I

106TH CONGRESS

1ST SESSION H. R. 602

To amend title 5, United States Code, to provide for the establishment

of a program under which long-term care insurance may be obtained

by Federal employees and annuitants.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 4, 1999

Mr. SCARBOROUGH (for himself and Mr. MICA) introduced the following bill;

which was referred to the Committee on Government Reform

A BILL

To amend title 5, United States Code, to provide for the

establishment of a program under which long-term care

insurance may be obtained by Federal employees and

annuitants.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Civil Service Long5 Term Care Insurance Benefit Act’’.
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1 SEC. 2. LONG-TERM CARE INSURANCE.

2 (a) IN GENERAL.—Subpart G of part III of title 5,

3 United States Code, is amended by adding at the end the

4 following:

5 ‘‘CHAPTER 90—LONG-TERM CARE INSURANCE

‘‘Sec.

‘‘9001. Definitions.

‘‘9002. Availability of insurance.

‘‘9003. Participating carriers.

‘‘9004. Administrative functions.

‘‘9005. Coordination with State laws.

‘‘9006. Commercial items.

6 ‘‘§ 9001. Definitions

7 ‘‘For purposes of this chapter:

8 ‘‘(1) EMPLOYEE.—The term ‘employee’ has the

9 meaning given such term by section 8901, but does

10 not include an individual employed by the govern11 ment of the District of Columbia.

12 ‘‘(2) ANNUITANT.—The term ‘annuitant’

13 means—

14 ‘‘(A) a former employee who, based on the

15 service of that individual, receives an annuity

16 under subchapter III of chapter 83, chapter 84,

17 or another retirement system for employees of

18 the Government (disregarding title XVIII of the

19 Social Security Act and any retirement system

20 established for employees described in section

21 2105(c)); and
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1 ‘‘(B) any individual who receives an annu2 ity under any retirement system referred to in

3 subparagraph (A) (disregarding those described

4 parenthetically) as the surviving spouse of an

5 employee (including an amount under section

6 8442(b)(1)(A), whether or not an annuity

7 under section 8442(b)(1)(B) is also payable) or

8 of a former employee under subparagraph (A);

9 but does not include a former employee of a Govern10 ment corporation excluded by regulation of the Of11 fice of Personnel Management or the spouse of such

12 a former employee.

13 ‘‘(3) ELIGIBLE RELATIVE.—The term ‘eligible

14 relative’, as used with respect to an employee or an15 nuitant, means each of the following:

16 ‘‘(A) The spouse of the employee or annu17 itant.

18 ‘‘(B) The father or mother of the employee

19 or annuitant, or an ancestor of either.

20 ‘‘(C) A stepfather or stepmother of the em21 ployee or annuitant.

22 ‘‘(D) The father-in-law or mother-in-law of

23 the employee or annuitant.

24 ‘‘(E) A son or daughter of the employee or

25 annuitant who is at least 18 years of age.
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1 ‘‘(F) A stepson or stepdaughter of the em2 ployee or annuitant who is at least 18 years of

3 age.

4 ‘‘(4) GOVERNMENT.—The term ‘Government’

5 means the Government of the United States, includ6 ing an agency or instrumentality thereof.

7 ‘‘(5) QUALIFIED CARRIER.—A carrier shall be

8 considered to be a ‘qualified carrier’, with respect to

9 a State, if it is licensed to issue group long-term

10 care insurance under the laws of such State.

11 ‘‘(6) QUALIFIED LONG-TERM CARE INSURANCE

12 CONTRACT.—The term ‘qualified long-term care in13 surance contract’ has the meaning given such term

14 by section 7702B of the Internal Revenue Code of

15 1986.

16 ‘‘(7) STATE.—The term ‘State’ means a State,

17 the District of Columbia, the Commonwealth of

18 Puerto Rico, the Commonwealth of the Northern

19 Mariana Islands, the Trust Territory of the Pacific

20 Islands, the Virgin Islands, Guam, American Samoa,

21 and any other territory or possession of the United

22 States.

23 ‘‘§ 9002. Availability of insurance

24 ‘‘(a) IN GENERAL.—The Office of Personnel Manage25 ment shall establish and administer a program through
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1 which employees and annuitants may obtain group long2 term care insurance for themselves, a spouse, or, to the

3 extent permitted under the terms of the contract of insur4 ance involved, any other eligible relative.

5 ‘‘(b) GENERAL REQUIREMENTS.—Long-term care in6 surance may not be offered under this chapter unless—

7 ‘‘(1) the only insurance protection provided is

8 coverage under qualified long-term care insurance

9 contracts; and

10 ‘‘(2) the insurance contract under which such

11 coverage is provided is issued by a qualified carrier.

12 ‘‘(c) REQUIREMENT THAT CONTRACT BE FULLY IN13 SURED.—In addition to the requirements otherwise appli14 cable under section 9001(8), in order to be considered a

15 qualified long-term care insurance contract for purposes

16 of this chapter, a contract must be fully insured, whether

17 through reinsurance with other companies or otherwise.

18 ‘‘(d) COVERAGE NOT REQUIRED FOR INDIVIDUALS

19 WHO WOULD BE IMMEDIATELY BENEFIT ELIGIBLE.—

20 Nothing in this chapter shall be considered to require that

21 long-term care insurance coverage be made available in the

22 case of any individual who would be immediately benefit

23 eligible.
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1 ‘‘§ 9003. Participating carriers

2 ‘‘(a) IDENTIFICATION OF PARTICIPATING CAR3 RIERS.—The Office of Personnel Management shall, be4 fore the start of each year—

5 ‘‘(1) identify each carrier through whom any

6 long-term care insurance may be obtained under this

7 chapter during such year; and

8 ‘‘(2) prepare a list of the carriers identified

9 under paragraph (1), and a summary description of

10 the insurance obtainable under this chapter from

11 each.

12 ‘‘(b) APPLICATION REQUIREMENTS, ETC.—In order

13 to carry out its responsibilities under subsection (a), the

14 Office shall annually specify the timetable (including any

15 application deadlines) and other procedures that must be

16 followed by carriers seeking to be allowed to offer long17 term care insurance under this chapter during the follow18 ing year.

19 ‘‘(c) INFORMATION TO PERMIT INFORMED DECI20 SIONMAKING.—The Office shall in a timely manner before

21 the start of each year—

22 ‘‘(1) publish in the Federal Register the list

23 (and summary description) prepared under sub24 section (a) for such year; and

25 ‘‘(2) make available to each individual eligible

26 to obtain long-term care insurance under this chap-
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1 ter such information, in a form acceptable to the Of2 fice after consultation with the carrier, as may be

3 necessary to enable the individual to exercise an in4 formed choice among the various options available

5 under this chapter.

6 ‘‘(d) BENEFIT CERTIFICATE.—The Office shall ar7 range to have the appropriate individual or individuals re8 ceive a certificate setting forth the benefits to which an

9 individual is entitled under this chapter, to whom the ben10 efits are payable, and the procedures for obtaining bene11 fits, and summarizing the provisions of the policy prin12 cipally affecting the individual or individuals involved. Any

13 such certificate shall be issued instead of the certificate

14 which the insurance company would otherwise be required

15 to issue.

16 ‘‘§ 9004. Administrative functions

17 ‘‘(a) IN GENERAL.—Except as provided in section

18 9003, the sole functions of the Office of Personnel Man19 agement under this chapter shall be as follows:

20 ‘‘(1) ENROLLMENT PERIODS.—To provide rea21 sonable opportunity (consisting of not less than one

22 continuous 30-day period each year) for eligible em23 ployees and annuitants to obtain long-term care in24 surance coverage under this chapter.
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1 ‘‘(2) WITHHOLDINGS.—To provide for a means

2 by which the cost of any long-term care insurance

3 coverage obtained under this chapter may be paid

4 for through withholdings from the pay or annuity of

5 the employee or annuitant involved.

6 ‘‘(3) CONTRACT AUTHORITY RELATING TO

7 GROUP LONG-TERM CARE INSURANCE.—To contract

8 for a qualified long-term care insurance contract

9 with each qualified carrier that offers such insur10 ance, so long as such carrier submits a timely appli11 cation under section 9003(b) and complies with such

12 other procedural rules as the Office may prescribe.

13 ‘‘(b) LIMITATIONS ON AUTHORITY.—Nothing in this

14 chapter shall be considered to permit or require the Office

15 to prescribe or negotiate over the benefits to be offered,

16 or any of the terms or conditions under which any such

17 benefits shall be offered, under this chapter.

18 ‘‘§ 9005. Coordination with State laws

19 ‘‘(a) IN GENERAL.—The provisions of any contract

20 under this chapter for group long-term care insurance may

21 include provisions to supersede and preempt any provi22 sions of State or local law described in subsection (b), or

23 any regulation issued thereunder.

24 ‘‘(b) DESCRIPTION.—This subsection applies with re25 spect to any provision of law which in effect carries out
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1 the same policy as section 5 of the long-term care insur2 ance model Act, promulgated by the National Association

3 of Insurance Commissioners (as adopted as of September

4 1997).

5 ‘‘§ 9006. Commercial items

6 ‘‘For purposes of the Office of Federal Procurement

7 Policy Act, a long-term care insurance contract under this

8 chapter shall be considered a commercial item, as defined

9 by section 4(12) of such Act.’’.

10 (b) CONFORMING AMENDMENT.—The analysis for

11 part III of title 5, United States Code, is amended by add12 ing at the end of subpart G the following:

‘‘90. Long-Term Care Insurance ......................................................... 9001’’.

13 SEC. 3. EFFECTIVE DATE.

14 The Office of Personnel Management shall take such

15 measures as may be necessary to ensure that long-term

16 care insurance coverage under title 5, United States Code,

17 as amended by this Act, may be obtained in time to take

18 effect beginning on the first day of the first applicable pay

19 period beginning on or after January 1, 2000.

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