United States Code (Last Updated: May 24, 2014) |
Title 5. GOVERNMENT ORGANIZATION AND EMPLOYEES |
Part III. EMPLOYEES |
SubPart G. Insurance and Annuities |
Chapter 89. HEALTH INSURANCE |
§ 8901. Definitions
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For the purpose of this chapter— (1) “employee” means— (A) an employee as defined by section 2105 of this title; (B) a Member of Congress as defined by section 2106 of this title; (C) a Congressional employee as defined by section 2107 of this title; (D) the President; (E) an individual first employed by the government of the District of Columbia before October 1, 1987 ;(F) an individual employed by Gallaudet College; (G) an individual employed by a county committee established under section 590h(b) of title 16; (H) an individual appointed to a position on the office staff of a former President under section 1(b) of the Act of August 25, 1958 (72 Stat. 838); (I) an individual appointed to a position on the office staff of a former President, or a former Vice President under section 4 of the Presidential Transition Act of 1963, as amended (78 Stat. 153), who immediately before the date of such appointment was an employee as defined under any other subparagraph of this paragraph; and (J) an individual who is employed by the Roosevelt Campobello International Park Commission and is a citizen of the United States, but does not include— (i) an employee of a corporation supervised by the Farm Credit Administration if private interests elect or appoint a member of the board of directors; (ii) an individual who is not a citizen or national of the United States and whose permanent duty station is outside the United States, unless the individual was an employee for the purpose of this chapter on September 30, 1979 , by reason of service in an Executive agency, the United States Postal Service, or the Smithsonian Institution in the area which was then known as the Canal Zone;(iii) an employee of the Tennessee Valley Authority; or (iv) an employee excluded by regulation of the Office of Personnel Management under section 8913(b) of this title; (2) “Government” means the Government of the United States and the government of the District of Columbia; (3) “annuitant” means— (A) an employee who retires— (i) on an immediate annuity under subchapter III of chapter 83 of this title, or another retirement system for employees of the Government, after 5 or more years of service; (ii) under section 8412 or 8414 of this title; (iii) for disability under subchapter III of chapter 83 of this title, chapter 84 of this title, or another retirement system for employees of the Government; or (iv) on an immediate annuity under a retirement system established for employees described in section 2105(c), in the case of an individual who elected under section 8347(q)(2) or 8461(n)(2) to remain subject to such a system; (B) a member of a family who receives an immediate annuity as the survivor of an employee (including a family member entitled to an amount under section 8442(b)(1)(A), whether or not such family member is entitled to an annuity under section 8442(b)(1)(B)) or of a retired employee described by subparagraph (A) of this paragraph; (C) an employee who receives monthly compensation under subchapter I of chapter 81 of this title and who is determined by the Secretary of Labor to be unable to return to duty; and (D) a member of a family who receives monthly compensation under subchapter I of chapter 81 of this title as the surviving beneficiary of— (i) an employee who dies as a result of injury or illness compensable under that subchapter; or (ii) a former employee who is separated after having completed 5 or more years of service and who dies while receiving monthly compensation under that subchapter and who has been held by the Secretary to have been unable to return to duty; (4) “service”, as used by paragraph (3) of this section, means service which is creditable under subchapter III of chapter 83 or chapter 84 of this title; (5) “member of family” means the spouse of an employee or annuitant and an unmarried dependent child under 22 years of age, including— (A) an adopted child or recognized natural child; and (B) a stepchild or foster child but only if the child lives with the employee or annuitant in a regular parent-child relationship; or such an unmarried dependent child regardless of age who is incapable of self-support because of mental or physical disability which existed before age 22; (6) “health benefits plan” means a group insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar group arrangement provided by a carrier for the purpose of providing, paying for, or reimbursing expenses for health services; (7) “carrier” means a voluntary association, corporation, partnership, or other nongovernmental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of, health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or underwritten by an employee organization and an association of organizations or other entities described in this paragraph sponsoring a health benefits plan; (8) “employee organization” means— (A) an association or other organization of employees which is national in scope, or in which membership is open to all employees of a Government agency who are eligible to enroll in a health benefits plan under this chapter and which, after December 31, 1978 , and beforeJanuary 1, 1980 , applied to the Office for approval of a plan provided under section 8903(3) of this title; and(B) an association or other organization which is national in scope, in which membership is open only to employees, annuitants, or former spouses, or any combination thereof, and which, during the 90-day period beginning on the date of enactment of section 8903a of this title, applied to the Office for approval of a plan provided under such section; (9) “dependent”, in the case of any child, means that the employee or annuitant involved is either living with or contributing to the support of such child, as determined in accordance with such regulations as the Office shall prescribe; (10) “former spouse” means a former spouse of an employee, former employee, or annuitant— (A) who has not remarried before age 55 after the marriage to the employee, former employee, or annuitant was dissolved, (B) who was enrolled in an approved health benefits plan under this chapter as a family member at any time during the 18-month period before the date of the dissolution of the marriage to the employee, former employee, or annuitant, and (C) (i) who is receiving any portion of an annuity under section 8345(j) or 8467 of this title or a survivor annuity under section 8341(h) or 8445 of this title (or benefits similar to either of the aforementioned annuity benefits under a retirement system for Government employees other than the Civil Service Retirement System or the Federal Employees’ Retirement System), (ii) as to whom a court order or decree referred to in section 8341(h), 8345(j), 8445, or 8467 of this title (or similar provision of law under any such retirement system other than the Civil Service Retirement System or the Federal Employees’ Retirement System) has been issued, or for whom an election has been made under section 8339(j)(3) or 8417(b) of this title (or similar provision of law), or (iii) who is otherwise entitled to an annuity or any portion of an annuity as a former spouse under a retirement system for Government employees, except that such term shall not include any such unremarried former spouse of a former employee whose marriage was dissolved after the former employee’s separation from the service (other than by retirement); and (11) “qualified clinical social worker” means an individual— (A) who is licensed or certified as a clinical social worker by the State in which such individual practices; or (B) who, if such State does not provide for the licensing or certification of clinical social workers— (i) is certified by a national professional organization offering certification of clinical social workers; or (ii) meets equivalent requirements (as prescribed by the Office).
Historical And Revision
Historical and Revision Notes | ||
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1966 Act | ||
Derivation | U.S. Code | Revised Statutes and Statutes at Large |
| Sept. 28, 1959, Pub. L. 86–382, § 2, 73 Stat. 709. July 8, 1963, Pub. L. 88–59, § 1, 77 Stat. 76. | |
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| Mar. 17, 1964, Pub. L. 88–284, § 1(1)–(4), 78 Stat. 164. |
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| Aug. 31, 1964, Pub. L. 88–531, § 1, 78 Stat. 737. |
| 5 U.S.C. 3002(f) (1st sentence, less words between 1st and 2d commas). | July 1, 1960, Pub. L. 86–568, § 115(d) “(f) (1st sentence, less words between 1st and 2d commas)”, 74 Stat. 303. |
The definition of “employee” in section 2105 of this title is broad enough to cover the officers and employees covered by former section 3001 with the exception of a Member of Congress, the President, an individual employed by the government of the District of Columbia, an individual employed by Gallaudet College, a United States commissioner, and an Official Reporter of Debates of the Senate and an individual employed by him. The first five have been added in paragraphs (1)(B), (D), (E), (F), and (G). The latter are covered by the definition of “Congressional employee” in section 2107 of this title and are included by the addition of a Congressional employee in paragraph (1)(C).
In paragraph (1)(ii), the words “the United States” are substituted for “a State of the United States or the District of Columbia”.
Paragraph (1)(iv) is added for clarity.
In paragraph (8), the words “before
The definition of “Commission” in former section 3001(h) is omitted as unnecessary as the full title “Civil Service Commission” is set forth the first time it is used in a section.
Standard changes are made to conform with the definitions applicable and the style of this title as outlined in the preface to the report.
1967 Act | ||
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Section of title 5 | Source (U.S. Code) | Source (Statutes at Large) |
8901(5) | 5 App.: 3001(d). | July 18, 1966, Pub. L. 89–504, § 601, 80 Stat. 303. |
References In Text
Section 1(b) of the Act of August 25, 1958 (72 Stat. 838), referred to in par. (1)(H), is section 1(b) of Pub. L. 85–745 which is set out as a note under section 102 of Title 3, The President.
Section 4 of the Presidential Transition Act of 1963, referred to in par. (1)(I), is section 4 of Pub. L. 88–277, which is set out as a note under section 102 of Title 3.
The date of enactment of section 8903a of this title, referred to in par. (8)(B), means the date of enactment of Pub. L. 99–53, which enacted section 8903a and which was approved
Amendments
2007—Par. (1)(J). Pub. L. 110–74 added subpar. (J).
1998—Par. (7). Pub. L. 105–266 substituted “organization and an association of organizations or other entities described in this paragraph sponsoring a health benefits plan;” for “organization;”.
1992—Par. (3)(A)(iv). Pub. L. 102–378, § 2(75)(A), substituted “8347(q)(2)” for “8347(p)(2)”.
Par. (10)(C)(ii). Pub. L. 102–378, § 2(75)(B), inserted comma after “8341(h)”.
1990—Par. (3)(A)(iv). Pub. L. 101–508 added cl. (iv).
1988—Par. (1)(H), (I). Pub. L. 100–679 added subpars. (H) and (I).
1986—Par. (1)(E). Pub. L. 99–335, § 207(l)(1), amended subpar. (E) generally, substituting “first employed” for “employed” and inserting “before
Par. (3)(A). Pub. L. 99–335, § 207(l)(2), amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: “an employee who retires on an immediate annuity under subchapter III of chapter 83 of this title or another retirement system for employees of the Government, after 5 or more years of service or for disability”.
Par. (3)(B). Pub. L. 99–556 inserted “(including a family member entitled to an amount under section 8442(b)(1)(A), whether or not such family member is entitled to an annuity under section 8442(b)(1)(B))”.
Par. (4). Pub. L. 99–335, § 207(l)(3), inserted “or chapter 84”.
Par. (10)(C)(i). Pub. L. 99–335, § 207(l)(4), inserted “or 8467”, “or 8445”, and “or the Federal Employees’ Retirement System”.
Par. (10)(C)(ii). Pub. L. 99–335, § 207(l)(5), substituted “8345(j), 8445, or 8467” for “or 8345(j)” and inserted “or the Federal Employees’ Retirement System” and “or 8417(b)”.
Par. (11). Pub. L. 99–251 added par. (11).
1985—Par. (8). Pub. L. 99–53 amended par. (8) generally, designating existing provisions as subpar. (A) and adding subpar. (B).
1984—Par. (10). Pub. L. 98–615 added par. (10).
1980—Par. (5). Pub. L. 96–179, § 2(1), inserted “dependent” after “unmarried” in provisions preceding subpar. (A) and in provisions following subpar. (B), inserted “or recognized natural child” after “child” in subpar. (A), and substituted “or foster child but only if the child;” for “, foster child, or recognized natural child who” in subpar. (B).
Par. (9). Pub. L. 96–179, § 2(2)–(4), added par. (9).
1979—Par. (1). Pub. L. 96–70 in cl. (ii) substituted provisions relating to an individual who was an employee for the purpose of this chapter on
Pub. L. 96–54 struck out cl. (G) which related to coverage of a United States Commissioner as an “employee”, and redesignated cl. (H) as (G).
1978—Par. (1)(iv). Pub. L. 95–454 substituted “Office of Personnel Management” for “Civil Service Commission”.
Par. (3)(A). Pub. L. 95–583 reduced period of service to 5 from 12 years.
Par. (8). Pub. L. 95–454 substituted “Office” for “Commission”.
Pub. L. 95–368 substituted “after
1973—Par. (1)(ii). Pub. L. 93–160 excluded from definition of “employee” persons who are not nationals of United States and whose permanent duty station is outside United States and Panama Canal Zone.
1970—Par. (1)(ii). Pub. L. 91–418, § 3(b), excluded from definition of “employee” a noncitizen employee whose permanent duty station is outside Panama Canal Zone.
Par. (3)(B). Pub. L. 91–418, § 2(a), redefined “annuitant” to be a member of a family who receives an immediate annuity as the survivor of an employee rather than as the survivor of an employee who dies after completing 5 or more years of service.
Par. (3)(D)(i). Pub. L. 91–418, § 2(b), redefined “annuitant” to be a member of a family who receives monthly compensation as the surviving beneficiary of an employee who dies as a result of a compensable injury or illness rather than as the survivor of an employee who, having completed 5 or more years of service, so dies.
Change Of Name
Gallaudet College, referred to in par. (1)(F), was redesignated Gallaudet University by section 101(a) of Pub. L. 99–371, which is classified to section 4301(a) of Title 20, Education.
Effective Date Of Amendment
Amendment by section 2(75)(A) of Pub. L. 102–378 effective
Amendment by Pub. L. 101–508 applicable with respect to any individual who, on or after
Amendment by Pub. L. 99–335 effective
Pub. L. 99–251, title I, § 105(c),
Amendment by Pub. L. 98–615 effective
Amendment by Pub. L. 96–179 effective
Amendment by Pub. L. 96–70 effective
Amendment by Pub. L. 96–54 effective
Amendment by Pub. L. 95–583 effective
Amendment by Pub. L. 95–454 effective 90 days after
Short Title Of Amendment
Pub. L. 106–394, § 1,
Pub. L. 105–266, § 1,
Pub. L. 100–654, § 1,
Pub. L. 99–251, § 1,
Miscellaneous
Pub. L. 107–304, § 4,
Pub. L. 105–266, § 4,
Pub. L. 104–37, title VI, § 601,
Pub. L. 103–409, § 5,
For provisions relating to treatment of certain Federal employees of Saint Elizabeths Hospital under certain Federal employee benefit programs, see section 207(o) of Pub. L. 99–335, set out as a note under section 8331 of this title.