§ 890.1610 Minimum standards for PSHB Program plans and Carriers

5 CFR 890.1610(a)(a) Minimum standards for PSHB plans. To qualify for approval by OPM, a health benefits plan under this subpart shall—

5 CFR 890.1610(a)(1)(1) Meet the minimum standards for health benefits plans at § 890.201, unless otherwise stated in this subpart;

5 CFR 890.1610(a)(2)(2) Provide prescription drug benefits pursuant to 5 U.S.C. 8903c(h)(2);

5 CFR 890.1610(a)(3)(3) Provide equivalent benefits and cost-sharing in the initial contract year to the carrier's FEHB plan, as applicable, pursuant to section 8903c(c)(2);

5 CFR 890.1610(a)(4)(4) Maintain separate reserves, including contingency reserves, with respect to enrollees in each PSHB plan as directed by OPM; and

5 CFR 890.1610(a)(5)(5) Begin coverage on January 1 of each year.

5 CFR 890.1610(b)(b) Minimum standards for PSHB Carriers. The minimum standards for health benefits carriers under this subpart shall be those contained in 48 CFR 1609.70.

5 CFR 890.1610(c)(c) Approval of plans with 1,500 or more Postal enrollees. To the greatest extent practicable, in the initial contract year, OPM shall approve a health benefits plan offered by a carrier under this subpart that has equivalent benefits and cost-sharing to the FEHB plan offered by that carrier in which the total enrollment of Postal Service employees and Postal Service annuitants was 1,500 or more in the 2023 contract year. OPM may exempt a comprehensive medical plan, as described in 5 U.S.C. 8903(4), from the requirement in this paragraph (c).

5 CFR 890.1610(d)(d) Withdrawal of plan approval. Failure on the part of the PSHB Carrier's plan to meet the standards in this section is cause for OPM's withdrawal of approval of the plan in accordance with § 890.1611.