5 U.S.C. § 8909 : US Code - Section 8909: Employees Health Benefits Fund

Search 5 U.S.C. § 8909 : US Code - Section 8909: Employees Health Benefits Fund

(a) There is in the Treasury of the United States an Employees
Health Benefits Fund which is administered by the Office of
Personnel Management. The contributions of enrollees and the
Government described by section 8906 of this title shall be paid
into the Fund. The Fund is available - 
(1) without fiscal year limitation for all payments to approved
health benefits plans; and
(2) to pay expenses for administering this chapter within the
limitations that may be specified annually by Congress.
Payments from the Fund to a plan participating in a letter-of-
credit arrangement under this chapter shall, in connection with
any payment or reimbursement to be made by such plan for a health
service or supply, be made, to the maximum extent practicable, on a
checks-presented basis (as defined under regulations of the
Department of the Treasury).
(b) Portions of the contributions made by enrollees and the
Government shall be regularly set aside in the Fund as follows:
(1) A percentage, not to exceed 1 percent of all contributions,
determined by the Office to be reasonably adequate to pay the
administrative expenses made available by subsection (a) of this
section.
(2) For each health benefits plan, a percentage, not to exceed
3 percent of the contributions toward the plan, determined by the
Office to be reasonably adequate to provide a contingency
reserve.
The Office, from time to time and in amounts it considers
appropriate, may transfer unused funds for administrative expenses
to the contingency reserves of the plans then under contract with
the Office. When funds are so transferred, each contingency reserve
shall be credited in proportion to the total amount of the
subscription charges paid and accrued to the plan for the contract
term immediately before the contract term in which the transfer is
made. The income derived from dividends, rate adjustments, or other
refunds made by a plan shall be credited to its contingency
reserve. The contingency reserves may be used to defray increases
in future rates, or may be applied to reduce the contributions of
enrollees and the Government to, or to increase the benefits
provided by, the plan from which the reserves are derived, as the
Office from time to time shall determine.
(c) The Secretary of the Treasury may invest and reinvest any of
the money in the Fund in interest-bearing obligations of the United
States, and may sell these obligations for the purposes of the
Fund. The interest on and the proceeds from the sale of these
obligations become a part of the Fund.
(d) When the assets, liabilities, and membership of employee
organizations sponsoring or underwriting plans approved under
section 8903(3) or 8903a of this title are merged, the assets
(including contingency reserves) and liabilities of the plans
sponsored or underwritten by the merged organizations shall be
transferred at the beginning of the contract term next following
the date of the merger to the plan sponsored or underwritten by the
successor organization. Each employee, annuitant, former spouse, or
person having continued coverage under section 8905a of this title
affected by a merger shall be transferred to the plan sponsored or
underwritten by the successor organization unless he enrolls in
another plan under this chapter. If the successor organization is
an organization described in section 8901(8)(B) of this title, any
employee, annuitant, former spouse, or person having continued
coverage under section 8905a of this title so transferred may not
remain enrolled in the plan after the end of the contract term in
which the merger occurs unless that individual is a full member of
such organization (as determined under section 8903a(d) of this
title).
(e)(1) Except as provided by subsection (d) of this section, when
a plan described by section 8903(3) or (4) or 8903a of this title
is discontinued under this chapter, the contingency reserve of that
plan shall be credited to the contingency reserves of the plans
continuing under this chapter for the contract term following that
in which termination occurs, each reserve to be credited in
proportion to the amount of the subscription charges paid and
accrued to the plan for the year of termination.
(2) Any crediting required under paragraph (1) pursuant to the
discontinuation of any plan under this chapter shall be completed
by the end of the second contract year beginning after such plan is
so discontinued.
(3) The Office shall prescribe regulations in accordance with
which this subsection shall be applied in the case of any plan
which is discontinued before being credited with the full amount to
which it would otherwise be entitled based on the discontinuation
of any other plan.
(f)(1) No tax, fee, or other monetary payment may be imposed,
directly or indirectly, on a carrier or an underwriting or plan
administration subcontractor of an approved health benefits plan by
any State, the District of Columbia, or the Commonwealth of Puerto
Rico, or by any political subdivision or other governmental
authority thereof, with respect to any payment made from the Fund.
(2) Paragraph (1) shall not be construed to exempt any carrier or
underwriting or plan administration subcontractor of an approved
health benefits plan 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 carrier or underwriting or plan
administration subcontractor from business conducted under this
chapter, if that tax, fee, or payment is applicable to a broad
range of business activity.
(g) The fund described in subsection (a) is available to pay
costs that the Office incurs for activities associated with
implementation of the demonstration project under section 1108 of
title 10.