,i #aafth ,,congress #ast ,session ,h4 ,r4 #ddic ,,in ,,the ,,house ,,of ,,representatives ,september #be1 #bjai,ms4 ,norton introduced the following bill2 which was referred to the ,committee on ,oversight and ,reform ,a ,,bill ,to provide a short-term disability insurance program for ,federal employees for disabilities that are not work-related1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,federal ,employee ,short-,term ,disability ,insurance ,act of #bjai4 #b4 ,purpose ,the purpose of this ,act is to offer voluntary insurance to ,federal employees for protection against the loss of pay resulting from-- 7#a7 short-term injury or disability2 7#b7 short-term leave taken for the purpose of caring for a family member2 7#c7 the birth of a child of such an employee2 or 7#d7 making arrangements to adopt a child or to become a foster parent4 #c4 ,non-work related disability insurance 7a7 ,in general ,title #e1 ,united ,states ,code1 is amended by inserting after chapter #hg the following3 #hh ,non-,work ,related ,short-,term ,disability ,insurance ,sec4 #hhja4 ,definitions4 #hhjb4 ,availability of insurance4 #hhjc4 ,contracting authority4 #hhjd4 ,benefits4 #hhje4 ,premiums4 #hhjf4 ,preemption4 #hhjg4 ,studies1 reports1 and audits4 #hhjh4 ,jurisdiction of courts4 #hhji4 ,administrative functions4 #hhaj4 ,cost accounting standards4 #hhja4 ,definitions ,for purposes of this chapter-- 7#a7 the term ,director means the ,director of the ,office of ,personnel ,management2 7#b7 the term employee means-- 7,a7 an employee defined in section #hija7a72 and 7,b7 an officer or employee of the ,united ,states ,postal ,service or of the ,postal ,regulatory ,commission2 7#c7 the term injury or disability1 with respect to an employee1 means that such employee is unable to perform the essential functions of such employee's position of employment with the ,federal ,government2 7#d7 the term member of family has the meaning given such term in section #hija7e72 7#e7 the term carrier means an insurance company that is licensed to issue disability insurance in all ,states1 taking into account any subsidiaries or affiliates of such a company2 and 7#f7 the term ,state includes the ,district of ,columbia4 #hhjb4 ,availability of insurance 7a7 ,the ,director shall establish and administer a program to make insurance coverage available under this chapter-- 7#a7 for an injury or disability not covered under chapter #ha2 7#b7 for leave to care for1 or leave to make arrangements to care for1 a member of family1 including the birth of a son or a daughter2 and 7#c7 for leave to make arrangements-- 7,a7 to become a foster parent2 or 7,b7 to adopt a child4 7b7 ,insurance shall not be available under this chapter if the injury or disability of an employee is-- 7#a7 caused by willful misconduct of such employee2 7#b7 caused by such employee's intention to bring about such injury or disability to himself or to another individual2 or 7#c7 proximately caused by the intoxication of such employee4 7c7 ,in addition to the requirements otherwise applicable under section #hhja7e71 an insurance contract under this chapter must be fully insured1 whether through reinsurance with other carriers or otherwise4 #hhjc4 ,contracting authority 7a7 ,the ,director shall1 without regard to any statute requiring competitive bidding1 contract with one or more carriers for a policy or policies of disability insurance as described under this chapter4 ,the ,director shall ensure that each resulting contract is awarded on the basis of contractor qualifications1 price1 and reasonable competition4 7b7 7#a7 ,each contract under this section shall contain-- 7,a7 a detailed statement of the benefits offered 7including any maximums1 limitations1 exclusions1 and other definitions of benefits72 7,b7 the premiums charged 7including any limitations or other conditions on their subsequent adjustment72 7,c7 the duration of the enrollment period2 and 7,d7 such other terms and conditions 7including procedures for establishing eligibility for insurance under this chapter7 as may be determined by the ,director1 consistent with the requirements of this chapter4 7#b7 ,premiums charged under a contract under this section shall reasonably and equitably reflect the cost of the benefits provided1 as determined by the ,director4 7c7 7#a7 ,each contract under this section shall require the carrier-- 7,a7 to provide payments or benefits described in section #hhjd7;c7 to an employee if such employee is entitled thereto under the terms of the contract2 and 7,b7 with respect to disputes regarding claims for payments or benefits under the terms of the contract-- 7i7 to establish internal procedures designed to resolve such disputes expeditiously2 and 7ii7 to establish1 for disputes not resolved through procedures under clause 7i71 procedures for one or more alternative means of dispute resolution involving independent third-party review under circumstances acceptable to the ,director4 7#b7 ,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 contract4 7#c7 ,nothing in this chapter shall be considered to grant authority for a third-party reviewer to change the terms of any contract under this chapter4 7d7 7#a7 ,each contract under this section shall be for a term of not less than #c years and not greater than #g years1 and may be terminated earlier than the termination date of such contract by the ,director in accordance with the terms of such contract4 ,however1 the rights and responsibilities of the enrolled employee1 the insurer1 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 contract4 7#b7 ,a contract described in paragraph 7#a7 may be made automatically renewable1 for a term of #a year each ,january #a1 unless written notice of non-renewal is given either by the ,director or the carrier not less than #ahj days before the renewal date1 or unless modified by mutual agreement4 7#c7 ,a contract described in paragraph 7#a7 shall include such provisions as may be necessary to ensure that1 once an employee becomes duly enrolled1 insurance coverage pursuant to that enrollment shall be terminated only if the individual is separated from ,federal service or1 where appropriate1 for non-payment of premiums4 #hhjd4 ,benefits 7a7 ,the ,director may prescribe reasonable minimum standards for benefit plans offered under this chapter4 7b7 7#a7 ,benefits provided to an employee under this chapter shall offset other benefits received by such employee for the same injury or disability1 leave to care for or make arrangements to care for a member of family 7including the birth of a son or a daughter71 or leave to make arrangements to adopt a child or become a foster parent including worker's compensation and disability retirement income4 7#b7 ,a contract providing benefits under this chapter-- 7,a7 shall not provide for a preexisting condition exclusion2 and 7,b7 shall not charge higher premiums1 deny coverage1 or drop coverage of an employee with a preexisting condition4 7#c7 ,a contract providing benefits under this chapter shall provide incentives for an employee who is receiving benefits under such contract to return to work4 7c7 7#a7 ,for each instance that such employee suffers an injury or disability1 takes leave to care for or make arrangements to care for a member of family 7including the birth of a son or a daughter71 or takes leave to make arrangements to adopt a child or become a foster parent1 and is eligible for benefits under this chapter1 such employee may receive benefits under this chapter for a period not to exceed #ab months beginning on the date on which such employee qualifies for such benefits4 ,an employee shall receive such benefits after the expiration of the waiting period selected by such employee under paragraph 7#b77;,a74 ,the amount of benefits shall be equal to the lesser of-- 7,a7 #gj percent of the annual rate of pay1 excluding bonuses1 of an employee at the time of the injury or disability of such employee occurs2 or 7,b7 #gj percent of the maximum rate of basic pay provided for grade ,,gs-#ae of the ,general ,schedule4 7#b7 7,a7 ,the period for which benefits are payable to an employee under this subsection shall begin after the completion of a waiting period1 subject to the requirement in subparagraph 7,c74 ,an employee shall elect one of the following waiting period options3 7i7 ,on the #hth day of continuous injury or disability1 leave to care for or to make arrangements to care for a member of family 7including the birth of a son or a daughter71 or leave to make arrangements to adopt a child or become a foster parent4 7ii7 ,on the #cast day of continuous disability1 leave to care for or to make arrangements to care for a member of family 7including the birth of a son or a daughter71 or leave to make arrangements to adopt a child or become a foster parent4 7iii7 ,on the #iast day of continuous disability1 leave to care for or to make arrangements to care for a member of family 7including the birth of a son or a daughter71 or leave to make arrangements to adopt a child or become a foster parent4 7iv7 ,on the #ahast day of continuous disability1 leave to care for or to make arrangements to care for a member of family 7including the birth of a son or a daughter71 or leave to make arrangements to adopt a child or become a foster parent4 7,b7 ,an employee who elects to receive benefits earlier shall pay a higher premium4 7,c7 ,a waiting period selected under subparagraph 7,a7 shall begin on the first day of an employee's injury or disability4 #hhje4 ,premiums 7a7 ,each eligible individual obtaining insurance coverage under this chapter shall be responsible for #ajj percent of the premiums for such coverage4 7b7 ,the amount necessary to pay the premiums for enrollment shall be withheld from the pay of the enrolled individual4 7c7 ,the carrier participating under this chapter shall maintain records that permit it to account for all amounts received under this chapter 7including investment earnings on those amounts7 separate and apart from all other funds4 7d7 7#a7 7,a7 ,the ,employees' ,life ,insurance ,fund is available1 without fiscal year limitation1 for reasonable expenses incurred in administering this chapter before the start of the first term described in section #hhjc7;d77#a71 including reasonable implementation costs4 7,b7 ,such ,fund shall be reimbursed1 before the end of the first year of a contract described in section #hhjc7;d77#a71 for all amounts obligated or expended under subparagraph 7,a7 7including lost investment income74 ,reimbursement under this subparagraph shall be made by the carrier in accordance with applicable provisions included in the relevant contract4 7,c7 7i7 ,there is hereby established in the ,employees' ,life ,insurance ,fund a ,non-,work ,related ,disability ,insurance ,administrative ,account1 which shall be available to the ,office of ,personnel ,management1 without fiscal year limitation1 to defray reasonable expenses incurred by the ,office in administering this chapter after the start of the first term described in section #hhjc7;d77#a74 7ii7 ,a contract under this chapter shall include appropriate provisions under which the carrier involved shall1 during each year1 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 7adjusted to reconcile for any earlier overestimates or underestimates under this subparagraph7 are defrayed4 7e7 ,nothing in this chapter shall1 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 enroll1 preclude the application of underwriting standards for later enrollment4 #hhjf4 ,preemption 7a7 ,the terms of any contract under this chapter which relate to the nature1 provision1 or extent of coverage or benefits 7including payments with respect to benefits7 shall supersede and preempt any ,state1 territorial1 tribal1 or local law1 or any regulation issued thereunder1 which relates to non-work related disability insurance or contracts4 7b7 7#a7 ,no tax1 fee1 or other monetary payment may be imposed or collected1 directly or indirectly1 by any ,state1 territory1 tribe1 or locality1 or by any political subdivision or other governmental authority thereof1 on1 or with respect to1 any premium paid for an insurance policy under this chapter4 7#b7 ,paragraph 7#a7 shall not be construed to exempt any company or other entity issuing a policy of insurance under this chapter from the imposition1 payment1 or collection of a tax1 fee1 or other monetary payment on the net income or profit accruing to or realized by such entity from business conducted under this chapter1 if that tax1 fee1 or payment is applicable to a broad range of business activity4 7c7 ,no law of a ,state1 territory1 tribe1 or locality1 pertaining to subrogation or reimbursement with respect to benefits provided under this chapter1 shall operate except as expressly adopted by the ,director4 #hhjg4 ,studies1 reports1 and audits 7a7 ,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 chapter4 7b7 ,each ,federal agency shall keep such records1 make such certifications1 and furnish the ,director1 the carrier1 or both1 with such information and reports as the ,director may require4 7c7 ,the ,director shall conduct periodic reviews of each plan under this chapter to ensure its competitiveness4 #hhjh4 ,jurisdiction of courts ,the district courts of the ,united ,states have original jurisdiction1 concurrent with the ,united ,states ,court of ,federal ,claims1 of a civil action or claim against the ,united ,states under this chapter after such administrative remedies as required under section #hhjc7;c7 have been exhausted1 but only to the extent judicial review is not precluded by any dispute resolution or other remedy under this chapter4 #hhji4 ,administrative functions 7a7 7#a7 ,except as otherwise provided in this chapter1 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 program4 7#b7 ,except as otherwise provided by law1 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 pay1 retention purposes1 and other rights1 benefits1 and conditions of employment for which length of service is a factor4 7b7 ,the carrier shall provide for periodic coordinated enrollment1 promotion1 and education efforts1 as specified by the ,director4 #hhaj4 ,cost accounting standards ,the cost accounting standards issued pursuant to section #aejb of title #da shall not apply with respect to an insurance contract under this chapter4 4 7b7 ,conforming amendment ,section #ajje7;f7 of title #ci1 ,united ,states ,code1 is amended by inserting #hh1 after #hg14 7c7 ,clerical amendment ,the analysis for part ,,iii of title #e1 ,united ,states ,code1 is amended by adding at the end of subpart ,g the following3 #hh4,non-,work ,related ,short-,term ,disability ,insurance#hhja 4 7d7 ,date of application ,the amendment made by subsection 7a7 shall apply to contracts that take effect with respect to the first calender year that begins more than #ah months after the date of enactment of this section4