5 U.S.C. § 8903a — Additional health benefits plans

Page 1249 TITLE 5—GOVERNMENT ORGANIZATION AND EMPLOYEES § 8903c as amended, set out as a note under section 8341 of this title. 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. § 8903a. Additional health benefits plans (a) In addition to any plan under section 8903 of this title, the Office of Personnel Manage- ment may contract for or approve one or more health benefits plans under this section. (b) A plan under this section may not be con- tracted for or approved unless it— (1) is sponsored or underwritten, and admin- istered, in whole or substantial part, by an employee organization described in section 8901(8)(B) of this title; (2) offers benefits of the types named by paragraph (1) or (2) of section 8904 of this title or both; (3) provides for benefits only by paying for, or providing reimbursement for, the cost of such benefits (as provided for under paragraph (1) or (2) of section 8903 of this title) or a com- bination thereof; and (4) is available only to individuals who, at the time of enrollment, are full members of the organization and to members of their fam- ilies. (c) A contract for a plan approved under this section shall require the carrier— (1) to enter into an agreement approved by the Office with an underwriting subcontractor licensed to issue group health insurance in all the States and the District of Columbia; or (2) to demonstrate ability to meet reason- able minimum financial standards prescribed by the Office. (d) For the purpose of this section, an indi- vidual shall be considered a full member of an organization if such individual is eligible to ex- ercise all rights and privileges incident to full membership in such organization (determined without regard to the right to hold elected of- fice). (Added Pub. L. 99–53, § 1(b)(1), June 17, 1985, 99 Stat. 93.) § 8903b. Authority to readmit an employee orga- nization plan (a) In the event that a plan described by sec- tion 8903(3) or 8903a is discontinued under this chapter (other than in the circumstance de- scribed in section 8909(d)), that discontinuation shall be disregarded, for purposes of any deter- mination as to that plan’s eligibility to be con- sidered an approved plan under this chapter, but only for purposes of any contract year later than the third contract year beginning after such plan is so discontinued. (b) A contract for a plan approved under this section shall require the carrier— (1) to demonstrate experience in service de- livery within a managed care system (includ- ing provider networks) throughout the United States; and (2) if the carrier involved would not other- wise be subject to the requirement set forth in section 8903a(c)(1), to satisfy such require- ment. (Added Pub. L. 105–266, § 6(a)(1), Oct. 19, 1998, 112 Stat. 2368.) Statutory Notes and Related Subsidiaries EFFECTIVE DATE Pub. L. 105–266, § 6(a)(3), Oct. 19, 1998, 112 Stat. 2369, provided that: ‘‘(A) IN GENERAL.—The amendments made by this subsection [enacting this section] shall apply as of the date of the enactment of this Act [Oct. 19, 1998], includ- ing with respect to any plan which has been discon- tinued as of such date. ‘‘(B) TRANSITION RULE.—For purposes of applying sec- tion 8903b(a) of title 5, United States Code (as amended by this subsection) with respect to any plan seeking to be readmitted for purposes of any contract year begin- ning before January 1, 2000, such section shall be ap- plied by substituting ‘second contract year’ for ‘third contract year’.’’ § 8903c. Postal Service Health Benefits Program (a) DEFINITIONS.—In this section— (1) the term ‘‘covered Medicare individual’’ means an individual who is entitled to benefits under Medicare part A, but excluding an indi- vidual who is eligible to enroll under such part under section 1818 or 1818A of the Social Secu- rity Act (42 U.S.C. 1395i–2, 1395i–2a); (2) the term ‘‘initial contract year’’ means the contract year beginning in January of 2025; (3) the term ‘‘initial participating carrier’’ means a carrier that enters into a contract with the Office to participate in the Program during the initial contract year; (4) the term ‘‘Medicare part A’’ means part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.); (5) the term ‘‘Medicare part B’’ means part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.); (6) the term ‘‘Office’’ means the Office of Personnel Management; (7) the term ‘‘Postal Service’’ means the United States Postal Service; (8) the term ‘‘Postal Service annuitant’’ means an annuitant enrolled in a health bene- fits plan under this chapter whose Government contribution is required to be paid under sec- tion 8906(g)(2); (9) the term ‘‘Postal Service employee’’ means an employee of the Postal Service en- rolled in a health benefits plan under this chapter whose Government contribution is paid by the Postal Service; (10) the term ‘‘Postal Service Medicare cov- ered annuitant’’ means an individual who— (A) is a Postal Service annuitant; and (B) is a covered Medicare individual; (11) the term ‘‘Program’’ means the Postal Service Health Benefits Program established under subsection (c) within the Federal Em- ployees Health Benefits Program; (12) the term ‘‘Program plan’’ means a health benefits plan offered under the Pro- gram; and (13) the definitions set forth in section 8901 shall apply, and for the purposes of applying