[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: 5CFR890.501]

[Page 467-468]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
                Subpart E_Contributions and Withholdings
 
Sec. 890.501  Government contributions.


    (a) The Government contribution toward subscription charges under 
all health benefits plans, for each enrolled employee who is paid 
biweekly, is the amount provided in section 8906 of title 5, United 
States Code, plus 4 percent of that amount.
    (b) In accordance with the provisions of 5 U.S.C. 8906(a) which take 
effect with the contract year that begins in January 1999, OPM will 
determine the amounts representing the weighted average of subscription 
charges in effect for each contract year, for self only enrollments and 
for self and family enrollments, as follows:
    (1) The determination of the weighted average of subscription 
charges will only include those health benefits plans which are 
continuing FEHB Program participation from one contract year to the 
next.
    (i) If OPM and the carrier for a plan that will continue 
participation have closed negotiations on rates for the upcoming 
contract year by September 1 of the current contract year, i.e., the 
determination year, OPM will use the plan's negotiated subscription 
charges for the upcoming contract year in the determination of the 
weighted average of subscription charges.
    (ii) If OPM and the carrier for a plan that applied to continue 
participation have not closed rate negotiations for the upcoming 
contract year by September 1 of the determination year, OPM will make a 
deemed adjustment to such plan's subscription charges for the current 
contract year for purposes of counting eligible enrollees of the plan in 
the determination of weighted average charges for the upcoming contract 
year. The deemed adjustment will equal any increase or decrease OPM 
finds in its determination of the weighted average of subscription 
charges for the upcoming contract year for all plans with which OPM has 
closed rates on September 1 of the determination year.
    (iii) There will be no subsequent adjustment in the weighted average 
charges applicable to the upcoming contract year to reflect rate 
negotiations closed after September 1 of the determination year.
    (2) Except as otherwise specified in paragraphs (b)(2) (i) and 
(b)(2)(ii) of this section, the weight OPM gives to each subscription 
charge for purposes of determining the weighted average of subscription 
charges for the upcoming contract year will be proportionate to the 
number of individuals who, as of March 31 of the determination year, are 
enrolled in the plan or benefits option to which such charge applies and 
are eligible for a Government health benefits contribution in the 
upcoming contract year.
    (i) When a subscription charge for an upcoming contract year applies 
to a plan that is the result of a merger of two or more plans which 
contract separately with OPM during the determination year, or applies 
to a plan which will cease to offer two benefits options, OPM will 
combine the self only enrollments and the self and family enrollments 
from the merging plans, or from a plan's two benefits options, for 
purposes of weighting subscription charges in effect for the successor 
plan for the upcoming contract year.
    (ii) When a comprehensive medical plan (CMP) varies subscription 
charges for different portions of the plan's service area and the plan's 
contract for the upcoming contract year will reconfigure geographic 
areas associated with subscription charges, so that there will not be a 
direct correlation between enrollment in the determination year and 
rating areas for the upcoming contract year, OPM will estimate what 
portion of the plan's enrollees on March 31 of the determination year 
will be subject to each of the plan's subscription rates for the 
upcoming contract year.
    (3) After OPM weights each subscription charge as provided in 
paragraphs (b)(2), (b)(2)(i), and (b)(2)(ii) of this section, OPM will 
compute the total of subscription charges associated with self only 
enrollments, and the total of subscription charges associated with self 
and family enrollments. OPM will divide each subscription charge total 
by the total number of enrollments such amount represents to obtain the 
program-wide weighted average subscription charges for self only and for

[[Page 468]]

self and family enrollments, respectively.
    (c) The Government contribution for annuitants and for employees who 
are not paid biweekly is a percentage of that fixed by paragraphs (a) 
and (b) of this section proportionate to the length of the pay period, 
rounding fractions of a cent to the nearest cent.
    (d) The Government contribution for employees whose annual pay is 
paid during a period shorter than 52 workweeks is determined on an 
annual basis and prorated over the number of installments of pay 
regularly paid during the year.
    (e) Except as provided in paragraphs (f) and (g) of this section, 
the employing office must make a contribution for an employee for each 
pay period during which the enrollment continues.
    (f) Temporary employees enrolled under 5 U.S.C. 8906a must pay the 
full subscription charge including the Government contribution. 
Employees with provisional appointments under Sec. 316.403 of this 
chapter are not considered to be enrolled under 5 U.S.C. 8906a for the 
purposes of this paragraph.
    (g) The Government contribution for an employee who enters the 
uniformed services and whose enrollment continues under Sec. 890.303(i) 
ceases after 365 days in nonpay status.

[33 FR 12510, Sept. 4, 1968, as amended at 47 FR 30963, July 16, 1982; 
54 FR 7756, Feb. 23, 1989; 56 FR 10143, Mar. 11, 1991; 60 FR 45658, 
Sept. 1, 1995; 63 FR 45934, Aug. 28, 1998; 64 FR 31488, June 11, 1999]