OPM prepares various legislative proposals during the preparation of its annual budget request, which align with its strategic goals and objectives. OPM designs these proposals to enhance and improve its programs, increase efficiencies in executing these programs, and reduce overall costs for the Government.

The FY 2025 legislative proposals for OPM are:

• Reimbursement for Corrections and Permanent Authority Regarding Voluntary Early Retirement Authority (VERA) or Voluntary Separation Incentive Payment (VSIP) Related Retirement Processing Costs;
• Establish OPM Trust Fund Authority for PSHB and FEHB Enrollment Systems
• Demonstration Project Authority;
• Human Resource Workforce Proposal;
• Improve Financial Management of Tribal FEHB Administrative Fee by Treating as Mandatory Authority;
• Expand Family Member Eligibility Under FEDVIP;
• Expand FEDVIP to Certain Tribal Employers;
• Expand FEHB to Tribal Colleges and Universities;
• Preempt State/Local Taxation of FEDVIP Carriers to Align with FEHB Carriers;
• Shorten FEDVIP Contract Terms to Allow Flexibility for New Carriers;
• Require Coverage of Three Primary Care Visits and Three Behavioral Health Visits Without Cost-Sharing;
• Limit Cost-Sharing for Insulin at $35 per Month

Reimbursement for Corrections and Permanent Authority Regarding VERA/VSIP Processing Costs

Makes the annual statutory provisions that require agencies to remit the case processing cost for any retirement applications resulting from Federal agencies’ utilization of Voluntary Early Retirement Authorities (VERA) or in conjunction with Voluntary Separation Incentive Payments permanent (VISP), and amends Title 5 to provide that when agencies submit certain corrections to retirement records for retired former employees, they include payment of the case processing cost to help cover the administrative cost of recalculating the annuity benefit.

Establish OPM Trust Fund Authority for PSHB and FEHB Enrollment Systems

Beginning in FY 2026, this proposal would allow OPM to access a capped amount of mandatory funding annually from the Employees Health Benefits Fund to develop and maintain eligibility and enrollment systems for PSHB and FEHB. The cap would start at $37 million in 2026 and gradually increase, for a 10-year cost of $474 million. This proposal would provide consistent, stable funding for continued operation of the PSHB eligibility and enrollment system and potential expansion to FEHB.

Demonstration Project Authority

This proposal would amend OPM’s current statutory authority to conduct and evaluate demonstration projects enterprise-wide. This would enhance the ability of OPM and employing agencies to conduct pilot programs by expanding the scope of activities that could be considered. By providing greater flexibility and a better approach to assess outcomes, OPM would be better positioned to promote innovation and learning.

Human Resource Workforce Proposal

This proposal would amend Title 5 to provide OPM statutory authority over strategic workforce analysis and development for the Federal Human Resources (HR) workforce. Although the need to improve strategic human capital management has been cited repeatedly by the Government Accountability Office (GAO) as a high risk to Federal operations, to date Federal HR workforce development has not received prioritization and resourcing commensurate with their critical value to hire, retain, develop and engage a high-quality workforce for the rest of government. Following the successful precedent set to address skills gaps in the Federal Acquisitions workforce, OPM seeks the ability to carry out government-wide, coordinated activities to build the capacity and capabilities of the Federal HR workforce.

Improve Financial Management of Tribal FEHB Administrative Fee by Treating as Mandatory Authority

This proposal would provide OPM with direct access to the administrative fee collected for the Tribal FEHB Program as mandatory authority. The fee, which is currently collected from Tribes for participation in the FEHB Program (up to 3 percent of monthly premiums or about $6 per-member-per-month), is not available to OPM outside of the discretionary appropriation for administrative expenses under current statute. The funds would be used for Tribal FEHB-related administrative expenses and system enhancements. These funds would be available to OPM without fiscal year limitation. This proposal would increase FEHB-related administrative costs by $20 million over 10 years.

Expand Family Member Eligibility Under FEDVIP

This proposal would amend the definition of a “member of family” under chapters 5 U.S.C 8901 to include persons up to 26 years of age. This expansion in eligibility for adult children will align coverage of dental and vision benefits with medical benefits, which were expanded up to age 26 through the Affordable Care Act.

Expand FEDVIP to Certain Tribal Employers

This proposal would amend Section 409 of the Indian Health Care Improvement Act (IHCIA), 25 U.S.C. 1647b, to expand entitlement to purchase FEDVIP coverage to tribes and tribal organizations carrying out programs under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5301 et seq.), the Tribally Controlled Schools Act of 1988 (25 U.S.C. 2501, et seq.), tribal colleges and universities defined by the Higher Education Act of 1965, and urban Indian organizations carrying out programs under subchapter IV of chapter 18 of title 25.

Expand FEHB to Tribal Colleges and Universities

This proposal would amend Section 409 of the Indian Health Care Improvement Act to expand FEHB eligibility to employees of Tribal colleges and universities (TCUs) that are overseen through the Bureau of Indian Education (BIE) under the Higher Education Act of 1965. There are 33 TCUs overseen by BIE, which are anticipated to increase FEHB enrollment by approximately 3,600. This proposal is not anticipated to impact FEHB premiums. There is no Federal budgetary impact of this proposal.

Preempt State/Local Taxation of FEDVIP Carriers to Align with FEHB Carriers

This proposal would add specific legislative language —consistent with OPM’s current interpretation— to the FEDVIP dental and vision benefit preemption statutes to further clarify that no tax, fee, or other monetary payment may be imposed on a qualified company (often referred to as a “FEDVIP carrier”) offering dental or vision benefits under the FEDVIP by any State, the District of Columbia, the Commonwealth of Puerto Rico, or any territory of the United States, or by any political subdivision or other Governmental authority thereof. It would clarify the statutory preemption and would ensure that no taxes, fees, or monetary assessments could be imposed on FEDVIP carriers. This proposal would maintain consistency across all OPM-administered insurance benefit programs which include similar preemption language.

Shorten FEDVIP Contract Terms to Allow Flexibility for New Carriers

The proposal would allow OPM greater flexibility to negotiate and, if necessary, enter into contract terms of a defined duration but not one dictated by a certain contract term. The amendments clarify that OPM can enter into contracts with dental and vision Carriers of at least one year that can automatically be renewed, which provides more flexibility than the current 7-year contract term. There is no Government contribution to FEDVIP enrollee premiums, so there is no direct Government cost for FEDVIP for this proposal.

Require Coverage of Three Primary Care Visits and Three Behavioral Health Visits Without Cost-Sharing

Beginning in plan year 2027, this proposal would require all plans and issuers, including FEHB carriers, to cover three primary care visits and three behavioral health visits each year without charging a copayment, coinsurance, or deductible-related fee. For High Deductible Health Plans, these services would be considered pre-deductible for meeting Health Savings Account requirements. This proposal would increase FEHB premiums by approximately 0.9 percent.

Limit Cost-Sharing for Insulin at $35 per Month

The Inflation Reduction Act limits Medicare beneficiary cost-sharing to $35 per covered insulin product for a month’s supply. Beginning in plan year 2025, this proposal would extend the cap on patient cost-sharing to insulin products in commercial markets, including FEHB. This proposal would increase FEHB premiums by approximately 0.1 percent.