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U.S. OFFICE OF PERSONNEL MANAGEMENT

LATEST NEWS NEWS

News Release

FOR IMMEDIATE RELEASE

Wednesday, August 07, 2013

Contact: Communications and Public Liaison

Tel: 202-606-2402

OPM Issues Proposed Rule Which Details HowMembers of Congress and Congressional Staff will

be Insured through the Health InsuranceExchanges

Washington, DC - The United States Office of Personnel Management (OPM) has issued a

proposed rule to implement the Affordable Care Act (ACA) requirement that Members of Congress

and congressional staff employed by the official office of a Member of Congress choose health plans

offered through Health Insurance Exchanges (also called Marketplaces).

Members of Congress and applicable congressional staff will not be eligible for premium tax credits

for Exchange plans, but the proposed rule clarifies that the participants will continue to have anemployer contribution toward their health insurance premiums. The amount of the employer

contribution toward their Exchange premiums is no more than would otherwise be made toward

coverage under the FEHB Program.

These proposed regulations implement the administrative aspects of switching Members of

Congress and congressional staff to their new insurance plans the same plans available to millions

of Americans through the new Exchanges, said Jon Foley, OPM Director of Planning and Policy.

The statute defines congressional staff to include those who work for the official office of a

Member of Congress. Because there is no existing statutory or regulatory definition of the term

official office, however, the rule proposes that the employing office of the Member of Congressdetermine whether an employed individual meets the statutory definition. Each Member of Congress

and congressional staff will be able to purchase health plans through individual Marketplace in each

State where he or she resides.

Along with the proposed rule, OPM issued a Benefits Administration Letter to the House and Senate

administrative offices to provide further guidance on the enrollment of covered individuals into

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Exchange plans. OPM staff will be working with relevant administrative staff in the House and

Senate to assist with addressing specific issues concerning eligibility, enrollment and payment

processes, with the goal being to ensure that Members of Congress and staff have as smooth as

possible a transition to plans offered on Exchanges.

FEHBP Information for Members of Congress and Congressional Staff (BAL 13-204) is

located at /retirement-services/publications-forms/benefits-administration-letters/#url=2013

Please see individual links below:

BAL - /retirement-services/publications-forms/benefits-administration-letters

/2013/13-204.pdf

Fact Sheet - /retirement-services/publications-forms/benefits-administration-letters

/2013/13-204attachment1.pdf

Q&A - /retirement-services/publications-forms/benefits-administration-letters

/2013/13-204attachment2.pdf

Federal Register Notice - https://s3.amazonaws.com/public-

inspection.federalregister.gov/2013-19222.pdf

- end -

Our mission is to Recruit, Retain and Honor a World-Class Workforce to Serve the American People.

OPM supports U.S. agencies with personnel services and policy leadership including staffing tools,

guidance on labor-management relations and programs to improve work force performance.

Tel: 202-606-2402 | Fax: 202-606-2264

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