible individuals to apply for FLTCIP 
coverage at any time with full underwriting. As a result, the FLTCIP is 
continuously open to new enrollment. However, it may be appropriate 
from time to time for OPM to suspend applications for FLTCIP coverage. 
For example, it may be appropriate to suspend applications to allow a 
period of time for revisions to underwriting processes or for premium 
repricing after a review of actuarial assumptions, in order to ensure 
that premium rates reasonably and equitably reflect the cost of the 
benefits provided as required by the statute, and to ensure that OPM 
can provide eligible individuals with the information needed to enable 
them to fully evaluate the advantages and disadvantages of obtaining 
LTCI under FLTCIP. The proposed changes create a process for suspending 
applications and communicating the start and end of such a suspension 
period.

Technical Corrections

    The current rules have some language that may be considered 
duplicative or would benefit from greater clarity. The proposed changes 
make such technical corrections, which do not make any substantive 
changes to the FLTCIP rules.

Proposed Changes by Section

    OPM proposes to make technical corrections to several sections. In 
5 CFR 875.101, OPM makes such corrections to the definitions of 
``Carrier'' and ``Eligible individual.'' Additional technical 
corrections are proposed to 5 CFR 875.102, 875.203, 875.204, 875.213, 
and 875.404.
    In 5 CFR 875.101, OPM proposes to amend the definition of ``Free 
look'' to clarify that the 30-day period is only ``after you are 
approved for coverage and receive the Benefit Booklet,'' and not just 
any time after receiving the Benefit Booklet. The free look applies to 
any approved coverage, including coverage increases. OPM proposes to 
add a definition of ``special application period'' to identify periods 
of applications for coverage with abbreviated underwriting for active 
workforce members and spouses. The term ``open season'' was not used 
here because such periods require some form of underwriting for 
enrollment and are held as determined by OPM and not on an annual 
basis. Conforming amendments are proposed throughout 5 CFR part 875 to 
use the term ``special application period'' instead of ``open season.''
    In 5 CFR 875.107, OPM proposes to add holding special application 
periods and suspending applications for FLTCIP coverage in its list of 
responsibilities. OPM proposes the process for such a suspension period 
in a new section at 5 CFR 875.110. Under this process, OPM may suspend 
applications for FLTCIP coverage, including coverage increases, for up 
to 24 months when it determines a suspension to be in the best 
interests of the Program. A duration of up to 24 months may be 
necessary to allow for revisions to underwriting processes or for the 
development and review of pricing assumptions and rates in order to 
ensure the premium rates reasonably and equitably reflect the cost of 
the benefits provided, and to ensure that OPM can provide eligible 
individuals with the information needed to enable them to fully 
evaluate the advantages and disadvantages of obtaining LTCI under 
FLTCIP. OPM will issue a Federal Register notice announcing the 
beginning and end date of the suspension period, at least 30 days 
before the start of the suspension period. The suspension period may be 
extended with another notice in the Federal Register at least 30 days 
before the end of the current suspension period. Additional conforming 
amendments are proposed throughout 5 CFR part 875 to note that 
applications for FLTCIP coverage are only permitted outside of a 
suspension period.
    OPM proposes to delete the language at 5 CFR 875.206. This section 
provided for the 60-day abbreviated underwriting period for new, newly 
eligible, or returning active workforce members and their spouses. This 
proposed rule eliminates this 60-day abbreviated underwriting period, 
thereby limiting abbreviated underwriting to special application 
periods, for which a definition and conforming amendments are proposed 
throughout 5 CFR part 875.
    In 5 CFR 875.207, OPM previously addressed nonpay status during an 
open season. OPM proposes to amend this section to use the term 
``special application period'' instead of ``open season.'' To limit 
program risk, OPM also proposes to allow only those individuals that 
return to pay status within 180 days after the end of a special 
application period to apply using the special application period's 
rules. Anyone who returns to pay status after missing at least half of 
the special application period and is eligible to apply using the rules 
of the special application period will have at least 60 days to do so.
    In 5 CFR 875.209, OPM proposes to amend paragraph (a) to require a 
qualified relative to provide identifying information about the 
workforce member that makes the qualified relative an eligible 
individual. This amendment clarifies the regulation and makes it 
consistent with the application required for the FLTCIP.
    In 5 CFR 875.210, OPM proposes to amend paragraph (b)(1) to clarify 
that the qualified relative of a workforce member that has been 
involuntarily separated remains eligible for coverage if their 
application has already been submitted even if coverage has not become 
effective. This situation only applies where the involuntary separation 
is not for misconduct in the Federal civilian service or a dishonorable 
discharge from the uniformed services.
    In 5 CFR 875.211, an individual that applies as an active workforce 
member, but whose eligibility status changes to annuitant, retired 
member of the uniformed services, or qualified relative, must reapply 
based on the applicable underwriting requirements. Under the proposed 
changes for abbreviated underwriting, the underwriting rules would be 
the same for all applications outside of special application periods. 
As such, OPM proposes to only require notification to the Carrier about 
a change in eligibility status after submitting an application for 
coverage as an active workforce member. No reapplication is necessary 
if the application was originally submitted with full underwriting.
    In 5 CFR 875.213, OPM proposes to delete paragraph (b). That 
paragraph contains a definition of ``domestic partner.'' The applicable 
definition of ``domestic partner'' is contained in 5 CFR 875.101 and 
applies to all of 5 CFR part 875.
    In 5 CFR 875.401, OPM proposes to remove paragraph (b). The 
language is now contained in 5 CFR 875.403.
    In 5 CFR 875.402, OPM confirms that there are no regularly 
scheduled open seasons. OPM proposes to amend this section to state 
that there may be special application periods as appropriate, that 
those special application periods will be announced in the Federal 
Register, and the special application periods would offer abbreviated 
underwriting to active workforce members and their spouses. OPM 
proposes to delete paragraph (c) since abbreviated underwriting would 
not be tied to new eligibility under the proposed changes to 5 CFR 
875.206.

[[Page 33655]]

    In 5 CFR 875.403, OPM addresses the timing for applications for 
FLTCIP coverage. OPM proposes to amend this section to confirm that 
applications for coverage, including coverage increases, are permitted 
outside of a suspension period. Applications outside of a special 
application period would be subject to full underwriting. The language 
from the removed paragraph (b) of 5 CFR 875.401 is now contained in 
this section.
    In 5 CFR 875.405, OPM proposes to remove all specific provisions 
based on the nature of the relationship. With the proposed changes to 
abbreviated underwriting, this language is unnecessary. All 
applications for FLTCIP coverage outside of a special application 
period would be subject to full underwriting.
    In 5 CFR 875.406, OPM proposes to amend paragraph (a)(1) to make it 
clear that, outside of a suspension period as described in 5 CFR 
875.110, applications for coverage increases are permitted with full 
underwriting.
    In 5 CFR 875.410, OPM proposes to amend the language by deleting 
the second sentence referencing abbreviated underwriting during any 
future open season. OPM is proposing to use the term ``special 
application period'' and addresses abbreviated underwriting rules for 
such a period in the proposed changes to 5 CFR 875.402.
    In 5 CFR 875.413, OPM proposes to clarify that the potential 
reinstatement window will begin with the date of the written notice of 
termination and not from the termination date itself. The written 
notice comes after the actual termination date, so this allows more 
time and does not adversely impact the individual if the Carrier is 
delayed in sending the written notice. The provisions reinstating 
coverage to the termination date remain unchanged.

Notice of Anticipated Suspension Period

    Based on the facts available to OPM at the time of publication of 
this NPRM, OPM anticipates a 24-month suspension period. Due to 
emerging program experience, OPM has determined that there is a strong 
likelihood that FLTCIP premium rates will need to be revised. OPM 
anticipates a need for a 24-month suspension period in order to ensure 
FLTCIP premium rates reasonably and equitably reflect the cost of 
benefits provided, and to revise or adjust as necessary. Based on the 
facts available to OPM at the time of publication of this NPRM, the 
suspension period pursuant to 5 CFR 875.110 will begin at the time this 
rule is finalized. OPM considers this NPRM to serve as the notice 
required under the proposed paragraph (b) of 5 CFR 875.110(b). In the 
final rule, OPM will confirm the specific dates and duration for the 
suspension period based on the most up-to-date information about the 
Program.

Expected Impact of Proposed Changes

    The proposed changes, including underwriting changes and any future 
suspensions of applications for FLTCIP coverage, would not affect 
current FLTCIP enrollees. Individuals already enrolled in FLTCIP will 
retain their coverage as long as they continue to pay premiums. The 
proposed 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.
    We expect 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 LTCI in the 
broader LTC market. The previously mentioned Treasury Report states 
that 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.\2\ 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.\3\
---------------------------------------------------------------------------

    \2\ See footnote 1.
    \3\ 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. The forgone 
annual premium for new enrollees would total less than $10 million per 
year during a 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.

Benefits of the Proposed Changes

    This proposed 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

[[Page 33656]]

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 proposes to amend title 5, Code of Federal 
Regulations part 875, as follows:

PART 875--FEDERAL LONG TERM CARE INSURANCE PROGRAM

0
1. The authority citation for 5 CFR 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, the 
definition of special application period.
    The revisions and addition 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 replacing ``and'' with ``;'' at the end of 
paragraph (b); replacing ``.'' with ``;'' at the end of paragraph (c); 
and adding paragraphs (d) and (e).
    The revisions and 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. 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 notice 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 date of the notice.
    (c) The duration of the suspension period, as determined at the 
discretion of the Director and not to exceed 24 months, will be 
announced in the Federal Register notice.
    (d) At least 30 days before the end of the suspension period, OPM 
may issue a notice in the Federal Register announcing an extension to 
the suspension period when OPM determines that such extension is in the 
best interest of the Program. Any extension will conform to the 
requirements of this subsection.

Subpart B--Eligibility

0
6. 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
7. 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   [Reserved]

0
8. Remove and reserve Sec.  875.206.
0
9. Revise Sec.  875.207 to read as follows:

[[Page 33657]]

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
10. 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
11. 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
12. 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
13. 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 of this chapter. 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 
of this chapter, 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
14. 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
15. 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 a Federal Register Notice. The Notice will include the requirements 
for eligible applicants during the special application period.
0
16. 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
17. 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 Federal Register Notice 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 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
18. 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
19. 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
20. Revise Sec.  875.410 to read as follows:

[[Page 33658]]

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
21. 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. 2022-11720 Filed 6-2-22; 8:45 am]
BILLING CODE P


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