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Report File
Date Issued
Submitting OIG
Office of Personnel Management OIG
Other Participating OIGs
Office of Personnel Management OIG
Agencies Reviewed/Investigated
Office of Personnel Management
Components
Federal Employees Health Benefits Program
Report Number
1C-8W-00-20-017
Report Type
Audit
Agency Wide
Yes
Number of Recommendations
17
Questioned Costs
$0
Funds for Better Use
$0
External Entity
UPMC Health Plan, Inc.

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
1 No $12,174,183 $0

We recommend that the Plan return $12,174,183 to the FEHBP for defective pricing in contract years 2014 through 2016.

10 No $1,612,812 $0

We recommend that the Plan return $1,612,812 to the FEHBP for Lost Investment Income (LII), calculated through May 31, 2021. We also recommend that the Plan return LII on amounts due for the period beginning June 1, 2021, until all defective pricing finding amounts have been returned to the FEHBP.

2 No $0 $0

We recommend that the Plan remove all HIF loadings from the FEHBP premium rate developments and MLR filing denominators (as applicable) that have been submitted to OPM under Contract CS2856.

11 No $0 $0

We recommend that the Contracting Officer adjust the Plan's MLR credit for contract years 2014 through 2016 once the defective pricing findings discussed in this report are resolved.

Office of Personnel Management OIG

United States