PRIA, Government Policy, Made Personal

Summary

People who get supplemental dental coverage must pay 100 percent of the premium. The Office will make simple rules about how and when people must pay. Premiums can be taken out of pay for employees, taken from annuities for annuitants, taken from pay or annuity for certain TRICARE-eligible individuals who get federal pay or survivor annuity (and are not former spouses), or billed directly to other TRICARE-eligible people. Any amounts taken out must be sent straight to the qualified company, and each qualified company must keep the accounting records the Office asks for. Money in the Employees Health Benefits Fund can be used, without fiscal year limits, to pay reasonable Office costs before the first contract period starts. A Dental Benefits Administrative Account is set up inside that Fund to pay reasonable Office costs after the first contract year begins. Contracts must make qualified companies put regular yearly contributions into that Account to cover the Office’s expected expenses.

Title 5, §8958

Government Organization and Employees, Source: USLM XML via OLRC

(a)Each eligible individual obtaining supplemental dental coverage under this chapter shall be responsible for 100 percent of the premiums for such coverage.

(b)The Office shall prescribe regulations specifying the terms and conditions under which individuals are required to pay the premiums for enrollment.

(c)The amount necessary to pay the premiums for enrollment may—

(1)in the case of an employee, be withheld from the pay of such an employee;

(2)in the case of an annuitant, be withheld from the annuity of such an annuitant;

(3)in the case of a covered TRICARE-eligible individual who receives pay from the Federal Government or an annuity from the Federal Government due to the death of a member of the uniformed services (as defined in section 101 of title 10), and is not a former spouse of a member of the uniformed services, be withheld from—

(A)the pay (including retired pay) of such individual; or

(B)the annuity paid to such individual; or

(4)in the case of a covered TRICARE-eligible individual who is not described in paragraph (3), be billed to such individual directly.

(d)All amounts withheld under this section shall be paid directly to the qualified company.

(e)Each participating qualified company shall maintain accounting records that contain such information and reports as the Office may require.

(f)(1)The Employee Health Benefits Fund is available, without fiscal year limitation, for reasonable expenses incurred by the Office in administering this chapter before the first day of the first contract period, including reasonable implementation costs.

(2)(A)There is established in the Employees Health Benefits Fund a Dental Benefits Administrative Account, which shall be available to the Office, without fiscal year limitation, to defray reasonable expenses incurred by the Office in administering this chapter after the start of the first contract year.

(B)A contract under this chapter shall include appropriate provisions under which the qualified company involved shall, during each year, make such periodic contributions to the Dental Benefits Administrative Account as necessary to ensure that the reasonable anticipated expenses of the Office in administering this chapter during such year are defrayed.

Notes & Related Subsidiaries

Editorial Notes

Amendments

2016—Subsec. (c)(3), (4). Pub. L. 114–328 added pars. (3) and (4).

Statutory Notes and Related Subsidiaries

Effective Date

of 2016 AmendmentAmendment by Pub. L. 114–328 applicable with respect to the first contract year for chapter 89A or 89B of this title, as applicable, that begins on or after Jan. 1, 2018, see section 715(c) of Pub. L. 114–328, set out as a note under section 8951 of this title.

Effective Date

Section effective Dec. 23, 2004, and applicable to contracts that take effect with respect to the calendar year 2006, see section 7 of Pub. L. 108–496, set out as a note under section 8951 of this title.

§8958 Premiums

Summary

Title 5, §8958

Notes & Related Subsidiaries

Editorial Notes

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Citations & Metadata