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; 1
(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 (
(I) an individual appointed to a position on the office staff of a former President, or a former Vice President under section 5 of the Presidential Transition Act of 1963, as amended (
(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 before January 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).
(
| Derivation | U.S. Code | Revised Statutes and Statutes at Large |
|---|---|---|
| 5 U.S.C. 3001. | Sept. 28, 1959,
July 8, 1963,
|
|
| Mar. 17, 1964,
|
||
| Aug. 31, 1964,
|
||
| 5 U.S.C. 3002(f) (1st sentence, less words between 1st and 2d commas). | July 1, 1960,
|
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 January 1, 1964" are substituted for "on or before December 31, 1963".
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.
| Section of title 5 | Source (U.S. Code) | Source (Statutes at Large) |
|---|---|---|
| 8901(5) | 5 App.: 3001(d). | July 18, 1966,
|
Section 1(b) of the Act of August 25, 1958 (
Section 5 of the Presidential Transition Act of 1963, referred to in par. (1)(I), is section 5 of
The date of enactment of section 8903a of this title, referred to in par. (8)(B), means the date of enactment of
2016-Par. (1)(I).
2007-Par. (1)(J).
1998-Par. (7).
1992-Par. (3)(A)(iv).
Par. (10)(C)(ii).
1990-Par. (3)(A)(iv).
1988-Par. (1)(H), (I).
1986-Par. (1)(E).
Par. (3)(A).
Par. (3)(B).
Par. (4).
Par. (10)(C)(i).
Par. (10)(C)(ii).
Par. (11).
1985-Par. (8).
1984-Par. (10).
1980-Par. (5).
Par. (9).
1979-Par. (1).
1978-Par. (1)(iv).
Par. (3)(A).
Par. (8).
1973-Par. (1)(ii).
1970-Par. (1)(ii).
Par. (3)(B).
Par. (3)(D)(i).
Gallaudet College, referred to in par. (1)(F), was redesignated Gallaudet University by section 101(a) of
Amendment by section 2(75)(A) of
Amendment by
Amendment by
Amendment by
Amendment by
Amendment by
Amendment by
Amendment by
Amendment by
"(a)
"(b)
"(1)
"(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and
"(B) for coverage effective on and after such date.
"(2)
"(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been permitted under the plan administered by the Overseas Private Investment Corporation; and
"(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a of such title for coverage effective on and after such date.
"(3)
"(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had ceased to meet the requirements for being considered an unmarried dependent child under chapter 89 of such title as of such date; and
"(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage effective on and after such date.
"(c)
"(1)
"(2)
"(d)
"(1) shall administer this section to provide for-
"(A) a period of notice and open enrollment for individuals affected by this section; and
"(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and
"(2) may prescribe regulations to implement this section.
"(e)
"(a)
"(1) in a health benefits plan administered by the Federal Deposit Insurance Corporation before the termination of such plan on or before January 2, 1999; or
"(2) subject to subsection (c), in a health benefits plan (not under chapter 89 of such title) with respect to which the eligibility of any employees or retired employees of the Board of Governors of the Federal Reserve System terminates on or before January 2, 1999,
shall be deemed to be a period of enrollment in a health benefits plan under chapter 89 of such title.
"(b)
"(A) meets the requirements of such chapter for eligibility to become so enrolled as an employee, annuitant, or former spouse (within the meaning of such chapter); or
"(B) would meet those requirements if, to the extent such requirements involve either retirement system under such title 5, such individual satisfies similar requirements or provisions of the Retirement Plan for Employees of the Federal Reserve System.
Any determination under subparagraph (B) shall be made under guidelines which the Office of Personnel Management shall establish in consultation with the Board of Governors of the Federal Reserve System.
"(2) Subject to subsection (c), any individual who, on or before January 2, 1999, is entitled to continued coverage under a health benefits plan described in subsection (a)(1) or (2) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, but only for the same remaining period as would have been allowable under the health benefits plan in which such individual was enrolled on or before January 2, 1999, if-
"(A) such individual had remained enrolled in such plan; and
"(B) such plan did not terminate, or the eligibility of such individual with respect to such plan did not terminate, as described in subsection (a).
"(3) Subject to subsection (c), any individual (other than an individual under paragraph (2)) who, on or before January 2, 1999, is covered under a health benefits plan described in subsection (a)(1) or (2) as an unmarried dependent child, but who does not then qualify for coverage under chapter 89 of title 5, United States Code, as a family member (within the meaning of such chapter) shall be deemed to be entitled to continued coverage under section 8905a of such title, to the same extent and in the same manner as if such individual had, on or before January 2, 1999, ceased to meet the requirements for being considered an unmarried dependent child of an enrollee under such chapter.
"(4) Coverage under chapter 89 of title 5, United States Code, pursuant to an enrollment under this section shall become effective on January 3, 1999 or such earlier date as established by the Office of Personnel Management after consultation with the Federal Deposit Insurance Corporation or the Board of Governors of the Federal Reserve System, as appropriate.
"(c)
"(d)
"(e)
"(1) shall administer the provisions of this section to provide for-
"(A) a period of notice and open enrollment for individuals affected by this section; and
"(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and
"(2) may prescribe regulations to implement this section."
"(a) For purposes of the administration of chapter 89 of title 5, United States Code, any period of enrollment under a health benefits plan administered by the Farm Credit Administration prior to the effective date of this Act [Oct. 21, 1995] shall be deemed to be a period of enrollment in a health benefits plan under chapter 89 of such title.
"(b)(1) An individual who, on September 30, 1995, is covered by a health benefits plan administered by the Farm Credit Administration may enroll in an approved health benefits plan described under section 8903 or 8903a of title 5, United States Code-
"(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and
"(B) for coverage effective on and after September 30, 1995.
"(2) An individual who, on September 30, 1995, is entitled to continued coverage under a health benefits plan administered by the Farm Credit Administration-
"(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been permitted under the plan administered by the Farm Credit Administration; and
"(B) may enroll in an approved health benefits plan described under sections 8903 or 8903a of such title in accordance with section 8905A of such title for coverage effective on and after September 30, 1995.
"(3) An individual who, on September 30, 1995, is covered as an unmarried dependent child under a health benefits plan administered by the Farm Credit Administration and who is not a member of family as defined under section 8901(5) of title 5, United States Code-
"(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had, on September 30, 1995, ceased to meet the requirements for being considered an unmarried dependent child under chapter 89 of such title; and
"(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage on and after September 30, 1995.
"(c) The Farm Credit Administration shall transfer to the Federal Employees Health Benefits Fund established under section 8909 of title 5, United States Code, amounts determined by the Director of the Office of Personnel Management, after consultation with the Farm Credit Administration, to be necessary to reimburse the Fund for the cost of providing benefits under this section not otherwise paid for by the individuals covered by this section. The amount so transferred shall be held in the Fund and used by the Office in addition to the amounts available under section 8906(g)(1) of such title.
"(d) The Office of Personnel Management-
"(1) shall administer the provisions of this section to provide for-
"(A) a period of notice and open enrollment for individuals affected by this section; and
"(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and
"(2) may prescribe regulations to implement this section."
"(a)
"(b)
"(A) either as an individual or for self and family, if such individual is an employee, annuitant, or former spouse as defined under section 8901 of such title; and
"(B) for coverage effective on and after January 8, 1995.
"(2) An individual who, on January 7, 1995, is entitled to continued coverage under a health benefits plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision-
"(A) shall be deemed to be entitled to continued coverage under section 8905a of title 5, United States Code, for the same period that would have been permitted under the plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision; and
"(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a of such title for coverage effective on and after January 8, 1995.
"(3) An individual who, on January 7, 1995, is covered as an unmarried dependent child under a health benefits plan administered by the Office of the Comptroller of the Currency or the Office of Thrift Supervision and who is not a member of family as defined under section 8901(5) of title 5, United States Code-
"(A) shall be deemed to be entitled to continued coverage under section 8905a of such title as though the individual had, on January 7, 1995, ceased to meet the requirements for being considered an unmarried dependent child under chapter 89 of such title; and
"(B) may enroll in an approved health benefits plan described under section 8903 or 8903a of such title in accordance with section 8905a for continued coverage effective on and after January 8, 1995.
"(c)
"(d)
"(1) shall administer the provisions of this section to provide for-
"(A) a period of notice and open enrollment for individuals affected by this section; and
"(B) no lapse of health coverage for individuals who enroll in a health benefits plan under chapter 89 of title 5, United States Code, in accordance with this section; and
"(2) may prescribe regulations to implement this section."
For provisions relating to treatment of certain Federal employees of Saint Elizabeths Hospital under certain Federal employee benefit programs, see section 207(o) of
1 See Change of Name note below.