In the Matter of the Petition by) December 8, 1998 ) DON A. KAISER ) 4752 W. 159th St., Apt. 4 ) ) ) ) Lawndale, CA 90260-2503 ) P.S. Docket No. DCA 98-254 APPEARANCE FOR PETITIONER: Don A. Kaiser 4752 W. 159th Street, Apt. 4 Lawndale, CA 90260-2503 APPEARANCE FOR RESPONDENT: Lupe Montoya Labor Relations Specialist United States Postal Service 7001 S. Central Avenue Los Angeles, CA 90052-9401
FINAL DECISION UNDER THE DEBT COLLECTION ACT OF 1982
Petitioner, Don A. Kaiser, filed a timely Petition under the Debt Collection Act of 1982, as amended, 5 U.S.C. §5514(a) after receiving a "Notice of Intent to Recover Premiums from Salary." The notice indicated that Respondent, United States Postal Service, intended to withhold a sum from his salary to recover the cost of health insurance coverage for a period during which Petitioner was in an unpaid status. As requested by Petitioner, this decision is being made based solely on written submittals.
FINDINGS OF FACT
1. Petitioner, then a full-time letter carrier, was removed from the Postal Service effective May 8, 1997 (Petitioner's Response to the Order of September 3, 1998 (Pet Response), Exh A).
2. Petitioner received no pay from pay period 08/97 (March 29, 1997) through pay period 10/98 (June 19, 1998) (Respondent's Answer (Answer), Exh 2).1/
3. On four occasions during that period, the Los Angeles Customer Service and Sales Office sent Petitioner notices (with invoices enclosed) indicating that Petitioner owed the Postal Service certain amounts, based on premiums for health benefits. Those notices were all sent to 1810 Vanderbilt Ln #4, Redondo Beach, CA 90278-2912. (Answer, Exh 1). The record contains no evidence that Petitioner received any of the notices.2/
4. On or about May 15, 1998, Petitioner received an invoice addressed to him at 4752 W. 159th St, Apt 4, Lawndale [CA] 90260-2503, indicating that he was indebted to Respondent for health benefit coverage and notifying him of Respondent's intent to recover the premiums from his salary. Upon receipt of this invoice, Petitioner filed this petition under the Debt Collection Act.
5. Title 5 of the Code of Federal Regulations, Part 890, contains the Office of Personnel Management (OPM) regulations regarding the Federal Employees Health
Benefits Program (FEHBP). Subpart C, §890.304, "Termination of Enrollment," provides that an employee's enrollment terminates on the last day of the pay period in which an employee is "separated from the service other than by retirement…." 3/ Subpart K, "Temporary Continuation of Coverage [TCC]," provides that "[f]ormer employees whose coverage ends because of a separation from Federal service" are to be notified by their employing office regarding their rights to elect TCC. The regulations specify particular deadlines by which the affected former employee must elect coverage. (5 C.F.R. §§890.1103 - 1105). The record does not reflect that Petitioner received any notice regarding his rights to temporary continuation of coverage or that he made an election to take advantage of that coverage.
6. With respect to health benefits coverage for an "employee" during "nonpay" status periods, the regulations provide that enrollment continues for up to 365 days in nonpay status. Further, the regulations make the employee responsible for the payment of premiums during the period in a nonpay status. 39 C.F.R. §§890.303(e), 890.502(a)(1), 890.502(b).4/
DECISION
Petitioner argues that he is not responsible for the premiums for his health insurance coverage because he had been removed from the Postal Service, was not notified of the availability of health insurance coverage, and did not elect temporary continuation of coverage.
Respondent argues that Petitioner was notified on four occasions of his obligation to pay the premiums but failed to respond to any of the letters that were sent. Further, Respondent points to the regulations that make an employee responsible for the payment of premiums during any period in which enrollment in the health benefits plan continues. Respondent also argues that Petitioner was aware of that obligation, based on a notice that he acknowledged receiving in January 1992.5/
Based on the record before me, I conclude that Petitioner is not liable for the health insurance premiums in dispute here. The record indicates that Petitioner was removed from the Postal Service effective May 8, 1997. At that point his eligibility for continuing health insurance coverage ceased, except under the provisions for temporary continuation of coverage. The record does not indicate that he was notified of that eligibility or that he elected TCC.
It appears that Respondent continued Petitioner's coverage under the Federal Employees Health Benefits Program as though Petitioner remained an employee in a nonpay (e.g., Leave Without Pay) status, as set out in the OPM regulations and the ELM. However, the record contains no evidence that would lead me to conclude that Petitioner remained an employee following his removal or that he was aware of any continuation of his health insurance benefits. Respondent has not shown that Petitioner received any of the notices before the one that triggered this petition.6/ Further, there is no indication in the record that Petitioner filed for any benefits under the FEHBP during the period in question.
I conclude that while Respondent may have continued Petitioner's health insurance benefits, the record does not show that Petitioner was either eligible for such benefits or that he was aware that the benefits were being continued. Accordingly, the petition is granted.
David I. Brochstein Administrative Judge
2. For reasons not explained in the record, these notices and one received later (Finding 4) only covered the health insurance premiums for the period from pay period 13/97 (beginning August 16, 1997) through pay period 8/98 (ending April 4, 1998).
3. See, also, Postal Service Employee and Labor Relations Manual (ELM), §524.74.
4. See, also, ELM §525.2.
5. That notice, however, related to continuation of health insurance benefits for an employee in a nonpay status, not to TCC for a former employee.
6. I note that the notices were sent to an address different from Petitioner's current address, and there has been no showing that the address used was valid at that time.