[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4401 Introduced in House (IH)]







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 Representatives 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.
``Sec. 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 government 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
                    ``(B) any individual who receives an annuity under 
                any retirement system referred to in subparagraph (A) 
                (disregarding those described parenthetically) as the 
                surviving spouse of an employee (including an amount 
                under section 8442(b)(1)(A), whether or not an annuity 
                under section 8442(b)(1)(B) is also payable) or of a 
                former employee under subparagraph (A);
        but does not include a former employee of a Government 
        corporation excluded by regulation of the Office of Personnel 
        Management or the spouse of such a former employee.
            ``(3) Eligible relative.--The term `eligible relative', as 
        used with respect to an employee or annuitant, means each of 
        the following:
                    ``(A) The spouse of the employee or annuitant.
                    ``(B) The father or mother of the employee or 
                annuitant, or an ancestor of either.
                    ``(C) A stepfather or stepmother of the employee or 
                annuitant.
                    ``(D) The father-in-law or mother-in-law of the 
                employee or annuitant.
                    ``(E) A son or daughter of the employee or 
                annuitant who is at least 18 years of age.
                    ``(F) A stepson or stepdaughter of the employee or 
                annuitant who is at least 18 years of age.
            ``(4) Government.--The term `Government' means the 
        Government of the United States, including 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 Office of Personnel Management under this 
        chapter.
            ``(6) Individual long-term care insurance.--The term 
        `individual long-term care insurance' 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 insurance 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.
``Sec. 9002. Availability of insurance
    ``(a) In General.--The Office of Personnel Management shall 
establish and administer a program through which employees and 
annuitants may obtain group or individual 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 insurance 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 Insured.--In addition to 
the requirements otherwise applicable 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.
``Sec. 9003. Participating carriers
    ``(a) Identification of Participating Carriers.--The Office of 
Personnel Management shall, before 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 following 
year.
    ``(c) Information To Permit Informed Decisionmaking.--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 subsection (a) for such year; and
            ``(2) make available to each individual eligible to obtain 
        long-term care insurance under this chapter such information, 
        in a form acceptable to the Office after consultation with the 
        carrier, as may be necessary to enable the individual to 
        exercise an informed choice among the various options available 
        under this chapter.
    ``(d) Policy or Benefit Certificate.--The Office shall arrange to 
have the appropriate individual or individuals 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 summarizing the 
provisions of the policy principally affecting the individual or 
individuals involved. Any such certificate shall be issued instead of 
the certificate which the insurance company would otherwise be required 
to issue.
``Sec. 9004. Administrative functions
    ``(a) In General.--Except as provided in section 9003, the sole 
functions of the Office of Personnel Management under this chapter 
shall be as follows:
            ``(1) Enrollment periods.--To provide reasonable 
        opportunity (consisting of not less than one continuous 30-day 
        period each year) for eligible employees and annuitants to 
        obtain long-term care insurance 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 Office--
            ``(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.
``Sec. 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 provisions of State or local law described in 
subsection (b), or any regulation issued thereunder.
    ``(b) Description.--This subsection applies with respect to any 
provision of law which in effect carries out the same policy as section 
5 of the long-term care insurance model Act, promulgated by the 
National Association of Insurance Commissioners (as adopted as of 
September 1997).
``Sec. 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 adding 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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