US (United States) Code. Title 5. Part III. Subpart G: Insurance and Annuities. Chapter 50: Long-term care

Codificación normativa de EEUU (Estados Unidos). Legislación federal estadounidense # Government organization and employees

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publicidad

-CITE-

5 USC CHAPTER 90 - LONG-TERM CARE INSURANCE 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

.

-HEAD-

CHAPTER 90 - LONG-TERM CARE INSURANCE

-MISC1-

Sec.

9001. Definitions.

9002. Availability of insurance.

9003. Contracting authority.

9004. Financing.

9005. Preemption.

9006. Studies, reports, and audits.

9007. Jurisdiction of courts.

9008. Administrative functions.

9009. Cost accounting standards.

-SECREF-

CHAPTER REFERRED TO IN OTHER SECTIONS

This chapter is referred to in title 10 section 1074k; title 22

section 7002.

-CITE-

5 USC Sec. 9001 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9001. Definitions

-STATUTE-

For purposes of this chapter:

(1) Employee. - The term ''employee'' means -

(A) an employee as defined by section 8901(1);

(B) an individual described in section 2105(e);

(C) an individual employed by the Tennessee Valley Authority;

and

(D) an employee of a nonappropriated fund instrumentality of

the Department of Defense described in section 2105(c),

but does not include an individual employed by the government of

the District of Columbia.

(2) Annuitant. - The term ''annuitant'' means -

(A) any individual who would satisfy the requirements of

paragraph (3) of section 8901 if, for purposes of such

paragraph, the term ''employee'' were considered to have the

meaning given to it under paragraph (1) of this subsection;

(FOOTNOTE 1) and

(FOOTNOTE 1) So in original. Probably should be ''section;''.

(B) any individual who -

(i) satisfies all requirements for title to an annuity

under subchapter III of chapter 83, chapter 84, or any other

retirement system for employees of the Government (whether

based on the service of such individual or otherwise), and

files application therefor;

(ii) is at least 18 years of age; and

(iii) would not (but for this subparagraph) otherwise

satisfy the requirements of this paragraph.

(3) Member of the uniformed services. - The term ''member of

the uniformed services'' means a member of the uniformed

services, other than a retired member of the uniformed services,

who is -

(A) on active duty or full-time National Guard duty for a

period of more than 30 days; or

(B) a member of the Selected Reserve.

(4) Retired member of the uniformed services. - The term

''retired member of the uniformed services'' means a member or

former member of the uniformed services entitled to retired or

retainer pay, including a member or former member retired under

chapter 1223 of title 10 who has attained the age of 60 and who

satisfies such eligibility requirements as the Office of

Personnel Management prescribes under section 9008.

(5) Qualified relative. - The term ''qualified relative'' means

each of the following:

(A) The spouse of an individual described in paragraph (1),

(2), (3), or (4).

(B) A parent, stepparent, or parent-in-law of an individual

described in paragraph (1) or (3).

(C) A child (including an adopted child, a stepchild, or, to

the extent the Office of Personnel Management by regulation

provides, a foster child) of an individual described in

paragraph (1), (2), (3), or (4), if such child is at least 18

years of age.

(D) An individual having such other relationship to an

individual described in paragraph (1), (2), (3), or (4) as the

Office may by regulation prescribe.

(6) Eligible individual. - The term ''eligible individual''

refers to an individual described in paragraph (1), (2), (3),

(4), or (5).

(7) Qualified carrier. - The term ''qualified carrier'' means

an insurance company (or consortium of insurance companies) that

is licensed to issue long-term care insurance in all States,

taking any subsidiaries of such a company into account (and, in

the case of a consortium, considering the member companies and

any subsidiaries thereof, collectively).

(8) State. - The term ''State'' includes the District of

Columbia.

(9) Qualified long-term care insurance contract. - The term

''qualified long-term care insurance contract'' has the meaning

given such term by section 7702B of the Internal Revenue Code of

1986.

(10) Appropriate secretary. - The term ''appropriate

Secretary'' means -

(A) except as otherwise provided in this paragraph, the

Secretary of Defense;

(B) with respect to the Coast Guard when it is not operating

as a service of the Navy, the Secretary of Transportation;

(C) with respect to the commissioned corps of the National

Oceanic and Atmospheric Administration, the Secretary of

Commerce; and

(D) with respect to the commissioned corps of the Public

Health Service, the Secretary of Health and Human Services.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 762; amended Pub. L. 107-104, Sec. 1, Dec. 27, 2001, 115

Stat. 1001; Pub. L. 107-107, div. A, title X, Sec. 1048(i)(6),

Dec. 28, 2001, 115 Stat. 1229; Pub. L. 107-314, div. A, title XI,

Sec. 1101(a), Dec. 2, 2002, 116 Stat. 2660.)

-REFTEXT-

REFERENCES IN TEXT

Section 7702B of the Internal Revenue Code of 1986, referred to

in par. (9), is classified to section 7702B of Title 26, Internal

Revenue Code.

-MISC2-

AMENDMENTS

2002 - Par. (1)(D). Pub. L. 107-314 added subpar. (D).

2001 - Par. (2). Pub. L. 107-104 amended heading and text of par.

(2) generally. Prior to amendment, text read as follows: ''The

term 'annuitant' has the meaning such term would have under

paragraph (3) of section 8901 if, for purposes of such paragraph,

the term 'employee' were considered to have the meaning given to it

under paragraph (1) of this subsection.''

Par. (3)(A). Pub. L. 107-107 substituted ''or'' for ''and'' after

semicolon.

EFFECTIVE DATE OF 2001 AMENDMENT

Pub. L. 107-104, Sec. 3, Dec. 27, 2001, 115 Stat. 1002, provided

that: ''The amendments made by this Act (amending this section and

section 9005 of this title) shall take effect as if included in the

enactment of section 1002 of the Long-Term Care Security Act

(Public Law 106-265; 114 Stat. 762).''

EFFECTIVE DATE

Pub. L. 106-265, title I, Sec. 1003, Sept. 19, 2000, 114 Stat.

770, provided that: ''The Office of Personnel Management shall take

such measures as may be necessary to ensure that long-term care

insurance coverage under title 5, United States Code, as amended by

this title (enacting this chapter), may be obtained in time to take

effect not later than the first day of the first applicable pay

period of the first fiscal year which begins after the end of the

18-month period beginning on the date of the enactment of this Act

(Sept. 19, 2000).''

SHORT TITLE

Pub. L. 106-265, title I, Sec. 1001, Sept. 19, 2000, 114 Stat.

762, provided that: ''This title (enacting this chapter) may be

cited as the 'Long-Term Care Security Act'.''

-TRANS-

TRANSFER OF FUNCTIONS

For transfer of authorities, functions, personnel, and assets of

the Coast Guard, including the authorities and functions of the

Secretary of Transportation relating thereto, to the Department of

Homeland Security, and for treatment of related references, see

sections 468(b), 551(d), 552(d), and 557 of Title 6, Domestic

Security, and the Department of Homeland Security Reorganization

Plan of November 25, 2002, as modified, set out as a note under

section 542 of Title 6.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 9002, 9004, 9008 of this

title.

-CITE-

5 USC Sec. 9002 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9002. Availability of insurance

-STATUTE-

(a) In General. - The Office of Personnel Management shall

establish and, in consultation with the appropriate Secretaries,

administer a program through which an individual described in

paragraph (1), (2), (3), (4), or (5) of section 9001 may obtain

long-term care insurance coverage under this chapter for such

individual.

(b) Discretionary Authority Regarding Nonappropriated Fund

Instrumentalities. - The Secretary of Defense may determine that a

nonappropriated fund instrumentality of the Department of Defense

is covered under this chapter or is covered under an alternative

long-term care insurance program.

(c) General Requirements. - Long-term care insurance may not be

offered under this chapter unless -

(1) the only coverage provided is under qualified long-term

care insurance contracts; and

(2) each insurance contract under which any such coverage is

provided is issued by a qualified carrier.

(d) Documentation Requirement. - As a condition for obtaining

long-term care insurance coverage under this chapter based on one's

status as a qualified relative, an applicant shall provide

documentation to demonstrate the relationship, as prescribed by the

Office.

(e) Underwriting Standards. -

(1) Disqualifying condition. - Nothing in this chapter shall be

considered to require that long-term care insurance coverage be

made available in the case of any individual who would be

eligible for benefits immediately.

(2) Spousal parity. - For the purpose of underwriting

standards, a spouse of an individual described in paragraph (1),

(2), (3), or (4) of section 9001 shall, as nearly as practicable,

be treated like that individual.

(3) Guaranteed issue. - Nothing in this chapter shall be

considered to require that long-term care insurance coverage be

guaranteed to an eligible individual.

(4) Requirement that contract be fully insured. - In addition

to the requirements otherwise applicable under section 9001(9),

in order to be considered a qualified long-term care insurance

contract for purposes of this chapter, a contract must be fully

insured, whether through reinsurance with other companies or

otherwise.

(5) Higher standards allowable. - Nothing in this chapter

shall, in the case of an individual applying for long-term care

insurance coverage under this chapter after the expiration of

such individual's first opportunity to enroll, preclude the

application of underwriting standards more stringent than those

that would have applied if that opportunity had not yet expired.

(f) Guaranteed Renewability. - The benefits and coverage made

available to eligible individuals under any insurance contract

under this chapter shall be guaranteed renewable (as defined by

section 7A(2) of the model regulations described in section

7702B(g)(2) of the Internal Revenue Code of 1986), including the

right to have insurance remain in effect so long as premiums

continue to be timely made. However, the authority to revise

premiums under this chapter shall be available only on a class

basis and only to the extent otherwise allowable under section

9003(b).

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 764; amended Pub. L. 107-314, div. A, title XI, Sec.

1101(b), Dec. 2, 2002, 116 Stat. 2660.)

-REFTEXT-

REFERENCES IN TEXT

Section 7702B(g)(2) of the Internal Revenue Code of 1986,

referred to in subsec. (f), is classified to section 7702B(g)(2) of

Title 26, Internal Revenue Code.

-MISC2-

AMENDMENTS

2002 - Subsecs. (b) to (f). Pub. L. 107-314 added subsec. (b) and

redesignated former subsecs. (b) to (e) as (c) to (f),

respectively.

-CITE-

5 USC Sec. 9003 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9003. Contracting authority

-STATUTE-

(a) In General. - The Office of Personnel Management shall,

without regard to section 5 of title 41 or any other statute

requiring competitive bidding, contract with one or more qualified

carriers for a policy or policies of long-term care insurance. The

Office shall ensure that each resulting contract (hereafter in this

chapter referred to as a ''master contract'') is awarded on the

basis of contractor qualifications, price, and reasonable

competition.

(b) Terms and Conditions. -

(1) In general. - Each master contract under this chapter shall

contain -

(A) a detailed statement of the benefits offered (including

any maximums, limitations, exclusions, and other definitions of

benefits);

(B) the premiums charged (including any limitations or other

conditions on their subsequent adjustment);

(C) the terms of the enrollment period; and

(D) such other terms and conditions as may be mutually agreed

to by the Office and the carrier involved, consistent with the

requirements of this chapter.

(2) Premiums. - Premiums charged under each master contract

entered into under this section shall reasonably and equitably

reflect the cost of the benefits provided, as determined by the

Office. The premiums shall not be adjusted during the term of the

contract unless mutually agreed to by the Office and the carrier.

(3) Nonrenewability. - Master contracts under this chapter may

not be made automatically renewable.

(c) Payment of Required Benefits; Dispute Resolution. -

(1) In general. - Each master contract under this chapter shall

require the carrier to agree -

(A) to provide payments or benefits to an eligible individual

if such individual is entitled thereto under the terms of the

contract; and

(B) with respect to disputes regarding claims for payments or

benefits under the terms of the contract -

(i) to establish internal procedures designed to

expeditiously resolve such disputes; and

(ii) to establish, for disputes not resolved through

procedures under clause (i), procedures for one or more

alternative means of dispute resolution involving independent

third-party review under appropriate circumstances by

entities mutually acceptable to the Office and the carrier.

(2) Eligibility. - A carrier's determination as to whether or

not a particular individual is eligible to obtain long-term care

insurance coverage under this chapter shall be subject to review

only to the extent and in the manner provided in the applicable

master contract.

(3) Other claims. - For purposes of applying the Contract

Disputes Act of 1978 to disputes arising under this chapter

between a carrier and the Office -

(A) the agency board having jurisdiction to decide an appeal

relative to such a dispute shall be such board of contract

appeals as the Director of the Office of Personnel Management

shall specify in writing (after appropriate arrangements, as

described in section 8(c) of such Act); and

(B) the district courts of the United States shall have

original jurisdiction, concurrent with the United States Court

of Federal Claims, of any action described in section 10(a)(1)

of such Act relative to such a dispute.

(4) Rule of construction. - Nothing in this chapter shall be

considered to grant authority for the Office or a third-party

reviewer to change the terms of any contract under this chapter.

(d) Duration. -

(1) In general. - Each master contract under this chapter shall

be for a term of 7 years, unless terminated earlier by the Office

in accordance with the terms of such contract. However, the

rights and responsibilities of the enrolled individual, the

insurer, and the Office (or duly designated third-party

administrator) under such contract shall continue with respect to

such individual until the termination of coverage of the enrolled

individual or the effective date of a successor contract thereto.

(2) Exception. -

(A) Shorter duration. - In the case of a master contract

entered into before the end of the period described in

subparagraph (B), paragraph (1) shall be applied by

substituting ''ending on the last day of the 7-year period

described in paragraph (2)(B)'' for ''of 7 years''.

(B) Definition. - The period described in this subparagraph

is the 7-year period beginning on the earliest date as of which

any long-term care insurance coverage under this chapter

becomes effective.

(3) Congressional notification. - No later than 180 days after

receiving the second report required under section 9006(c), the

President (or his designee) shall submit to the Committees on

Government Reform and on Armed Services of the House of

Representatives and the Committees on Governmental Affairs and on

Armed Services of the Senate, a written recommendation as to

whether the program under this chapter should be continued

without modification, terminated, or restructured. During the

180-day period following the date on which the President (or his

designee) submits the recommendation required under the preceding

sentence, the Office of Personnel Management may not take any

steps to rebid or otherwise contract for any coverage to be

available at any time following the expiration of the 7-year

period described in paragraph (2)(B).

(4) Full portability. - Each master contract under this chapter

shall include such provisions as may be necessary to ensure that,

once an individual becomes duly enrolled, long-term care

insurance coverage obtained by such individual pursuant to that

enrollment shall not be terminated due to any change in status

(such as separation from Government service or the uniformed

services) or ceasing to meet the requirements for being

considered a qualified relative (whether as a result of

dissolution of marriage or otherwise).

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 764.)

-REFTEXT-

REFERENCES IN TEXT

The Contract Disputes Act of 1978, referred to in subsec. (c)(3),

is Pub. L. 95-563, Nov. 1, 1978, 92 Stat. 2383, as amended, which

is classified principally to chapter 9 (Sec. 601 et seq.) of Title

41, Public Contracts. Sections 8(c) and 10(a)(1) of the Act are

classified to sections 607(c) and 609(a)(1), respectively, of Title

41. For complete classification of this Act to the Code, see Short

Title note set out under section 601 of Title 41 and Tables.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 9002, 9004, 9007 of this

title.

-CITE-

5 USC Sec. 9004 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9004. Financing

-STATUTE-

(a) In General. - Each eligible individual obtaining long-term

care insurance coverage under this chapter shall be responsible for

100 percent of the premiums for such coverage.

(b) Withholdings. -

(1) In general. - The amount necessary to pay the premiums for

enrollment may -

(A) in the case of an employee, be withheld from the pay of

such employee;

(B) in the case of an annuitant, be withheld from the annuity

of such annuitant;

(C) in the case of a member of the uniformed services

described in section 9001(3), be withheld from the pay of such

member; and

(D) in the case of a retired member of the uniformed services

described in section 9001(4), be withheld from the retired pay

or retainer pay payable to such member.

(2) Voluntary withholdings for qualified relatives. -

Withholdings to pay the premiums for enrollment of a qualified

relative may, upon election of the appropriate eligible

individual (described in section 9001(1)-(4)), be withheld under

paragraph (1) to the same extent and in the same manner as if

enrollment were for such individual.

(c) Direct Payments. - All amounts withheld under this section

shall be paid directly to the carrier.

(d) Other Forms of Payment. - Any enrollee who does not elect to

have premiums withheld under subsection (b) or whose pay, annuity,

or retired or retainer pay (as referred to in subsection (b)(1)) is

insufficient to cover the withholding required for enrollment (or

who is not receiving any regular amounts from the Government, as

referred to in subsection (b)(1), from which any such withholdings

may be made, and whose premiums are not otherwise being provided

for under subsection (b)(2)) shall pay an amount equal to the full

amount of those charges directly to the carrier.

(e) Separate Accounting Requirement. - Each carrier participating

under this chapter shall maintain records that permit it to account

for all amounts received under this chapter (including investment

earnings on those amounts) separate and apart from all other funds.

(f) Reimbursements. -

(1) Reasonable initial costs. -

(A) In general. - The Employees' Life Insurance Fund is

available, without fiscal year limitation, for reasonable

expenses incurred by the Office of Personnel Management in

administering this chapter before the start of the 7-year

period described in section 9003(d)(2)(B), including reasonable

implementation costs.

(B) Reimbursement requirement. - Such Fund shall be

reimbursed, before the end of the first year of that 7-year

period, for all amounts obligated or expended under

subparagraph (A) (including lost investment income). Such

reimbursement shall be made by carriers, on a pro rata basis,

in accordance with appropriate provisions which shall be

included in master contracts under this chapter.

(2) Subsequent costs. -

(A) In general. - There is hereby established in the

Employees' Life Insurance Fund a Long-Term Care Administrative

Account, which shall be available to the Office, without fiscal

year limitation, to defray reasonable expenses incurred by the

Office in administering this chapter after the start of the

7-year period described in section 9003(d)(2)(B).

(B) Reimbursement requirement. - Each master contract under

this chapter shall include appropriate provisions under which

the carrier involved shall, during each year, make such

periodic contributions to the Long-Term Care Administrative

Account as necessary to ensure that the reasonable anticipated

expenses of the Office in administering this chapter during

such year (adjusted to reconcile for any earlier overestimates

or underestimates under this subparagraph) are defrayed.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 766.)

-CITE-

5 USC Sec. 9005 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9005. Preemption

-STATUTE-

(a) Contractual Provisions. - The terms of any contract under

this chapter which relate to the nature, provision, or extent of

coverage or benefits (including payments with respect to benefits)

shall supersede and preempt any State or local law, or any

regulation issued thereunder, which relates to long-term care

insurance or contracts.

(b) Premiums. -

(1) In general. - No tax, fee, or other monetary payment may be

imposed or collected, directly or indirectly, by any State, the

District of Columbia, or the Commonwealth of Puerto Rico, or by

any political subdivision or other governmental authority

thereof, on, or with respect to, any premium paid for an

insurance policy under this chapter.

(2) Rule of construction. - Paragraph (1) shall not be

construed to exempt any company or other entity issuing a policy

of insurance under this chapter from the imposition, payment, or

collection of a tax, fee, or other monetary payment on the net

income or profit accruing to or realized by such entity from

business conducted under this chapter, if that tax, fee, or

payment is applicable to a broad range of business activity.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 768; amended Pub. L. 107-104, Sec. 2, Dec. 27, 2001, 115

Stat. 1001.)

-MISC1-

AMENDMENTS

2001 - Pub. L. 107-104 designated existing provisions as subsec.

(a), inserted heading, and added subsec. (b).

EFFECTIVE DATE OF 2001 AMENDMENT

Amendment by Pub. L. 107-104 effective as if included in the

enactment of section 1002 of Pub. L. 106-265, see section 3 of Pub.

L. 107-104, set out as a note under section 9001 of this title.

-CITE-

5 USC Sec. 9006 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9006. Studies, reports, and audits

-STATUTE-

(a) Provisions Relating to Carriers. - Each master contract under

this chapter shall contain provisions requiring the carrier -

(1) to furnish such reasonable reports as the Office of

Personnel Management determines to be necessary to enable it to

carry out its functions under this chapter; and

(2) to permit the Office and representatives of the General

Accounting Office to examine such records of the carrier as may

be necessary to carry out the purposes of this chapter.

(b) Provisions Relating to Federal Agencies. - Each Federal

agency shall keep such records, make such certifications, and

furnish the Office, the carrier, or both, with such information and

reports as the Office may require.

(c) Reports by the General Accounting Office. - The General

Accounting Office shall prepare and submit to the President, the

Office of Personnel Management, and each House of Congress, before

the end of the third and fifth years during which the program under

this chapter is in effect, a written report evaluating such

program. Each such report shall include an analysis of the

competitiveness of the program, as compared to both group and

individual coverage generally available to individuals in the

private insurance market. The Office shall cooperate with the

General Accounting Office to provide periodic evaluations of the

program.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 768.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 9003 of this title.

-CITE-

5 USC Sec. 9007 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9007. Jurisdiction of courts

-STATUTE-

The district courts of the United States have original

jurisdiction of a civil action or claim described in paragraph (1)

or (2) of section 9003(c), after such administrative remedies as

required under such paragraph (1) or (2) (as applicable) have been

exhausted, but only to the extent judicial review is not precluded

by any dispute resolution or other remedy under this chapter.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 768.)

-CITE-

5 USC Sec. 9008 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9008. Administrative functions

-STATUTE-

(a) In General. - The Office of Personnel Management shall

prescribe regulations necessary to carry out this chapter.

(b) Enrollment Periods. - The Office shall provide for periodic

coordinated enrollment, promotion, and education efforts in

consultation with the carriers.

(c) Consultation. - Any regulations necessary to effect the

application and operation of this chapter with respect to an

eligible individual described in paragraph (3) or (4) of section

9001, or a qualified relative thereof, shall be prescribed by the

Office in consultation with the appropriate Secretary.

(d) Informed Decisionmaking. - The Office shall ensure that each

eligible individual applying for long-term care insurance under

this chapter is furnished the information necessary to enable that

individual to evaluate the advantages and disadvantages of

obtaining long-term care insurance under this chapter, including

the following:

(1) The principal long-term care benefits and coverage

available under this chapter, and how those benefits and coverage

compare to the range of long-term care benefits and coverage

otherwise generally available.

(2) Representative examples of the cost of long-term care, and

the sufficiency of the benefits available under this chapter

relative to those costs. The information under this paragraph

shall also include -

(A) the projected effect of inflation on the value of those

benefits; and

(B) a comparison of the inflation-adjusted value of those

benefits to the projected future costs of long-term care.

(3) Any rights individuals under this chapter may have to

cancel coverage, and to receive a total or partial refund of

premiums. The information under this paragraph shall also

include -

(A) the projected number or percentage of individuals likely

to fail to maintain their coverage (determined based on lapse

rates experienced under similar group long-term care insurance

programs and, when available, this chapter); and

(B)(i) a summary description of how and when premiums for

long-term care insurance under this chapter may be raised;

(ii) the premium history during the last 10 years for each

qualified carrier offering long-term care insurance under this

chapter; and

(iii) if cost increases are anticipated, the projected

premiums for a typical insured individual at various ages.

(4) The advantages and disadvantages of long-term care

insurance generally, relative to other means of accumulating or

otherwise acquiring the assets that may be needed to meet the

costs of long-term care, such as through tax-qualified retirement

programs or other investment vehicles.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 768.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 9001 of this title.

-CITE-

5 USC Sec. 9009 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart G - Insurance and Annuities

CHAPTER 90 - LONG-TERM CARE INSURANCE

-HEAD-

Sec. 9009. Cost accounting standards

-STATUTE-

The cost accounting standards issued pursuant to section 26(f) of

the Office of Federal Procurement Policy Act (41 U.S.C. 422(f))

shall not apply with respect to a long-term care insurance contract

under this chapter.

-SOURCE-

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114

Stat. 769.)

-CITE-

5 USC Subpart H - Access to Criminal History Record

Information 01/06/03

-EXPCITE-

TITLE 5 - GOVERNMENT ORGANIZATION AND EMPLOYEES

PART III - EMPLOYEES

Subpart H - Access to Criminal History Record Information

.

-HEAD-

Subpart H - Access to Criminal History Record Information

-SECREF-

SUBPART REFERRED TO IN OTHER SECTIONS

This subpart is referred to in section 9701 of this title.

-CITE-