Legislative Proposals

The FY 2024 legislative proposals for OPM are:

• CSRS Disabled Child Benefit Equalization,
• Student Loan Repayment,
• Repeal Aggregate Rate Pay Limitation,
• Improve Financial Management of Tribal FEHB Administrative Fee by Treating as Mandatory Authority,
• Expand FEHB to Tribal Colleges and Universities,
• Require Coverage of Three Primary Care Visits and Three Behavioral Health Visits without Cost-Sharing,
• Expand Medicare Drug Inflationary Rebates to Include the Commercial Market,
• Limit Cost-Sharing for Insulin at $35 per Month,
• Shorten FEDVIP Contract Terms to Allow Flexibility for New Carriers,
• Preempt State/Local Taxation of FEDVIP Carriers to Align with FEHB Carriers,
• Expand FEDVIP to Certain Tribal Employers,
• Expand Family Member Eligibility under FEDVIP, and
• Improve CHCO Council Effectiveness (OPM Administration and Rotating Vice CHCO Chair).

CSRS Disabled Child Benefit Equalization

This proposal would add paragraph (5) to subsection (e) of section 8341 of title 5, United States Code, providing that a disabled child’s benefit paid under the Civil Service Retirement System (CSRS) that was terminated because the child regained the ability for self-support, may be restored if the child again becomes incapable of self-support because of a disability that began before the child reached age 18. This authority already exists under the Federal Employees’ Retirement System at 5 U.S.C. 8443(b) and will correct an inequity relating to annuities for disabled dependents.

Student Loan Repayment

This proposal provides an increase to the allowable amounts an agency may provide and amends the required service agreement period an employee must enter into to receive a student loan repayment. The proposal also clarifies that the maximum allowable total amount of $100,000 applies to the employee over the lifetime of the employee’s Federal civilian service. This means that if the employee received a student loan repayment, left Federal civilian service, and subsequently returned to Federal civilian service, the amount of any new student loan repayment benefits would be added to the amount of the past student loan repayment benefits in applying the $100,000 lifetime limit.

Repeal Aggregate Rate Pay Limitation

This proposal would repeal the aggregate limitation on pay under 5 U.S.C. 5307 for all employees who receive payments under title 5, United States Code. This change would bolster agency retention efforts and would increase the pool of employees willing to seek promotion to the Senior Executive Service (SES). The aggregate limitation on pay caps the total amount of title 5 allowances, differentials, bonuses, awards, and other similar payments an employee may receive in a calendar year, when combined with the employee's basic pay. The aggregate limitation on pay is currently set at EX-I ($226,300 in 2022) or the Vice President’s salary ($261,400 in 2022) for SES/SL/ST employees in certified performance appraisal systems. The proposal would also move the performance appraisal system certification provisions for members of the SES and senior-level employees paid under 5 U.S.C. 5376 (SL/ST) currently found in 5307(d) to a new subchapter III of chapter 43. This new subchapter III of chapter 43 would provide the Director of the Office of Personnel Management sole authority to certify and decertify SES and SL/ST performance appraisal systems and issue regulations regarding certification criteria and procedures.

Improve Financial Management of Tribal FEHB Administrative Fee by Treating as Mandatory Authority

This proposal would provide OPM with direct access to the administrative fee collected for the Tribal FEHB Program as mandatory authority. The fee, which is currently collected from Tribes for participation in the FEHB Program (up to 3 percent of monthly premiums or about $6 per-member-per-month), is not available to OPM outside of the discretionary appropriation for administrative expenses under current statute. The funds would be used for Tribal FEHB-related administrative expenses and system enhancements. These funds would be available to OPM without fiscal year limitation. This proposal would increase FEHB-related administrative costs by $20 million over 10 years.

Expand FEHB to Tribal Colleges and Universities

This proposal would amend Section 409 of the Indian Health Care Improvement Act to expand FEHB eligibility to employers of Tribal colleges and universities (TCUs) that are overseen through the Bureau of Indian Education (BIE) under the Higher Education Act of 1965. There are 33 TCUs overseen by BIE, which are anticipated to increase FEHB enrollment by 3,500. This proposal would increase FEHB enrollment by 0.8% and is not anticipated to impact FEHB premiums. There is no federal budgetary impact of this proposal.

Require Coverage of Three Primary Care Visits and Three Behavioral Health Visits Without Cost-Sharing

Beginning in plan year 2026, this proposal would require all plans and issuers, including FEHB carriers, to cover three primary care visits and three behavioral health visits each year without charging a copayment, coinsurance, or deductible-related fee. For High Deductible Health Plans, these services would be considered pre-deductible for meeting Health Savings Account requirements. This proposal would increase FEHB premiums by approximately 0.8 percent.

Expand Medicare Drug Inflationary Rebates to Include the Commercial Market

The Inflation Reduction Act requires manufacturers to pay rebates to Medicare when drug prices for certain rebatable Medicare Part B or Part D drugs rise at a rate that is faster than the rate of inflation. The budget includes an allowance to revise the formula to calculate these rebates beyond Medicare utilization to include drug units used by commercial plans. Doing so would provide additional savings while discouraging manufacturers from raising drug prices for commercial coverage, including FEHB.

Limit Cost-Sharing for Insulin at $35 per Month

Beginning in plan year 2026, this proposal would require all plans and issuers, including FEHB carriers, to limit cost sharing for insulin at $35 per month. This proposal would increase FEHB premiums by approximately 0.1 percent.

Shorten FEDVIP Contract Terms to Allow Flexibility for New Carriers

The proposal would allow OPM greater flexibility to negotiate and, if necessary, enter into contract terms of a defined duration but not one dictated by a certain contract term. The amendments clarify that OPM can enter into contracts with dental and vision Carriers of at least one year that can automatically be renewed, which provides more flexibility than the current 7-year contract term. There is no government contribution to FEDVIP enrollee premiums, so there is no direct government cost for FEDVIP for this proposal.

Preempt State/Local Taxation of FEDVIP Carriers to Align with FEHB Carriers

This proposal would add specific legislative language to the FEDVIP dental and vision benefit preemption statutes stating that no tax, fee, or other monetary payment may be imposed on a qualified company (often referred to as a “FEDVIP carrier”) offering dental or vision benefits under the FEDVIP by any State, the District of Columbia, the Commonwealth of Puerto Rico, or any territory of the United States, or by any political subdivision or other Governmental authority thereof. It would clarify the statutory preemption and would ensure that no taxes, fees, or monetary assessments could be imposed on FEDVIP carriers. This proposal would maintain consistency across all OPM-administered insurance benefit programs which include similar preemption language.

Expand FEDVIP to Certain Tribal Employers

This proposal would amend Section 409 of the Indian Health Care Improvement Act (IHCIA), 25 U.S.C. 1647b, to expand entitlement to purchase FEDVIP coverage to tribes and tribal organizations carrying out programs under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5301 et seq.), the Tribally Controlled Schools Act of 1988 (25 U.S.C. 2501, et seq.), tribal colleges and universities defined by the Higher Education Act of 1965, and urban Indian organizations carrying out programs under subchapter IV of chapter 18 of title 25.

Expanded Family Member Eligibility Under FEDVIP

This proposal would amend the definition of a dependent family member under chapters 89A and 89B of Title 5 (5 U.S.C 8901) to include persons up to 26 years of age.

This would align availability of vision and dental coverage for dependent children up to age 26 under the Federal Employees Dental and Vision Insurance Program (FEDVIP) with the availability of health coverage under FEHB, pursuant to Public Health Service Act added by section 1001 of the Patient Protection and Affordable Care Act (Pub. L. No. 111-148), as amended section 2301 of the Health Care and Education Reconciliation Act of 2010 (Pub. L. No. 111-152) (collectively, the “Affordable Care Act”).

Improve CHCO Council Effectiveness (OPM Administration and Rotating Vice CHCO Chair)

This proposal adopts and implements key ideas from the March 2021 National Academy of Public Administration (NAPA) report on how to improve OPM. These ideas strengthen OPM, its role as the government-wide leader for strategic human capital management, and the Chief Human Capital Officers (CHCO) Council. First, the proposal adds a rotating vice-chair to the CHCO Council from among its members. The NAPA report identified this specific change as a way for the CHCO Council to be more effective and inclusive of the views of its members. This proposal executes that, by amending section 1303 of Public Law 107-296, with the requirement for the new vice chairperson position being held by a member of the CHCO Council for one-year terms. The second part of this proposal requires OPM, by statute, to administer the CHCO Council. This ensures OPM and the CHCOs will be closely aligned to create a stronger federal workforce with OPM as the government-wide strategic leader. The NAPA report included a finding that OPM’s role as the leader in human capital management should be reaffirmed.

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