Home/CFR/Title 5/Part 890
FEDERAL · 5 CFR

Part 890 — Federal Employees Health Benefits Program

190 sections · Title 5: Administrative Personnel

§ 890.101Definitions; time computations.
§ 890.102Coverage.
§ 890.103Correction of errors.
§ 890.104Initial decision and reconsideration on enrollment.
§ 890.105Filing claims for payment or service.
§ 890.106Carrier entitlement to pursue subrogation and reimbursement recoveries.
§ 890.107Court review.
§ 890.108Will OPM waive requirements for continued coverage during retirement?
§ 890.109Exclusion of certain periods of eligibility when determining continued coverage during retirement.
§ 890.110Enrollment reconciliation.
§ 890.111Continuation of eligibility for former Federal employees of the Civilian Marksmanship Program.
§ 890.112Continuation of coverage for certain Senate Restaurants employees.
§ 890.113Designation of FEHB Program services as emergency services under the Antideficiency Act.
§ 890.114Surprise billing and transparency.
§ 890.115Special provisions for Postal Service employees, Postal Service annuitants, and their eligible family members.
§ 890.201Minimum standards for health benefits plans.
§ 890.202Minimum standards for health benefits carriers.
§ 890.203Application for approval of, and proposal of amendments to, health benefit plans.
§ 890.204Withdrawal of approval of health benefits plans or carriers.
§ 890.205Nonrenewal of contracts of health benefits plans.
§ 890.301Opportunities for employees to enroll or change enrollment; effective dates.
§ 890.302Coverage of family members.
§ 890.303Continuation of enrollment.
§ 890.304Termination of enrollment.
§ 890.305Reinstatement of enrollment after military service.
§ 890.306When can annuitants or survivor annuitants change enrollment or reenroll and what are the effective dates?
§ 890.307Waiver or suspension of annuity or compensation.
§ 890.308Disenrollment and removal from enrollment.
§ 890.401Temporary extension of coverage and conversion.
§ 890.501Government contributions.
§ 890.502Withholdings, contributions, LWOP, premiums, and direct premium payment.
§ 890.503Reserves.
§ 890.504Disposition of contingency reserves upon reorganization or merger of plans.
§ 890.505Recurring premium payments to carriers.
§ 890.601Coverage.
§ 890.602Opportunity to change enrollment.
§ 890.603Effective date.
§ 890.604§ 890.604 [Reserved]
§ 890.605Persons confined on effective date.
§ 890.801Introduction.
§ 890.802Definition.
§ 890.803Who may enroll.
§ 890.804Coverage.
§ 890.805Application time limitations.
§ 890.806When can former spouses change enrollment or reenroll and what are the effective dates?
§ 890.807When do enrollments terminate, cancel or suspend?
§ 890.808Employing office responsibilities.
§ 890.901Purpose.
§ 890.902Definition.
§ 890.903Covered services.
§ 890.904Determination of FEHB benefit payment.
§ 890.905Limits on inpatient hospital and physician charges.
§ 890.906Retired enrolled individuals coinsurance payments.
§ 890.907Effective dates.
§ 890.908Notification of HHS.
§ 890.909End-of-year settlements.
§ 890.910Provider information.
§ 890.1001Scope and purpose.
§ 890.1002Use of terminology.
§ 890.1003Definitions.
§ 890.1004Bases for mandatory debarments.
§ 890.1005Time limits for OPM to initiate mandatory debarments.
§ 890.1006Notice of proposed mandatory debarment.
§ 890.1007Minimum length of mandatory debarments.
§ 890.1008Mandatory debarment for longer than the minimum length.
§ 890.1009Contesting proposed mandatory debarments.
§ 890.1010Debarring official's decision of contest.
§ 890.1011Bases for permissive debarments.
§ 890.1012Time limits for OPM to initiate permissive debarments.
§ 890.1013Deciding whether to propose a permissive debarment.
§ 890.1014Notice of proposed permissive debarment.
§ 890.1015Minimum and maximum length of permissive debarments.
§ 890.1016Aggravating and mitigating factors used to determine the length of permissive debarments.
§ 890.1017Determining length of debarment based on revocation or suspension of a provider's professional licensure.
§ 890.1018Determining length of debarment for an entity owned or controlled by a sanctioned provider.
§ 890.1019Determining length of debarment based on ownership or control of a sanctioned entity.
§ 890.1020Determining length of debarment based on false, wrongful, or deceptive claims.
§ 890.1021Determining length of debarment based on failure to furnish information needed to resolve claims.
§ 890.1022Contesting proposed permissive debarments.
§ 890.1023Information considered in deciding a contest.
§ 890.1024Standard and burden of proof for deciding contests.
§ 890.1025Cases where additional fact-finding is not required.
§ 890.1026Procedures if a fact-finding proceeding is not required.
§ 890.1027Cases where an additional fact-finding proceeding is required.
§ 890.1028Conducting a fact-finding proceeding.
§ 890.1029Deciding a contest after a fact-finding proceeding.
§ 890.1030Effect of a suspension.
§ 890.1031Grounds for suspension.
§ 890.1032Length of suspension.
§ 890.1033Notice of suspension.
§ 890.1034Counting a period of suspension as part of a subsequent debarment.
§ 890.1035Provider contests of suspensions.
§ 890.1036Information considered in deciding a contest.
§ 890.1037Cases where additional fact-finding is not required.
§ 890.1038Deciding a contest without additional fact-finding.
§ 890.1039Cases where additional fact-finding is required.
§ 890.1040Conducting a fact-finding proceeding.
§ 890.1041Deciding a contest after a fact-finding proceeding.
§ 890.1042Effective dates of debarments.
§ 890.1043Effect of debarment on a provider.
§ 890.1044Entities notified of OPM-issued debarments and suspensions.
§ 890.1045Informing persons covered by FEHBP about debarment or suspension of their provider.
§ 890.1046Effect of debarment or suspension on payments for services furnished in emergency situations.
§ 890.1047Special rules for institutional providers.
§ 890.1048Waiver of debarment for a provider that is the sole source of health care services in a community.
§ 890.1049Claims for non-emergency items or services furnished by a debarred or suspended provider.
§ 890.1050Exception to a provider's debarment for an individual enrollee.
§ 890.1051Applying for reinstatement when period of debarment expires.
§ 890.1052Reinstatements without application.
§ 890.1053Table of procedures and effective dates for reinstatements.
§ 890.1054Agencies and entities to be notified of reinstatements.
§ 890.1055Contesting a denial of reinstatement.
§ 890.1060Purpose and scope of civil monetary penalties and assessments.
§ 890.1061Bases for penalties and assessments.
§ 890.1062Deciding whether to impose penalties and assessments.
§ 890.1063Maximum amounts of penalties and assessments.
§ 890.1064Determining the amounts of penalties and assessments to be imposed on a provider.
§ 890.1065Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments.
§ 890.1066Notice of proposed penalties and assessments.
§ 890.1067Provider contests of proposed penalties and assessments.
§ 890.1068Effect of not contesting proposed penalties and assessments.
§ 890.1069Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments.
§ 890.1070Deciding contests of proposed penalties and assessments.
§ 890.1071Further appeal rights after final decision to impose penalties and assessments.
§ 890.1072Collecting penalties and assessments.
§ 890.1101Purpose.
§ 890.1102Definitions.
§ 890.1103Eligibility.
§ 890.1104Notification by agency.
§ 890.1105Initial election of temporary continuation of coverage; application time limitations and effective dates.
§ 890.1106Coverage.
§ 890.1107Length of temporary continuation of coverage.
§ 890.1108Opportunities to change enrollment; effective dates.
§ 890.1109Premium payments.
§ 890.1110Termination of enrollment or coverage.
§ 890.1111Employing office responsibilities.
§ 890.1112Denial of continuation of coverage due to involuntary separation for gross misconduct.
§ 890.1113The administrative charge.
§ 890.1201Purpose.
§ 890.1202Definitions.
§ 890.1203Coverage.
§ 890.1204Effective date of coverage.
§ 890.1205Change in type of enrollment.
§ 890.1206Cancellation of coverage.
§ 890.1207Termination of coverage.
§ 890.1208Premiums.
§ 890.1209Responsibilities of the U.S. Department of State.
§ 890.1210Reconsideration and appeal rights.
§ 890.1301Purpose.
§ 890.1302Duration.
§ 890.1303Eligibility.
§ 890.1304Enrollment.
§ 890.1305Termination and cancellation.
§ 890.1306Government premium contributions.
§ 890.1307Data collection.
§ 890.1308Carrier participation.
§ 890.1401Purpose.
§ 890.1402Definitions and deemed references.
§ 890.1403Tribal employer purchase of FEHB requires current deposit of premium payment and timely payment of administrative fee.
§ 890.1404Tribal employer election and agreement to purchase FEHB.
§ 890.1405Tribal employees eligible for enrollment.
§ 890.1406Correction of enrollment errors.
§ 890.1407Enrollment process; effective dates.
§ 890.1408Change in enrollment type, plan, or option.
§ 890.1409Cancellation of coverage or decreases in enrollment.
§ 890.1410Termination of enrollment and 31-day temporary extension of coverage; and conversion to individual policy.
§ 890.1411Temporary Continuation of Coverage (TCC).
§ 890.1412Non-pay status, insufficient pay, or change to ineligible position.
§ 890.1413Premiums and administrative fee.
§ 890.1414Responsibilities of the tribal employer.
§ 890.1415Reconsideration of enrollment and eligibility decisions and appeal rights.
§ 890.1416Filing claims for payment or service and court review.
§ 890.1417No continuation of FEHB enrollment into retirement from employment with a tribal employer.
§ 890.1418No continuation of FEHB enrollment in compensationer status past 365 days.
§ 890.1601Purpose.
§ 890.1602Definitions and deemed references.
§ 890.1603Eligibility for the Postal Service Health Benefits Program.
§ 890.1604Medicare enrollment requirement for certain Postal Service annuitants and eligible family members.
§ 890.1605Enrollment in the initial contract year.
§ 890.1606Opportunities to enroll, change enrollment, or reenroll; effective dates.
§ 890.1607Initial decision and reconsideration.
§ 890.1608Disenrollment, removal, termination, cancellation, and suspension.
§ 890.1609Temporary extension of coverage, conversion, or temporary continuation of coverage.
§ 890.1610Minimum standards for PSHB Program plans and Carriers.
§ 890.1611Withdrawal of approval of health benefits plan or carrier.
§ 890.1612Information sharing.
§ 890.1613Postal Service contract year beginning date, Medicare late enrollment penalty, calculations for the Postal Service Retiree Health Benefits Fund, and clarification of statutory terms.
§ 890.1614Other administrative provisions.
§ 890.1615Crediting separate reserves for PSHB.
§ 890.1616Medicare Part D.