[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR890.104]

[Page 439]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
             Subpart A_Administration and General Provisions
 
Sec. 890.104  Initial decision and reconsideration on enrollment.

    (a) Who may file. Except as provided under Sec. 890.1112, an 
individual may request an agency or retirement system to reconsider an 
initial decision of its employing office denying coverage or change of 
enrollment.
    (b) Initial employing office decision. An employing office's 
decision is considered an initial decision as used in paragraph (a) of 
this section when rendered by the employing office in writing and 
stating the right to an independent level of review (reconsideration) by 
the agency or retirement system. However, an initial decision rendered 
at the highest level of review available within OPM is not subject to 
reconsideration.
    (c) Reconsideration. (1) A request for reconsideration must be made 
in writing, must include the claimant's name, address, date of birth, 
Social Security number, name of carrier, reason(s) for the request, and, 
if applicable, retirement claim number.
    (2) The reconsideration review must be an independent review 
designated at or above the level at which the initial decision was 
rendered.
    (d) Time limit. A request for reconsideration of an initial decision 
must be filed within 30 calendar days from the date of the written 
decision stating the right to a reconsideration. The time limit on 
filing may be extended when the individual shows that he or she was not 
notified of the time limit and was not otherwise aware of it, or that he 
or she was prevented by circumstances beyond his or her control from 
making the request within the time limit. An agency or retirement system 
decision in response to a request for reconsideration of an employing 
office's decision is a final decision as described in paragraph (e) of 
this section.
    (e) Final decision. After reconsideration, the agency or retirement 
system must issue a final decision, which must be in writing and must 
fully set forth the findings and conclusions.

[59 FR 66437, Dec. 27, 1994]