Unknown. Final rule

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--- schema: federal-register doc_type: fedreg source_file: FR-2015-05-21.xml --- 80 98 Thursday, May 21, 2015 Contents Agriculture Agriculture Department See National Agricultural Statistics Service Consumer Financial Protection Bureau of Consumer Financial Protection NOTICES Requests for Information: Student Loan Servicing, 29302-29312 2015-12276 Children Children and Families Administration NOTICES Awards of Single-Source Cooperative Agreements: American Public Human Services Association for the Association of Administrators of the Interstate Compact on the Placement of Children, 29322-29323 2015-12418 Coast Guard Coast Guard RULES Drawbridge Operations:

St. Croix River, Stillwater, MN, 29220 2015-12353 Commerce Commerce Department See Industry and Security Bureau See International Trade Administration See National Oceanic and Atmospheric Administration Commodity Futures Commodity Futures Trading Commission NOTICES Orders: Southwest Power Pool, Inc.; Application for Exemption From Certain Provisions of the Commodity Exchange Act, 29490-29522 2015-12346 Community Living Administration Community Living Administration NOTICES Applications for New Awards:

National Institute on Disability, Independent Living, and Rehabilitation Research; Rehabilitation Research and Training Centers, 29326-29330 2015-12311 Priorities, Requirements, Definitions, and Selection Criteria: National Institute on Disability, Independent Living, and Rehabilitation Research; Rehabilitation Research and Training Centers, 29323-29325 2015-12308 Single Source Non-Competing Continuation Cooperative Agreements: Eight Grant Projects Under the Part A--The Enhanced ADRC Options Counseling Program, 29325-29326 2015-12312 Defense Department Defense Department NOTICES Agency Information Collection Activities;

Proposals, Submissions, and Approvals, 29314-29315 2015-12345 Privacy Act; Systems of Records, 29312-29317 2015-12334 2015-12324 Defense Nuclear Defense Nuclear Facilities Safety Board NOTICES Meetings; Sunshine Act, 29317 2015-12393 Drug Drug Enforcement Administration PROPOSED RULES Schedules of Controlled Substances: Acetyl Fentanyl; Temporary Placement into Schedule I, 29227-29230 2015-12331 NOTICES Importers of Controlled Substances; Registrations: Fisher Clinical Services, Inc., 29338 2015-12328 Mallinckrodt, LLC, 29338 2015-12325 Mylan Pharmaceuticals, Inc., 29337 2015-12327 Myoderm, 29336-29337 2015-12329 Noramco, Inc., 29337-29338 2015-12323 Manufacturers of Controlled Substances;

Applications: PCAS-NANOSYN, LLC, 29336 2015-12330 Education Department Education Department NOTICES Meetings: National Advisory Council on Indian Education, 29318-29319 2015-12265 National Board for Education Sciences, 29317-29318 2015-12320 Energy Department Energy Department See Federal Energy Regulatory Commission Environmental Protection Environmental Protection Agency PROPOSED RULES Air Quality State Implementation Plans; Approvals and Promulgations: North Carolina; Non-interference Demonstration for Federal Low-Reid Vapor Pressure Requirement for Gaston and Mecklenburg Counties, 29230-29237 2015-12348 North Carolina;

Redesignation of the Charlotte-Rock Hill, 2008 8-Hour Ozone Nonattainment Area to Attainment, 29250-29262 2015-12352 Tennessee; Redesignation of the Knoxville 2008 8-Hour Ozone Nonattainment Area to Attainment; Designation of Areas for Air Quality Planning Purposes, 29237-29250 2015-12347 NOTICES Test Data Under the Toxic Substances Control Act, 29320-29321 2015-12336 Federal Aviation Federal Aviation Administration RULES Airworthiness Directives: Airbus Helicopters (Previously Eurocopter France) Helicopters, 29205-29208 2015-12004 Special Conditions:

Cirrus Design Corporation Model SF50 Airplane; Full Authority Digital Engine Control System; Withdrawal, 29205 2015-12262 Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures: Miscellaneous Amendments, 29208-29220 2015-12108 2015-12110 2015-12111 2015-12123 PROPOSED RULES Airworthiness Directives: Turbomeca S.A. Turboshaft Engines, 29224-29226 2015-12039 Amendments of Class E Airspace: Tekamah, NE, 29226-29227 2015-12105 NOTICES Release of Airport Property:

Lewistown Municipal Airport, Lewistown, MT, 29382-29383 2015-12373 Federal Energy Federal Energy Regulatory Commission NOTICES Combined Filings, 29319-29320 2015-12297 Federal Railroad Federal Railroad Administration NOTICES Buy America Waivers: Long Island Rail Road; Purchase of Seven U.S.-Made Turnouts Containing Four Non-Domestic Components, 29383-29384 2015-12332 Federal Reserve Federal Reserve System NOTICES Changes in Bank Control: Acquisitions of Shares of a Bank or Bank Holding Company, 29322 2015-12317 Formations of, Acquisitions by, and Mergers of Bank Holding Companies, 29322 2015-12318 Proposals To Engage in or To Acquire Companies Engaged in Permissible Nonbanking Activities, 29321 2015-12319 Fish Fish and Wildlife Service PROPOSED RULES Endangered and Threatened Wildlife and Plants:

Louisiana Black Bear; Removal From List of Endangered and Threatened Wildlife; Removal of Similarity-of-Appearance Protections for American Black Bear, 29394-29429 2015-11748 Revisions to Regulations for Petitions, 29286-29296 2015-12316 Refuge-Specific Regulations; Public Use: Kenai National Wildlife Refuge, 29277-29286 2015-12099 Health and Human Health and Human Services Department See Children and Families Administration See Community Living Administration See National Institutes of Health NOTICES Agency Information Collection Activities;

Proposals, Submissions, and Approvals, 29330-29331 2015-12274 Homeland Homeland Security Department See Coast Guard Industry Industry and Security Bureau RULES Wassenaar Arrangement Plenary Agreements Implementation and Country Policy Amendments, 29432-29456 2015-10579 NOTICES Reporting on Offsets Agreements Related to Sales of Defense Articles or Defense Services to Foreign Countries or Foreign Firms, 29299-29300 2015-12394 Interior Interior Department See Fish and Wildlife Service See Land Management Bureau See National Park Service International Trade Adm International Trade Administration NOTICES Antidumping or Countervailing Duty Investigations, Orders, or Reviews:

Lined Paper Products From India, 29300-29301 2015-12337 International Trade Com International Trade Commission NOTICES Investigations; Determinations, Modifications, and Rulings, etc.: Certain Snowmobiles With Engines Having Exhaust Temperature-Controlled Engine Technology and Components Thereof, 29336 2015-12301 Justice Department Justice Department See Drug Enforcement Administration NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals: Entry of Appearance as Attorney or Representative Before the Immigration Court, 29339-29340 2015-12310 Identification of Imported Explosive Materials, 29338-29339 2015-12309 Unfair Immigration-Related Employment Practices Complaint Form, 29340 2015-12313 Labor Department Labor Department See Occupational Safety and Health Administration Land Land Management Bureau NOTICES Meetings:

John Day—Snake Resource Advisory Council, 29333-29334 2015-12299 Requests for Nominations: Resource Advisory Councils, 29332-29333 2015-12358 Resource Management Plans: Coastal Monument; Inclusion of the Point Arena-Stornetta Unit, CA, 29331-29332 2015-12360 Maritime Maritime Administration NOTICES Guidance for Industry and Staff: Merchant Marine Awards and Flags Program; Policy Announcements, 29384-29387 2015-12088 NASA National Aeronautics and Space Administration NOTICES Meetings:

NASA Advisory Council; Science Committee; Planetary Protection Subcommittee, 29348 2015-12326 National Agricultural National Agricultural Statistics Service NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals, 29299 2015-12322 National Highway National Highway Traffic Safety Administration PROPOSED RULES Motor Vehicle Safety Standards: Motorcycle Helmets, 29458-29487 2015-11756 National Institute National Institutes of Health NOTICES Meetings:

Eunice Kennedy Shriver National Institute of Child Health and Human Development, 29331 2015-12251 National Oceanic National Oceanic and Atmospheric Administration RULES International Fisheries: Western and Central Pacific Fisheries for Highly Migratory Species; Fishing Effort Limits in Purse Seine Fisheries for 2015, 29220-29223 2015-12286 PROPOSED RULES Endangered and Threatened Wildlife and Plants: Revisions to Regulations for Petitions, 29286-29296 2015-12316 Fisheries Off West Coast States:

Coastal Pelagic Species Fisheries; Annual Specifications, 29296-29298 2015-12321 NOTICES Environmental Impact Statements; Availability, etc.: Mid-Atlantic Fishery Management Council; Fisheries of the Northeastern United States; Scoping Process, 29301-29302 2015-12261 National Park National Park Service NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals: Cape Lookout National Seashore Cultural Resource Values and Vulnerabilities Assessment, 29334-29335 2015-12306 Records of Decisions:

Golden Gate National Recreation Area, California, 29335-29336 2015-12376 Nuclear Regulatory Nuclear Regulatory Commission NOTICES Emergency Planning Exemption Requests: Decommissioning Nuclear Power Plants, 29348-29350 2015-12377 Guidance: Nonmetallic Thermal Insulation for Austenitic Stainless Steel, 29350-29351 2015-12292 Occupational Safety Health Adm Occupational Safety and Health Administration NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals:

Asbestos in Shipyards Standard, 29344-29345 2015-12289 Cadmium in Construction Standard, 29346-29348 2015-12288 Marine Terminals and Longshoring Standards, 29341-29342 2015-12245 Expansions of Recognition: Curtis-Straus, LLC, 29342-29344 2015-12287 Meetings: Preparations for the UN Sub-Committee of Experts on the Globally Harmonized System of Classification and Labelling of Chemicals, 29345-29346 2015-12268 Personnel Personnel Management Office RULES Federal Employees Health Benefits Program;

Subrogation and Reimbursement Recovery, 29203-29205 2015-12378 Pipeline Pipeline and Hazardous Materials Safety Administration PROPOSED RULES Pipeline Safety: Plastic Pipe, 29263-29277 2015-12113 NOTICES Special Permit Applications: Delayed Applications, 29387-29388 2015-11815 Hazardous Materials, 29388-29389 2015-11827 Postal Regulatory Postal Regulatory Commission NOTICES New Postal Products, 29351-29352 2015-12269 2015-12270 Presidential Documents Presidential Documents PROCLAMATIONS Special Observances:

Head Start, 50th Anniversary (Proc. 9284), 29523-29526 2015-12574 ADMINISTRATIVE ORDERS Iraq; Continuation of National Emergency (Notice of May 19, 2015), 29527 2015-12575 Securities Securities and Exchange Commission NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals, 29376-29378 2015-12285 Self-Regulatory Organizations; Proposed Rule Changes: Fixed Income Clearing Corp., 29352-29357 2015-12281 ICE Clear Credit, LLC, 29357 2015-12282 International Securities Exchange, LLC, 29358-29359 2015-12283 NASDAQ Stock Market, LLC, 29359-29364, 29370-29376 2015-12280 2015-12284 Options Clearing Corp., 29364-29370 2015-12293 2015-12294 Small Business Small Business Administration NOTICES Administrator's Line of Succession Designation, 29378-29379 2015-12362 Disaster Declarations:

Alabama, 29379 2015-12366 West Virginia, 29378 2015-12372 State Department State Department NOTICES Culturally Significant Objects Imported for Exhibition: Gustave Caillebotte—The Painter's Eye, 29380-29381 2015-12481 Power and Pathos—Bronze Sculpture of the Hellenistic World; Pergamon and the Art of the Hellenistic Kingdom, 29379-29380 2015-12482 Van Gogh and Nature, 29381 2015-12480 Exchange Visitor Program: Establishment of a Private Sector U.S.-Mexico Intern Program, 29380 2015-12333 Surface Transportation Surface Transportation Board NOTICES Abandonment Exemptions:

R.J. Corman Railroad Co./Allentown Lines, Inc., Lehigh County, PA, 29390 2015-12314 Lease and Operation Exemptions: LEWPAC, LLC; Mount Vernon Terminal Railway, LLC, 29389-29390 2015-12368 Petitions for Declaratory Orders: Tri-City Railroad Co., 29390-29391 2015-12409 Tennessee Tennessee Valley Authority NOTICES Environmental Impact Statements; Availability, etc.: Disposal of Coal Combustion Residuals From the Bull Run Fossil Plant, 29381-29382 2015-12305 Trade Representative Trade Representative, Office of United States NOTICES WTO Dispute Settlement Proceeding Regarding Certain Measures Providing Export-Contingent Subsidies to Enterprises in Several Industrial Sectors in China;

Correction, 29382 2015-12279 Transportation Department Transportation Department See Federal Aviation Administration See Federal Railroad Administration See Maritime Administration See National Highway Traffic Safety Administration See Pipeline and Hazardous Materials Safety Administration See Surface Transportation Board Treasury Treasury Department NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals, 29391 2015-12307 U.S. Institute United States Institute of Peace NOTICES Facility Management Services, 29391-29392 2015-12291 Separate Parts In This Issue Part II Interior Department, Fish and Wildlife Service, 29394-29429 2015-11748 Part III Commerce Department, Industry and Security Bureau, 29432-29456 2015-10579 Part IV Transportation Department, National Highway Traffic Safety Administration, 29458-29487 2015-11756 Part V Commodity Futures Trading Commission, 29490-29522 2015-12346 Part VI Presidential Documents, 29523-29527 2015-12574 2015-12575 Reader Aids Consult the Reader Aids section at the end of this page for phone numbers, online resources, finding aids, reminders, and notice of recently enacted public laws.

To subscribe to the Federal Register Table of Contents LISTSERV electronic mailing list, go to http://listserv.access.gpo.gov and select Online mailing list archives, FEDREGTOC-L, Join or leave the list (or change settings); then follow the instructions. 80 98 Thursday, May 21, 2015 Rules and Regulations OFFICE OF PERSONNEL MANAGEMENT 5 CFR Part 890 RIN 3206-AN14 Federal Employees Health Benefits Program; Subrogation and Reimbursement Recovery AGENCY: Office of Personnel Management.

ACTION: Final rule. SUMMARY: The United States Office of Personnel Management

(OPM)is issuing a final rule to amend the Federal Employees Health Benefits

(FEHB)Program regulations to reaffirm the conditional nature of FEHB Program benefits and benefit payments under the plan's coverage as subject to a carrier's entitlement to subrogation and reimbursement recovery, and therefore, that such entitlement falls within the preemptive scope of the FEHA Act. FEHB contracts and brochures must include, and in practice already include, a provision incorporating the carrier's subrogation and reimbursement rights, and FEHB plan brochures must contain an explanation of the carrier's subrogation and reimbursement policy. DATES: This final rule is effective June 22, 2015. FOR FURTHER INFORMATION CONTACT: Marguerite Martel, Senior Policy Analyst at

(202)606-0004. SUPPLEMENTARY INFORMATION: The FEHB Act, as codified at 5 U.S.C. 8902(m)(1), provides: “The terms of any contract under this chapter which relate to the nature, provision, or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans.” This final regulation reaffirms that a covered individual's entitlement to FEHB benefits and benefit payments is conditioned upon, and limited by, a carrier's entitlement to subrogation and reimbursement recoveries pursuant to a subrogation or reimbursement clause in the FEHB contract. This final regulation also reaffirms that a FEHB carrier's rights and responsibilities pertaining to subrogation and reimbursement relate to the nature, provision and extent of coverage or benefits and benefit payments provided under title 5, United States Code Chapter 89, and therefore are effective notwithstanding any state or local law or regulation relating to health insurance or plans. Some state courts have interpreted ambiguity in Section 8902(m)(1) to reach a contrary result and thereby to allow state laws to prevent or limit subrogation or reimbursement rights under FEHB contracts. In this final rule, OPM is exercising its rulemaking authority under 5 U.S.C. 8913 to ensure that carriers enjoy the full subrogation and reimbursement rights provided for under their contracts. The interpretation of Section 8902(m)(1) promulgated herein comports with longstanding Federal policy and furthers Congress's goals of reducing health care costs and enabling uniform, nationwide application of FEHB contracts. The FEHB program insures approximately 8.2 million federal employees, annuitants, and their families, a significant proportion of whom are covered through nationwide fee-for-service plans with uniform rates. The government pays on average approximately 70% of Federal employees' plan premiums. 5 U.S.C. 8906(b), (f). The government's share of FEHB premiums in 2014 was approximately $33 billion, a figure that tends to increase each year. OPM estimates that FEHB carriers were reimbursed by approximately $126 million in subrogation recoveries in that year. Subrogation recoveries translate to premium cost savings for the federal government and FEHB enrollees. OPM proposed this amendment in a notice of proposed rulemaking on January 7, 2015 (80 FR 931). The proposed rule had a 30 day comment period during which OPM received 3 comments. Responses to comments on the proposed rule: OPM received comments from an association of FEHB carriers, a trade association serving subrogation and recovery professionals, and a provider of subrogation and recovery services. The comments all expressed support for the regulation and suggested some changes to clarify the language in the proposed rule. All commenters suggested edits to the proposed definitions of “subrogation” and “reimbursement” at 5 CFR 890.101 to more completely reflect the universe of FEHB Program plan recoveries. All three commenters expressed concern with the reference to “a responsible third party” in the definitions, indicating that the use of this phrase has been interpreted to foreclose “first party” claims for subrogation and recoveries, such as uninsured and underinsured motorist coverage, and recommended adding other insurance including workers' compensation insurance, to the definition to be consistent with entitlements listed in the proposed § 890.106(c)(2) and (f). OPM agrees that the definitions of subrogation and reimbursement should include first party claims. In addition, commenters noted that § 890.106(b) and

(f)should be updated to reflect this change. The definitions at § 890.101 and other corresponding sections have been updated accordingly as necessary. The commenters also suggested additional specific changes to the proposed definition of “reimbursement.” Two of the commenters noted that the definition of reimbursement should address the situation of both illness and injury. OPM has revised the definition of reimbursement to accept this change. One commenter suggested that the final rule clarify that the right of reimbursement is cumulative with and not exclusive of the right of subrogation. OPM has incorporated this clarification. Two commenters suggested that the definition should reflect that a covered individual need not have actually received a recovery payment so long as the covered individual is entitled to receive a payment. OPM does not agree that the right of reimbursement is sufficiently broad to require an individual to reimburse the carrier in a circumstance where the individual has not actually received a recovery, and rejects this change. One commenter indicated that the right of reimbursement is specific to a recovery from an individual who has received a third party payment while the right of subrogation permits a carrier to recover directly from other sources. OPM agrees with this comment and has clarified the definition of “subrogation” accordingly. One commenter suggested that § 890.106(b) be amended to align the regulation and FEHB carrier contract requirements. OPM has revised this section to refer to contractual requirements. One commenter noted that § 890.106(f) should be clarified to ensure that the carrier has a subrogation right to recover directly from a responsible insurer all amounts available to or on behalf of the covered individual. We have clarified the provision accordingly. Two commenters noted that proposed § 890.106(b) and

(h)did not clearly reflect OPM's intention for this regulation to apply to existing contracts. We agree and are slightly revising the language of paragraphs

(b)and

(h)to be clearer. Paragraph

(h)formalizes OPM's longstanding interpretation of what Section 8902(m)(1) has meant since Congress enacted it in 1978. This interpretation applies to all FEHBA contracts. Paragraph (b)(1) in the final rule likewise formalizes OPM's longstanding interpretation of subrogation and reimbursement clauses in carrier contracts as constituting a condition of and a limitation on the nature of benefits or benefits payments and on the provision of benefit payments. See Carrier Letter 2012-18. FEHBA contracts that contain subrogation and reimbursement clauses condition benefits and benefit payments on giving the carrier a right to pursue subrogation and reimbursement and therefore are directly related to benefits, benefit payments, and coverage within the meaning of Section 8902(m)(1). The interpretations in paragraphs (b)(1) and

(h)together clarify and ensure that carriers enjoy full subrogation and reimbursement rights notwithstanding any state law to the contrary, and they apply in any pending or future case. To clarify further the relationship among subrogation, reimbursement, benefits, and coverage, we are also in paragraph (b)(2) requiring carrier contracts that contain subrogation and reimbursement clauses to contain language specifying that benefits and benefit payments are extended to a covered individual on the condition that the carrier may pursue and receive subrogation and reimbursement. This substantive requirement, unlike the interpretation discussed above, will govern any benefit payment made under any carrier contract entered into after this regulation goes into effect. OPM is issuing this final rule with changes to §§ 890.101(a) and 890.106(b) and

(f)as described above. Regulatory Flexibility Act I certify that this regulation will not have a significant economic impact on a substantial number of small entities because the regulation because the regulation only affects health insurance benefits of Federal employees and annuitants. Executive Order 12866. Regulatory Review This rule has been reviewed by the Office of Management and Budget in accordance with Executive Orders 13563 and 12866. Federalism We have examined this rule in accordance with Executive Order 13132, Federalism, and have determined that this rule restates existing rights, roles and responsibilities of State, local, or tribal governments. List of Subjects in 5 CFR Parts 890 Administrative practice and procedure, Government employees, Health facilities, Health insurance, Health professions, Hostages, Iraq, Kuwait, Lebanon, Military personnel, Reporting and recordkeeping requirements, Retirement. U.S. Office of Personnel Management. Katherine Archuleta, Director. PART 890—FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM 1. The authority citation for part 890 continues to read as follows: Authority: 5 U.S.C. 8913. Sec. 890.301 also issued under sec. 311 of Pub. L. 111-03, 123 Stat. 64; Sec. 890.111 also issued under section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec. 890.112 also issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 U.S.C. 8913; Sec. 890.803 also issued under 50 U.S.C. 403p, 22 U.S.C. 4069c and 4069c-1; subpart L also issued under sec. 599C of Pub. L. 101-513, 104 Stat. 2064, as amended; Sec. 890.102 also issued under sections 11202(f), 11232(e), 11246

(b)and

(c)of Pub. L. 105-33, 111 Stat. 251; and section 721 of Pub. L. 105-261, 112 Stat. 2061. 2. In § 890.101, in paragraph (a), add definitions in alphabetical order for “reimbursement” and “subrogation” to read as follows: § 890.101 Definitions; time computations.

(a)* * * *Reimbursement* means a carrier's pursuit of a recovery if a covered individual has suffered an illness or injury and has received, in connection with that illness or injury, a payment from any party that may be liable, any applicable insurance policy, or a workers' compensation program or insurance policy, and the terms of the carrier's health benefits plan require the covered individual, as a result of such payment, to reimburse the carrier out of the payment to the extent of the benefits initially paid or provided. The right of reimbursement is cumulative with and not exclusive of the right of subrogation. *Subrogation* means a carrier's pursuit of a recovery from any party that may be liable, any applicable insurance policy, or a workers' compensation program or insurance policy, as successor to the rights of a covered individual who suffered an illness or injury and has obtained benefits from that carrier's health benefits plan. 3. Section 890.106 is revised to read as follows: § 890.106 Carrier entitlement to pursue subrogation and reimbursement recoveries.

(a)All health benefit plan contracts shall provide that the Federal Employees Health Benefits

(FEHB)carrier is entitled to pursue subrogation and reimbursement recoveries, and shall have a policy to pursue such recoveries in accordance with the terms of this section. (b)(1) Any FEHB carriers' right to pursue and receive subrogation and reimbursement recoveries constitutes a condition of and a limitation on the nature of benefits or benefit payments and on the provision of benefits under the plan's coverage.

(2)Any health benefits plan contract that contains a subrogation or reimbursement clause shall provide that benefits and benefit payments are extended to a covered individual on the condition that the FEHB carrier may pursue and receive subrogation and reimbursement recoveries pursuant to the contract.

(c)Contracts shall provide that the FEHB carriers' rights to pursue and receive subrogation or reimbursement recoveries arise upon the occurrence of the following:

(1)The covered individual has received benefits or benefit payments as a result of an illness or injury; and

(2)The covered individual has accrued a right of action against a third party for causing that illness or injury; or has received a judgment, settlement or other recovery on the basis of that illness or injury; or is entitled to receive compensation or recovery on the basis of the illness or injury, including from insurers of individual (non-group) policies of liability insurance that are issued to and in the name of the enrollee or a covered family member.

(d)A FEHB carrier's exercise of its right to pursue and receive subrogation or reimbursement recoveries does not give rise to a claim within the meaning of 5 CFR 890.101 and is therefore not subject to the disputed claims process set forth at 5 CFR 890.105.

(e)Any subrogation or reimbursement recovery on the part of a FEHB carrier shall be effectuated against the recovery first (before any of the rights of any other parties are effectuated) and is not impacted by how the judgment, settlement, or other recovery is characterized, designated, or apportioned.

(f)Pursuant to a subrogation or reimbursement clause, the FEHB carrier may recover directly from any party that may be liable, or from the covered individual, or from any applicable insurance policy, or a workers' compensation program or insurance policy, all amounts available to or received by or on behalf of the covered individual by judgment, settlement, or other recovery, to the extent of the amount of benefits that have been paid or provided by the carrier.

(g)Any contract must contain a provision incorporating the carrier's subrogation and reimbursement rights as a condition of and a limitation on the nature of benefits or benefit payments and on the provision of benefits under the plan's coverage. The corresponding health benefits plan brochure must contain an explanation of the carrier's subrogation and reimbursement policy.

(h)A carrier's rights and responsibilities pertaining to subrogation and reimbursement under any FEHB contract relate to the nature, provision, and extent of coverage or benefits (including payments with respect to benefits) within the meaning of 5 U.S.C. 8902(m)(1). These rights and responsibilities are therefore effective notwithstanding any state or local law, or any regulation issued thereunder, which relates to health insurance or plans. [FR Doc. 2015-12378 Filed 5-20-15; 8:45 am]

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