5 U.S.C. § 8901 — Definitions

Page 1234 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 1 See Change of Name note below. HISTORICAL AND REVISION NOTES—CONTINUED Derivation U.S. Code Revised Statutes and Statutes at Large (b), (c) ....... 5 U.S.C. 2091(a) (words between 6th and 7th com- mas of 1st sen- tence and 2d sen- tence), (d) (words between 1st and 2d commas of 1st sen- tence, and 2d sen- tence). Aug. 17, 1954, ch. 752, § 2(a) (words between 6th and 7th commas of 1st sen- tence and 2d sentence), 68 Stat. 736. July 1, 1960, Pub. L. 86–568, § 115(c) ‘‘(d) (words be- tween 1st and 2d commas of 1st sentence, and 2d sentence)’’, 74 Stat. 302. Oct. 6, 1964, Pub. L. 88–631, § 2, 78 Stat. 1007. In subsection (a), the words ‘‘Except as otherwise pro- vided herein’’ are omitted as unnecessary since the au- thority to prescribe regulations is carried into this sec- tion. In subsection (b), the words ‘‘section 1501 of title 31, District of Columbia Code’’ are substituted for ‘‘section 1 of the District of Columbia Teachers’ Salary Act of 1955 (69 Stat. 521), as amended (Sec. 31–1501, D.C. Code, 1961 edition)’’. Standard changes are made to conform with the defi- nitions applicable and the style of this title as outlined in the preface to the report. Editorial Notes AMENDMENTS 1978—Subsec. (a). Pub. L. 95–454, § 906(a)(2), sub- stituted ‘‘Office of Personnel Management’’ for ‘‘Civil Service Commission’’. Subsec. (b). Pub. L. 95–454, § 906(a)(3), substituted ‘‘Of- fice’’ for ‘‘Commission’’ wherever appearing. Pub. L. 95–437 substituted ‘‘intermittent employ- ment’’ for ‘‘intermittent or part-time employment’’ in provision preceding par. (1), and added par. (3). Pub. L. 95–454, § 906(c)(2)(F), (G), substituted ‘‘3401’’ for ‘‘3391’’ in par. (3). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1978 AMENDMENT Amendment by Pub. L. 95–454 effective 90 days after Oct. 13, 1978, see section 907 of Pub. L. 95–454, set out as a note under section 1101 of this title. CHAPTER 89—HEALTH INSURANCE Sec. 8901. Definitions. 8902. Contracting authority. 8902a. Debarment and other sanctions. 8903. Health benefits plans. 8903a. Additional health benefits plans. 8903b. Authority to readmit an employee organiza- tion plan. 8903c. Postal Service Health Benefits Program. 8904. Types of benefits. 8905. Election of coverage. 8905a. Continued coverage. 8906. Contributions. 8906a. Temporary employees. 8907. Information to individuals eligible to enroll. 8908. Coverage of restored employees and survivor or disability annuitants. 8909. Employees Health Benefits Fund. 8909a. Postal Service Retiree Health Benefits Fund. 8910. Studies, reports, and audits. 8911. Advisory committee. 8912. Jurisdiction of courts. 8913. Regulations. 8914. Effect of other statutes. Editorial Notes AMENDMENTS 2022—Pub. L. 117–108, title I, § 102(a)(2)(B), Apr. 6, 2022, 136 Stat. 1135, added item 8903c. 2006—Pub. L. 109–435, title VIII, § 803(a)(2), Dec. 20, 2006, 120 Stat. 3252, added item 8909a. 1998—Pub. L. 105–266, § 6(a)(2), Oct. 19, 1998, 112 Stat. 2369, added item 8903b. 1988—Pub. L. 100–654, title I, § 101(b), title II, § 201(a)(2), title III, § 301(b), Nov. 14, 1988, 102 Stat. 3841, 3845, 3846, added items 8902a, 8905a, and 8906a. Pub. L. 100–238, title I, § 108(a)(3)(B), Jan. 8, 1988, 101 Stat. 1748, added item 8914. 1985—Pub. L. 99–53, §§ 1(b)(2), 3(a)(2)(B), June 17, 1985, 99 Stat. 94, 95, added item 8903a and inserted ‘‘or dis- ability’’ after ‘‘and survivor’’ in item 8908. 1984—Pub. L. 98–615, § 3(8), Nov. 8, 1984, 98 Stat. 3204, substituted ‘‘Information to individuals eligible to en- roll’’ for ‘‘Information to employees’’ in item 8907. 1976—Pub. L. 94–342, § 1(b), July 6, 1976, 90 Stat. 808, substituted ‘‘employees and survivor annuitants’’ for ‘‘employee’’ in item 8908. § 8901. Definitions For the purpose of this chapter— (1) ‘‘employee’’ means— (A) an employee as defined by section 2105 of this title; (B) a Member of Congress as defined by section 2106 of this title; (C) a Congressional employee as defined by section 2107 of this title; (D) the President; (E) an individual first employed by the government of the District of Columbia be- fore October 1, 1987; (F) an individual employed by Gallaudet College; 1 (G) an individual employed by a county committee established under section 590h(b) of title 16; (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 be- fore the date of such appointment was an employee as defined under any other sub- paragraph 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 pri- vate interests elect or appoint a member of the board of directors; (ii) an individual who is not a citizen or national of the United States and whose per- manent duty station is outside the United States, unless the individual was an em- ployee for the purpose of this chapter on September 30, 1979, by reason of service in an Executive agency, the United States Postal Service, or the Smithsonian Institution in the area which was then known as the Canal Zone; (iii) an employee of the Tennessee Valley Authority; or Page 1235 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 (iv) an employee excluded by regulation of the Office of Personnel Management under section 8913(b) of this title; (2) ‘‘Government’’ means the Government of the United States and the government of the District of Columbia; (3) ‘‘annuitant’’ means— (A) an employee who retires— (i) on an immediate annuity under sub- chapter III of chapter 83 of this title, or another retirement system for employees of the Government, after 5 or more years of service; (ii) under section 8412 or 8414 of this title; (iii) for disability under subchapter III of chapter 83 of this title, chapter 84 of this title, or another retirement system for employees of the Government; or (iv) on an immediate annuity under a re- tirement system established for employees described in section 2105(c), in the case of an individual who elected under section 8347(q)(2) or 8461(n)(2) to remain subject to such a system; (B) a member of a family who receives an immediate annuity as the survivor of an em- ployee (including a family member entitled to an amount under section 8442(b)(1)(A), whether or not such family member is enti- tled to an annuity under section 8442(b)(1)(B)) or of a retired employee de- scribed by subparagraph (A) of this para- graph; (C) an employee who receives monthly compensation under subchapter I of chapter 81 of this title and who is determined by the Secretary of Labor to be unable to return to duty; and (D) a member of a family who receives monthly compensation under subchapter I of chapter 81 of this title as the surviving bene- ficiary of— (i) an employee who dies as a result of injury or illness compensable under that subchapter; or (ii) a former employee who is separated after having completed 5 or more years of service and who dies while receiving monthly compensation under that sub- chapter and who has been held by the Sec- retary to have been unable to return to duty; (4) ‘‘service’’, as used by paragraph (3) of this section, means service which is creditable under subchapter III of chapter 83 or chapter 84 of this title; (5) ‘‘member of family’’ means the spouse of an employee or annuitant and an unmarried dependent child under 22 years of age, includ- ing— (A) an adopted child or recognized natural child; and (B) a stepchild or foster child but only if the child lives with the employee or annu- itant in a regular parent-child relationship; or such an unmarried dependent child regard- less of age who is incapable of self-support be- cause of mental or physical disability which existed before age 22; (6) ‘‘health benefits plan’’ means a group in- surance policy or contract, medical or hospital service agreement, membership or subscrip- tion contract, or similar group arrangement provided by a carrier for the purpose of pro- viding, paying for, or reimbursing expenses for health services; (7) ‘‘carrier’’ means a voluntary association, corporation, partnership, or other nongovern- mental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of, health services under group insurance policies or contracts, medical or hospital serv- ice agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or under- written by an employee organization and an association of organizations or other entities described in this paragraph sponsoring a health benefits plan; (8) ‘‘employee organization’’ means— (A) 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 this chapter and which, after December 31, 1978, and before January 1, 1980, applied to the Of- fice for approval of a plan provided under section 8903(3) of this title; and (B) an association or other organization which is national in scope, in which mem- bership is open only to employees, annu- itants, or former spouses, or any combina- tion thereof, and which, during the 90-day period beginning on the date of enactment of section 8903a of this title, applied to the Of- fice for approval of a plan provided under such section; (9) ‘‘dependent’’, in the case of any child, means that the employee or annuitant in- volved is either living with or contributing to the support of such child, as determined in ac- cordance with such regulations as the Office shall prescribe; (10) ‘‘former spouse’’ means a former spouse of an employee, former employee, or annu- itant— (A) who has not remarried before age 55 after the marriage to the employee, former employee, or annuitant was dissolved, (B) who was enrolled in an approved health benefits plan under this chapter as a family member at any time during the 18-month pe- riod before the date of the dissolution of the marriage to the employee, former employee, or annuitant, and (C)(i) who is receiving any portion of an annuity under section 8345(j) or 8467 of this title or a survivor annuity under section 8341(h) or 8445 of this title (or benefits simi- lar to either of the aforementioned annuity benefits under a retirement system for Gov- ernment employees other than the Civil Service Retirement System or the Federal Employees’ Retirement System), (ii) as to whom a court order or decree re- ferred to in section 8341(h), 8345(j), 8445, or 8467 of this title (or similar provision of law Page 1236 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 under any such retirement system other than the Civil Service Retirement System or the Federal Employees’ Retirement System) has been issued, or for whom an election has been made under section 8339(j)(3) or 8417(b) of this title (or similar provision of law), or (iii) who is otherwise entitled to an annu- ity or any portion of an annuity as a former spouse under a retirement system for Gov- ernment employees, except that such term shall not include any such unremarried former spouse of a former employee whose marriage was dissolved after the former employee’s separation from the service (other than by retirement); and (11) ‘‘qualified clinical social worker’’ means an individual— (A) who is licensed or certified as a clinical social worker by the State in which such in- dividual practices; or (B) who, if such State does not provide for the licensing or certification of clinical so- cial workers— (i) is certified by a national professional organization offering certification of clin- ical social workers; or (ii) meets equivalent requirements (as prescribed by the Office). (Pub. L. 89–554, Sept. 6, 1966, 80 Stat. 600; Pub. L. 90–83, § 1(95), Sept. 11, 1967, 81 Stat. 219; Pub. L. 91–418, §§ 2, 3(b), Sept. 25, 1970, 84 Stat. 869; Pub. L. 93–160, § 1(b), Nov. 27, 1973, 87 Stat. 635; Pub. L. 95–368, § 2, Sept. 17, 1978, 92 Stat. 606; Pub. L. 95–454, title IX, § 906(a)(2), (3), Oct. 13, 1978, 92 Stat. 1224; Pub. L. 95–583, § 2, Nov. 2, 1978, 92 Stat. 2482; Pub. L. 96–54, § 2(a)(52), Aug. 14, 1979, 93 Stat. 384; Pub. L. 96–70, title I, § 1209(c), Sept. 27, 1979, 93 Stat. 463; Pub. L. 96–179, § 2, Jan. 2, 1980, 93 Stat. 1299; Pub. L. 98–615, § 3(1), Nov. 8, 1984, 98 Stat. 3202; Pub. L. 99–53, § 1(a), June 17, 1985, 99 Stat. 93; Pub. L. 99–251, title I, § 105(a), Feb. 27, 1986, 100 Stat. 15; Pub. L. 99–335, title II, § 207(l), June 6, 1986, 100 Stat. 598; Pub. L. 99–556, title V, § 503, Oct. 27, 1986, 100 Stat. 3141; Pub. L. 100–679, § 13(c), Nov. 17, 1988, 102 Stat. 4071; Pub. L. 101–508, title VII, § 7202(l), Nov. 5, 1990, 104 Stat. 1388–339; Pub. L. 102–378, § 2(75), Oct. 2, 1992, 106 Stat. 1355; Pub. L. 105–266, § 3(a), Oct. 19, 1998, 112 Stat. 2366; Pub. L. 110–74, § 1, Aug. 9, 2007, 121 Stat. 723; Pub. L. 114–136, § 2(c)(5), Mar. 18, 2016, 130 Stat. 305.) HISTORICAL AND REVISION NOTES 1966 ACT Derivation U.S. Code Revised Statutes and Statutes at Large .................. 5 U.S.C. 3001. Sept. 28, 1959, Pub. L. 86–382, § 2, 73 Stat. 709. July 8, 1963, Pub. L. 88–59, § 1, 77 Stat. 76. Mar. 17, 1964, Pub. L. 88–284, § 1(1)–(4), 78 Stat. 164. Aug. 31, 1964, Pub. L. 88–531, § 1, 78 Stat. 737. .................. 5 U.S.C. 3002(f) (1st sentence, less words between 1st and 2d commas). July 1, 1960, Pub. L. 86–568, § 115(d) ‘‘(f) (1st sentence, less words between 1st and 2d commas)’’, 74 Stat. 303. The definition of ‘‘employee’’ in section 2105 of this title is broad enough to cover the officers and employ- ees covered by former section 3001 with the exception of a Member of Congress, the President, an individual em- ployed by the government of the District of Columbia, an individual employed by Gallaudet College, a United States commissioner, and an Official Reporter of De- bates of the Senate and an individual employed by him. The first five have been added in paragraphs (1)(B), (D), (E), (F), and (G). The latter are covered by the defini- tion of ‘‘Congressional employee’’ in section 2107 of this title and are included by the addition of a Congres- sional employee in paragraph (1)(C). In paragraph (1)(ii), the words ‘‘the United States’’ are substituted for ‘‘a State of the United States or the District of Columbia’’. Paragraph (1)(iv) is added for clarity. In paragraph (8), the words ‘‘before January 1, 1964’’ are substituted for ‘‘on or before December 31, 1963’’. The definition of ‘‘Commission’’ in former section 3001(h) is omitted as unnecessary as the full title ‘‘Civil Service Commission’’ is set forth the first time it is used in a section. Standard changes are made to conform with the defi- nitions applicable and the style of this title as outlined in the preface to the report. 1967 ACT Section of title 5 Source (U.S. Code) Source (Statutes at Large) 8901(5) ....... 5 App.: 3001(d). July 18, 1966, Pub. L. 89–504, § 601, 80 Stat. 303. Editorial Notes REFERENCES IN TEXT Section 1(b) of the Act of August 25, 1958 (72 Stat. 838), referred to in par. (1)(H), is section 1(b) of Pub. L. 85–745 which is set out as a note under section 102 of Title 3, The President. Section 5 of the Presidential Transition Act of 1963, referred to in par. (1)(I), is section 5 of Pub. L. 88–277, which is set out as a note under section 102 of Title 3, The President. The date of enactment of section 8903a of this title, referred to in par. (8)(B), means the date of enactment of Pub. L. 99–53, which enacted section 8903a and which was approved June 17, 1985. AMENDMENTS 2016—Par. (1)(I). Pub. L. 114–136 substituted ‘‘section 5’’ for ‘‘section 4’’. 2007—Par. (1)(J). Pub. L. 110–74 added subpar. (J). 1998—Par. (7). Pub. L. 105–266 substituted ‘‘organiza- tion and an association of organizations or other enti- ties described in this paragraph sponsoring a health benefits plan;’’ for ‘‘organization;’’. 1992—Par. (3)(A)(iv). Pub. L. 102–378, § 2(75)(A), sub- stituted ‘‘8347(q)(2)’’ for ‘‘8347(p)(2)’’. Par. (10)(C)(ii). Pub. L. 102–378, § 2(75)(B), inserted comma after ‘‘8341(h)’’. 1990—Par. (3)(A)(iv). Pub. L. 101–508 added cl. (iv). 1988—Par. (1)(H), (I). Pub. L. 100–679 added subpars. (H) and (I). 1986—Par. (1)(E). Pub. L. 99–335, § 207(l)(1), amended subpar. (E) generally, substituting ‘‘first employed’’ for ‘‘employed’’ and inserting ‘‘before October 1, 1987’’. Par. (3)(A). Pub. L. 99–335, § 207(l)(2), amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: ‘‘an employee who retires on an immediate an- nuity under subchapter III of chapter 83 of this title or another retirement system for employees of the Gov- ernment, after 5 or more years of service or for dis- ability’’. Par. (3)(B). Pub. L. 99–556 inserted ‘‘(including a fam- ily member entitled to an amount under section 8442(b)(1)(A), whether or not such family member is en- titled to an annuity under section 8442(b)(1)(B))’’. Par. (4). Pub. L. 99–335, § 207(l)(3), inserted ‘‘or chapter 84’’. Par. (10)(C)(i). Pub. L. 99–335, § 207(l)(4), inserted ‘‘or 8467’’, ‘‘or 8445’’, and ‘‘or the Federal Employees’ Re- tirement System’’. Page 1237 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 Par. (10)(C)(ii). Pub. L. 99–335, § 207(l)(5), substituted ‘‘8345(j), 8445, or 8467’’ for ‘‘or 8345(j)’’ and inserted ‘‘or the Federal Employees’ Retirement System’’ and ‘‘or 8417(b)’’. Par. (11). Pub. L. 99–251 added par. (11). 1985—Par. (8). Pub. L. 99–53 amended par. (8) gen- erally, designating existing provisions as subpar. (A) and adding subpar. (B). 1984—Par. (10). Pub. L. 98–615 added par. (10). 1980—Par. (5). Pub. L. 96–179, § 2(1), inserted ‘‘depend- ent’’ after ‘‘unmarried’’ in provisions preceding subpar. (A) and in provisions following subpar. (B), inserted ‘‘or recognized natural child’’ after ‘‘child’’ in subpar. (A), and substituted ‘‘or foster child but only if the child;’’ for ‘‘, foster child, or recognized natural child who’’ in subpar. (B). Par. (9). Pub. L. 96–179, § 2(2)–(4), added par. (9). 1979—Par. (1). Pub. L. 96–70 in cl. (ii) substituted pro- visions relating to an individual who was an employee for the purpose of this chapter on Sept. 30, 1979, by rea- son of service in an Executive agency, United States Postal Service, or Smithsonian Institution in area which was then known as Canal Zone for provisions re- lating to Panama Canal Zone. Pub. L. 96–54 struck out cl. (G) which related to cov- erage of a United States Commissioner as an ‘‘em- ployee’’, and redesignated cl. (H) as (G). 1978—Par. (1)(iv). Pub. L. 95–454 substituted ‘‘Office of Personnel Management’’ for ‘‘Civil Service Commis- sion’’. Par. (3)(A). Pub. L. 95–583 reduced period of service to 5 from 12 years. Par. (8). Pub. L. 95–454 substituted ‘‘Office’’ for ‘‘Com- mission’’. Pub. L. 95–368 substituted ‘‘after December 31, 1978, and before January 1, 1980’’ for ‘‘before January 1, 1964’’. 1973—Par. (1)(ii). Pub. L. 93–160 excluded from defini- tion of ‘‘employee’’ persons who are not nationals of United States and whose permanent duty station is outside United States and Panama Canal Zone. 1970—Par. (1)(ii). Pub. L. 91–418, § 3(b), excluded from definition of ‘‘employee’’ a noncitizen employee whose permanent duty station is outside Panama Canal Zone. Par. (3)(B). Pub. L. 91–418, § 2(a), redefined ‘‘annu- itant’’ to be a member of a family who receives an im- mediate annuity as the survivor of an employee rather than as the survivor of an employee who dies after completing 5 or more years of service. Par. (3)(D)(i). Pub. L. 91–418, § 2(b), redefined ‘‘annu- itant’’ to be a member of a family who receives month- ly compensation as the surviving beneficiary of an em- ployee who dies as a result of a compensable injury or illness rather than as the survivor of an employee who, having completed 5 or more years of service, so dies. Statutory Notes and Related Subsidiaries CHANGE OF NAME Gallaudet College, referred to in par. (1)(F), was re- designated Gallaudet University by section 101(a) of Pub. L. 99–371, which is classified to section 4301(a) of Title 20, Education. EFFECTIVE DATE OF 1992 AMENDMENT Amendment by section 2(75)(A) of Pub. L. 102–378 ef- fective Nov. 5, 1990, and amendment by section 2(75)(B) of Pub. L. 102–378 effective Oct. 2, 1992, see section 9(a), (b)(6) of Pub. L. 102–378, set out as a note under section 6303 of this title. EFFECTIVE DATE OF 1990 AMENDMENT Amendment by Pub. L. 101–508 applicable with re- spect to any individual who, on or after Jan. 1, 1987, moves from employment in nonappropriated fund in- strumentality of Department of Defense or Coast Guard, that is described in section 2105(c) of this title, to employment in Department or Coast Guard, that is not described in section 2105(c), or who moves from em- ployment in Department or Coast Guard, that is not described in section 2105(c), to employment in non- appropriated fund instrumentality of Department or Coast Guard, that is described in section 2105(c), see section 7202(m)(1) of Pub. L. 101–508, set out as a note under section 2105 of this title. EFFECTIVE DATE OF 1986 AMENDMENTS Amendment by Pub. L. 99–335 effective Jan. 1, 1987, see section 702(a) of Pub. L. 99–335, set out as an Effec- tive Date note under section 8401 of this title. Pub. L. 99–251, title I, § 105(c), Feb. 27, 1986, 100 Stat. 15, provided that: ‘‘The amendments made by sub- sections (a) and (b) [amending this section and section 8902 of this title] shall be effective with respect to con- tracts entered into or renewed for calendar years begin- ning after December 31, 1986.’’ EFFECTIVE DATE OF 1984 AMENDMENT Amendment by Pub. L. 98–615 effective May 7, 1985, with enumerated exceptions, and applicable to any in- dividual who is married to an employee or annuitant on or after that date, see section 4(a)(2) of Pub. L. 98–615, as amended, set out as a note under section 8341 of this title. EFFECTIVE DATE OF 1980 AMENDMENT Amendment by Pub. L. 96–179 effective Jan. 2, 1980, except that no benefits under this chapter that are made available by reason of amendment of this section and section 8341 of this title by Pub. L. 96–179 shall be payable for any period before Oct. 1, 1979, see section 5(a) of Pub. L. 96–179, set out as a note under section 8341 of this title. EFFECTIVE DATE OF 1979 AMENDMENTS Amendment by Pub. L. 96–70 effective Oct. 1, 1979, see section 3304 of Pub. L. 96–70, set out as an Effective Date note under section 3601 of Title 22, Foreign Rela- tions and Intercourse. Amendment by Pub. L. 96–54 effective July 12, 1979, see section 2(b) of Pub. L. 96–54, set out as a note under section 305 of this title. EFFECTIVE DATE OF 1978 AMENDMENTS Amendment by Pub. L. 95–583 effective Nov. 2, 1978, see section 3 of Pub. L. 95–583, set out as a note under section 8706 of this title. Amendment by Pub. L. 95–454 effective 90 days after Oct. 13, 1978, see section 907 of Pub. L. 95–454, set out as a note under section 1101 of this title. SHORT TITLE OF 2000 AMENDMENT Pub. L. 106–394, § 1, Oct. 30, 2000, 114 Stat. 1629, pro- vided that: ‘‘This Act [amending sections 8421a and 8905 of this title and enacting provisions set out as a note under section 8421a of this title] may be cited as the ‘Federal Employees Health Benefits Children’s Equity Act of 2000’.’’ SHORT TITLE OF 1998 AMENDMENT Pub. L. 105–266, § 1, Oct. 19, 1998, 112 Stat. 2363, pro- vided that: ‘‘This Act [enacting section 8903b of this title, amending this section and sections 5948, 8902 to 8903, and 8909 of this title, and enacting provisions set out as notes under this section and sections 5948, 8902, 8902a, 8903b, and 8909 of this title] may be cited as the ‘Federal Employees Health Care Protection Act of 1998’.’’ SHORT TITLE OF 1988 AMENDMENT Pub. L. 100–654, § 1, Nov. 14, 1988, 102 Stat. 3837, pro- vided that: ‘‘This Act [enacting sections 8440a, 8902a, 8905a, and 8906a of this title, amending sections 8902, 8903, 8905, 8909, and 8913 of this title, and enacting provi- sions set out as notes under sections 8902, 8902a, and 8906a of this title] may be cited as the ‘Federal Employ- ees Health Benefits Amendments Act of 1988’.’’ Page 1238 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 SHORT TITLE OF 1986 AMENDMENT Pub. L. 99–251, § 1, Feb. 27, 1986, 100 Stat. 14, provided that: ‘‘This Act [amending this section, sections 1103, 3502, 5334, 5924, 6312, 8332, 8339 to 8342, 8345, 8902, 8903, 8905, and 8909 of this title, and section 35 of Title 24, Hospitals and Asylums, enacting provisions set out as notes under this section and sections 7901, 8339, 8341, 8345, 8902, 8904, 8905, and 8909 of this title, and amending provisions set out as notes under sections 8341 and 8902 of this title] may be cited as the ‘Federal Employees Benefits Improvement Act of 1986’.’’ CONTINUATION OF HEALTH BENEFITS COVERAGE FOR IN- DIVIDUALS ENROLLED IN A PLAN ADMINISTERED BY THE OVERSEAS PRIVATE INVESTMENT CORPORATION Pub. L. 107–304, § 4, Nov. 27, 2002, 116 Stat. 2364, pro- vided that: ‘‘(a) ENROLLMENT IN CHAPTER 89 Plan.—For purposes of the administration of chapter 89 of title 5, United States Code, any period of enrollment under a health benefits plan administered by the Overseas Private In- vestment Corporation [now the United States Inter- national Development Finance Corporation] before the effective date of this Act [probably means Nov. 27, 2002, the date of enactment of Pub. L. 107–304] shall be deemed to be a period of enrollment in a health bene- fits plan under chapter 89 of such title. ‘‘(b) CONTINUED COVERAGE.— ‘‘(1) IN GENERAL.—Any individual who, as of the en- rollment eligibility date, is covered by a health bene- fits plan administered by the Overseas Private In- vestment Corporation may enroll in an approved health benefits plan described under section 8903 or 8903a of title 5, United States Code— ‘‘(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and ‘‘(B) for coverage effective on and after such date. ‘‘(2) INDIVIDUALS CURRENTLY UNDER CONTINUED COV- ERAGE.—An individual who, as of the enrollment eli- gibility date, is entitled to continued coverage under a health benefits plan administered by the Overseas Private Investment Corporation— ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been permitted under the plan administered by the Overseas Private Investment Corporation; and ‘‘(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a of such title for coverage effective on and after such date. ‘‘(3) UNMARRIED DEPENDENT CHILDREN.—An indi- vidual who, as of the enrollment eligibility date, is covered as an unmarried dependent child under a health benefits plan administered by the Overseas Private Investment Corporation and who is not a member of family as defined under section 8901(5) of title 5, United States Code— ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had ceased to meet the requirements for being considered an unmarried dependent child under chapter 89 of such title as of such date; and ‘‘(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage effective on and after such date. ‘‘(c) TRANSFERS TO THE EMPLOYEES HEALTH BENEFITS FUND.— ‘‘(1) IN GENERAL.—The Overseas Private Investment Corporation [now the United States International De- velopment Finance Corporation] shall transfer to the Employees Health Benefits Fund established under section 8909 of title 5, United States Code, amounts determined by the Director of the Office of Personnel Management, after consultation with the Overseas Private Investment Corporation, to be necessary to reimburse the Fund for the cost of providing benefits under this section not otherwise paid for by the indi- viduals covered by this section. ‘‘(2) AVAILABILITY OF FUNDS.—The amounts trans- ferred under paragraph (1) shall be held in the Fund and used by the Office in addition to amounts avail- able under section 8906(g)(1) of title 5, United States Code. ‘‘(d) ADMINISTRATION AND REGULATIONS.—The Office of Personnel Management— ‘‘(1) shall administer this section to provide for— ‘‘(A) a period of notice and open enrollment for individuals affected by this section; and ‘‘(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and ‘‘(2) may prescribe regulations to implement this section. ‘‘(e) ENROLLMENT ELIGIBILITY DATE.—For purposes of this section, the term ‘enrollment eligibility date’ means the last day on which coverage under a health benefits plan administered by the Overseas Private In- vestment Corporation is available. Such date shall be determined by the Office of Personnel Management in consultation with the Overseas Private Investment Corporation.’’ CONTINUED COVERAGE FOR INDIVIDUALS ENROLLED IN PLAN ADMINISTERED BY FEDERAL DEPOSIT INSURANCE CORPORATION OR FOR EMPLOYEES OF BOARD OF GOV- ERNORS OF FEDERAL RESERVE SYSTEM Pub. L. 105–266, § 4, Oct. 19, 1998, 112 Stat. 2367, pro- vided that: ‘‘(a) ENROLLMENT IN CHAPTER 89 PLAN.—For purposes of chapter 89 of title 5, United States Code, any period of enrollment— ‘‘(1) in a health benefits plan administered by the Federal Deposit Insurance Corporation before the ter- mination of such plan on or before January 2, 1999; or ‘‘(2) subject to subsection (c), in a health benefits plan (not under chapter 89 of such title) with respect to which the eligibility of any employees or retired employees of the Board of Governors of the Federal Reserve System terminates on or before January 2, 1999, shall be deemed to be a period of enrollment in a health benefits plan under chapter 89 of such title. ‘‘(b) CONTINUED COVERAGE.—(1) Subject to subsection (c), any individual who, on or before January 2, 1999, is enrolled in a health benefits plan described in sub- section (a)(1) or (2) may enroll in an approved health benefits plan under chapter 89 of title 5, United States Code, either as an individual or for self and family, if, after taking into account the provisions of subsection (a), such individual— ‘‘(A) meets the requirements of such chapter for eli- gibility to become so enrolled as an employee, annu- itant, or former spouse (within the meaning of such chapter); or ‘‘(B) would meet those requirements if, to the ex- tent such requirements involve either retirement sys- tem under such title 5, such individual satisfies simi- lar requirements or provisions of the Retirement Plan for Employees of the Federal Reserve System. Any determination under subparagraph (B) shall be made under guidelines which the Office of Personnel Management shall establish in consultation with the Board of Governors of the Federal Reserve System. ‘‘(2) Subject to subsection (c), any individual who, on or before January 2, 1999, is entitled to continued cov- erage under a health benefits plan described in sub- section (a)(1) or (2) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, but only for the same remaining period as would have been allowable under the health benefits plan in which such individual was enrolled on or before January 2, 1999, if— ‘‘(A) such individual had remained enrolled in such plan; and Page 1239 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8901 ‘‘(B) such plan did not terminate, or the eligibility of such individual with respect to such plan did not terminate, as described in subsection (a). ‘‘(3) Subject to subsection (c), any individual (other than an individual under paragraph (2)) who, on or be- fore January 2, 1999, is covered under a health benefits plan described in subsection (a)(1) or (2) as an unmar- ried dependent child, but who does not then qualify for coverage under chapter 89 of title 5, United States Code, as a family member (within the meaning of such chapter) shall be deemed to be entitled to continued coverage under section 8905a of such title, to the same extent and in the same manner as if such individual had, on or before January 2, 1999, ceased to meet the re- quirements for being considered an unmarried depend- ent child of an enrollee under such chapter. ‘‘(4) Coverage under chapter 89 of title 5, United States Code, pursuant to an enrollment under this sec- tion shall become effective on January 3, 1999 or such earlier date as established by the Office of Personnel Management after consultation with the Federal De- posit Insurance Corporation or the Board of Governors of the Federal Reserve System, as appropriate. ‘‘(c) ELIGIBILITY FOR FEHBP LIMITED TO INDIVIDUALS LOSING ELIGIBILITY UNDER FORMER HEALTH PLAN.— Nothing in subsection (a)(2) or any paragraph of sub- section (b) (to the extent such paragraph relates to the plan described in subsection (a)(2)) shall be considered to apply with respect to any individual whose eligi- bility for coverage under such plan does not involun- tarily terminate on or before January 2, 1999. ‘‘(d) TRANSFERS TO THE EMPLOYEES HEALTH BENEFITS FUND.—The Federal Deposit Insurance Corporation and the Board of Governors of the Federal Reserve System shall transfer to the Employees Health Benefits Fund under section 8909 of title 5, United States Code, amounts determined by the Director of the Office of Personnel Management, after consultation with the Federal Deposit Insurance Corporation and the Board of Governors of the Federal Reserve System, to be nec- essary to reimburse the Fund for the cost of providing benefits under this section not otherwise paid for by the individuals covered by this section. The amounts so transferred shall be held in the Fund and used by the Office of Personnel Management in addition to amounts available under section 8906(g)(1) of such title. ‘‘(e) ADMINISTRATION AND REGULATIONS.—The Office of Personnel Management— ‘‘(1) shall administer the provisions of this section to provide for— ‘‘(A) a period of notice and open enrollment for individuals affected by this section; and ‘‘(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and ‘‘(2) may prescribe regulations to implement this section.’’ CONTINUED COVERAGE FOR INDIVIDUALS ENROLLED IN PLAN ADMINISTERED BY FARM CREDIT ADMINISTRATION Pub. L. 104–37, title VI, § 601, Oct. 21, 1995, 109 Stat. 328, provided that: ‘‘(a) For purposes of the administration of chapter 89 of title 5, United States Code, any period of enrollment under a health benefits plan administered by the Farm Credit Administration prior to the effective date of this Act [Oct. 21, 1995] shall be deemed to be a period of en- rollment in a health benefits plan under chapter 89 of such title. ‘‘(b)(1) An individual who, on September 30, 1995, is covered by a health benefits plan administered by the Farm Credit Administration may enroll in an approved health benefits plan described under section 8903 or 8903a of title 5, United States Code— ‘‘(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and ‘‘(B) for coverage effective on and after September 30, 1995. ‘‘(2) An individual who, on September 30, 1995, is enti- tled to continued coverage under a health benefits plan administered by the Farm Credit Administration— ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been per- mitted under the plan administered by the Farm Credit Administration; and ‘‘(B) may enroll in an approved health benefits plan described under sections 8903 or 8903a of such title in accordance with section 8905A of such title for cov- erage effective on and after September 30, 1995. ‘‘(3) An individual who, on September 30, 1995, is cov- ered as an unmarried dependent child under a health benefits plan administered by the Farm Credit Admin- istration and who is not a member of family as defined under section 8901(5) of title 5, United States Code— ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had, on September 30, 1995, ceased to meet the requirements for being considered an un- married dependent child under chapter 89 of such title; and ‘‘(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage on and after September 30, 1995. ‘‘(c) The Farm Credit Administration shall transfer to the Federal Employees Health Benefits Fund estab- lished under section 8909 of title 5, United States Code, amounts determined by the Director of the Office of Personnel Management, after consultation with the Farm Credit Administration, to be necessary to reim- burse the Fund for the cost of providing benefits under this section not otherwise paid for by the individuals covered by this section. The amount so transferred shall be held in the Fund and used by the Office in addi- tion to the amounts available under section 8906(g)(1) of such title. ‘‘(d) The Office of Personnel Management— ‘‘(1) shall administer the provisions of this section to provide for— ‘‘(A) a period of notice and open enrollment for individuals affected by this section; and ‘‘(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and ‘‘(2) may prescribe regulations to implement this section.’’ CONTINUED COVERAGE FOR INDIVIDUALS ENROLLED IN PLAN ADMINISTERED BY OFFICE OF THE COMPTROLLER OF THE CURRENCY OR OFFICE OF THRIFT SUPERVISION Pub. L. 103–409, § 5, Oct. 25, 1994, 108 Stat. 4232, pro- vided that: ‘‘(a) ENROLLMENT IN CHAPTER 89 PLAN.—For purposes of the administration of chapter 89 of title 5, United States Code, any period of enrollment under a health benefits plan administered by the Office of the Comp- troller of the Currency or the Office of Thrift Super- vision before the termination of such plans on January 7, 1995, shall be deemed to be a period of enrollment in a health benefits plan under chapter 89 of such title. ‘‘(b) CONTINUED COVERAGE.—(1) Any individual who, on January 7, 1995, is covered by a health benefits plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision may enroll in an approved health benefits plan described under section 8903 or 8903a of title 5, United States Code— ‘‘(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and ‘‘(B) for coverage effective on and after January 8, 1995. ‘‘(2) An individual who, on January 7, 1995, is entitled to continued coverage under a health benefits plan ad- ministered by the Office of the Comptroller of the Cur- rency or the Office of Thrift Supervision— Page 1240 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8902 ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been per- mitted under the plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision; and ‘‘(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a of such title for cov- erage effective on and after January 8, 1995. ‘‘(3) An individual who, on January 7, 1995, is covered as an unmarried dependent child under a health bene- fits plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision and who is not a member of family as defined under section 8901(5) of title 5, United States Code— ‘‘(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had, on January 7, 1995, ceased to meet the requirements for being considered an unmarried dependent child under chapter 89 of such title; and ‘‘(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage effective on and after January 8, 1995. ‘‘(c) TRANSFERS TO THE EMPLOYEES HEALTH BENEFITS FUND.—The Office of the Comptroller of the Currency and the Office of Thrift Supervision shall transfer to the Employees Health Benefits Fund established under section 8909 of title 5, United States Code, amounts de- termined by the Director of the Office of Personnel Management, after consultation with the Office of the Comptroller of the Currency and the Office of Thrift Supervision, to be necessary to reimburse the Fund for the cost of providing benefits under this section not otherwise paid for by the individuals covered by this section. The amounts so transferred shall be held in the Fund and used by the Office in addition to amounts available under section 8906(g)(1) of such title. ‘‘(d) ADMINISTRATION AND REGULATIONS.—The Office of Personnel Management— ‘‘(1) shall administer the provisions of this section to provide for— ‘‘(A) a period of notice and open enrollment for individuals affected by this section; and ‘‘(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and ‘‘(2) may prescribe regulations to implement this section.’’ CONTINUED COVERAGE UNDER CERTAIN FEDERAL EM- PLOYEE BENEFIT PROGRAMS FOR CERTAIN EMPLOYEES OF SAINT ELIZABETHS HOSPITAL For provisions relating to treatment of certain Fed- eral employees of Saint Elizabeths Hospital under cer- tain Federal employee benefit programs, see section 207(o) of Pub. L. 99–335, set out as a note under section 8331 of this title. § 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 re- newable from term to term in the absence of no- tice of termination by either party. (b) To be eligible as a carrier for the plan de- scribed by section 8903(2) of this title, a com- pany must be licensed to issue group health in- surance in all the States and the District of Co- lumbia. (c) A contract for a plan described by section 8903(1) or (2) of this title shall require the car- rier— (1) to reinsure with other companies which elect to participate, under an equitable for- mula 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 for- mula to be determined by the carrier and the affiliates and approved by the Office. (d) Each contract under this chapter shall con- tain a detailed statement of benefits offered and shall include such maximums, limitations, ex- clusions, and other definitions of benefits as the Office considers necessary or desirable. (e) The Office may prescribe reasonable min- imum standards for health benefits plans de- scribed by section 8903 or 8903a of this title and for carriers offering the plans. Approval of a plan may be withdrawn only after notice and op- portunity for hearing to the carrier concerned without regard to subchapter II of chapter 5 and chapter 7 of this title. The Office may terminate the contract of a carrier effective at the end of the contract term, if the Office finds that at no time during the preceding two contract terms did the carrier have 300 or more employees and annuitants, exclusive of family members, en- rolled in the plan. (f) A contract may not be made or a plan ap- proved which excludes an individual because of race, sex, health status, or, at the time of the first opportunity to enroll, because of age. (g) A contract may not be made or a plan ap- proved which does not offer to each employee, annuitant, family member, former spouse, or person having continued coverage under section 8905a of this title whose enrollment in the plan is ended, except by a cancellation of enrollment, a temporary extension of coverage during which he may exercise the option to convert, without evidence of good health, to a nongroup contract providing health benefits. An employee, annu- itant, family member, former spouse, or person having continued coverage under section 8905a of this title who exercises this option shall pay the full periodic charges of the nongroup con- tract. (h) The benefits and coverage made available under subsection (g) of this section are noncancelable by the carrier except for fraud, over-insurance, or nonpayment of periodic charges. (i) Rates charged under health benefits plans described by section 8903 or 8903a of this title shall reasonably and equitably reflect the cost of the benefits provided. Rates under health ben- efits plans described by section 8903(1) and (2) of this title shall be determined on a basis which, in the judgment of the Office, is consistent with the lowest schedule of basic rates generally charged for new group health benefit plans issued to large employers. The rates determined for the first contract term shall be continued for later contract terms, except that they may be readjusted for any later term, based on past ex- perience and benefit adjustments under the later contract. Any readjustment in rates shall be made in advance of the contract term in which