Document ID: ./input/supremecourt_opinions/opinions/16pdf/16-149_6jfm.pdf
Page Number: 6

Cite as:  581 U. S. ____ (2017) 

3 

Opinion of the Court 

provisions requiring those carriers to seek subrogation and
reimbursement.  Accordingly,  OPM  has  issued  detailed
regulations  governing  subrogation  and  reimbursement 
clauses in FEHBA contracts.  See 5 CFR §890.106 (2016). 
Under  those  regulations,  a  carrier’s  “right  to  pursue  and 
receive  subrogation  and  reimbursement  recoveries  consti-
tutes  a  condition  of  and  a  limitation  on  the  nature  of 
benefits or benefit payments and on the provision of bene-
fits under the plan’s coverage.”  §890.106(b)(1).

In  2015,  after  notice  and  comment,  OPM  published  a 
rule  confirming  that  “[a]  carrier’s  rights  and  responsibili-
ties  pertaining  to  subrogation  and  reimbursement  under
any [FEHBA] contract relate to the nature, provision, and
extent  of  coverage  or  benefits  (including  payments  with
respect  to  benefits)  within  the  meaning  of ”  §8902(m)(1).
§890.106(h).    Such  “rights  and  responsibilities,”  OPM’s
rule provides, “are . . . effective notwithstanding any state
or  local  law,  or  any  regulation  issued  thereunder,  which 
relates to health insurance or plans.”  Ibid.  Its rule, OPM 
explained, “comports with longstanding Federal policy and
furthers  Congres[s’]  goals  of  reducing  health  care  costs
and enabling uniform, nationwide application of [FEHBA]
contracts.”  80 Fed. Reg. 29203 (2015) (final rule). 

B 
Respondent  Jodie  Nevils  is  a  former  federal  employee
who  enrolled  in  and  was  insured  under  a  FEHBA  plan
offered  by  petitioner  Coventry  Health  Care  of  Missouri.1 
Nevils  v.  Group  Health  Plan,  Inc.,  418  S. W. 3d  451,  453 
(Mo.  2014)  (Nevils  I ).  When  Nevils  was  injured  in  an 
automobile  accident,  Coventry  paid  his  medical  expenses. 
Ibid.    Nevils  sued  the  driver  who  caused  his  injuries  and 
recovered a settlement award.  Ibid.  Based on its contract 

—————— 

1 Coventry  was  formerly  known  as  Group  Health  Plan,  Inc.    Pet.  for 
Cert. ii.  We refer to both the current and former entities as “Coventry.”