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Pub.L. 106-266 To designate the Federal facility located at 1301 Emmet Street in Charlottesville, Virginia, as the ``Pamela B. Gwin Hall''. <> ...


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[[Page 761]]

                    FEDERAL LONG-TERM CARE INSURANCE

[[Page 114 STAT. 762]]

Public Law 106-265
106th Congress

                                 An Act


 
 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, members of the uniformed services, and civilian and 
  military retirees, provide for the correction of retirement coverage 
      errors under chapters 83 and 84 of such title, and for other 
           purposes. <<NOTE: Sept. 19, 2000 -  [H.R. 4040]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

TITLE <<NOTE: Long-Term Care Security Act.>>  I--FEDERAL LONG-TERM CARE 
INSURANCE

SEC. 1001. SHORT TITLE. <<NOTE: 5 USC 9001 note.>> 

    This title may be cited as the ``Long-Term Care Security Act''.

SEC. 1002. 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. Contracting authority.
``9004. Financing.
``9005. Preemption.
``9006. Studies, reports, and audits.
``9007. Jurisdiction of courts.
``9008. Administrative functions.
``9009. Cost accounting standards.

``Sec. 9001. Definitions

    For purposes of this chapter:
            ``(1) Employee.--The term `employee' means--
                    ``(A) an employee as defined by section 8901(1);
                    ``(B) an individual described in section 2105(e); 
                and
                    ``(C) an individual employed by the Tennessee Valley 
                Authority,
        but does not include an individual employed by the government of 
        the District of Columbia.
            ``(2) Annuitant.--The term `annuitant' has the meaning such 
        term would have under paragraph (3) of section 8901 if, for 
        purposes of such paragraph, the term `employee' were considered 
        to have the meaning given to it under paragraph (1) of this 
        subsection.

[[Page 114 STAT. 763]]

            ``(3) Member of the uniformed services.--The term `member of 
        the uniformed services' means a member of the uniformed 
        services, other than a retired member of the uniformed services, 
        who is--
                    ``(A) on active duty or full-time National Guard 
                duty for a period of more than 30 days; and
                    ``(B) a member of the Selected Reserve.
            ``(4) Retired member of the uniformed services.--The term 
        `retired member of the uniformed services' means a member or 
        former member of the uniformed services entitled to retired or 
        retainer pay, including a member or former member retired under 
        chapter 1223 of title 10 who has attained the age of 60 and who 
        satisfies such eligibility requirements as the Office of 
        Personnel Management prescribes under section 9008.
            ``(5) Qualified relative.--The term `qualified relative' 
        means each of the following:
                    ``(A) The spouse of an individual described in 
                paragraph (1), (2), (3), or (4).
                    ``(B) A parent, stepparent, or parent-in-law of an 
                individual described in paragraph (1) or (3).
                    ``(C) A child (including an adopted child, a 
                stepchild, or, to the extent the Office of Personnel 
                Management by regulation provides, a foster child) of an 
                individual described in paragraph (1), (2), (3), or (4), 
                if such child is at least 18 years of age.
                    ``(D) An individual having such other relationship 
                to an individual described in paragraph (1), (2), (3), 
                or (4) as the Office may by regulation prescribe.
            ``(6) Eligible individual.--The term `eligible individual' 
        refers to an individual described in paragraph (1), (2), (3), 
        (4), or (5).
            ``(7) Qualified carrier.--The term `qualified carrier' means 
        an insurance company (or consortium of insurance companies) that 
        is licensed to issue long-term care insurance in all States, 
        taking any subsidiaries of such a company into account (and, in 
        the case of a consortium, considering the member companies and 
        any subsidiaries thereof, collectively).
            ``(8) State.--The term `State' includes the District of 
        Columbia.
            ``(9) 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.
            ``(10) Appropriate secretary.--The term `appropriate 
        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 Secretary of Health and Human 
                Services.

[[Page 114 STAT. 764]]

``Sec. 9002. Availability of insurance

    ``(a) In General.--The Office of Personnel Management shall 
establish and, in consultation with the appropriate Secretaries, 
administer a program through which an individual described in paragraph 
(1), (2), (3), (4), or (5) of section 9001 may obtain long-term care 
insurance coverage under this chapter for such individual.
    ``(b) General Requirements.--Long-term care insurance may not be 
offered under this chapter unless--
            ``(1) the only coverage provided is under qualified long-
        term care insurance contracts; and
            ``(2) each insurance contract under which any such coverage 
        is provided is issued by a qualified carrier.

    ``(c) Documentation Requirement.--As a condition for obtaining long-
term care insurance coverage under this chapter based on one's status as 
a qualified relative, an applicant shall provide documentation to 
demonstrate the relationship, as prescribed by the Office.
    ``(d) Underwriting Standards.--
            ``(1) 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 eligible for benefits immediately.
            ``(2) Spousal parity.--For the purpose of underwriting 
        standards, a spouse of an individual described in paragraph (1), 
        (2), (3), or (4) of section 9001 shall, as nearly as 
        practicable, be treated like that individual.
            ``(3) Guaranteed issue.--Nothing in this chapter shall be 
        considered to require that long-term care insurance coverage be 
        guaranteed to an eligible individual.
            ``(4) Requirement that contract be fully insured.--In 
        addition to the requirements otherwise applicable under section 
        9001(9), 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.
            ``(5) Higher standards allowable.--Nothing in this chapter 
        shall, in the case of an individual applying for long-term care 
        insurance coverage under this chapter after the expiration of 
        such individual's first opportunity to enroll, preclude the 
        application of underwriting standards more stringent than those 
        that would have applied if that opportunity had not yet expired.

    ``(e) Guaranteed Renewability.--The benefits and coverage made 
available to eligible individuals under any insurance contract under 
this chapter shall be guaranteed renewable (as defined by section 7A(2) 
of the model regulations described in section 7702B(g)(2) of the 
Internal Revenue Code of 1986), including the right to have insurance 
remain in effect so long as premiums continue to be timely made. 
However, the authority to revise premiums under this chapter shall be 
available only on a class basis and only to the extent otherwise 
allowable under section 9003(b).

``Sec. 9003. Contracting authority

    ``(a) In General.--The Office of Personnel Management shall, without 
regard to section 5 of title 41 or any other statute requiring 
competitive bidding, contract with one or more qualified carriers for a 
policy or policies of long-term care insurance. The Office

[[Page 114 STAT. 765]]

shall ensure that each resulting contract (hereafter in this chapter 
referred to as a `master contract') is awarded on the basis of 
contractor qualifications, price, and reasonable competition.
    ``(b) Terms and Conditions.--
            ``(1) In general.--Each master contract under this chapter 
        shall contain--
                    ``(A) a detailed statement of the benefits offered 
                (including any maximums, limitations, exclusions, and 
                other definitions of benefits);
                    ``(B) the premiums charged (including any 
                limitations or other conditions on their subsequent 
                adjustment);
                    ``(C) the terms of the enrollment period; and
                    ``(D) such other terms and conditions as may be 
                mutually agreed to by the Office and the carrier 
                involved, consistent with the requirements of this 
                chapter.
            ``(2) Premiums.--Premiums charged under each master contract 
        entered into under this section shall reasonably and equitably 
        reflect the cost of the benefits provided, as determined by the 
        Office. The premiums shall not be adjusted during the term of 
        the contract unless mutually agreed to by the Office and the 
        carrier.
            ``(3) Nonrenewability.--Master contracts under this chapter 
        may not be made automatically renewable.

    ``(c) Payment of Required Benefits; Dispute Resolution.--
            ``(1) In general.--Each master contract under this chapter 
        shall require the carrier to agree--
                    ``(A) to provide payments or benefits to an eligible 
                individual if such individual is entitled thereto under 
                the terms of the contract; and
                    ``(B) with respect to disputes regarding claims for 
                payments or benefits under the terms of the contract--
                          ``(i) to establish internal procedures 
                      designed to expeditiously resolve such disputes; 
                      and
                          ``(ii) to establish, for disputes not resolved 
                      through procedures under clause (i), procedures 
                      for one or more alternative means of dispute 
                      resolution involving independent third-party 
                      review under appropriate circumstances by entities 
                      mutually acceptable to the Office and the carrier.
            ``(2) Eligibility.--A carrier's determination as to whether 
        or not a particular individual is eligible to obtain long-term 
        care insurance coverage under this chapter shall be subject to 
        review only to the extent and in the manner provided in the 
        applicable master contract.
            ``(3) Other claims.--For purposes of applying the Contract 
        Disputes Act of 1978 to disputes arising under this chapter 
        between a carrier and the Office--
                    ``(A) the agency board having jurisdiction to decide 
                an appeal relative to such a dispute shall be such board 
                of contract appeals as the Director of the Office of 
                Personnel Management shall specify in writing (after 
                appropriate arrangements, as described in section 8(c) 
                of such Act); and
                    ``(B) <<NOTE: Courts.>>  the district courts of the 
                United States shall have original jurisdiction, 
                concurrent with the United States Court of Federal 
                Claims, of any action described in section 10(a)(1) of 
                such Act relative to such a dispute.

[[Page 114 STAT. 766]]

            ``(4) Rule of construction.--Nothing in this chapter shall 
        be considered to grant authority for the Office or a third-party 
        reviewer to change the terms of any contract under this chapter.

    ``(d) Duration.--
            ``(1) In general.--Each master contract under this chapter 
        shall be for a term of 7 years, unless terminated earlier by the 
        Office in accordance with the terms of such contract. However, 
        the rights and responsibilities of the enrolled individual, the 
        insurer, and the Office (or duly designated third-party 
        administrator) under such contract shall continue with respect 
        to such individual until the termination of coverage of the 
        enrolled individual or the effective date of a successor 
        contract thereto.
            ``(2) Exception.--
                    ``(A) Shorter duration.--In the case of a master 
                contract entered into before the end of the period 
                described in subparagraph (B), paragraph (1) shall be 
                applied by substituting `ending on the last day of the 
                7-year period described in paragraph (2)(B)' for `of 7 
                years'.
                    ``(B) Definition.--The period described in this 
                subparagraph is the 7-year period beginning on the 
                earliest date as of which any long-term care insurance 
                coverage under this chapter becomes effective.
            ``(3) <<NOTE: Deadline. President.>>  Congressional 
        notification.--No later than 180 days after receiving the second 
        report required under section 9006(c), the President (or his 
        designee) shall submit to the Committees on Government Reform 
        and on Armed Services of the House of Representatives and the 
        Committees on Governmental Affairs and on Armed Services of the 
        Senate, a written recommendation as to whether the program under 
        this chapter should be continued without modification, 
        terminated, or restructured. During the 180-day period following 
        the date on which the President (or his designee) submits the 
        recommendation required under the preceding sentence, the Office 
        of Personnel Management may not take any steps to rebid or 
        otherwise contract for any coverage to be available at any time 
        following the expiration of the 7-year period described in 
        paragraph (2)(B).
            ``(4) Full portability.--Each master contract under this 
        chapter shall include such provisions as may be necessary to 
        ensure that, once an individual becomes duly enrolled, long-term 

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