(a) This part prescribes policies and procedures to ensure that services acquired under the FEGLI Program contract conform to the contract's quality requirements.
(b) OPM will make an initial evaluation of the Contractor's system of internal controls under the quality assurance program required by 2146.270 of this chapter and will acknowledge in writing whether or not the system is consistent with the requirements set forth in this subpart. After the initial review, subsequent periodic reviews may be limited to changes in the Contractor's internal control guidelines. However, a limited review does not diminish the Contractor's obligation to apply the full internal control system.
[58 FR 40380, July 28, 1993, as amended at 70 FR 41153, July 18, 2005]
(a) The contractor shall develop and apply a quality assurance program specifying procedures for assuring contract quality, as directed by the contracting officer. At a minimum, the program should include procedures to address:
(1) Accuracy of payments and recovery of overpayments;
(2) Timeliness of payments to beneficiaries;
(3) Quality of services and responsiveness to beneficiaries;
(4) Quality of service and responsiveness to OPM; and
(5) Detection and recovery of fraudulent claims.
(b) The Contractor must prepare overpayment recovery guidelines to include a system of internal controls.
(c) The contracting officer may order the correction of a deficiency or a modification in the contractor's services and/or quality assurance program. The contractor shall take the necessary action promptly to implement the contracting officer's order. If the contracting officer orders the correction of a deficiency or a modification of the contractor's services and/or quality assurance program pursuant to this paragraph after the contract year has begun, the costs incurred in correcting the deficiency or making the modification will not be considered to the contractor's detriment in the cost control factor of the service charge [if applicable] for the following contract year. However, if there is a deficiency, the deficiency itself may be taken into consideration.
[58 FR 40380, July 28, 1993, as amended at 70 FR 41153, July 18, 2005]
The clause at 2152.246-70 shall be inserted in all FEGLI Program contracts.