United States Code
USC most recently checked for updates: Jan 29, 2023
The Office shall contract with a reasonable number of qualified companies for a policy or policies of benefits described under section 8954 without regard to section 6101(b) to (d) of title 41 or any other statute requiring competitive bidding. An employee organization may contract with a qualified company for the purpose of participating with that qualified company in any contract between the Office and that qualified company.
The Office shall ensure that each resulting contract is awarded on the basis of contractor qualifications, price, and reasonable competition.
Each contract under this section shall contain—
the requirements under section 8902(d), (f), and (i) made applicable to contracts under this section by regulations prescribed by the Office;
the terms of the enrollment period; and
such other terms and conditions as may be mutually agreed to by the Office and the qualified company involved, consistent with the requirements of this chapter and regulations prescribed by the Office.
Nothing in this chapter shall, in the case of an individual electing dental supplemental benefit coverage under this chapter after the expiration of such individual’s first opportunity to enroll, preclude the application of waiting periods more stringent than those that would have applied if that opportunity had not yet expired.
Each contract under this chapter shall require the qualified company to agree—
to provide payments or benefits to an eligible individual if such individual is entitled thereto under the terms of the contract; and
with respect to disputes regarding claims for payments or benefits under the terms of the contract—
to establish internal procedures designed to expeditiously resolve such disputes; and
to establish, for disputes not resolved through procedures under clause (i), procedures for 1 or more alternative means of dispute resolution involving independent third-party review under appropriate circumstances by entities mutually acceptable to the Office and the qualified company.
A determination by a qualified company as to whether or not a particular individual is eligible to obtain coverage under this chapter shall be subject to review only to the extent and in the manner provided in the applicable contract.
For purposes of applying the Contract Disputes Act of 1978 1
to disputes arising under this chapter between a qualified company and the Office—
1See References in Text note below.
the agency board having jurisdiction to decide an appeal relative to such a dispute shall be such board of contract appeals as the Director of the Office of Personnel Management shall specify in writing (after appropriate arrangements, as described in section 8(c) 1 of such Act); and
the district courts of the United States shall have original jurisdiction, concurrent with the United States Court of Federal Claims, of any action described in section 10(a)(1) 1 of such Act relative to such a dispute.
Nothing in this section shall be considered to grant authority for the Office or third-party reviewer to change the terms of any contract under this chapter.
Contracts under this chapter shall be for a uniform term of 7 years and may not be renewed automatically.
cite as: 5 USC 8953