B-151658, JUN. 26, 1963

B-151658: Jun 26, 1963

Additional Materials:

Contact:

Edda Emmanuelli Perez
(202) 512-2853
EmmanuelliPerezE@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

CORRECTION OF THE CODE NUMBER TO 103 WAS MADE ON STANDARD FORM NO. 2809. HODGES CERTIFIED THAT HER HUSBAND WAS NOT DEPENDENT. SHE WAS BILLED FOR UNDERPAYMENT OF FEDERAL EMPLOYEES HEALTH BENEFIT DEDUCTIONS FOR THE PAY PERIOD ENDING OCTOBER 14. THE COLLECTION BILL STATES THAT SHE WAS ERRONEOUSLY ENROLLED UNDER CODE 102 WHICH REQUIRES A DEDUCTION OF $5.82 PER PAY PERIOD AND THAT THE CORRECT CODE 103 REQUIRES A DEDUCTION OF $7.12 PER PAY PERIOD. SHE WAS CHARGED THIS $1.30 FOR 40 PAY PERIODS WHICH TOTALS $52. WHICH WAS ENCLOSED WITH YOUR LETTER. SHE SAYS THAT THE ANSWERS ON HER ENROLLMENT PAPERS WERE OBVIOUSLY INCONSISTENT WITH THE DESIGNATION OF CODE 103. THAT SINCE THE AMOUNT OF HER HEALTH INSURANCE PREMIUM WAS SET BY THE ANSWERS GIVEN ON HER ENROLLMENT PAPER.

B-151658, JUN. 26, 1963

TO OREN T. SKOUGE, M.D.:

BY LETTER DATED MAY 23, 1963, YOUR REFERENCE 5224-141, WITH ATTACHED COLLECTION VOUCHER AND ENCLOSURES, YOU REQUESTED OUR DECISION AS TO WHETHER THE INDEBTEDNESS OF AN EMPLOYEE, MRS. PATRICIA D. HODGES, 2213 MANNS DRIVE, OKLAHOMA CITY, OKLAHOMA, MAY BE WAIVED. THE INDEBTEDNESS IN THE AMOUNT OF $52 AROSE AS THE RESULT OF UNDERPAYMENT OF PREMIUMS UNDER THE FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM.

THE RECORD SHOWS THAT THE EMPLOYEE EXECUTED STANDARD FORM NO. 2809 (HEALTH BENEFITS REGISTRATION FORM) ON SEPTEMBER 14, 1961. IN IT SHE ENROLLED FOR SELF AND FAMILY IN ENROLLMENT CODE 102, HIGH OPTION OF THE SERVICE BENEFIT PLAN, LISTING HER CHILD AND NONDEPENDENT HUSBAND. CORRECTION OF THE CODE NUMBER TO 103 WAS MADE ON STANDARD FORM NO. 2809, APRIL 29, 1963, RETROACTIVELY EFFECTIVE OCTOBER 1, 1961. CODE 102 APPLIES TO ENROLLMENT IN THE PLAN FOR EMPLOYEE AND FAMILY; CODE 103 APPLIES TO ENROLLMENT IN THE PLAN FOR FEMALE EMPLOYEE AND FAMILY INCLUDING NONDEPENDENT HUSBAND. IN HER ENROLLMENT MRS. HODGES CERTIFIED THAT HER HUSBAND WAS NOT DEPENDENT. ON MAY 1, 1963, SHE WAS BILLED FOR UNDERPAYMENT OF FEDERAL EMPLOYEES HEALTH BENEFIT DEDUCTIONS FOR THE PAY PERIOD ENDING OCTOBER 14, 1961, THROUGH THE PAY PERIOD ENDING APRIL 13, 1963. THE COLLECTION BILL STATES THAT SHE WAS ERRONEOUSLY ENROLLED UNDER CODE 102 WHICH REQUIRES A DEDUCTION OF $5.82 PER PAY PERIOD AND THAT THE CORRECT CODE 103 REQUIRES A DEDUCTION OF $7.12 PER PAY PERIOD, A DIFFERENCE OF $1.30. SHE WAS CHARGED THIS $1.30 FOR 40 PAY PERIODS WHICH TOTALS $52.

IN A MEMORANDUM DATED MAY 3, 1963, WHICH WAS ENCLOSED WITH YOUR LETTER, MRS. HODGES REQUESTS THAT THE INDEBTEDNESS BE WAIVED. SHE SAYS THAT THE ANSWERS ON HER ENROLLMENT PAPERS WERE OBVIOUSLY INCONSISTENT WITH THE DESIGNATION OF CODE 103; THAT PAYMENT OF THE INDEBTEDNESS WOULD CAUSE HER FINANCIAL HARDSHIP; AND THAT SINCE THE AMOUNT OF HER HEALTH INSURANCE PREMIUM WAS SET BY THE ANSWERS GIVEN ON HER ENROLLMENT PAPER, AND THE ERROR WAS NOT DETECTED BY THE VETERANS ADMINISTRATION OR THE INSURANCE CARRIER, SHE FEELS SHE SHOULD NOT HAVE TO PAY THE INDEBTEDNESS.

SECTION 2 (D) OF THE FEDERAL EMPLOYEES HEALTH BENEFITS ACT OF 1959, APPROVED SEPTEMBER 28, 1959, PUB.L. 86-382, 73 STAT. 709, DEFINES "MEMBER OF FAMILY" AS INCLUDING, AMONG OTHERS, AN EMPLOYEE'S SPOUSE AND UNMARRIED CHILDREN UNDER NINETEEN YEARS OF AGE. THE LANGUAGE USED IN THE ACT EVIDENCES THAT A "FAMILY" IS TO BE CONSIDERED AS A WHOLE AND THAT NO RECOGNITION IS INTENDED TO BE GIVEN TO PART OF A FAMILY. SECTION 3 (A) OF THE ACT PROVIDES THAT AN EMPLOYEE MAY ENROLL IN A HEALTH BENEFITS PLAN "EITHER AS AN INDIVIDUAL OR FOR SELF AND FAMILY.'

SECTION 7 (A) (1) PROVIDES THAT THE GOVERNMENT'S CONTRIBUTION FOR HEALTH BENEFITS FOR EMPLOYEES ENROLLED IN THE SERVICE BENEFITS PLAN, IN ADDITION TO THE CONTRIBUTIONS REQUIRED BY PARAGRAPH (3) SHALL BE 50 PERCENT OF THE LOWEST RATES CHARGED BY A CARRIER FOR THE LEVEL OF BENEFITS OFFERED BUT NOT LESS THAN $3 OR MORE THAN $4.25 BIWEEKLY FOR AN EMPLOYEE WHO IS ENROLLED FOR SELF AND FAMILY AND NOT LESS THAN $1.75 OR MORE THAN $2.50 BIWEEKLY FOR A FEMALE EMPLOYEE ENROLLED FOR SELF AND FAMILY INCLUDING A NONDEPENDENT HUSBAND. PARAGRAPH (3) PROVIDES FOR SALARY WITHHOLDINGS AND GOVERNMENT CONTRIBUTIONS IN THE SAME RATIO AS PARAGRAPH (1) FOR ADMINISTRATIVE COSTS AND FOR RESERVES. PARAGRAPH (4) PROVIDES THAT THERE SHALL BE WITHHELD FROM THE SALARY OF EACH ENROLLED EMPLOYEE SO MUCH AS IS NECESSARY, AFTER DEDUCTING THE CONTRIBUTIONS OF THE GOVERNMENT, TO PAY THE TOTAL CHARGE FOR HIS ENROLLMENT. SECTION 7 (C) (1) PROVIDES THAT THE SUMS AUTHORIZED TO BE CONTRIBUTED BY THE GOVERNMENT WITH RESPECT TO AN EMPLOYEE SUCH AS MRS. HODGES SHALL BE PAID FROM THE APPROPRIATION WHICH IS USED FOR PAYMENT OF SALARY, WAGE, OR OTHER COMPENSATION OF SUCH EMPLOYEE.

SECTION 10 (A) AUTHORIZES THE CIVIL SERVICE COMMISSION TO PROMULGATE SUCH REGULATIONS AS MAY BE NECESSARY TO CARRY OUT THE PROVISIONS OF THE ACT. PURSUANT TO SUCH AUTHORITY THE COMMISSION PROMULGATED REGULATIONS IMPLEMENTING THE ACT. 5 CFR 89.21 (A) READS AS FOLLOWS:

"THE GOVERNMENT CONTRIBUTION FOR ALL PLANS, EXCEPT THOSE FOR WHICH ANOTHER CONTRIBUTION IS SET BY PARAGRAPH (B) OF THIS SECTION, FOR EACH ENROLLED EMPLOYEE WHO IS PAID BIWEEKLY IS AS FOLLOWS:

TABLE

"FOR AN EMPLOYEE ENROLLED FOR SELF ALONE ------------------- $1.30

FOR AN EMPLOYEE ENROLLED FOR SELF AND FAMILY --------------3.12

FOR A FEMALE EMPLOYEE ENROLLED FOR SELF AND A FAMILY

WHICH INCLUDES A NONDEPENDENT HUSBAND ------------------- 1.82"

AS SHOWN ABOVE, MRS. HODGES HAD THE CHOICE OF ENROLLING IN THE PLAN EITHER AS AN INDIVIDUAL OR FOR HERSELF AND FAMILY. SHE CHOSE TO ENROLL FOR HERSELF AND FAMILY. SINCE SHE HAD A NONDEPENDENT HUSBAND, THE CORRECT CODE FOR HER ENROLLMENT IS CODE 103. HOWEVER, SHE ERRONEOUSLY DESIGNATED CODE 102. THE TOTAL ENROLLMENT CHARGE PER BIWEEKLY PAY PERIOD UNDERBOTH CODE 102 AND CODE 103 IS THE SAME, NAMELY, $8.94; HOWEVER, THE GOVERNMENT'S CONTRIBUTION UNDER CODE 102 IS SET BY STATUTORY REGULATION AT $3.12 AS AGAINST $1.82 UNDER CODE 103, SO THAT THE CHARGE TO THE EMPLOYEE IS $5.82 UNDER CODE 102 BUT IS $7.12 UNDER CODE 103--- A DIFFERENCE OF $1.30 PER PAY PERIOD.

THE CHANGE FROM CODE 102 TO CODE 103 DID NOT CHANGE MRS. HODGES' ENROLLMENT. SHE HAD THE PROTECTION SHE ENROLLED FOR. THE PURPOSE OF THE CHANGE TO CODE 103 WAS TO ADJUST THE GOVERNMENT'S CONTRIBUTION TOWARD THE COST OF HER ENROLLMENT FOR SELF AND FAMILY AS REQUIRED BY LAW. THE ACTION IN RETROACTIVELY ADJUSTING THE GOVERNMENT'S CONTRIBUTION WAS, IN EFFECT, A RECOVERY OF AN OVERPAYMENT OF SALARY WHICH MUST BE REPAID BECAUSE IT IS A DEBT DUE THE UNITED STATES. B 149859, DECEMBER 3, 1962 (42 COMP. GEN. -

FURTHERMORE, IT IS WELL-ESTABLISHED THAT IN THE ABSENCE OF A STATUTE SO PROVIDING NO OFFICER OR EMPLOYEE OF THE GOVERNMENT MAY WAIVE AN INDEBTEDNESS TO THE UNITED STATES.

ACCORDINGLY, WE MAY NOT UNDERTAKE TO GRANT RELIEF TO MRS. HODGES. THE PROVISIONS OF THE ACT OF JULY 15, 1954, 68 STAT. 482, 5 U.S.C. 46D, PROVIDING FOR RECOVERY BY DEPARTMENTS AND ESTABLISHMENTS OF ERRONEOUS PAYMENTS TO EMPLOYEES IS PROPERLY FOR APPLICATION. THE COLLECTION VOUCHER IS RETURNED HEREWITH.