Federal Employees Health Benefits Reform Act of 1983

Federal Employees Health Benefits Reform Act of 1983 - Reorganizes and revises the Federal employees health benefits program.

Requires a carrier to apply to the Office of Personnel Management (OPM) for approval of any health benefits plan it is seeking to offer to Federal employees. Requires OPM to approve such a plan if: (1) the rates charged for each level of benefits will be consistent with the lowest rate schedule for comparable levels under the carrier's other group policies; (2) each level of benefits will provide comprehensive benefits to an enrollee or eligible family member in a plan year without additional enrollee payments if the enrollee has incurred creditable deductible and coinsurance expenditures in such year equal to the maximum enrollee financial participation amount under the plan; (3) the carrier agrees to offer each level of benefits to eligible enrollees at uniform premium rates for at least one plan year; (4) the carrier agrees to operate a health services utilization review system; (5) the carrier agrees to accept for enrollment any employee without regard to race, sex, health, or age; (6) the carrier will provide written statements of the rights and obligations of the plan and its enrollees, and enrollee identification card, and a description of the procedures for obtaining benefits to all enrollees; (7) enrollment in the plan will be terminated if any enrollee changes his or her enrollment to another health plan during the plan year; (8) a 31-day extension of coverage will be offered to any enrollee whose eligibility under this Act is ended, during which time such individual shall have the option to convert to a nongroup contract with the carrier; (9) the carrier has adequate reinsurance of its plan against loss or is financially stable and able to absorb any such loss; and (10) the carrier agrees to furnish any reports required by OPM. Authorizes OPM to withdraw approval of a health benefits plan if the plan is not in compliance with this Act.

Sets forth enrollment procedures for Federal employees and their families. Requires an agency or retirement system to provide information on the available health benefits plans to employees during each open enrollment season. Permits an employee to change his or her coverage or that of his or her family upon application with the employing agency or retirement system within 60 days of a change in family status. Requires agencies and retirement systems to keep carriers informed with respect to the status of the enrollees in their plans.

Requires OPM to determine before the start of each plan year the basic rates of Government contributions toward the premium charges for all enrollments in qualified health benefits plans. Provides that for all periods during which an enrollment continues, a Government contribution shall be payable on behalf of each enrolled employee and annuitant. Sets forth requirements for Government contributions with respect to part-time employees and employees on leave without pay. Requires Government contributions towards the administrative costs of health benefits plans. Specifies the sources for Government contributions toward premiums and administrative costs for employees generally, for elected officials, for legislative branch employees, and for employees on leave without pay. Requires that such Government contributions be paid: (1) by OPM in the case of annuitant enrollments; (2) by the U.S. Postal Service in the case of retired officers or employees of the U.S. Postal Service or their survivors; (3) by the District of Columbia governments in the case of retired officers or employees of the District of Columbia government or their survivors; and (4) from the Employees' Compensation Fund in the case of annuitants currently receiving monthly compensation.

Specifies an agency's liability for noncompliance with collection or withholding requirements with respect to Government contributions toward health plan premiums and administrative costs.

Permits enrollment in a health benefits plans or restoration of coverage which has been terminated in the case of: (1) reinstated employees; (2) former disability annuitants who experience a recurrence of their disability or loss of earning capacity; and (3) surviving spouses whose survivor annuities were terminated because of remarriage and are later restored.

Retains in the Treasury the Employees Health Benefits Fund as established under current law. Permits OPM to use the enrollees' contingency reserve account for any expenses it considers proper for the benefit of enrollees.

Sets forth requirements with respect to studies and reports under this Act and jurisdiction over civil actions arising under this Act.

Requires OPM to prescribe regulations to carry out this Act. Specifies the employees who may not be excluded from coverage under a health benefits plan pursuant to OPM regulations. Requires that such regulations provide for the beginning and ending dates of coverage of enrollees.

Makes the amendments under this Act effective on October 1, 1984. Authorizes OPM to automatically assign individuals enrolled in health benefits plans before October 1, 1984, who do not specify a choice with respect to health plan coverage in effect on or after such date or who are enrolled with carriers no longer participating in the Federal employees health benefits program to a plan reasonably similar to their coverage before such date, unless an individual notifies OPM that such an assignment is unacceptable.

Requires the termination on September 30, 1984, of all health plan contracts made by OPM under the existing Federal employees health benefits program.

Provides that the contingency reserve funds, the administrative reserve funds, and the balance remaining in the Employee Health Benefits Fund on September 30, 1984, shall remain available for expenditure as provided under the existing Federal employees health benefits program.

Amends the Retired Federal Employees Health Benefits Act to eliminate the Government-wide health plan for retired Federal employees established under such Act. Provides for the automatic transfer of any retired Federal employees enrolled in such plan on December 31, 1983, to an appropriate level of benefits under the indemnity benefit plan which exists under the current Federal employees health benefits program, unless an individual elects to enroll in another type of plan available under such program.

Provides that if a retired Federal employee enrolls for self-only in a health benefits plan, the Government shall contribute each month toward his or her subscription charge an amount equal to the current monthly premium of an individual under title XVIII (Medicare) of the Social Security Act.

Makes funds available out of the Employees Health Benefits Fund for the payment of Government contributions to health benefits plans for retired Federal employees as provided under the Retired Federal Employees Health Benefits Act. Requires that any funds credited to the Retired Employees Health Benefits Fund on January 1, 1984, be transferred to the Employees Health Benefits Fund and set aside for purposes of such Act.