Federal Employees Health Benefits Access Act

Summary

Federal Employees Health Benefits Access Act - Prohibits a Government health services contract from being made or a plan approved unless the carrier agrees to offer to the general public the same benefits as would be offered under such contract or plan to Federal employees and annuitants and their family members. Requires premiums for coverage to be established in conformance with such requirements as the Office of Personnel Management (OPM) shall prescribe. Specifies that in no event shall this Act's enactment result in any: (1) increase in the level of individual or Government contributions required, including copayments or deductibles; (2) decrease in the types of benefits offered; or (3) other change that would adversely affect the coverage afforded to employees and annuitants and their family members. Permits a carrier to file an application with OPM setting forth reasons why it, or a plan provided by such carrier, should be excluded from the requirements of this Act. Allows OPM, in reviewing any such application, to consider such factors as: (1) any bona fide enrollment restrictions which would make the application of this Act inappropriate; (2) whether compliance would jeopardize the financial solvency of the plan or carrier or otherwise compromise its ability to offer health benefits; and (3) the anticipated duration of the requested exclusion and what efforts the plan or carrier proposes to take in order to be able to comply with this Act. Requires a claim for payment or reimbursement to be submitted on a standard form or in a standard manner as may be required by OPM in relation to health benefit plans. Directs OPM to: (1) prepare information relating to the use of advance directives regarding the type or intensity of care which an individual desires in the event that such individual becomes unable to communicate by reason of incapacity due to illness or injury; and (2) require, as a condition for contract approval, that appropriate provisions be included so that such information may be made available to enrollees of the plan involved. Requires OPM to conduct a demonstration project to assess the feasibility and desirability of offering the use of arbitration, instead of litigation, to resolve medical malpractice claims arising out of covered health care services. Sets forth provisions regarding project requirements and evaluation.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 28 February 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 28 February 1995

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• Introduced in House

  summary · EN · 28 February 1995

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