
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 2, 2001]
[Document not affected by Public Laws enacted between
  January 2, 2001 and January 28, 2002]
[CITE: 5USC8905a]

 
             TITLE 5--GOVERNMENT ORGANIZATION AND EMPLOYEES
 
                           PART III--EMPLOYEES
 
                   Subpart G--Insurance and Annuities
 
                      CHAPTER 89--HEALTH INSURANCE
 
Sec. 8905a. Continued coverage

    (a) Any individual described in paragraph (1) or (2) of subsection 
(b) may elect to continue coverage under this chapter in accordance with 
the provisions of this section.
    (b) This section applies with respect to--
        (1) any employee who--
            (A) is separated from service, whether voluntarily or 
        involuntarily, except that if the separation is involuntary, 
        this section shall not apply if the separation is for gross 
        misconduct (as defined under regulations which the Office of 
        Personnel Management shall prescribe); and
            (B) would not otherwise be eligible for any benefits under 
        this chapter (determined without regard to any temporary 
        extension of coverage and without regard to any benefits 
        available under a nongroup contract); and

        (2) any individual who--
            (A) ceases to meet the requirements for being considered an 
        unmarried dependent child under this chapter;
            (B) on the day before so ceasing to meet the requirements 
        referred to in subparagraph (A), was covered under a health 
        benefits plan under this chapter as a member of the family of an 
        employee or annuitant; and
            (C) would not otherwise be eligible for any benefits under 
        this chapter (determined without regard to any temporary 
        extension of coverage and without regard to any benefits 
        available under a nongroup contract).

    (c)(1) The Office shall prescribe regulations and provide for the 
inclusion of appropriate terms in contracts with carriers to provide 
that--
        (A) with respect to an employee who becomes (or will become) 
    eligible for continued coverage under this section as a result of 
    separation from service, the separating agency shall, before the end 
    of the 30-day period beginning on the date as of which coverage 
    (including any temporary extensions of coverage) would otherwise 
    end, notify the individual of such individual's rights under this 
    section; and
        (B) with respect to a child of an employee or annuitant who 
    becomes eligible for continued coverage under this section as a 
    result of ceasing to meet the requirements for being considered a 
    member of the employee's or annuitant's family--
            (i) the employee or annuitant may provide written notice of 
        the child's change in status (complete with the child's name, 
        address, and such other information as the Office may by 
        regulation require)--
                (I) to the employee's employing agency; or
                (II) in the case of an annuitant, to the Office; and

            (ii) if the notice referred to in clause (i) is received 
        within 60 days after the date as of which the child involved 
        first ceases to meet the requirements involved, the employing 
        agency or the Office (as the case may be) must, within 14 days 
        after receiving such notice, notify the child of such child's 
        rights under this section.

    (2) In order to obtain continued coverage under this section, an 
appropriate written election (submitted in such manner as the Office by 
regulation prescribes) must be made--
        (A) in the case of an individual seeking continued coverage 
    based on a separation from service, before the end of the 60-day 
    period beginning on the later of--
            (i) the effective date of the separation; or
            (ii) the date the separated individual receives the notice 
        required under paragraph (1)(A); or

        (B) in the case of an individual seeking continued coverage 
    based on a change in circumstances making such individual ineligible 
    for coverage as an unmarried dependent child, before the end of the 
    60-day period beginning on the later of--
            (i) the date as of which such individual first ceases to 
        meet the requirements for being considered an unmarried 
        dependent child; or
            (ii) the date such individual receives notice under 
        paragraph (1)(B)(ii);

    except that if a parent fails to provide the notice required under 
    paragraph (1)(B)(i) in timely fashion, the 60-day period under this 
    subparagraph shall be based on the date under clause (i), 
    irrespective of whether or not any notice under paragraph (1)(B)(ii) 
    is provided.

    (d)(1)(A) Except as provided in paragraphs (4) and (5), an 
individual receiving continued coverage under this section shall be 
required to pay currently into the Employees Health Benefits Fund, under 
arrangements satisfactory to the Office, an amount equal to the sum of--
        (i) the employee and agency contributions which would be 
    required in the case of an employee enrolled in the same health 
    benefits plan and level of benefits; and
        (ii) an amount, determined under regulations prescribed by the 
    Office, necessary for administrative expenses, but not to exceed 2 
    percent of the total amount under clause (i).

    (B) Payments under this section to the Fund shall--
        (i) in the case of an individual whose continued coverage is 
    based on such individual's separation, be made through the agency 
    which last employed such individual; or
        (ii) in the case of an individual whose continued coverage is 
    based on a change in circumstances referred to in subsection 
    (c)(2)(B), be made through--
            (I) the Office, if, at the time coverage would (but for this 
        section) otherwise have been discontinued, the individual was 
        covered as the child of an annuitant; or
            (II) if, at the time referred to in subclause (I), the 
        individual was covered as the child of an employee, the 
        employee's employing agency as of such time.

    (2) If an individual elects to continue coverage under this section 
before the end of the applicable period under subsection (c)(2), but 
after such individual's coverage under this chapter (including any 
temporary extensions of coverage) expires, coverage shall be restored 
retroactively, with appropriate contributions (determined in accordance 
with paragraph (1), (4), or (5), as the case may be) and claims (if 
any), to the same extent and effect as though no break in coverage had 
occurred.
    (3)(A) An individual making an election under subsection (c)(2)(B) 
may, at such individual's option, elect coverage either as an individual 
or, if appropriate, for self and family.
    (B) For the purpose of this paragraph, members of an individual's 
family shall be determined in the same way as would apply under this 
chapter in the case of an enrolled employee.
    (C) Nothing in this paragraph shall be considered to limit an 
individual making an election under subsection (c)(2)(A) to coverage for 
self alone.
    (4)(A) If the basis for continued coverage under this section is an 
involuntary separation from a position, or a voluntary separation from a 
surplus position, in or under the Department of Defense due to a 
reduction in force, or the Department of Energy due to a reduction in 
force resulting from the establishment of the National Nuclear Security 
Administration--
        (i) the individual shall be liable for not more than the 
    employee contributions referred to in paragraph (1)(A)(i); and
        (ii) the agency which last employed the individual shall pay the 
    remaining portion of the amount required under paragraph (1)(A).

    (B) This paragraph shall apply with respect to any individual whose 
continued coverage is based on a separation occurring on or after the 
date of enactment of this paragraph and before--
        (i) October 1, 2003; or
        (ii) February 1, 2004, if specific notice of such separation was 
    given to such individual before October 1, 2003.

    (C) For the purpose of this paragraph, ``surplus position'' means a 
position which is identified in pre-reduction-in-force planning as no 
longer required, and which is expected to be eliminated under formal 
reduction-in-force procedures.
    (5)(A) If the basis for continued coverage under this section is an 
involuntary separation from a position in or under the Department of 
Veterans Affairs due to a reduction in force or a title 38 staffing 
readjustment, or a voluntary or involuntary separation from a Department 
of Energy position at a Department of Energy facility at which the 
Secretary is carrying out a closure project selected under section 3143 
of the National Defense Authorization Act for Fiscal Year 1997 (42 
U.S.C. 7274n)--
        (i) the individual shall be liable for not more than the 
    employee contributions referred to in paragraph (1)(A)(i); and
        (ii) the agency which last employed the individual shall pay the 
    remaining portion of the amount required under paragraph (1)(A).

    (B) This paragraph shall only apply with respect to individuals 
whose continued coverage is based on a separation occurring on or after 
the date of the enactment of this paragraph.
    (e)(1) Continued coverage under this section may not extend beyond--
        (A) in the case of an individual whose continued coverage is 
    based on separation from service, the date which is 18 months after 
    the effective date of the separation; or
        (B) in the case of an individual whose continued coverage is 
    based on ceasing to meet the requirements for being considered an 
    unmarried dependent child, the date which is 36 months after the 
    date on which the individual first ceases to meet those 
    requirements, subject to paragraph (2).

    (2) In the case of an individual who--
        (A) ceases to meet the requirements for being considered an 
    unmarried dependent child;
        (B) as of the day before so ceasing to meet the requirements 
    referred to in subparagraph (A), was covered as the child of a 
    former employee receiving continued coverage under this section 
    based on the former employee's separation from service; and
        (C) so ceases to meet the requirements referred to in 
    subparagraph (A) before the end of the 18-month period beginning on 
    the date of the former employee's separation from service,

extended coverage under this section may not extend beyond the date 
which is 36 months after the separation date referred to in subparagraph 
(C).
    (f)(1) The Office shall prescribe regulations under which, in 
addition to any individual otherwise eligible for continued coverage 
under this section, and to the extent practicable, continued coverage 
may also, upon appropriate written application, be afforded under this 
section--
        (A) to any individual who--
            (i) if subparagraphs (A) and (C) of paragraph (10) of 
        section 8901 were disregarded, would be eligible to be 
        considered a former spouse within the meaning of such paragraph; 
        but
            (ii) would not, but for this subsection, be eligible to be 
        so considered; and

        (B) to any individual whose coverage as a family member would 
    otherwise terminate as a result of a legal separation.

    (2) The terms and conditions for coverage under the regulations 
shall include--
        (A) consistent with subsection (c), any necessary notification 
    provisions, and provisions under which an election period of at 
    least 60 days' duration is afforded;
        (B) terms and conditions identical to those under subsection 
    (d), except that contributions to the Employees Health Benefits Fund 
    shall be made through such agency as the Office by regulation 
    prescribes;
        (C) provisions relating to the termination of continued 
    coverage, except that continued coverage under this section may not 
    (subject to paragraph (3)) extend beyond the date which is 36 months 
    after the date on which the qualifying event under this subsection 
    (the date of divorce, annulment, or legal separation, as the case 
    may be) occurs; and
        (D) provisions designed to ensure that any coverage pursuant to 
    this subsection does not adversely affect any eligibility for 
    coverage which the individual involved might otherwise have under 
    this chapter (including as a result of any change in personal 
    circumstances) if this subsection had not been enacted.

    (3) In the case of an individual--
        (A) who becomes eligible for continued coverage under this 
    subsection based on a divorce, annulment, or legal separation from a 
    person who, as of the day before the date of the divorce, annulment, 
    or legal separation (as the case may be) was receiving continued 
    coverage under this section for self and family based on such 
    person's separation from service; and
        (B) whose divorce, annulment, or legal separation (as the case 
    may be) occurs before the end of the 18-month period beginning on 
    the date of the separation from service referred to in subparagraph 
    (A),

extended coverage under this section may not extend beyond the date 
which is 36 months after the date of the separation from service, as 
referred to in subparagraph (A).

(Added Pub. L. 100-654, title II, Sec. 201(a)(1), Nov. 14, 1988, 102 
Stat. 3841; amended Pub. L. 102-484, div. D, title XLIV, Sec. 4438(a), 
Oct. 23, 1992, 106 Stat. 2725; Pub. L. 103-337, div. A, title III, 
Sec. 341(d), Oct. 5, 1994, 108 Stat. 2720; Pub. L. 104-106, div. A, 
title X, Sec. 1036, Feb. 10, 1996, 110 Stat. 431; Pub. L. 106-65, div. 
A, title XI, Sec. 1104(c), div. C, title XXXII, Sec. 3244, Oct. 5, 1999, 
113 Stat. 777, 965; Pub. L. 106-117, title XI, Sec. 1106, Nov. 30, 1999, 
113 Stat. 1598; Pub. L. 106-398, Sec. 1 [div. C, title XXXI, 
Sec. 3136(h)], Oct. 30, 2000, 114 Stat. 1654, 1654A-459.)

                       References in Text

    The date of enactment of this paragraph, referred to in subsec. 
(d)(4)(B), is the date of enactment of Pub. L. 102-484, which was 
approved Oct. 23, 1992.
    The date of the enactment of this paragraph, referred to in subsec. 
(d)(5)(B), is the date of enactment of Pub. L. 106-117, which was 
approved Nov. 30, 1999.


                               Amendments

    2000--Subsec. (d)(5)(A). Pub. L. 106-398, in introductory 
provisions, inserted ``, or a voluntary or involuntary separation from a 
Department of Energy position at a Department of Energy facility at 
which the Secretary is carrying out a closure project selected under 
section 3143 of the National Defense Authorization Act for Fiscal Year 
1997 (42 U.S.C. 7274n)'' after ``readjustment''.
    1999--Subsec. (d)(1)(A). Pub. L. 106-117, Sec. 1106(1), substituted 
``paragraphs (4) and (5)'' for ``paragraph (4)'' in introductory 
provisions.
    Subsec. (d)(2). Pub. L. 106-117, Sec. 1106(2), substituted ``(1), 
(4), or (5)'' for ``(1) or (4)''.
    Subsec. (d)(4)(A). Pub. L. 106-65, Sec. 3244, inserted ``, or the 
Department of Energy due to a reduction in force resulting from the 
establishment of the National Nuclear Security Administration'' after 
``reduction in force'' in introductory provisions.
    Subsec. (d)(4)(B). Pub. L. 106-65, Sec. 1104(c), added cls. (i) and 
(ii) and struck out former cls. (i) and (ii) which read as follows:
    ``(i) October 1, 1999; or
    ``(ii) February 1, 2000, if specific notice of such separation was 
given to such individual before October 1, 1999.''
    Subsec. (d)(5). Pub. L. 106-117, Sec. 1106(3), added par. (5).
    1996--Subsec. (d)(4)(A). Pub. L. 104-106, Sec. 1036(1), inserted ``, 
or a voluntary separation from a surplus position,'' after ``an 
involuntary separation from a position'' in introductory provisions.
    Subsec. (d)(4)(C). Pub. L. 104-106, Sec. 1036(2), added subpar. (C).
    1994--Subsec. (d)(4)(B). Pub. L. 103-337 substituted ``October 1, 
1999'' for ``October 1, 1997'' in cls. (i) and (ii) and ``February 1, 
2000'' for ``February 1, 1998'' in cl. (ii).
    1992--Subsec. (d)(1)(A). Pub. L. 102-484, Sec. 4438(a)(1), 
substituted ``Except as provided in paragraph (4), an individual'' for 
``An individual''.
    Subsec. (d)(2). Pub. L. 102-484, Sec. 4438(a)(2), substituted ``in 
accordance with paragraph (1) or (4), as the case may be)'' for ``in 
accordance with paragraph (1))''.
    Subsec. (d)(4). Pub. L. 102-484, Sec. 4438(a)(3), added par. (4).


                    Effective Date of 1999 Amendment

    Amendment by section 3244 of Pub. L. 106-65 effective Mar. 1, 2000, 
see section 3299 of Pub. L. 106-65, set out as an Effective Date note 
under section 2401 of Title 50, War and National Defense.


                             Effective Date

    Section applicable with respect to any calendar year beginning, and 
contracts entered into or renewed for any calendar year beginning, after 
the end of the 9-month period beginning Nov. 14, 1988, and with respect 
to any qualifying event occurring on or after the first day of the first 
calendar year beginning after the end of such 9-month period, see 
section 203 of Pub. L. 100-654, set out as an Effective Date of 1988 
Amendment note under section 8902 of this title.


                           Source of Payments

    Section 4438(b)(1) of Pub. L. 102-484 provided that: ``Any amount 
which becomes payable by an agency as a result of the enactment of 
subsection (a) [amending this section] shall be paid out of funds or 
appropriations available for salaries and expenses of such agency.''

                  Section Referred to in Other Sections

    This section is referred to in sections 8902, 8903, 8905, 8909 of 
this title; title 10 sections 1078a, 1086a, 1145.
