5 U.S.C. § 8906 : US Code - Section 8906: Contributions

Search 5 U.S.C. § 8906 : US Code - Section 8906: Contributions

(a)(1) Not later than October 1 of each year, the Office of
Personnel Management shall determine the weighted average of the
subscription charges that will be in effect during the following
contract year with respect to - 
(A) enrollments under this chapter for self alone; and
(B) enrollments under this chapter for self and family.
(2) In determining each weighted average under paragraph (1), the
weight to be given to a particular subscription charge shall, with
respect to each plan (and option) to which it is to apply, be
commensurate with the number of enrollees enrolled in such plan
(and option) as of March 31 of the year in which the determination
is being made.
(3) For purposes of paragraph (2), the term "enrollee" means any
individual who, during the contract year for which the weighted
average is to be used under this section, will be eligible for a
Government contribution for health benefits.
(b)(1) Except as provided in paragraphs (2), (3), and (4), the
biweekly Government contribution for health benefits for an
employee or annuitant enrolled in a health benefits plan under this
chapter is adjusted to an amount equal to 72 percent of the
weighted average under subsection (a)(1)(A) or (B), as applicable.
For an employee, the adjustment begins on the first day of the
employee's first pay period of each year. For an annuitant, the
adjustment begins on the first day of the first period of each year
for which an annuity payment is made.
(2) The biweekly Government contribution for an employee or
annuitant enrolled in a plan under this chapter shall not exceed 75
percent of the subscription charge.
(3) In the case of an employee who is occupying a position on a
part-time career employment basis (as defined in section 3401(2) of
this title), the biweekly Government contribution shall be equal to
the percentage which bears the same ratio to the percentage
determined under this subsection (without regard to this paragraph)
as the average number of hours of such employee's regularly
scheduled workweek bears to the average number of hours in the
regularly scheduled workweek of an employee serving in a comparable
position on a full-time career basis (as determined under
regulations prescribed by the Office).
(4) In the case of persons who are enrolled in a health benefits
plan as part of the demonstration project under section 1108 of
title 10, the Government contribution shall be subject to the
limitation set forth in subsection (i) of that section.
(c) There shall be withheld from the pay of each enrolled
employee and (except as provided in subsection (i) of this section)
the annuity of each enrolled annuitant and there shall be
contributed by the Government, amounts, in the same ratio as the
contributions of the employee or annuitant and the Government under
subsection (b) of this section, which are necessary for the
administrative costs and the reserves provided for by section
8909(b) of this title.
(d) The amount necessary to pay the total charge for enrollment,
after the Government contribution is deducted, shall be withheld
from the pay of each enrolled employee and (except as provided in
subsection (i) of this section) from the annuity of each enrolled
annuitant. The withholding for an annuitant shall be the same as
that for an employee enrolled in the same health benefits plan and
level of benefits.
(e)(1)(A) An employee enrolled in a health benefits plan under
this chapter who is placed in a leave without pay status may have
his coverage and the coverage of members of his family continued
under the plan for not to exceed 1 year under regulations
prescribed by the Office.
(B) During each pay period in which an enrollment continues under
subparagraph (A) - 
(i) employee and Government contributions required by this
section shall be paid on a current basis; and
(ii) if necessary, the head of the employing agency shall
approve advance payment, recoverable in the same manner as under
section 5524a(c), of a portion of basic pay sufficient to pay
current employee contributions.
(C) Each agency shall establish procedures for accepting direct
payments of employee contributions for the purposes of this
paragraph.
(2) An employee who enters on approved leave without pay to serve
as a full-time officer or employee of an organization composed
primarily of employees as defined by section 8901 of this title,
within 60 days after entering on that leave without pay, may file
with his employing agency an election to continue his health
benefits enrollment and arrange to pay currently into the Employees
Health Benefits Fund, through his employing agency, both employee
and agency contributions from the beginning of leave without pay.
The employing agency shall forward the enrollment charges so paid
to the Fund. If the employee does not so elect, his enrollment will
continue during nonpay status and end as provided by paragraph (1)
of this subsection and implementing regulations.
(3)(A) An employing agency may pay both the employee and
Government contributions, and any additional administrative
expenses otherwise chargeable to the employee, with respect to
health care coverage for an employee described in subparagraph (B)
and the family of such employee.
(B) An employee referred to in subparagraph (A) is an employee
who - 
(i) is enrolled in a health benefits plan under this chapter;
(ii) is a member of a reserve component of the armed forces;
(iii) is called or ordered to active duty in support of a
contingency operation (as defined in section 101(a)(13) of title
10);
(iv) is placed on leave without pay or separated from service
to perform active duty; and
(v) serves on active duty for a period of more than 30
consecutive days.
(C) Notwithstanding the one-year limitation on coverage described
in paragraph (1)(A), payment may be made under this paragraph for a
period not to exceed 24 months.
(f) The Government contribution, and any additional payments
under subsection (e)(3)(A), for health benefits for an employee
shall be paid - 
(1) in the case of employees generally, from the appropriation
or fund which is used to pay the employee;
(2) in the case of an elected official, from an appropriation
or fund available for payment of other salaries of the same
office or establishment;
(3) in the case of an employee of the legislative branch who is
paid by the Chief Administrative Officer of the House of
Representatives, from the applicable accounts of the House of
Representatives; and
(4) in the case of an employee in a leave without pay status,
from the appropriation or fund which would be used to pay the
employee if he were in a pay status.
(g)(1) Except as provided in paragraphs (2) and (3), the
Government contributions authorized by this section for health
benefits for an annuitant shall be paid from annual appropriations
which are authorized to be made for that purpose and which may be
made available until expended.
(2)(A) The Government contributions authorized by this section
for health benefits for an individual who first becomes an
annuitant by reason of retirement from employment with the United
States Postal Service on or after July 1, 1971, or for a survivor
of such an individual or of an individual who died on or after July
1, 1971, while employed by the United States Postal Service, shall
through September 30, 2016, be paid by the United States Postal
Service, and thereafter shall be paid first from the Postal Service
Retiree Health Benefits Fund up to the amount contained in the
Fund, with any remaining amount paid by the United States Postal
Service.
(B) In determining any amount for which the Postal Service is
liable under this paragraph, the amount of the liability shall be
prorated to reflect only that portion of total service which is
attributable to civilian service performed (by the former postal
employee or by the deceased individual referred to in subparagraph
(A), as the case may be) after June 30, 1971, as estimated by the
Office of Personnel Management.
(3) The Government contribution for persons enrolled in a health
benefits plan as part of the demonstration project under section
1108 of title 10 shall be paid as provided in subsection (i) of
that section.
(h) The Office shall provide for conversion of biweekly rates of
contribution specified by this section to rates for employees and
annuitants paid on other than a biweekly basis, and for this
purpose may provide for the adjustment of the converted rate to the
nearest cent.
(i) An annuitant whose annuity is insufficient to cover the
withholdings required for enrollment in a particular health
benefits plan may enroll (or remain enrolled) in such plan,
notwithstanding any other provision of this section, if the
annuitant elects, under conditions prescribed by regulations of the
Office, to pay currently into the Employees Health Benefits Fund,
through the retirement system that administers the annuitant's
health benefits enrollment, an amount equal to the withholdings
that would otherwise be required under this section.