[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: 5CFR890.1305]

[Page 516]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
   Subpart M_Department of Defense Federal Employees Health Benefits 
                      Program Demonstration Project
 
Sec. 890.1305  Termination and cancellation.

    (a) If an enrolled eligible beneficiary moves out of a demonstration 
area, the enrollment of the eligible beneficiary and all family members 
will be terminated. If an enrolled eligible beneficiary moves to an area 
located within a demonstration area, he or she will continue to be 
eligible to participate in the demonstration project. If the eligible 
beneficiary was enrolled prior to the move in an HMO that does not serve 
the new demonstration area, the eligible beneficiary will have an 
opportunity to select a new health plan offered by a carrier 
participating in the demonstration project in the new area. If the 
eligible beneficiary was enrolled in a fee-for-service plan prior to the 
move and moves to another area that is within an existing demonstration 
area, the eligible beneficiary can maintain his or her current coverage.
    (b) If an enrolled eligible beneficiary disenrolls, cancels, or 
terminates enrollment for any reason, he or she will not be eligible to 
reenroll in the demonstration project. Once coverage ends, eligible 
beneficiaries and all family members have the right to resume all of the 
benefits to which they are entitled to under title 10 of the United 
States Code. Medicare-covered eligible beneficiaries and their eligible 
family members who had Medigap policies prior to their enrollment in the 
demonstration project are entitled to reinstate that coverage under the 
conditions stated in section 1108(l) of title 10, United States Code.
    (c) Eligible beneficiaries and their family members are eligible for 
Temporary Continuation of Coverage (TCC) under the conditions and for 
the durations described in subpart K or until the end of the 
demonstration project, whichever occurs first. The effective date of TCC 
for eligible beneficiaries or their eligible family members will be the 
day after other coverage under this subpart ends. Eligible beneficiaries 
or their eligible family members selecting TCC must enroll in a health 
plan offered by a carrier participating in the demonstration project. If 
an eligible beneficiary or eligible family member enrolled in DoD TCC 
moves from a demonstration project area, coverage ends. DoD TCC 
enrollees will be responsible for paying the entire DoD premium rate 
(OPM's approved net-to-carrier DoD rate plus 4 percent for contingency 
and administration reserves) plus 2 percent of this premium rate for 
administration of the program. DoD will make arrangements to collect 
premiums plus the 2 percent administrative charge from eligible 
beneficiaries and forward them to OPM's Employees Health Benefits Fund. 
OPM will establish procedures for receiving the 2 percent administrative 
payment into the Employees Health Benefits Fund and making this amount 
available to DoD for administration of the program.
    (d) Enrolled eligible beneficiaries are not eligible for the 
temporary extension of coverage and conversion opportunities described 
in subpart D of this part.