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5 U.S.C. § 8954 — Benefits

Federal law — U.S. Code and appendices · legal_authorities

5 U.S.C. § 8954 — Benefits

**(a)** The Office may prescribe reasonable minimum standards for enhanced dental benefits plans offered under this chapter and for qualified companies offering the plans. **(b)** Each contract may include more than 1 level of benefits that shall be made available to all eligible individuals. **(c)** The benefits to be provided under enhanced dental benefits plans under this chapter may be of the following types: (1) Diagnostic. (2) Preventive. (3) Emergency care. (4) Restorative. (5) Oral and maxillofacial surgery. (6) Endodontics. (7) Periodontics. (8) Prosthodontics. (9) Orthodontics. **(d)** A contract approved under this chapter shall require the qualified company to cover the geographic service delivery area specified by the Office. The Office shall require qualified companies to include dentally underserved areas in their service delivery areas. **(e)** If an individual has dental coverage under a health benefits plan under chapter 89 and also has coverage under a plan under this chapter, the health benefits plan under chapter 89 shall be the first payor of any benefit payments.

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Source location: Title 5, Chapter 89A, § 8954; chapter-89a-enhanced-dental-benefits.md

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Federal law — U.S. Code and appendices · legal_authorities

5 U.S.C. § 8951 — Definitions

In this chapter: (1) The term “employee” means an employee defined under section 8901(1) and an employee of the District of Columbia courts. (2) The terms “annuitant”, “member of family”, and “dependent” have the meanings as such terms are defined under paragraphs (3), (5), and (9), respectively, of section 8901. (3) The term “eligible individual” refers to an individual described in paragraph (1), (2), or (8), without regard to whether the individual is enrolled in a health benefits plan under chapter 89. (4) The term “Office” means the Office of Personnel Management. (5) The term “qualified company” means a company (or consortium of companies or an employee organization defined under section 8901(8)) that offers indemnity, preferred provider organization, health maintenance organization, or discount dental programs and if required is licensed to issue applicable coverage in any number of 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). (6) The term “employee organization” means an association or other organization of employees which is national in scope, or in which membership is open to all employees of a Government agency who are eligible to enroll in a health benefits plan under chapter 89. (7) The term “State” includes the District of Columbia. (8) The term “covered TRICARE-eligible individual” means an individual entitled to dental care under chapter 55 of title 10, pursuant to section 1076c of such title, who the Secretary of Defense determines should be an eligible individual for purposes of this chapter.

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Federal law — U.S. Code and appendices · legal_authorities

5 U.S.C. § 8954 — Benefits

Page 1276 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8953 1 See References in Text note below. year 2006, see section 7 of Pub. L. 108–496, set out as a note under section 8951 of this title. § 8953. Contracting authority (a)(1) The Office shall contract with a reason- able number of qualified companies for a policy or policies of benefits described under section 8954 without regard to section 6101(b) to (d) of title 41 or any other statute requiring competi- tive bidding. An employee organization may contract with a qualified company for the pur- pose of participating with that qualified com- pany in any contract between the Office and that qualified company. (2) The Office shall ensure that each resulting contract is awarded on the basis of contractor qualifications, price, and reasonable competi- tion. (b) Each contract under this section shall con- tain— (1) the requirements under section 8902(d), (f), and (i) made applicable to contracts under this section by regulations prescribed by the Office; (2) the terms of the enrollment period; and (3) such other terms and conditions as may be mutually agreed to by the Office and the qualified company involved, consistent with the requirements of this chapter and regula- tions prescribed by the Office. (c) Nothing in this chapter shall, in the case of an individual electing dental supplemental ben- efit coverage under this chapter after the expi- ration of such individual’s first opportunity to enroll, preclude the application of waiting peri- ods more stringent than those that would have applied if that opportunity had not yet expired. (d)(1) Each contract under this chapter shall require the qualified company to agree— (A) to provide payments or benefits to an el- igible individual if such i

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