I 

113TH CONGRESS 

1ST SESSION H. R. 2698 

To provide a short-term disability insurance program for Federal employees 

for disabilities that are not work-related, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 16, 2013 

Ms. NORTON introduced the following bill; which was referred to the 

Committee on Oversight and Government Reform 

A BILL 

To provide a short-term disability insurance program for 

Federal employees for disabilities that are not workrelated, and for other purposes. 

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 ‘‘Federal Employee 

5 Short-Term Disability Insurance Act of 2013’’. 

6 SEC. 2. PURPOSE. 

7 The purpose of this Act is to offer voluntary insur8 ance to Federal employees for protection against the loss 

9 of pay resulting from— 

10 (1) short-term injury or disability; 

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1 (2) short-term leave taken for the purpose of 

2 caring for a family member; 

3 (3) the birth of a child of such an employee; or 

4 (4) making arrangements to adopt a child or to 

5 become a foster parent. 

6 SEC. 3. NON-WORK RELATED DISABILITY INSURANCE. 

7 (a) IN GENERAL.—Title 5, United States Code, is 

8 amended by inserting after chapter 87 the following: 

9 ‘‘CHAPTER 88—NON-WORK RELATED 

10 SHORT-TERM DISABILITY INSURANCE 

‘‘Sec. 

‘‘8801. Definitions. 

‘‘8802. Availability of insurance. 

‘‘8803. Contracting authority. 

‘‘8804. Benefits. 

‘‘8805. Premiums. 

‘‘8806. Preemption. 

‘‘8807. Studies, reports, and audits. 

‘‘8808. Jurisdiction of courts. 

‘‘8809. Administrative functions. 

‘‘8810. Cost accounting standards. 

11 ‘‘§ 8801. Definitions 

12 ‘‘For purposes of this chapter— 

13 ‘‘(1) the term ‘Director’ means the Director of 

14 the Office of Personnel Management; 

15 ‘‘(2) the term ‘employee’ means— 

16 ‘‘(A) an employee defined in section 

17 8901(1); and 

18 ‘‘(B) an officer or employee of the United 

19 States Postal Service or of the Postal Regu20 latory Commission; 

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1 ‘‘(3) the term ‘injury or disability’, with respect 

2 to an employee, means that such employee is unable 

3 to perform the essential functions of such employee’s 

4 position of employment with the Federal Govern5 ment; 

6 ‘‘(4) the term ‘member of family’ has the mean7 ing given such term in section 8901(5); 

8 ‘‘(5) the term ‘carrier’ means an insurance 

9 company that is licensed to issue disability insurance 

10 in all States, taking into account any subsidiaries or 

11 affiliates of such a company; and 

12 ‘‘(6) the term ‘State’ includes the District of 

13 Columbia. 

14 ‘‘§ 8802. Availability of insurance 

15 ‘‘(a) The Director shall establish and administer a 

16 program to make insurance coverage available under this 

17 chapter— 

18 ‘‘(1) for an injury or disability not covered 

19 under chapter 81; 

20 ‘‘(2) for leave to care for, or leave to make ar21 rangements to care for, a member of family, includ22 ing the birth of a son or a daughter; and 

23 ‘‘(3) for leave to make arrangements— 

24 ‘‘(A) to become a foster parent; or 

25 ‘‘(B) to adopt a child. 

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1 ‘‘(b) Insurance shall not be available under this chap2 ter if the injury or disability of an employee is— 

3 ‘‘(1) caused by willful misconduct of such em4 ployee; 

5 ‘‘(2) caused by such employee’s intention to 

6 bring about such injury or disability to himself or to 

7 another individual; or 

8 ‘‘(3) proximately caused by the intoxication of 

9 such employee. 

10 ‘‘(c) In addition to the requirements otherwise appli11 cable under section 8801(5), an insurance contract under 

12 this chapter must be fully insured, whether through rein13 surance with other carriers or otherwise. 

14 ‘‘§ 8803. Contracting authority 

15 ‘‘(a) The Director shall, without regard to any statute 

16 requiring competitive bidding, contract with one or more 

17 carriers for a policy or policies of disability insurance as 

18 described under this chapter. The Director shall ensure 

19 that each resulting contract is awarded on the basis of 

20 contractor qualifications, price, and reasonable competi21 tion. 

22 ‘‘(b)(1) Each contract under this section shall con23 tain— 

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1 ‘‘(A) a detailed statement of the benefits of2 fered (including any maximums, limitations, exclu3 sions, and other definitions of benefits); 

4 ‘‘(B) the premiums charged (including any limi5 tations or other conditions on their subsequent ad6 justment); 

7 ‘‘(C) the duration of the enrollment period; and 

8 ‘‘(D) such other terms and conditions (includ9 ing procedures for establishing eligibility for insur10 ance under this chapter) as may be determined by 

11 the Director, consistent with the requirements of 

12 this chapter. 

13 ‘‘(2) Premiums charged under a contract under this 

14 section shall reasonably and equitably reflect the cost of 

15 the benefits provided, as determined by the Director. 

16 ‘‘(c)(1) Each contract under this section shall require 

17 the carrier— 

18 ‘‘(A) to provide payments or benefits described 

19 in section 8804(c) to an employee if such employee 

20 is entitled thereto under the terms of the contract; 

21 and 

22 ‘‘(B) with respect to disputes regarding claims 

23 for payments or benefits under the terms of the con24 tract— 

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1 ‘‘(i) to establish internal procedures de2 signed to resolve such disputes expeditiously; 

3 and 

4 ‘‘(ii) to establish, for disputes not resolved 

5 through procedures under clause (i), procedures 

6 for one or more alternative means of dispute 

7 resolution involving independent third-party re8 view under circumstances acceptable to the Di9 rector. 

10 ‘‘(2) The carrier’s determination as to whether or not 

11 a particular employee is eligible to obtain insurance cov12 erage under this chapter shall be subject to review to the 

13 extent and in the manner provided in the applicable con14 tract. 

15 ‘‘(3) Nothing in this chapter shall be considered to 

16 grant authority for a third-party reviewer to change the 

17 terms of any contract under this chapter. 

18 ‘‘(d)(1) Each contract under this section shall be for 

19 a term of not less than 3 years and not greater than 7 

20 years, and may be terminated earlier than the termination 

21 date of such contract by the Director in accordance with 

22 the terms of such contract. However, the rights and re23 sponsibilities of the enrolled employee, the insurer, and the 

24 Director under each contract shall continue with respect 

25 to such employee until the termination of coverage of the 

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1 enrolled employee or the effective date of a successor con2 tract. 

3 ‘‘(2) A contract described in paragraph (1) may be 

4 made automatically renewable, for a term of 1 year each 

5 January 1, unless written notice of non-renewal is given 

6 either by the Director or the carrier not less than 180 

7 days before the renewal date, or unless modified by mutual 

8 agreement. 

9 ‘‘(3) A contract described in paragraph (1) shall in10 clude such provisions as may be necessary to ensure that, 

11 once an employee becomes duly enrolled, insurance cov12 erage pursuant to that enrollment shall be terminated only 

13 if the individual is separated from Federal service or, 

14 where appropriate, for non-payment of premiums. 

15 ‘‘§ 8804. Benefits 

16 ‘‘(a) The Director may prescribe reasonable minimum 

17 standards for benefit plans offered under this chapter. 

18 ‘‘(b)(1) Benefits provided to an employee under this 

19 chapter shall offset other benefits received by such em20 ployee for the same injury or disability, leave to care for 

21 or make arrangements to care for a member of family (in22 cluding the birth of a son or a daughter), or leave to make 

23 arrangements to adopt a child or become a foster parent 

24 including worker’s compensation and disability retirement 

25 income. 

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1 ‘‘(2) A contract providing benefits under this chap2 ter— 

3 ‘‘(A) shall not provide for a preexisting condi4 tion exclusion; and 

5 ‘‘(B) shall not charge higher premiums, deny 

6 coverage, or drop coverage of an employee with a 

7 preexisting condition. 

8 ‘‘(3) A contract providing benefits under this chapter 

9 shall provide incentives for an employee who is receiving 

10 benefits under such contract to return to work. 

11 ‘‘(c)(1) For each instance that such employee suffers 

12 an injury or disability, takes leave to care for or make 

13 arrangements to care for a member of family (including 

14 the birth of a son or a daughter), or takes leave to make 

15 arrangements to adopt a child or become a foster parent, 

16 and is eligible for benefits under this chapter, such em17 ployee may receive benefits under this chapter for a period 

18 not to exceed 12 months beginning on the date on which 

19 such employee qualifies for such benefits. An employee 

20 shall receive such benefits after the expiration of the wait21 ing period selected by such employee under paragraph 

22 (2)(A). The amount of benefits shall be equal to the lesser 

23 of— 

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1 ‘‘(A) 70 percent of the annual rate of pay, ex2 cluding bonuses, of an employee at the time of the 

3 injury or disability of such employee occurs; or 

4 ‘‘(B) 70 percent of the maximum rate of basic 

5 pay provided for grade GS–15 of the General Sched6 ule. 

7 ‘‘(2)(A) The period for which benefits are payable to 

8 an employee under this subsection shall begin after the 

9 completion of a waiting period, subject to the requirement 

10 in subparagraph (C). An employee shall elect one of the 

11 following waiting period options: 

12 ‘‘(i) On the 8th day of continuous injury or dis13 ability, leave to care for or to make arrangements to 

14 care for a member of family (including the birth of 

15 a son or a daughter), or leave to make arrangements 

16 to adopt a child or become a foster parent. 

17 ‘‘(ii) On the 31st day of continuous disability, 

18 leave to care for or to make arrangements to care 

19 for a member of family (including the birth of a son 

20 or a daughter), or leave to make arrangements to 

21 adopt a child or become a foster parent. 

22 ‘‘(iii) On the 91st day of continuous disability, 

23 leave to care for or to make arrangements to care 

24 for a member of family (including the birth of a son 

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1 or a daughter), or leave to make arrangements to 

2 adopt a child or become a foster parent. 

3 ‘‘(iv) On the 181st day of continuous disability, 

4 leave to care for or to make arrangements to care 

5 for a member of family (including the birth of a son 

6 or a daughter), or leave to make arrangements to 

7 adopt a child or become a foster parent. 

8 ‘‘(B) An employee who elects to receive benefits ear9 lier shall pay a higher premium. 

10 ‘‘(C) A waiting period selected under subparagraph 

11 (A) shall begin on the first day of an employee’s injury 

12 or disability. 

13 ‘‘§ 8805. Premiums 

14 ‘‘(a) Each eligible individual obtaining insurance cov15 erage under this chapter shall be responsible for 100 per16 cent of the premiums for such coverage. 

17 ‘‘(b) The amount necessary to pay the premiums for 

18 enrollment shall be withheld from the pay of the enrolled 

19 individual. 

20 ‘‘(c) The carrier participating under this chapter 

21 shall maintain records that permit it to account for all 

22 amounts received under this chapter (including investment 

23 earnings on those amounts) separate and apart from all 

24 other funds. 

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1 ‘‘(d)(1)(A) The Employees’ Life Insurance Fund is 

2 available, without fiscal year limitation, for reasonable ex3 penses incurred in administering this chapter before the 

4 start of the first term described in section 8803(d)(1), in5 cluding reasonable implementation costs. 

6 ‘‘(B) Such Fund shall be reimbursed, before the end 

7 of the first year of a contract described in section 

8 8803(d)(1), for all amounts obligated or expended under 

9 subparagraph (A) (including lost investment income). Re10 imbursement under this subparagraph shall be made by 

11 the carrier in accordance with applicable provisions in12 cluded in the relevant contract. 

13 ‘‘(C)(i) There is hereby established in the Employees’ 

14 Life Insurance Fund a Non-Work Related Disability In15 surance Administrative Account, which shall be available 

16 to the Office of Personnel Management, without fiscal 

17 year limitation, to defray reasonable expenses incurred by 

18 the Office in administering this chapter after the start of 

19 the first term described in section 8803(d)(1). 

20 ‘‘(ii) A contract under this chapter shall include ap21 propriate provisions under which the carrier involved shall, 

22 during each year, make such periodic contributions to the 

23 Non-Work Related Disability Insurance Administrative 

24 Account as necessary to ensure that the reasonable antici25 pated expenses of the Office of Personnel Management in 

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1 administering this chapter during such year (adjusted to 

2 reconcile for any earlier overestimates or underestimates 

3 under this subparagraph) are defrayed. 

4 ‘‘(e) Nothing in this chapter shall, in the case of an 

5 enrolled individual applying for an extension of insurance 

6 coverage under this chapter after the expiration of such 

7 enrolled individual’s first opportunity to enroll, preclude 

8 the application of underwriting standards for later enroll9 ment. 

10 ‘‘§ 8806. Preemption 

11 ‘‘(a) The terms of any contract under this chapter 

12 which relate to the nature, provision, or extent of coverage 

13 or benefits (including payments with respect to benefits) 

14 shall supersede and preempt any State, territorial, tribal, 

15 or local law, or any regulation issued thereunder, which 

16 relates to non-work related disability insurance or con17 tracts. 

18 ‘‘(b)(1) No tax, fee, or other monetary payment may 

19 be imposed or collected, directly or indirectly, by any 

20 State, territory, tribe, or locality, or by any political sub21 division or other governmental authority thereof, on, or 

22 with respect to, any premium paid for an insurance policy 

23 under this chapter. 

24 ‘‘(2) Paragraph (1) shall not be construed to exempt 

25 any company or other entity issuing a policy of insurance 

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1 under this chapter from the imposition, payment, or collec2 tion of a tax, fee, or other monetary payment on the net 

3 income or profit accruing to or realized by such entity 

4 from business conducted under this chapter, if that tax, 

5 fee, or payment is applicable to a broad range of business 

6 activity. 

7 ‘‘(c) No law of a State, territory, tribe, or locality, 

8 pertaining to subrogation or reimbursement with respect 

9 to benefits provided under this chapter, shall operate ex10 cept as expressly adopted by the Director. 

11 ‘‘§ 8807. Studies, reports, and audits 

12 ‘‘(a) A contract under this chapter shall contain pro13 visions requiring the carrier to furnish such reasonable re14 ports as the Director determines to be necessary to enable 

15 the Director to carry out the Director’s functions under 

16 this chapter. 

17 ‘‘(b) Each Federal agency shall keep such records, 

18 make such certifications, and furnish the Director, the 

19 carrier, or both, with such information and reports as the 

20 Director may require. 

21 ‘‘(c) The Director shall conduct periodic reviews of 

22 each plan under this chapter to ensure its competitiveness. 

23 ‘‘§ 8808. Jurisdiction of courts 

24 ‘‘The district courts of the United States have origi25 nal jurisdiction, concurrent with the United States Court 

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1 of Federal Claims, of a civil action or claim against the 

2 United States under this chapter after such administrative 

3 remedies as required under section 8803(c) have been ex4 hausted, but only to the extent judicial review is not pre5 cluded by any dispute resolution or other remedy under 

6 this chapter. 

7 ‘‘§ 8809. Administrative functions 

8 ‘‘(a)(1) Except as otherwise provided in this chapter, 

9 the Director shall prescribe regulations necessary to carry 

10 out this chapter and to make arrangements as necessary 

11 with other agencies and payroll systems to implement the 

12 program. 

13 ‘‘(2) Except as otherwise provided by law, the Direc14 tor shall specify in regulation the treatment of time spent 

15 by an individual in receipt of benefits under this chapter 

16 for the purposes of periodic increases in pay, retention 

17 purposes, and other rights, benefits, and conditions of em18 ployment for which length of service is a factor. 

19 ‘‘(b) The carrier shall provide for periodic coordinated 

20 enrollment, promotion, and education efforts, as specified 

21 by the Director. 

22 ‘‘§ 8810. Cost accounting standards 

23 ‘‘The cost accounting standards issued pursuant to 

24 section 1502 of title 41 shall not apply with respect to 

25 an insurance contract under this chapter.’’. 

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1 (b) CONFORMING AMENDMENT.—Section 1005(f) of 

2 title 39, United States Code, is amended by inserting 

3 ‘‘88,’’ after ‘‘87,’’. 

4 (c) CLERICAL AMENDMENT.—The analysis for part 

5 III of title 5, United States Code, is amended by adding 

6 at the end of subpart G the following: 

‘‘88. Non-Work Related Short-Term Disability Insurance 8801’’. 

7 (d) DATE OF APPLICATION.—The amendment made 

8 by subsection (a) shall apply to contracts that take effect 

9 with respect to the first calender year that begins more 

10 than 18 months after the date of enactment of this sec11 tion. 

Æ 

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