[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7337 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 7337
To provide a short-term disability insurance program for Federal
employees for disabilities that are not work-related, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2024
Ms. Norton introduced the following bill; which was referred to the
Committee on Oversight and Accountability
_______________________________________________________________________
A BILL
To provide a short-term disability insurance program for Federal
employees for disabilities that are not work-related, and for other
purposes.
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 ``Federal Employee Short-Term
Disability Insurance Act of 2024''.
SEC. 2. PURPOSE.
The purpose of this Act is to offer voluntary insurance to Federal
employees for protection against the loss of pay resulting from--
(1) short-term injury or disability;
(2) short-term leave taken for the purpose of caring for a
family member;
(3) the birth of a child of such an employee; or
(4) making arrangements to adopt a child or to become a
foster parent.
SEC. 3. NON-WORK RELATED DISABILITY INSURANCE.
(a) In General.--Title 5, United States Code, is amended by
inserting after chapter 87 the following:
``CHAPTER 88--NON-WORK RELATED SHORT-TERM DISABILITY INSURANCE
``Sec.
``8801. Definitions.
``8802. Availability of insurance.
``8803. Contracting authority.
``8804. Benefits.
``8805. Premiums.
``8806. Preemption.
``8807. Studies, reports, and audits.
``8808. Jurisdiction of courts.
``8809. Administrative functions.
``8810. Cost accounting standards.
``Sec. 8801. Definitions
``For purposes of this chapter--
``(1) the term `Director' means the Director of the Office
of Personnel Management;
``(2) the term `employee' means--
``(A) an employee defined in section 8901(1); and
``(B) an officer or employee of the United States
Postal Service or of the Postal Regulatory Commission;
``(3) the term `injury or disability', with respect to an
employee, means that such employee is unable to perform the
essential functions of such employee's position of employment
with the Federal Government;
``(4) the term `member of family' has the meaning given
such term in section 8901(5);
``(5) the term `carrier' means an insurance company that is
licensed to issue disability insurance in all States, taking
into account any subsidiaries or affiliates of such a company;
and
``(6) the term `State' includes the District of Columbia.
``Sec. 8802. Availability of insurance
``(a) The Director shall establish and administer a program to make
insurance coverage available under this chapter--
``(1) for an injury or disability not covered under chapter
81;
``(2) for leave to care for, or leave to make arrangements
to care for, a member of family, including the birth of a
child; and
``(3) for leave to make arrangements--
``(A) to become a foster parent; or
``(B) to adopt a child.
``(b) Insurance shall not be available under this chapter if the
injury or disability of an employee is--
``(1) caused by willful misconduct of such employee;
``(2) caused by such employee's intention to bring about
such injury or disability to himself or to another individual;
or
``(3) proximately caused by the intoxication of such
employee.
``(c) In addition to the requirements otherwise applicable under
section 8801(5), an insurance contract under this chapter must be fully
insured, whether through reinsurance with other carriers or otherwise.
``Sec. 8803. Contracting authority
``(a) The Director shall, without regard to any statute requiring
competitive bidding, contract with one or more carriers for a policy or
policies of disability insurance as described under this chapter. The
Director shall ensure that each resulting contract is awarded on the
basis of contractor qualifications, price, and reasonable competition.
``(b)(1) Each contract under this section 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 duration of the enrollment period; and
``(D) such other terms and conditions (including procedures
for establishing eligibility for insurance under this chapter)
as may be determined by the Director, consistent with the
requirements of this chapter.
``(2) Premiums charged under a contract under this section shall
reasonably and equitably reflect the cost of the benefits provided, as
determined by the Director.
``(c)(1) Each contract under this section shall require the
carrier--
``(A) to provide payments or benefits described in section
8804(c) to an employee if such employee 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
resolve such disputes expeditiously; 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
circumstances acceptable to the Director.
``(2) The carrier's determination as to whether or not a particular
employee is eligible to obtain insurance coverage under this chapter
shall be subject to review to the extent and in the manner provided in
the applicable contract.
``(3) Nothing in this chapter shall be considered to grant
authority for a third-party reviewer to change the terms of any
contract under this chapter.
``(d)(1) Each contract under this section shall be for a term of
not less than 3 years and not greater than 7 years, and may be
terminated earlier than the termination date of such contract by the
Director in accordance with the terms of such contract. However, the
rights and responsibilities of the enrolled employee, the insurer, and
the Director under each contract shall continue with respect to such
employee until the termination of coverage of the enrolled employee or
the effective date of a successor contract.
``(2) A contract described in paragraph (1) may be made
automatically renewable, for a term of 1 year each January 1, unless
written notice of non-renewal is given either by the Director or the
carrier not less than 180 days before the renewal date, or unless
modified by mutual agreement.
``(3) A contract described in paragraph (1) shall include such
provisions as may be necessary to ensure that, once an employee becomes
duly enrolled, insurance coverage pursuant to that enrollment shall be
terminated only if the individual is separated from Federal service or,
where appropriate, for non-payment of premiums.
``Sec. 8804. Benefits
``(a) The Director may prescribe reasonable minimum standards for
benefit plans offered under this chapter.
``(b)(1) Benefits provided to an employee under this chapter shall
offset other benefits received by such employee for the same injury or
disability, leave to care for or make arrangements to care for a member
of family (including the birth of a child), or leave to make
arrangements to adopt a child or become a foster parent including
worker's compensation and disability retirement income.
``(2) A contract providing benefits under this chapter--
``(A) shall not provide for a preexisting condition
exclusion; and
``(B) shall not charge higher premiums, deny coverage, or
drop coverage of an employee with a preexisting condition.
``(3) A contract providing benefits under this chapter shall
provide incentives for an employee who is receiving benefits under such
contract to return to work.
``(c)(1) For each instance that such employee suffers an injury or
disability, takes leave to care for or make arrangements to care for a
member of family (including the birth of a child), or takes leave to
make arrangements to adopt a child or become a foster parent, and is
eligible for benefits under this chapter, such employee may receive
benefits under this chapter for a period not to exceed 12 months
beginning on the date on which such employee qualifies for such
benefits. An employee shall receive such benefits after the expiration
of the waiting period selected by such employee under paragraph (2)(A).
The amount of benefits shall be equal to the lesser of--
``(A) 70 percent of the annual rate of pay, excluding
bonuses, of an employee at the time of the injury or disability
of such employee occurs; or
``(B) 70 percent of the maximum rate of basic pay provided
for grade GS-15 of the General Schedule.
``(2)(A) The period for which benefits are payable to an employee
under this subsection shall begin after the completion of a waiting
period, subject to the requirement in subparagraph (C). An employee
shall elect one of the following waiting period options:
``(i) On the 8th day of continuous injury or disability,
leave to care for or to make arrangements to care for a member
of family (including the birth of a child), or leave to make
arrangements to adopt a child or become a foster parent.
``(ii) On the 31st day of continuous disability, leave to
care for or to make arrangements to care for a member of family
(including the birth of a child), or leave to make arrangements
to adopt a child or become a foster parent.
``(iii) On the 91st day of continuous disability, leave to
care for or to make arrangements to care for a member of family
(including the birth of a child), or leave to make arrangements
to adopt a child or become a foster parent.
``(iv) On the 181st day of continuous disability, leave to
care for or to make arrangements to care for a member of family
(including the birth of a child), or leave to make arrangements
to adopt a child or become a foster parent.
``(B) An employee who elects to receive benefits earlier shall pay
a higher premium.
``(C) A waiting period selected under subparagraph (A) shall begin
on the first day of an employee's injury or disability.
``Sec. 8805. Premiums
``(a) Each eligible individual obtaining insurance coverage under
this chapter shall be responsible for 100 percent of the premiums for
such coverage.
``(b) The amount necessary to pay the premiums for enrollment shall
be withheld from the pay of the enrolled individual.
``(c) The carrier participating under this chapter shall maintain
records that permit it to account for all amounts received under this
chapter (including investment earnings on those amounts) separate and
apart from all other funds.
``(d)(1)(A) The Employees' Life Insurance Fund is available,
without fiscal year limitation, for reasonable expenses incurred in
administering this chapter before the start of the first term described
in section 8803(d)(1), including reasonable implementation costs.
``(B) Such Fund shall be reimbursed, before the end of the first
year of a contract described in section 8803(d)(1), for all amounts
obligated or expended under subparagraph (A) (including lost investment
income). Reimbursement under this subparagraph shall be made by the
carrier in accordance with applicable provisions included in the
relevant contract.
``(C)(i) There is hereby established in the Employees' Life
Insurance Fund a Non-Work Related Disability Insurance Administrative
Account, which shall be available to the Office of Personnel
Management, without fiscal year limitation, to defray reasonable
expenses incurred by the Office in administering this chapter after the
start of the first term described in section 8803(d)(1).
``(ii) A contract under this chapter shall include appropriate
provisions under which the carrier involved shall, during each year,
make such periodic contributions to the Non-Work Related Disability
Insurance Administrative Account as necessary to ensure that the
reasonable anticipated expenses of the Office of Personnel Management
in administering this chapter during such year (adjusted to reconcile
for any earlier overestimates or underestimates under this
subparagraph) are defrayed.
``(e) Nothing in this chapter shall, in the case of an enrolled
individual applying for an extension of insurance coverage under this
chapter after the expiration of such enrolled individual's first
opportunity to enroll, preclude the application of underwriting
standards for later enrollment.
``Sec. 8806. Preemption
``(a) The terms of any contract under this chapter which relate to
the nature, provision, or extent of coverage or benefits (including
payments with respect to benefits) shall supersede and preempt any
State, territorial, tribal, or local law, or any regulation issued
thereunder, which relates to non-work related disability insurance or
contracts.
``(b)(1) No tax, fee, or other monetary payment may be imposed or
collected, directly or indirectly, by any State, territory, tribe, or
locality, or by any political subdivision or other governmental
authority thereof, on, or with respect to, any premium paid for an
insurance policy under this chapter.
``(2) Paragraph (1) shall not be construed to exempt any company or
other entity issuing a policy of insurance under this chapter from the
imposition, payment, or collection of a tax, fee, or other monetary
payment on the net income or profit accruing to or realized by such
entity from business conducted under this chapter, if that tax, fee, or
payment is applicable to a broad range of business activity.
``(c) No law of a State, territory, tribe, or locality, pertaining
to subrogation or reimbursement with respect to benefits provided under
this chapter, shall operate except as expressly adopted by the
Director.
``Sec. 8807. Studies, reports, and audits
``(a) A contract under this chapter shall contain provisions
requiring the carrier to furnish such reasonable reports as the
Director determines to be necessary to enable the Director to carry out
the Director's functions under this chapter.
``(b) Each Federal agency shall keep such records, make such
certifications, and furnish the Director, the carrier, or both, with
such information and reports as the Director may require.
``(c) The Director shall conduct periodic reviews of each plan
under this chapter to ensure its competitiveness.
``Sec. 8808. Jurisdiction of courts
``The district courts of the United States have original
jurisdiction, concurrent with the United States Court of Federal
Claims, of a civil action or claim against the United States under this
chapter after such administrative remedies as required under section
8803(c) have been exhausted, but only to the extent judicial review is
not precluded by any dispute resolution or other remedy under this
chapter.
``Sec. 8809. Administrative functions
``(a)(1) Except as otherwise provided in this chapter, the Director
shall prescribe regulations necessary to carry out this chapter and to
make arrangements as necessary with other agencies and payroll systems
to implement the program.
``(2) Except as otherwise provided by law, the Director shall
specify in regulation the treatment of time spent by an individual in
receipt of benefits under this chapter for the purposes of periodic
increases in pay, retention purposes, and other rights, benefits, and
conditions of employment for which length of service is a factor.
``(b) The carrier shall provide for periodic coordinated
enrollment, promotion, and education efforts, as specified by the
Director.
``Sec. 8810. Cost accounting standards
``The cost accounting standards issued pursuant to section 1502 of
title 41 shall not apply with respect to an insurance contract under
this chapter.''.
(b) Conforming Amendment.--Section 1005(f) of title 39, United
States Code, is amended by inserting ``88,'' after ``87,''.
(c) Clerical Amendment.--The analysis for part III of title 5,
United States Code, is amended by adding at the end of subpart G the
following:
``88. Non-Work Related Short-Term Disability 8801''.
Insurance.
(d) Date of Application.--The amendment made by subsection (a)
shall apply to contracts that take effect with respect to the first
calender year that begins more than 18 months after the date of
enactment of this section.
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