DCL-03-39, Federal Office of Personnel Management Interim Rule Implementing Federal Employees Health Benefits Plan Children’s Equity Act of 2000 -- Opportunity to Comment

DEAR COLLEAGUE LETTER

DCL-03-39

ATTACHMENT: OPM Interim Rule Implementing FEHB Children's Equity Act of 2000

DATE: October 31, 2003

TO: All State IV-D Directors

RE: Federal Office of Personnel Management Interim Rule Implementing Federal Employees Health Benefits Plan Children’s Equity Act of 2000 -- Opportunity to Comment

Dear Colleague:

The Federal Office of Personnel Management (OPM) has published an interim rule implementing the Federal Employees Health Benefits (FEHB) Children’s Equity Act of 2000 (Public Law 106-394), which mandates the enrollment of a Federal employee for self and family coverage in the FEHB Program, if the employee is subject to a court or administrative order requiring him/her to provide health benefits for his/her child(ren) and the employee does not provide documentation of compliance with the order. OPM must receive comments to this interim rule on or before December 1, 2003.

As specified in the introductory text to the interim rule,

“Before the enactment of Public Law 106–394, a court or State administrative agency could issue an order for an individual to provide health benefits for his or her child(ren); however, there was nothing in the FEHB law to require compliance. While the issuance of such an order was an event that allowed an employee to enroll or to change from self only to self and family, the enrollment was voluntary on the employee’s part.

“The law now makes compliance with the court or administrative order mandatory. A Federal employee subject to such an order must enroll for self and family coverage in a health plan that provides full benefits in the area where the children live or provide documentation to the agency that he or she has obtained other health benefits for the children. If the employee does not do so, the agency will enroll the employee involuntarily as follows: (1) If the employee has no FEHB coverage, the agency will enroll him or her for self and family coverage in the option of the Blue Cross and Blue Shield Service Benefit Plan that provides the lower level of coverage; (2) if the employee has a self only enrollment in a fee-for-service plan or in an HMO that serves the area where the children live, the agency will change his or her enrollment to self and family in the same option of the same plan; (3) if the employee is enrolled in an HMO that does not serve the area where the children live, the agency will change his or her enrollment to self and family in the lower option of the Blue Cross and Blue Shield Service Benefit Plan.

“As long as the court or administrative order is in effect, and the employee has at least one child identified in the order who is still eligible under the FEHB Program, the employee cannot cancel his or her enrollment, change to self only, or change to a plan that does not serve the area in which the child or children live, unless he or she provides documentation that he or she has other coverage for the children. If the court or administrative order is still in effect at the time the employee retires, and if at least one child is still eligible for FEHB, the employee must continue FEHB into retirement (if eligible) and cannot make any of these changes after retirement for as long as the order remains in effect and the child continues to be eligible under 5 U.S.C. 8901(5).

“If such an employee goes into a nonpay status, or if his or her salary becomes insufficient to make the premium withholdings, he or she cannot choose to terminate the enrollment. Instead, the employee must continue the coverage and either make direct premium payments or incur a debt to the Government. (By law, an employee’s enrollment still terminates after 1 year in nonpay status.) If the annuity of an employee who remained subject to such a court or administrative order upon retirement becomes insufficient to make the premium withholdings, the annuitant cannot choose to terminate the enrollment. Instead, he or she must continue the coverage and make direct premium payments for as long as the order remains in effect and the child continues to be eligible under 5 U.S.C.8901(5).”

The interim rule is effective on October 31, 2003.

We encourage states to review the enclosed interim rule with comment period and to send your comments to OPM, at the address listed in the Federal Register, during the comment period, which ends December 1, 2003. We would appreciate your sending us a copy of any comments you submit to OPM. Please send the copy of your comments to OCSE, 370 L’Enfant Promenade, SW, Washington, DC 20447, attn: Division of Policy, or by email to ahagan@acf.hhs.gov.

If you have any questions, or need additional information, please contact Andrew J. Hagan, OCSE Policy Division at 202-401-5375.

A copy of the interim rule is enclosed.

Sincerely,

Sherri Z. Heller, Ed.D.
Commissioner
Office of Child Support Enforcement

Enclosure:

cc: Regional Program Managers
ACF Regional Administrators