Q. Why is OPM publishing this proposed rule?

Q. Why is OPM publishing this proposed rule?
A. This proposed rule is being published to implement the provisions of the Affordable Care Act that require the enrollment of Members of Congress and official staff into Exchange plans. The proposed regulation, open for comment, would implement the requirement that Members of Congress get their health benefits from the Exchanges along with their designated congressional staff and it establishes a way for premiums to continue to be paid with an employer contribution.

Q. Why are Members of Congress and certain Congressional staff no longer eligible for FEHB?
A. The Affordable Care Act includes a provision that Members of Congress and congressional staff employed by the official office of a Member of Congress must obtain coverage from health plans created under the Act or coverage offered via an Affordable Insurance Exchange (Exchanges).

Q. When will these individuals lose FEHB eligibility?
A. Members of Congress and their congressional staff employed by the official office will no longer be eligible for FEHB coverage as of January 1, 2014.

Q. Which Congressional staff will remain eligible for FEHB?
A. This provision of the Act, Section 1312, defines congressional staff as all full-time and part-time employees employed by the official office of a Member of Congress. Because there is not an existing statutory or regulatory definition, OPM believes that Members of Congress are best able to designate which of their staff members work in their official office (and therefore, must choose health plans from the Exchanges). Under the proposed rule, the designation must be made by October of the year before the coverage year so individuals know whether, during open enrollment, to participate in the appropriate state Exchange or the FEHB Program for the following year. OPM may extend the deadline for designation of staff for up to 30 days for the first year. The proposed rule states that this designation will be effective for the entire plan year during which the staff member works for that Member of Congress.

Q. Will Members of Congress and their staff continue to receive a Government Contribution toward the cost of their health insurance premiums?
A. Members of Congress and their congressional staff who are no longer eligible for enrollment in an FEHB plan will continue to receive a Government contribution toward the cost of their premiums for health plans purchased on the Exchange. This contribution will be no greater than the Government contribution provided for other Federal employees eligible for FEHB coverage and purchasing coverage offered by an FEHB plan.