I
106TH CONGRESS
1ST SESSION
H. R. 1111
To amend title 5, United States Code, to provide for the establishment
of a program under which long-term care insurance is made available
to Federal employees and annuitants, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 16, 1999
Mrs. MORELLA introduced the following bill; which was referred to the Com-
mittee on Government Reform, and in addition to the Committee on
Armed Services, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned
A BILL
To amend title 5, United States Code, to provide for the
establishment of a program under which long-term care
insurance is made available to Federal employees and
annuitants, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Federal Civilian and
Uniformed Services Long-Term Care Insurance Act of
1999’’.
SEC. 2. LONG-TERM CARE INSURANCE.
Subpart G of part III of title 5, United States Code,
is amended by adding at the end the following:
‘‘Chapter 90—Long-Term Care Insurance
‘‘Sec.
‘‘9001. Definitions.
‘‘9002. Eligibility to obtain coverage.
‘‘9003. Contracting authority.
‘‘9004. Long-term care benefits.
‘‘9005. Financing.
‘‘9006. Regulations.
‘‘§ 9001. Definitions
‘‘For purposes of this chapter:
‘‘(1) 
EMPLOYEE.—The 
term 
‘employee’
means—
‘‘(A) an employee as defined by section
8901(1)(A)–(H); and
‘‘(B) an individual described in section
2105(e).
‘‘(2) ANNUITANT.—The term ‘annuitant’ has
the meaning such term would have under paragraph
(3) of section 8901 if, for purposes of such para-
graph, the term ‘employee’ were considered to have
the meaning given to it under paragraph (1) of this
subsection.
‘‘(3) QUALIFIED RELATIVE.—The term ‘quali-
fied relative’, as used with respect to a sponsoring
individual, means—
‘‘(A) the spouse of such sponsoring indi-
vidual;
‘‘(B) a parent or parent-in-law of such
sponsoring individual; and
‘‘(C) any other person bearing a relation-
ship to such sponsoring individual specified by
the Office in regulations.
‘‘(4) 
SPONSORING
INDIVIDUAL.—The 
term
‘sponsoring individual’ refers to an individual de-
scribed in paragraph (1), (2), (3), or (4) of section
9002(b).
‘‘(5) CARRIER.—The term ‘carrier’ means a vol-
untary association, corporation, partnership, or
other nongovernmental organization which is law-
fully engaged in providing, paying for, or reimburs-
ing the cost of, qualified long-term care services
under group insurance policies or contracts, or simi-
lar group arrangements, in consideration of pre-
miums or other periodic charges payable to the car-
rier.
‘‘(6) QUALIFIED LONG-TERM CARE SERVICES.—
The term ‘qualified long-term care services’ has the
meaning given such term by section 7702B of the
Internal Revenue Code of 1986.
‘‘(7) OFFICE.—The term ‘Office’ means the Of-
fice of Personnel Management.
‘‘(8) APPROPRIATE SECRETARY.—The term ‘ap-
propriate Secretary’ means—
‘‘(A) except as otherwise provided in this
paragraph, the Secretary of Defense;
‘‘(B) with respect to the Coast Guard when
it is not operating as a service of the Navy, the
Secretary of Transportation;
‘‘(C) with respect to the commissioned
corps of the National Oceanic and Atmospheric
Administration, the Secretary of Commerce;
and
‘‘(D) with respect to the commissioned
corps of the Public Health Service, the Sec-
retary of Health and Human Services.
‘‘§ 9002. Eligibility to obtain coverage
‘‘(a) IN GENERAL.—Any eligible individual may ob-
tain long-term care insurance coverage under this chapter
for himself or herself, in accordance with applicable provi-
sions of this chapter.
‘‘(b) ELIGIBLE INDIVIDUAL DEFINED.—For pur-
poses of this section, the term ‘eligible individual’ means
each of the following:
‘‘(1) EMPLOYEE.—An employee who has com-
pleted 6 months of continuous service as an em-
ployee under other than a temporary appointment
limited to 6 months or less.
‘‘(2) ANNUITANT.—An annuitant.
‘‘(3) MEMBER
OF
THE
UNIFORMED
SERV-
ICES.—A member of the uniformed services on ac-
tive duty for a period of more than 30 days or full-
time National Guard duty (as defined in section
101(d)(5) of title 10) who satisfies such eligibility
requirements as the Office prescribes under section
9006(c).
‘‘(4) RETIRED
MEMBER
OF
THE
UNIFORMED
SERVICES.—A member of the uniformed services en-
titled to retired or retainer pay (other than under
chapter 1223 of title 10) who satisfies such eligi-
bility requirements as the Office prescribes under
section 9006(c).
‘‘(5) QUALIFIED
RELATIVE.—A qualified rel-
ative of a sponsoring individual.
‘‘(c) CERTIFICATION REQUIREMENT.—As a condition
for obtaining long-term care insurance coverage under this
chapter based on one’s status as a qualified relative, cer-
tification from the applicant’s sponsoring individual shall
be required as to—
‘‘(1) such sponsoring individual’s status, as de-
scribed in paragraph (1), (2), (3), or (4) of sub-
section (b) (as applicable), as of the time of the
qualified relative’s application for coverage; and
‘‘(2) the existence of the claimed relationship as
of that time.
Any such certification shall be submitted at such time and
in such form and manner as the Office shall by regulation
prescribe.
‘‘(d) DISQUALIFYING CONDITION.—Nothing in this
chapter shall be considered to require that long-term care
insurance coverage be made available in the case of any
individual who would be immediately benefit eligible.
‘‘§ 9003. Contracting authority
‘‘(a) IN GENERAL.—The Office may, without regard
to section 3709 of the Revised Statutes or other statute
requiring competitive bidding, contract with qualified car-
riers to provide group long-term care insurance under this
chapter, except that the Office may not have contracts in
effect under this section with more than 3 qualified car-
riers as of any given time.
‘‘(b) QUALIFIED CARRIERS.—To be considered a
qualified carrier under this chapter, a company must be
licensed to issue group long-term care insurance in all the
States and the District of Columbia.
‘‘(c) TERMS AND CONDITIONS.—
‘‘(1) IN GENERAL.—Each contract under this
section shall contain a detailed statement of the ben-
efits offered (including any maximums, limitations,
exclusions, and other definitions of benefits), the
rates charged (including any limitations or other
conditions on their subsequent adjustment), and
such other terms and conditions as may be mutually
agreed to by the Office and the carrier involved, con-
sistent with the requirements of this chapter.
‘‘(2) RATES.—The rates charged under any
contract under this section shall reasonably reflect
the cost of the benefits provided under such con-
tract.
‘‘(d) NONCANCELABILITY.—The benefits and cov-
erage made available to individuals under any contract
under this section shall be guaranteed to be renewable and
may not be canceled by the carrier except for nonpayment
of charges.
‘‘(e) PAYMENT OF REQUIRED BENEFITS; DISPUTE
RESOLUTION.—Each contract under this section shall re-
quire the carrier to agree—
‘‘(1) to pay or provide benefits in an individual
case if the Office (or a duly designated third-party
administrator) finds that the individual involved is
entitled thereto under the terms of the contract; and
‘‘(2) to participate in administrative procedures
designed to bring about the expeditious resolution of
disputes arising under such contract, including, in
appropriate circumstances, one or more alternative
means of dispute resolution.
‘‘(f) DURATION.—
‘‘(1) IN GENERAL.—Each contract under this
section shall be for a term of 5 years, but may be
made automatically renewable from term to term in
the absence of notice of termination by either party.
However, the rights and responsibilities of the en-
rolled individual, the insurer, and the Office (or duly
designated third-party administrator) under any
such contract shall continue until the termination of
coverage of the enrolled individual.
‘‘(2) 
TERMINATION
OF
INDIVIDUAL
COV-
ERAGE.—Group long-term care insurance coverage
obtained by an individual under this chapter shall
terminate only upon the occurrence of any of the fol-
lowing:
‘‘(A) DEATH.—The death of the insured.