§890.1610. Minimum standards for PSHB Program plans and Carriers.
5 C.F.R. § 890.1610
Minimum standards for PSHB plans. To qualify for approval by OPM, a health benefits plan under this subpart shall—
Meet the minimum standards for health benefits plans at § 890.201, unless otherwise stated in this subpart;
Provide prescription drug benefits pursuant to 5 U.S.C. 8903c(h)(2);
Provide equivalent benefits and cost-sharing in the initial contract year to the carrier's FEHB plan, as applicable, pursuant to section 8903c(c)(2);
Maintain separate reserves, including contingency reserves, with respect to enrollees in each PSHB plan as directed by OPM; and
Begin coverage on January 1 of each year.
Minimum standards for PSHB Carriers. The minimum standards for health benefits carriers under this subpart shall be those contained in 48 CFR 1609.70.
Approval of plans with 1,500 or more Postal enrollees. To the greatest extent practicable, in the initial contract year, OPM shall approve a health benefits plan offered by a carrier under this subpart that has equivalent benefits and cost-sharing to the FEHB plan offered by that carrier in which the total enrollment of Postal Service employees and Postal Service annuitants was 1,500 or more in the 2023 contract year. OPM may exempt a comprehensive medical plan, as described in 5 U.S.C. 8903(4), from the requirement in this paragraph (c).
Withdrawal of plan approval. Failure on the part of the PSHB Carrier's plan to meet the standards in this section is cause for OPM's withdrawal of approval of the plan in accordance with § 890.1611.
Notes, amendments, and revision history
Source
Source: 88 FR 20403, Apr. 6, 2023, unless otherwise noted.
Authority
Authority: 5 U.S.C. 8913. Sec. 890.102 also issued under sections 11202(f), 11232(e), and 11246(b) of Pub. L. 105-33, 111 Stat. 251. Sec. 890.111 also issued under 36 U.S.C. 5522. Sec. 890.112 also issued under 2 U.S.C. 2051. Sec. 890.113 also issued under section 1110 of Pub. L. 116-92, 133 Stat. 1198 (5 U.S.C. 8702 note). Sec. 890.301 also issued under 26 U.S.C. 9801. Sec. 890.302(b) also issued under 42 U.S.C. 300gg-14. Sec. 890.803 also issued under 50 U.S.C. 3516 (formerly 50 U.S.C. 403p); 22 U.S.C. 4069c and 4069c-1. Subpart L also issued under section 599C of Pub. L. 101-513, 104 Stat. 2064 (5 U.S.C. 5561 note). Subpart M also issued under 10 U.S.C. 1108; 25 U.S.C. 1647b. Subpart P also issued under 5 U.S.C. 8903c.
Source
Source: 33 FR 12510, Sept. 4, 1968, unless otherwise noted.