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5 U.S.C. § 8909 — Employees Health Benefits Fund

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

5 U.S.C. § 8909 — Employees Health Benefits Fund

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Stable record: federal_law:legal_authorities:record_usc_e5e0e66ded8f96060224232c
Source file: Laws/federal/codes/united-states-code/title-5/section-8909-employees-health-benefits-fund--5d29bbb93b.md
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Source location: Title 5, Chapter 89, § 8909; chapter-089-health-insurance.md

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**(a)** There is in the Treasury of the United States an Employees Health Benefits Fund which is administered by the Office of Personnel Management. The contributions of enrollees and the Government described by [section 8906 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8906&num=0&edition=prelim) shall be paid into the Fund. The Fund is available— (1) without fiscal year limitation for all payments to approved health benefits plans; and (2) to pay expenses for administering this chapter within the limitations that may be specified annually by Congress, except that the amounts required to be set aside under subsection (b)(2) shall not be subject to the limitations that may be specified annually by Congress. Payments from the Fund to a plan participating in a letter-of-credit arrangement under this chapter shall, in connection with any payment or reimbursement to be made by such plan for a health service or supply, be made, to the maximum extent practicable, on a checks-presented basis (as defined under regulations of the Department of the Treasury). **(b)** Portions of the contributions made by enrollees and the Government shall be regularly set aside in the Fund as follows: (1) A percentage, not to exceed 1 percent of all contributions, determined by the Office to be reasonably adequate to pay the administrative expenses made available by subsection (a) of this section. (2) In fiscal year 2026, $66,000,000, to be derived from all contributions, and to remain available until the end of fiscal year 2035, for the Director of the Office to carry out subsections (c) through (f) of the FEHB Protection Act of 2025. (3) For each health benefits plan, a percentage, not to exceed 3 percent of the contributions toward the plan, determined by the Office to be reasonably adequate to provide a contingency reserve. The Office, from time to time and in amounts it considers appropriate, may transfer unused funds for administrative expenses to the contingency reserves of the plans then under contract with the Office. When funds are so transferred, each contingency reserve shall be credited in proportion to the total amount of the subscription charges paid and accrued to the plan for the contract term immediately before the contract term in which the transfer is made. The income derived from dividends, rate adjustments, or other refunds made by a plan shall be credited to its contingency reserve. The contingency reserves may be used to defray increases in future rates, or may be applied to reduce the contributions of enrollees and the Government to, or to increase the benefits provided by, the plan from which the reserves are derived, as the Office from time to time shall determine. **(c)** The Secretary of the Treasury may invest and reinvest any of the money in the Fund in interest-bearing obligations of the United States, and may sell these obligations for the purposes of the Fund. The interest on and the proceeds from the sale of these obligations become a part of the Fund. **(d)** When the assets, liabilities, and membership of employee organizations sponsoring or underwriting plans approved under section 8903(3) or 8903a of this title are merged, the assets (including contingency reserves) and liabilities of the plans sponsored or underwritten by the merged organizations shall be transferred at the beginning of the contract term next following the date of the merger to the plan sponsored or underwritten by the successor organization. Each employee, annuitant, former spouse, or person having continued coverage under [section 8905a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8905a&num=0&edition=prelim) affected by a merger shall be transferred to the plan sponsored or underwritten by the successor organization unless he enrolls in another plan under this chapter. If the successor organization is an organization described in [section 8901(8)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8901/8/B&num=0&edition=prelim), any employee, annuitant, former spouse, or person having continued coverage under [section 8905a of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8905a&num=0&edition=prelim) so transferred may not remain enrolled in the plan after the end of the contract term in which the merger occurs unless that individual is a full member of such organization (as determined under [section 8903a(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8903a/d&num=0&edition=prelim)). **(e)** (1) Except as provided by subsection (d) of this section, when a plan described by section 8903(3) or (4) or 8903a of this title is discontinued under this chapter, the contingency reserve of that plan shall be credited to the contingency reserves of the plans continuing under this chapter for the contract term following that in which termination occurs, each reserve to be credited in proportion to the amount of the subscription charges paid and accrued to the plan for the year of termination. (2) Any crediting required under paragraph (1) pursuant to the discontinuation of any plan under this chapter shall be completed by the end of the second contract year beginning after such plan is so discontinued. (3) The Office shall prescribe regulations in accordance with which this subsection shall be applied in the case of any plan which is discontinued before being credited with the full amount to which it would otherwise be entitled based on the discontinuation of any other plan. **(f)** (1) No tax, fee, or other monetary payment may be imposed, directly or indirectly, on a carrier or an underwriting or plan administration subcontractor of an approved health benefits plan by any State, the District of Columbia, or the Commonwealth of Puerto Rico, or by any political subdivision or other governmental authority thereof, with respect to any payment made from the Fund. (2) Paragraph (1) shall not be construed to exempt any carrier or underwriting or plan administration subcontractor of an approved health benefits plan 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 carrier or underwriting or plan administration subcontractor from business conducted under this chapter, if that tax, fee, or payment is applicable to a broad range of business activity. **(g)** The fund described in subsection (a) is available to pay costs that the Office incurs for activities associated with implementation of the demonstration project under [section 1108 of title 10](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1108&num=0&edition=prelim).

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

10 U.S.C. § 1108 — Health care coverage through Federal Employees Health Benefits program: demonstration project

**(a) FEHBP Option Demonstration.—** The Secretary of Defense, after consulting with the other administering Secretaries, shall enter into an agreement with the Office of Personnel Management to conduct a demonstration project (in this section referred to as the “demonstration project”) under which eligible beneficiaries described in subsection (b) and residing within one of the areas covered by the demonstration project may enroll in health benefits plans offered through the Federal Employees Health Benefits program under chapter 89 of title 5. The number of eligible beneficiaries and family members of such beneficiaries under subsection (b)(2) who may be enrolled in health benefits plans during the enrollment period under subsection (d)(2) may not exceed 66,000. **(b) Eligible Beneficiaries; Coverage.—** (1) An eligible beneficiary under this subsection is— (A) a member or former member of the uniformed services described in [section 1074(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1074/b&num=0&edition=prelim) who is entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act ([42 U.S.C. 1395c](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395c&num=0&edition=prelim) et seq.); (B) an individual who is an unremarried former spouse of a member or former member described in section 1072(2)(F) or 1072(2)(G)); (C) an individual who is— (i) a dependent of a deceased member or former member described in section 1076(b) or 1076(a)(2)(B) of this title or of a member who died while on active duty for a period of more than 30 days; and (ii) a member of family as defined in [section 8901(5) of title 5](https://uscode.house.gov/view.xhtml?req=gran

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5 U.S.C. § 8341 — Survivor annuities

**(a)** For the purpose of this section— (1) “widow” means the surviving wife of an employee or Member who— (A) was married to him for at least 9 months immediately before his death; or (B) is the mother of issue by that marriage; (2) “widower” means the surviving husband of an employee or Member who— (A) was married to her for at least 9 months immediately before her death; or (B) is the father of issue by that marriage; (3) “dependent”, in the case of any child, means that the employee or Member involved was, at the time of the employee or Member’s death, either living with or contributing to the support of such child, as determined in accordance with such regulations as the Office of Personnel Management shall prescribe; and (4) “child” means— (A) an unmarried dependent child under 18 years of age, including (i) an adopted child, and (ii) a stepchild but only if the stepchild lived with the employee or Member in a regular parent-child relationship, and (iii) a recognized natural child, and (iv) a child who lived with and for whom a petition of adoption was filed by an employee or Member, and who is adopted by the surviving spouse of the employee or Member after his death; (B) such unmarried dependent child regardless of age who is incapable of self-support because of mental or physical disability incurred before age 18; or (C) such unmarried dependent child between 18 and 22 years of age who is a student regularly pursuing a full-time course of study or training in residence in a high school, trade school, technical or vocational institute, junior college, college, university, or comparable recognized educational institution. For the purpose of this paragraph and subsection (e) of this section, a child whose 22nd birthday occurs before July

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

5 U.S.C. § 8905 — Election of coverage

**(a)** An employee may enroll in an approved health benefits plan described in section 8903 or 8903a— (1) as an individual; (2) for self plus one; or (3) for self and family. **(b)** An annuitant who at the time he becomes an annuitant was enrolled in a health benefits plan under this chapter— (1) as an employee for a period of not less than— (A) the 5 years of service immediately before retirement; (B) the full period or periods of service between the last day of the first period, as prescribed by regulations of the Office of Personnel Management, in which he is eligible to enroll in the plan and the date on which he becomes an annuitant; or (C) the full period or periods of service beginning with the enrollment which became effective before January 1, 1965, and ending with the date on which he becomes an annuitant; whichever is shortest; or (2) as a member of the family of an employee or annuitant; may continue his enrollment under the conditions of eligibility prescribed by regulations of the Office. The Office may, in its sole discretion, waive the requirements of this subsection in the case of an individual who fails to satisfy such requirements if the Office determines that, due to exceptional circumstances, it would be against equity and good conscience not to allow such individual to be enrolled as an annuitant in a health benefits plan under this chapter 11 So in original. Probably should be followed by a period. **(c)** (1) A former spouse may— (A) within 60 days after the dissolution of the marriage, or (B) in the case of a former spouse of a former employee whose marriage was dissolved after the employee’s retirement, within 60 days after the dissolution of the marriage or, if later, within 60 days after an election is made under se

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5 U.S.C. § 8901 — Definitions

For the purpose of this chapter— (1) “employee” means— (A) an employee as defined by [section 2105 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section2105&num=0&edition=prelim); (B) a Member of Congress as defined by [section 2106 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section2106&num=0&edition=prelim); (C) a Congressional employee as defined by [section 2107 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section2107&num=0&edition=prelim); (D) the President; (E) an individual first employed by the government of the District of Columbia before October 1, 1987; (F) an individual employed by Gallaudet College; 11 See Change of Name note below. (G) an individual employed by a county committee established under [section 590h(b) of title 16](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title16-section590h/b&num=0&edition=prelim); (H) an individual appointed to a position on the office staff of a former President under section 1(b) of the Act of August 25, 1958 (72 Stat. 838); (I) an individual appointed to a position on the office staff of a former President, or a former Vice President under section 5 of the Presidential Transition Act of 1963, as amended (78 Stat. 153), who immediately before the date of such appointment was an employee as defined under any other subparagraph of this paragraph; and (J) an individual who is employed by the Roosevelt Campobello International Park Commission and is a citizen of the United States, but does not include— (i) an employee of a corporation supervised by the Farm Credit Administration if private interests elect or appoint a member of the board of directors; (ii) a

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5 U.S.C. § 8905a — Continued coverage

**(a)** Any individual described in subsection (b) may elect to continue coverage under this chapter in accordance with the provisions of this section. **(b)** This section applies with respect to— (1) any employee who— (A) is separated from service, whether voluntarily or involuntarily, except that if the separation is involuntary, this section shall not apply if the separation is for gross misconduct (as defined under regulations which the Office of Personnel Management shall prescribe); and (B) would not otherwise be eligible for any benefits under this chapter (determined without regard to any temporary extension of coverage and without regard to any benefits available under a nongroup contract); (2) any individual who— (A) ceases to meet the requirements for being considered an unmarried dependent child under this chapter; (B) on the day before so ceasing to meet the requirements referred to in subparagraph (A), was covered under a health benefits plan under this chapter as a member of the family of an employee or annuitant; and (C) would not otherwise be eligible for any benefits under this chapter (determined without regard to any temporary extension of coverage and without regard to any benefits available under a nongroup contract); and (3) any employee who— (A) is enrolled in a health benefits plan under this chapter; (B) is a member of a reserve component of the armed forces; (C) is called or ordered to active duty in support of a contingency operation (as defined in [section 101(a)(13) of title 10](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section101/a/13&num=0&edition=prelim)); (D) is placed on leave without pay or separated from service to perform active duty; and (E) serves on active duty for a p

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5 U.S.C. § 8906 — Contributions

**(a)** (1) Not later than October 1 of each year, the Office of Personnel Management shall determine the weighted average of the subscription charges that will be in effect during the following contract year with respect to— (A) enrollments under this chapter for self alone; (B) enrollments under this chapter for self plus one; and (C) enrollments under this chapter for self and family. (2) In determining each weighted average under paragraph (1), the weight to be given to a particular subscription charge shall, with respect to each plan (and option) to which it is to apply, be commensurate with the number of enrollees enrolled in such plan (and option) as of March 31 of the year in which the determination is being made. (3) For purposes of paragraph (2), the term “enrollee” means any individual who, during the contract year for which the weighted average is to be used under this section, will be eligible for a Government contribution for health benefits. **(b)** (1) Except as provided in paragraphs (2), (3), and (4), the biweekly Government contribution for health benefits for an employee or annuitant enrolled in a health benefits plan under this chapter is adjusted to an amount equal to 72 percent of the weighted average under subsection (a)(1)(A) or (B), as applicable. For an employee, the adjustment begins on the first day of the employee’s first pay period of each year. For an annuitant, the adjustment begins on the first day of the first period of each year for which an annuity payment is made. (2) The biweekly Government contribution for an employee or annuitant enrolled in a plan under this chapter shall not exceed 75 percent of the subscription charge. (3) In the case of an employee who is occupying a position on a part-time career employment b

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5 U.S.C. § 8902 — Contracting authority

**(a)** The Office of Personnel Management may contract with qualified carriers offering plans described by section 8903 or 8903a of this title, without regard to section 6101(b) to (d) of title 41 or other statute requiring competitive bidding. Each contract shall be for a uniform term of at least 1 year, but may be made automatically renewable from term to term in the absence of notice of termination by either party. **(b)** To be eligible as a carrier for the plan described by [section 8903(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8903/2&num=0&edition=prelim), a company must be licensed to issue group health insurance in all the States and the District of Columbia. **(c)** A contract for a plan described by section 8903(1) or (2) of this title shall require the carrier— (1) to reinsure with other companies which elect to participate, under an equitable formula based on the total amount of their group health insurance benefit payments in the United States during the latest year for which the information is available, to be determined by the carrier and approved by the Office; or (2) to allocate its rights and obligations under the contract among its affiliates which elect to participate, under an equitable formula to be determined by the carrier and the affiliates and approved by the Office. **(d)** Each contract under this chapter shall contain a detailed statement of benefits offered and shall include such maximums, limitations, exclusions, and other definitions of benefits as the Office considers necessary or desirable. **(e)** The Office may prescribe reasonable minimum standards for health benefits plans described by section 8903 or 8903a of this title and for carriers offering the plans. Approval of a pla

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5 U.S.C. § 1101 — Office of Personnel Management

The Office of Personnel Management is an independent establishment in the executive branch. The Office shall have an official seal, which shall be judicially noticed, and shall have its principal office in the District of Columbia, and may have field offices in other appropriate locations.

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

12 U.S.C. § 5437 — Transfer of employees

**(a) In general** (1) **Office of Thrift Supervision employees** (A) *In general* — Except as provided in [section 5584 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title12-section5584&num=0&edition=prelim), all employees of the Office of Thrift Supervision shall be transferred to the Office of the Comptroller of the Currency or the Corporation for employment in accordance with this section. (B) *Allocating employees for transfer to receiving agencies* — The Director of the Office of Thrift Supervision, the Comptroller of the Currency, and the Chairperson of the Corporation shall— (i) jointly determine the number of employees of the Office of Thrift Supervision necessary to perform or support the functions that are transferred to the Office of the Comptroller of the Currency or the Corporation by this title; 11 See References in Text note below. and (ii) consistent with the determination under clause (i), jointly identify employees of the Office of Thrift Supervision for transfer to the Office of the Comptroller of the Currency or the Corporation. (2) **Employees transferred; service periods credited** — For purposes of this section, periods of service with a Federal home loan bank, a joint office of Federal home loan banks, or a Federal reserve bank shall be credited as periods of service with a Federal agency. (3) **Appointment authority for excepted service transferred** (A) *In general* — Except as provided in subparagraph (B), any appointment authority of the Office of Thrift Supervision under Federal law that relates to the functions transferred under [section 5412 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title12-section5412&num=0&edition=prelim), including the regulations of

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12 U.S.C. § 5601 — Transfer of certain personnel

**(a) In general** (1) **Certain Federal Reserve System employees transferred** (A) *Identifying employees for transfer* — The Bureau and the Board of Governors shall— (i) jointly determine the number of employees of the Board of Governors necessary to perform or support the consumer financial protection functions of the Board of Governors that are transferred to the Bureau by this title; 11 See References in Text note below. and (ii) consistent with the number determined under clause (i), jointly identify employees of the Board of Governors for transfer to the Bureau, in a manner that the Bureau and the Board of Governors, in their sole discretion, determine equitable. (B) *Identified employees transferred* — All employees of the Board of Governors identified under subparagraph (A)(ii) shall be transferred to the Bureau for employment. (C) *Federal reserve bank employees* — Employees of any Federal reserve bank who are performing consumer financial protection functions on behalf of the Board of Governors shall be treated as employees of the Board of Governors for purposes of subparagraphs (A) and (B). (2) **Certain FDIC employees transferred** (A) *Identifying employees for transfer* — The Bureau and the Board of Directors of the Federal Deposit Insurance Corporation shall— (i) jointly determine the number of employees of that Corporation necessary to perform or support the consumer financial protection functions of the Corporation that are transferred to the Bureau by this title; 1 and (ii) consistent with the number determined under clause (i), jointly identify employees of the Corporation for transfer to the Bureau, in a manner that the Bureau and the Board of Directors of the Corporation, in their sole discretion, determine equitab

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