II

106TH CONGRESS

1ST SESSION S. 36

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 SENATE OF THE UNITED STATES

JANUARY 19, 1999

Mr. GRASSLEY (for himself and Mr. GRAHAM) introduced the following bill;

which was read twice and referred to the Committee on Governmental Affairs

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 ‘‘The American Worker

5 Long-Term Care Affordability Act of 1999’’.
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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 ‘‘In this chapter:

8 ‘‘(1) The term ‘employee’ has the meaning

9 given such term by section 8901, but does not in10 clude an individual employed by the government of

11 the District of Columbia.

12 ‘‘(2) The term ‘annuitant’—

13 ‘‘(A) means—

14 ‘‘(i) a former employee who, based on

15 the service of that individual, receives an

16 annuity under subchapter III of chapter

17 83, chapter 84, or another retirement sys18 tem for employees of the Government (dis19 regarding title XVIII of the Social Security

20 Act (42 U.S.C. 1395 et seq.) and any re21 tirement system established for employees

22 described in section 2105(c)); and
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1 ‘‘(ii) any individual who receives an

2 annuity under any retirement system re3 ferred to in clause (i) (disregarding those

4 described parenthetically) as the surviving

5 spouse of an employee (including an

6 amount under section 8442(b)(1)(A),

7 whether or not an annuity under section

8 8442(b)(1)(B) is also payable) or of a

9 former employee under clause (i); and

10 ‘‘(B) does not include a former employee of

11 a Government corporation excluded by regula12 tion of the Office of Personnel Management or

13 the spouse of such a former employee.

14 ‘‘(3) The term ‘eligible relative’, as used with

15 respect to an employee or annuitant, means each of

16 the following:

17 ‘‘(A) The spouse of the employee or annu18 itant.

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

20 or annuitant, or an ancestor of either.

21 ‘‘(C) A stepfather or stepmother of the em22 ployee or annuitant.

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

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

2 annuitant who is at least 18 years of age.

3 ‘‘(F) A stepson or stepdaughter of the em4 ployee or annuitant who is at least 18 years of

5 age.

6 ‘‘(4) The term ‘Government’ means the Govern7 ment of the United States, including an agency or

8 instrumentality thereof.

9 ‘‘(5) The term ‘group long-term care insurance’

10 means group long-term care insurance purchased by

11 the Office of Personnel Management under this

12 chapter.

13 ‘‘(6) The term ‘individual long-term care insur14 ance’ means any long-term care insurance offered

15 under this chapter which is not group long-term care

16 insurance.

17 ‘‘(7) A carrier shall be considered to be a ‘quali18 fied carrier’, with respect to a State, if it is licensed

19 to issue group or individual long-term care insurance

20 (as the case may be) under the laws of such State.

21 ‘‘(8) The term ‘qualified long-term care insur22 ance contract’ has the meaning given such term by

23 section 7702B of the Internal Revenue Code of

24 1986.
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1 ‘‘(9) The term ‘State’ means a State, the Dis2 trict of Columbia, the Commonwealth of Puerto

3 Rico, the Commonwealth of the Northern Mariana

4 Islands, the Trust Territory of the Pacific Islands,

5 the Virgin Islands, Guam, American Samoa, and

6 any other territory or possession of the United

7 States.

8 ‘‘§ 9002. Availability of insurance

9 ‘‘(a) The Office of Personnel Management shall es10 tablish and administer a program through which employ11 ees and annuitants may obtain group or individual long12 term care insurance for themselves, a spouse, or, to the

13 extent permitted under the terms of the contract of insur14 ance involved, any other eligible relative.

15 ‘‘(b) Long-term care insurance may not be offered

16 under this chapter unless—

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

18 coverage under qualified long-term care insurance

19 contracts; and

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

21 coverage is provided is issued by a qualified carrier.

22 ‘‘(c) In addition to the requirements otherwise appli23 cable under section 9001(8), in order to be considered a

24 qualified long-term care insurance contract for purposes
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1 of this chapter, a contract shall be fully insured, whether

2 through reinsurance with other companies or otherwise.

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

4 require that long-term care insurance coverage be made

5 available in the case of any individual who would be imme6 diately benefit eligible.

7 ‘‘§ 9003. Participating carriers

8 ‘‘(a) Before the beginning of each year, the Office of

9 Personnel Management shall—

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

11 long-term care insurance may be obtained under this

12 chapter during such year; and

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

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

15 the insurance obtainable under this chapter from

16 each.

17 ‘‘(b) In order to carry out its responsibilities under

18 subsection (a), the Office shall annually specify the time19 table (including any application deadlines) and other pro20 cedures that shall be followed by carriers seeking to be

21 allowed to offer long-term care insurance under this chap22 ter during the following year.

23 ‘‘(c) Before the beginning of each year, the Office

24 shall in a timely manner—
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1 ‘‘(1) publish in the Federal Register the list

2 (and summary description) prepared under sub3 section (a) for such year; and

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

5 to obtain long-term care insurance under this chap6 ter such information, in a form acceptable to the Of7 fice after consultation with the carrier, as may be

8 necessary to enable the individual to exercise an in9 formed choice among the various options available

10 under this chapter.

11 ‘‘(d)(1) The Office shall arrange to have the appro12 priate individual or individuals receive—

13 ‘‘(A) a copy of any policy of insurance obtained

14 under this chapter; or

15 ‘‘(B) in the case of group long-term care insur16 ance, a certificate setting forth the benefits to which

17 an individual is entitled, to whom the benefits are

18 payable, and the procedures for obtaining benefits,

19 and summarizing the provisions of the policy prin20 cipally affecting the individual or individuals in21 volved.

22 ‘‘(2) Any certificate issued under paragraph (1)(B)

23 shall be issued instead of the certificate which the insur24 ance company would otherwise be required to issue.
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1 ‘‘§ 9004. Administrative functions

2 ‘‘(a) Except as provided in section 9003, the sole

3 functions of the Office of Personnel Management under

4 this chapter shall be as follows:

5 ‘‘(1) To provide reasonable opportunity (con6 sisting of not less than one continuous 30-day period

7 each year) for eligible employees and annuitants to

8 obtain long-term care insurance coverage under this

9 chapter.

10 ‘‘(2) To provide for a means by which the cost

11 of any long-term care insurance coverage obtained

12 under this chapter may be paid for through

13 withholdings from the pay or annuity of the em14 ployee or annuitant involved.

15 ‘‘(3) To contract for a qualified long-term care

16 insurance contract (in the case of group long-term

17 care insurance) with each qualified carrier that of18 fers such insurance, if such carrier submits a timely

19 application under section 9003(b) and complies with

20 such other procedural rules as the Office may pre21 scribe.

22 ‘‘(b) Nothing in this chapter shall be considered to

23 permit or require the Office to—

24 ‘‘(1) prevent from being offered under this

25 chapter any individual long-term care insurance

26 under a qualified contract; or
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1 ‘‘(2) prescribe or negotiate over the benefits to

2 be offered, or any of the terms or conditions under

3 which any such benefits shall be offered, under this

4 chapter.

5 ‘‘§ 9005. Coordination with State laws

6 ‘‘(a) The provisions of any contract under this chap7 ter for group long-term care insurance may include provi8 sions to supersede and preempt any provisions of State

9 or local law described in subsection (b), or any regulation

10 issued thereunder.

11 ‘‘(b) This subsection applies to any provision of law

12 which in effect carries out the same policy as section 5

13 of the long-term care insurance model Act, promulgated

14 by the National Association of Insurance Commissioners

15 (as adopted as of September 1997).

16 ‘‘§ 9006. Commercial items

17 ‘‘For purposes of the Office of Federal Procurement

18 Policy Act (41 U.S.C. 403 et seq.), a long-term care insur19 ance contract under this chapter shall be considered a

20 commercial item, as defined in section 4(12) of such Act.’’.

21 (b) CONFORMING AMENDMENT.—The table of chap22 ters for part III of title 5, United States Code, is amended

23 by adding at the end of subpart G the following:

‘‘90. Long-Term Care Insurance ......................................................... 9001’’.
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1 SEC. 3. EFFECTIVE DATE.

2 The Office of Personnel Management shall take all

3 necessary actions to ensure that long-term care insurance

4 coverage under chapter 90 of title 5, United States Code,

5 (as added by this Act) may be obtained in time to take

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

7 period beginning on or after January 1, 2000.

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