[Federal Register Volume 81, Number 140 (Thursday, July 21, 2016)]
[Notices]
[Page 47445]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-17212]
[[Page 47445]]
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OFFICE OF PERSONNEL MANAGEMENT
Notice of Federal Long Term Care Insurance Program Enrollee
Decision Period for Current Enrollees
AGENCY: Office of Personnel Management.
ACTION: Notice of Federal Long Term Care Insurance Program Enrollee
Decision Period for Current Enrollees.
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SUMMARY: The U.S. Office of Personnel Management (OPM) is announcing
rules for current enrollees in the Federal Long Term Care Insurance
Program (FLTCIP) who will be eligible to change coverage during a
limited Enrollee Decision Period to be held this year. These rules
pertain only to current eligible enrollees who may make certain changes
because of premium rate increases that affect most enrollees. Eligible
enrollees whose application was received on or before July 31, 2015,
and whose enrollment was approved may make changes during this Enrollee
Decision Period, provided they are not in benefit eligible status.
Enrollees affected by the premium rate increase will receive
information from Long Term Care Partners, the administrator of FLTCIP,
with information on their opportunities to make changes to their
coverage.
DATES: The Enrollee Decision Period will be from July 18, 2016 through
September 30, 2016.
FOR FURTHER INFORMATION CONTACT: Enrollees may call 1-800-LTC-FEDS (1-
800-582-3337) (TTY: 1-800-843-3557) or visit http://www.ltcfeds.com.
For purposes of this Federal Register notice only, the contact at OPM
is Rina Shah, Senior Policy Analyst, Planning and Policy Analysis at
[email protected] or (202) 606-1427.
SUPPLEMENTARY INFORMATION: The Long-Term Care Security Act (Pub. L.
106-265) directs OPM to provide periodic opportunities for eligible
persons to apply for coverage under the FLTCIP. OPM has issued
regulations (5 CFR 875.402-875.404) which set forth procedures for
FLTCIP open seasons. This notice is issued under the provisions of
Sec. 875.402(c). The Enrollee Decision Period described in this Notice
is solely for current enrollees affected by the premium increase to
make coverage changes. Eligible enrollees will be notified directly
about the Enrollee Decision Period by Long Term Care Partners, LLC, the
program administrator.
Enrollees who are subject to the premium rate increase effective
November 1, 2016 will receive an offer package from Long Term Care
Partners, LLC, with personalized options to allow them to reduce their
coverage in order to mitigate the effect of the premium increase.
Enrollees who make coverage changes outside of the personalized
options provided during the Enrollee Decision Period may be subject to
full underwriting, as specified in Sec. 875.403, and different premium
calculation rules.
Qualified enrollees under these special rules: Persons enrolled in
a FLTCIP standard plan whose application was received on or before July
31, 2015, and whose enrollment was approved, are eligible to make
changes during the Enrollee Decision Period, provided they are not
currently eligible for benefits and were not 80 years of age or older
at purchase. Qualified enrollees will receive an offer package with
personalized options.
Underwriting requirements: Eligible enrollees who wish to reduce
their coverage or keep their current coverage (subject to any
applicable rate increase) will be able to do so without underwriting.
They may also change to a specified personalized option without
underwriting. No enrollee's coverage will change unless he or she
voluntarily chooses to change it. Coverage increases require full
underwriting.
Billing age: For enrollees who retain their current benefits,
premiums are based on the enrollee's age at purchase. For enrollees who
choose to increase their benefits, outside of the Enrollee Decision
Period personalized options, premiums will be determined on a blended
rate basis, taking into account the enrollee's age at purchase and the
enrollee's attained age as of November 1, 2016.
Premiums: Enrollees affected by the premium increase will receive
detailed written information in the 2016 Enrollee Decision Period offer
package. This package will be mailed from Long Term Care Partners, LLC,
the program administrator, and will include the specific amount of
their increase. The package will also include personalized options to
help enrollees reduce the effect of the premium increase. At least one
of the options will allow enrollees to reduce coverage in order to
maintain their current premium at or below the current level that is
paid. Premiums for coverage changes will vary according to the coverage
options selected. Eligible enrollees may also be given an opportunity
to stop paying premiums and convert their coverage to a paid-up,
limited benefit (a consumer protection feature that is built into
FLTCIP coverage).
Effective date: The effective date of coverage changes that do not
require underwriting will be November 1, 2016. Coverage changes
requiring underwriting, if approved, will be effective the first day of
the month following approval of the request, but not before November 1,
2016.
Enrollees who make coverage changes during the Enrollee Decision
Period will receive a new Schedule of Benefits. Enrollees will have 30
days after the date the Schedule of Benefits is received to cancel
their Enrollee Decision Period coverage changes and revert to their
original coverage with the full premium increase.
Authority: 5 U.S.C. 9008; 5 CFR 875.402.
U.S. Office of Personnel Management.
Beth Cobert,
Acting Director.
[FR Doc. 2016-17212 Filed 7-19-16; 11:15 am]
BILLING CODE 6325-63-P