I
105TH CONGRESS
2D SESSION
H. R. 4401
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
AUGUST 5, 1998
Mr. MICA introduced the following bill; which was referred to the Committee
on Government Reform and Oversight
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.
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 ‘‘Civil Service Long-
Term Care Insurance Benefit Act’’.
SEC. 2. LONG-TERM CARE INSURANCE.
(a) IN GENERAL.—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. Availability of insurance.
‘‘9003. Participating carriers.
‘‘9004. Administrative functions.
‘‘9005. Coordination with State laws.
‘‘9006. Commercial items.
‘‘§ 9001. Definitions
‘‘For purposes of this chapter:
‘‘(1) EMPLOYEE.—The term ‘employee’ has the
meaning given such term by section 8901, but does
not include an individual employed by the govern-
ment of the District of Columbia.
‘‘(2) 
ANNUITANT.—The 
term 
‘annuitant’
means—
‘‘(A) a former employee who, based on the
service of that individual, receives an annuity
under subchapter III of chapter 83, chapter 84,
or another retirement system for employees of
the Government (disregarding title XVIII of the
Social Security Act and any retirement system
established for employees described in section
2105(c)); and
‘‘(F) A stepson or stepdaughter of the em-
ployee or annuitant who is at least 18 years of
age.
‘‘(4) GOVERNMENT.—The term ‘Government’
means the Government of the United States, includ-
ing an agency or instrumentality thereof.
‘‘(5) GROUP LONG-TERM CARE INSURANCE.—
The term ‘group long-term care insurance’ means
group long-term care insurance purchased by the Of-
fice of Personnel Management under this chapter.
‘‘(6) INDIVIDUAL
LONG-TERM
CARE
INSUR-
ANCE.—The term ‘individual long-term care insur-
ance’ means any long-term care insurance offered
under this chapter which is not group long-term care
insurance.
‘‘(7) QUALIFIED CARRIER.—A carrier shall be
considered to be a ‘qualified carrier’, with respect to
a State, if it is licensed to issue group or individual
long-term care insurance (as the case may be) under
the laws of such State.
‘‘(8) QUALIFIED LONG-TERM CARE INSURANCE
CONTRACT.—The term ‘qualified long-term care in-
surance contract’ has the meaning given such term
by section 7702B of the Internal Revenue Code of
1986.
‘‘(9) STATE.—The term ‘State’ means a State,
the District of Columbia, the Commonwealth of
Puerto Rico, the Commonwealth of the Northern
Mariana Islands, the Trust Territory of the Pacific
Islands, the Virgin Islands, Guam, American Samoa,
and any other territory or possession of the United
States.
‘‘§ 9002. Availability of insurance
‘‘(a) IN GENERAL.—The Office of Personnel Manage-
ment shall establish and administer a program through
which employees and annuitants may obtain group or indi-
vidual long-term care insurance for themselves, a spouse,
or, to the extent permitted under the terms of the contract
of insurance involved, any other eligible relative.
‘‘(b) GENERAL REQUIREMENTS.—Long-term care in-
surance may not be offered under this chapter unless—
‘‘(1) the only insurance protection provided is
coverage under qualified long-term care insurance
contracts; and
‘‘(2) the insurance contract under which such
coverage is provided is issued by a qualified carrier.
‘‘(c) REQUIREMENT THAT CONTRACT BE FULLY IN-
SURED.—In addition to the requirements otherwise appli-
cable under section 9001(8), in order to be considered a
qualified long-term care insurance contract for purposes
of this chapter, a contract must be fully insured, whether
through reinsurance with other companies or otherwise.
‘‘(d) COVERAGE NOT REQUIRED FOR INDIVIDUALS
WHO WOULD BE IMMEDIATELY BENEFIT ELIGIBLE.—
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. Participating carriers
‘‘(a) IDENTIFICATION
OF
PARTICIPATING
CAR-
RIERS.—The Office of Personnel Management shall, be-
fore the start of each year—
‘‘(1) identify each carrier through whom any
long-term care insurance may be obtained under this
chapter during such year; and
‘‘(2) prepare a list of the carriers identified
under paragraph (1), and a summary description of
the insurance obtainable under this chapter from
each.
‘‘(b) APPLICATION REQUIREMENTS, ETC.—In order
to carry out its responsibilities under subsection (a), the
Office shall annually specify the timetable (including any
application deadlines) and other procedures that must be
followed by carriers seeking to be allowed to offer long-
term care insurance under this chapter during the follow-
ing year.
‘‘(c) INFORMATION TO PERMIT INFORMED DECI-
SIONMAKING.—The Office shall in a timely manner before
the start of each year—
‘‘(1) publish in the Federal Register the list
(and summary description) prepared under sub-
section (a) for such year; and
‘‘(2) make available to each individual eligible
to obtain long-term care insurance under this chap-
ter such information, in a form acceptable to the Of-
fice after consultation with the carrier, as may be
necessary to enable the individual to exercise an in-
formed choice among the various options available
under this chapter.
‘‘(d) POLICY OR BENEFIT CERTIFICATE.—The Office
shall arrange to have the appropriate individual or individ-
uals receive a copy of any policy of insurance obtained
under this chapter or, in the case of group long-term care
insurance, a certificate setting forth the benefits to which
an individual is entitled, to whom the benefits are payable,
and the procedures for obtaining benefits, and summariz-
ing the provisions of the policy principally affecting the
individual or individuals involved. Any such certificate
shall be issued instead of the certificate which the insur-
ance company would otherwise be required to issue.
‘‘§ 9004. Administrative functions
‘‘(a) IN GENERAL.—Except as provided in section
9003, the sole functions of the Office of Personnel Man-
agement under this chapter shall be as follows:
‘‘(1) ENROLLMENT PERIODS.—To provide rea-
sonable opportunity (consisting of not less than one
continuous 30-day period each year) for eligible em-
ployees and annuitants to obtain long-term care in-
surance coverage under this chapter.
‘‘(2) WITHHOLDINGS.—To provide for a means
by which the cost of any long-term care insurance
coverage obtained under this chapter may be paid
for through withholdings from the pay or annuity of
the employee or annuitant involved.
‘‘(3) CONTRACT
AUTHORITY
RELATING
TO
GROUP LONG-TERM CARE INSURANCE.—To contract
for a qualified long-term care insurance contract (in
the case of group long-term care insurance) with
each qualified carrier that offers such insurance, so
long as such carrier submits a timely application
under section 9003(b) and complies with such other
procedural rules as the Office may prescribe.
‘‘(b) LIMITATIONS ON AUTHORITY.—Nothing in this
chapter shall be considered to permit or require the Of-
fice—
‘‘(1) to prevent from being offered under this
chapter any individual long-term care insurance
under a qualified contract therefor; or
‘‘(2) to prescribe or negotiate over the benefits
to be offered, or any of the terms or conditions
under which any such benefits shall be offered,
under this chapter.
‘‘§ 9005. Coordination with State laws
‘‘(a) IN GENERAL.—The provisions of any contract
under this chapter for group long-term care insurance may
include provisions to supersede and preempt any provi-
sions of State or local law described in subsection (b), or
any regulation issued thereunder.
‘‘(b) DESCRIPTION.—This subsection applies with re-
spect to any provision of law which in effect carries out
the same policy as section 5 of the long-term care insur-
ance model Act, promulgated by the National Association
of Insurance Commissioners (as adopted as of September
1997).
‘‘§ 9006. Commercial items
‘‘For purposes of the Office of Federal Procurement
Policy Act, a long-term care insurance contract under this
chapter shall be considered a commercial item, as defined
by section 4(12) of such Act.’’.
(b) CONFORMING AMENDMENT.—The analysis for
part III of title 5, United States Code, is amended by add-
ing at the end of subpart G the following:
‘‘90. Long-Term Care Insurance .........................................................
9001’’.
SEC. 3. EFFECTIVE DATE.
The Office of Personnel Management shall take such
measures as may be necessary to ensure that long-term
care insurance coverage under title 5, United States Code,
as amended by this Act, may be obtained in time to take
effect beginning on the first day of the first applicable pay
period beginning on or after January 1, 2000.
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