
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 2, 2001]
[Document not affected by Public Laws enacted between
  January 2, 2001 and January 28, 2002]
[CITE: 5USC9003]

 
             TITLE 5--GOVERNMENT ORGANIZATION AND EMPLOYEES
 
                           PART III--EMPLOYEES
 
                   Subpart G--Insurance and Annuities
 
                  CHAPTER 90--LONG-TERM CARE INSURANCE
 
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 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) 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.

        (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) 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 care insurance 
    coverage obtained by such individual pursuant to that enrollment 
    shall not be terminated due to any change in status (such as 
    separation from Government service or the uniformed services) or 
    ceasing to meet the requirements for being considered a qualified 
    relative (whether as a result of dissolution of marriage or 
    otherwise).

(Added Pub. L. 106-265, title I, Sec. 1002(a), Sept. 19, 2000, 114 Stat. 
764.)

                       References in Text

    The Contract Disputes Act of 1978, referred to in subsec. (c)(3), is 
Pub. L. 95-563, Nov. 1, 1978, 92 Stat. 2383, as amended, which is 
classified principally to chapter 9 (Sec. 601 et seq.) of Title 41, 
Public Contracts. Sections 8(c) and 10(a)(1) of the Act are classified 
to sections 607(c) and 609(a)(1), respectively, of Title 41. For 
complete classification of this Act to the Code, see Short Title note 
set out under section 601 of Title 41 and Tables.

                  Section Referred to in Other Sections

    This section is referred to in sections 9002, 9004, 9007 of this 
title.
