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5 U.S.C. § 8956 — Election of coverage
Federal law — U.S. Code and appendices · legal_authorities
**(a)** An eligible individual may enroll in a dental benefits plan for self-only, self plus one, or for self and family. If an eligible individual has a spouse who is also eligible to enroll, either spouse, but not both, may enroll for self plus one or self and family. An individual may not be enrolled both as an employee, annuitant, or other individual eligible to enroll and as a member of the family.
**(b)** The Office shall prescribe regulations under which—
(1) an eligible individual may enroll in a dental benefits plan; and
(2) an enrolled individual may change the self-only, self plus one, or self and family coverage of that individual.
**(c)**
(1) Regulations under subsection (b) shall permit an eligible individual to cancel or transfer the enrollment of that individual to another dental benefits plan—
(A) before the start of any contract term in which there is a change in rates charged or benefits provided, in which a new plan is offered, or in which an existing plan is terminated; or
(B) during other times and under other circumstances specified by the Office.
(2) A transfer under paragraph (1) shall be subject to waiting periods provided under a new plan.
**(d)** Coverage under a dental benefits plan under this chapter for any employee or a covered TRICARE-eligible individual enrolled in such a plan and who, as a result of a lapse in appropriations, is furloughed or excepted from furlough and working without pay shall continue during such lapse and may not be cancelled as a result of nonpayment of premiums or other periodic charges due to such lapse.
Source: Supplied U.S. Code snapshot — release unconfirmed · 5 U.S.C. § 8956
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Stable record: federal_law:legal_authorities:record_usc_b40f27a719061b6b3aef38a6
Source file: Laws/federal/codes/united-states-code/title-5/section-8956-election-of-coverage--a9dd71638d.md
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Source location: Title 5, Chapter 89A, § 8956; chapter-89a-enhanced-dental-benefits.md
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**(a)** An eligible individual may enroll in a dental benefits plan for self-only, self plus one, or for self and family. If an eligible individual has a spouse who is also eligible to enroll, either spouse, but not both, may enroll for self plus one or self and family. An individual may not be enrolled both as an employee, annuitant, or other individual eligible to enroll and as a member of the family.
**(b)** The Office shall prescribe regulations under which—
(1) an eligible individual may enroll in a dental benefits plan; and
(2) an enrolled individual may change the self-only, self plus one, or self and family coverage of that individual.
**(c)**
(1) Regulations under subsection (b) shall permit an eligible individual to cancel or transfer the enrollment of that individual to another dental benefits plan—
(A) before the start of any contract term in which there is a change in rates charged or benefits provided, in which a new plan is offered, or in which an existing plan is terminated; or
(B) during other times and under other circumstances specified by the Office.
(2) A transfer under paragraph (1) shall be subject to waiting periods provided under a new plan.
**(d)** Coverage under a dental benefits plan under this chapter for any employee or a covered TRICARE-eligible individual enrolled in such a plan and who, as a result of a lapse in appropriations, is furloughed or excepted from furlough and working without pay shall continue during such lapse and may not be cancelled as a result of nonpayment of premiums or other periodic charges due to such lapse.
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Federal law — U.S. Code and appendices · legal_authorities
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.
Source: Supplied U.S. Code snapshot — release unconfirmed · 5 U.S.C. § 8951
Stored review status: release_metadata_unconfirmed. Explicit cross-reference supplied in source Markdown; currentness and applicability require review.
Federal law — U.S. Code and appendices · legal_authorities
**(a) In General.—** The Office of Personnel Management shall, without regard to section 6101(b) to (d) 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 re
Source: Supplied U.S. Code snapshot — release unconfirmed · 5 U.S.C. § 9003
Stored review status: release_metadata_unconfirmed. Explicit cross-reference supplied in source Markdown; currentness and applicability require review.
Federal law — U.S. Code and appendices · legal_authorities
**(a)** An eligible individual may enroll in a vision benefits plan for self-only, self plus one, or for self and family. If an eligible individual has a spouse who is also eligible to enroll, either spouse, but not both, may enroll for self plus one or self and family. An individual may not be enrolled both as an employee, annuitant, or other individual eligible to enroll and as a member of the family.
**(b)** The Office shall prescribe regulations under which—
(1) an eligible individual may enroll in a vision benefits plan; and
(2) an enrolled individual may change the self-only, self plus one, or self and family coverage of that individual.
**(c)**
(1) Regulations under subsection (b) shall permit an eligible individual to cancel or transfer the enrollment of that individual to another vision benefits plan—
(A) before the start of any contract term in which there is a change in rates charged or benefits provided, in which a new plan is offered, or in which an existing plan is terminated; or
(B) during other times and under other circumstances specified by the Office.
(2) A transfer under paragraph (1) shall be subject to waiting periods provided under a new plan.
**(d)** Coverage under a vision benefits plan under this chapter for any employee or a covered TRICARE-eligible individual enrolled in such a plan and who, as a result of a lapse in appropriations, is furloughed or excepted from furlough and working without pay shall continue during such lapse and may not be cancelled as a result of nonpayment of premiums or other periodic charges due to such lapse.
Source: Supplied U.S. Code snapshot — release unconfirmed · 5 U.S.C. § 8986
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Federal law — U.S. Code and appendices · legal_authorities
Page 1277
TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES
§ 8956
1 So in original. Probably should be followed by a comma.
Office. The Office shall require qualified compa-
nies 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.
(Added Pub. L. 108–496, § 2, Dec. 23, 2004, 118 Stat.
4003.)
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Section effective Dec. 23, 2004, and applicable to con-
tracts that take effect with respect to the calendar
year 2006, see section 7 of Pub. L. 108–496, set out as a
note under section 8951 of this title.
§ 8955. Information to individuals eligible to en-
roll
(a) The qualified companies 1 at the direction
and with the approval of the Office, shall make
available to each individual eligible to enroll in
a dental benefits plan information on services
and benefits (including maximums, limitations,
and exclusions), that the Office considers nec-
essary to enable the individual to make an in-
formed decision about electing coverage.
(b) The Office shall make available to each in-
dividual eligible to enroll in a dental benefits
plan, information on services and benefits pro-
vided
by
qualified
companies
participating
under chapter 89.
(Added Pub. L. 108–496, § 2, Dec. 23, 2004, 118 Stat.
4004.)
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Section effective Dec. 23, 2004, and applicable to con-
tracts that take effect with respect to the calendar
year 2006, see section 7 of Pub. L. 108–496, set out as a
note under section 8951 of this title.
§
Source: Supplied 2024 U.S. Code historical extraction · 5 U.S.C. § 8956
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.