[Federal Register Volume 60, Number 55 (Wednesday, March 22, 1995)]
[Proposed Rules]
[Pages 15074-15075]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-7031]



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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. 60, No. 55 / Wednesday, March 22, 1995 / 
Proposed Rules
[[Page 15074]]

OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 890

RIN 3206-AG40


Federal Employees Health Benefits Program; HMO Plan Applications

agency: Office of Personnel Management.

action: Proposed rulemaking.

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summary: The Office of Personnel Management (OPM) is issuing proposed 
regulations that would clarify the policy under which it invites 
applications from comprehensive medical plans (HMO's) to participate in 
the Federal Employees Health Benefits (FEHB) Program. This 
clarification is necessary in order to ensure that OPM and the HMO's 
are providing the best possible service to FEHB enrollees.

dates: Comments must be received on or before May 22, 1995.

addresses: Written comments may be sent to Lucretia F. Myers, Assistant 
Director for Insurance Programs, Retirement and Insurance Group, Office 
of Personnel Management, P.O. Box 57, Washington, DC 20044; delivered 
to OPM, Room 4351, 1900 E Street NW., Washington, DC.; or FAXed to 
(202) 606-0633.

for further information contact: Mary Ann Mercer, (202) 606-0004.

supplementary information: On December 5, 1994, OPM published an 
interim regulation in the Federal Register (59 FR 62283) to clarify the 
policy under which it invites applications from comprehensive medical 
plans (HMO's) to participate in the FEHB Program. This year, OPM made a 
determination not to invite new plan applications, with a limited 
exception, for contract year 1996.
    OPM received numerous written comments and phone calls concerning 
the regulation. All of the commenters object that OPM did not give 
HMO's sufficient notice of its determination not to accept applications 
for the 1996 contract year. They contend that many HMO's had already 
expended a substantial amount of time in preparation for the 
application process and that OPM's decision, therefore, has caused them 
undue hardship.
    After careful consideration of the comments received, OPM has 
concluded that its timeframes had, in fact, been too compressed to 
allow for a thorough review of all the consequences of the decision not 
to invite applications. As a result, OPM has decided to accept both 
applications and benefit change proposals for contract year 1996. In 
addition, OPM is issuing this regulation as proposed rulemaking in 
order to provide the public with a longer comment period. Because the 
deadline for submission of applications is already past, OPM is 
extending the application due date for the 1996 contract year from 
January 31 to March 31, 1995.

E.O. 12866, Regulatory Review

    This rule has been reviewed by OMB in accordance with E.O. 12866.

Regulatory Flexibility Act

    I certify that these regulations will not have a significant 
economic impact on a substantial number of small entities because they 
primarily affect OPM's administrative procedures.

List of Subjects in 5 CFR Part 890

    Administrative practice and procedure, Government employees, Health 
facilities, Health insurance, Health professions, Hostages, Iraq, 
Kuwait, Lebanon, Reporting and recordkeeping requirements, Retirement.

Office of Personnel Management.
James B. King,
Director.

    Accordingly, OPM proposes to amend 5 CFR part 890 as follows:

PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM

    1. The authority citation for part 890 continues to read as 
follows:

    Authority: 5 U.S.C. 8913; Sec. 890.803 also issued under 50 
U.S.C. 403p, 22 U.S.C. 4069c and 4069c-1; subpart L also issued 
under sec. 599C of Pub. L. 101-513, 104 Stat. 2064, as amended.

    2. In Sec. 890.203, paragraph (a)(1) is revised, paragraphs (a)(2) 
through (a)(4) are redesignated as paragraphs (a)(3) through (a)(5) 
respectively; newly designated paragraph (a)(5) is amended by revising 
the last sentence; a new paragraph (a)(2) is added; and a heading is 
added for paragraph (b) to read as follows:


Sec. 890.203  Application for approval of, and proposal of amendments 
to, health benefits plans.

    (a) New plan applications. (1) The Director of OPM shall consider 
applications to participate in the FEHB Program from comprehensive 
medical plans (CMP's) at his or her discretion. If the Director of OPM 
determines that it is beneficial to enrollees and the Federal Employees 
Health Benefits Program to invite new plans to join the Program, OPM 
will publish a notice in the Federal Register.
    (2) When invited to participate, CMP's should apply for approval by 
writing to the Office of Personnel Management, Washington, DC 20415. 
Application letters must be accompanied by any descriptive material, 
financial data, or other documentation required by OPM. Plans must 
submit the letter and attachments in the OPM-specified format by 
January 31, or another date specified by OPM, of the year preceding the 
contract year for which applications are being accepted. Plans must 
submit evidence demonstrating they meet all requirements for approval 
by March 31 of the year preceding the contract year for which 
applications are being accepted. Plans that miss either deadline cannot 
be considered for participation in the next contract year. All newly 
approved plans must submit benefit and rate proposals to OPM by May 31 
of the year preceding the contract year for which applications are 
being accepted in order to be considered for participation in that 
contract year. OPM may make counter-proposals at any time.
* * * * *
    (5) * * * The extent of the data and documentation to be submitted 
by a plan so certified by HHS, as well as by a non-certified plan, for 
a particular review cycle may be obtained by writing directly to the 
Office of Insurance Programs, Retirement and Insurance Group, Office of 
Personnel Management, Washington, DC 20415. [[Page 15075]] 
    (b) Participating plans. * * *

[FR Doc. 95-7031 Filed 3-21-95; 8:45 am]
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