| Home > 106th Congressional Public Laws > Pub.L. 106-266 To designate the Federal facility located at 1301 Emmet Street in Charlottesville, Virginia, as the ``Pamela B. Gwin Hall''. <> ...
Pub.L. 106-266 To designate the Federal facility located at 1301 Emmet Street in Charlottesville, Virginia, as the ``Pamela B. Gwin Hall''. <> ...
FEDERAL LONG-TERM CARE INSURANCE
[[Page 114 STAT. 762]]
Public Law 106-265
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
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
``9002. Availability of insurance.
``9003. Contracting authority.
``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);
``(C) an individual employed by the Tennessee Valley
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
[[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,
``(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
``(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
``(10) Appropriate secretary.--The term `appropriate
``(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
``(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
[[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
``(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
``(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
``(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
``(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;
``(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.
``(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
``(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
``(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
``(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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106th Congressional Public Laws Records and Documents
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