---
kind: "section"
citation: "5 U.S.C. § 9004"
title: "5"
title_heading: "Government Organization and Employees"
number: "9004"
heading: "Financing"
release: "119-102"
url: "https://uscodex.org/usc/5/9004"
units:
  - "Part III — Employees"
  - "Subpart G — Insurance and Annuities"
  - "Chapter 90 — Long-Term Care Insurance"
---

# §9004. Financing

- (a) **In General.—** Each [eligible individual](/usc/5/9001.md?p=6) obtaining long-term care insurance coverage under this chapter shall be responsible for 100 percent of the premiums for such coverage.
- (b) **Withholdings.—**
  - (1) **In general.—** The amount necessary to pay the premiums for enrollment may—
    - (A) in the case of an [employee](/usc/5/9001.md?p=1), be withheld from the pay of such [employee](/usc/5/9001.md?p=1);
    - (B) in the case of an [annuitant](/usc/5/9001.md?p=2), be withheld from the annuity of such [annuitant](/usc/5/9001.md?p=2);
    - (C) in the case of a [member of the uniformed services](/usc/5/9001.md?p=3) described in [section 9001(3)](/usc/5/9001.md?p=3), be withheld from the pay of such [member](/usc/5/5531.md?p=1); and
    - (D) in the case of a [retired member of the uniformed services](/usc/5/9001.md?p=4) described in [section 9001(4)](/usc/5/9001.md?p=4), be withheld from the retired pay or retainer pay payable to such [member](/usc/5/5531.md?p=1).
  - (2) **Voluntary withholdings for qualified relatives.—** Withholdings to pay the premiums for enrollment of a [qualified relative](/usc/5/9001.md?p=5) may, upon election of the appropriate [eligible individual](/usc/5/9001.md?p=6) (described in [section 9001(1)–(4)](/usc/5/9001.md?p=1..4)), be withheld under [paragraph (1)](#b-1) to the same extent and in the same manner as if enrollment were for such individual.
- (c) **Direct Payments.—** All amounts withheld under this section shall be paid directly to the carrier.
- (d) **Other Forms of Payment.—** Any enrollee who does not elect to have premiums withheld under [subsection (b)](#b) or whose pay, annuity, or [retired or retainer pay](/usc/5/5531.md?p=3) (as referred to in [subsection (b)(1)](#b-1)) is insufficient to cover the withholding required for enrollment (or who is not receiving any regular amounts from the Government, as referred to in [subsection (b)(1)](#b-1), from which any such withholdings may be made, and whose premiums are not otherwise being provided for under [subsection (b)(2)](#b-2)) shall pay an amount equal to the full amount of those charges directly to the carrier.
- (e) **Separate Accounting Requirement.—** Each carrier participating under this chapter shall maintain records that permit it to [account](/usc/5/8401.md?p=1) for all amounts received under this chapter (including investment earnings on those amounts) separate and apart from all other funds.
- (f) **Reimbursements.—**
  - (1) **Reasonable initial costs.—**
    - (A) **In general.—** The [Employees](/usc/5/9001.md?p=1)’ Life Insurance Fund is available, without fiscal year limitation, for reasonable expenses incurred by the Office of Personnel Management in administering this chapter before the start of the 7-year period described in [section 9003(d)(2)(B)](/usc/5/9003.md?p=d-2-B), including reasonable implementation costs.
    - (B) **Reimbursement requirement.—** Such Fund shall be reimbursed, before the end of the first year of that 7-year period, for all amounts obligated or expended under [subparagraph (A)](#f-1-A) (including lost investment income). Such reimbursement shall be made by carriers, on a pro rata basis, in accordance with appropriate provisions which shall be included in master contracts under this chapter.
  - (2) **Subsequent costs.—**
    - (A) **In general.—** There is hereby established in the [Employees](/usc/5/9001.md?p=1)’ Life Insurance Fund a Long-Term Care Administrative [Account](/usc/5/8401.md?p=1), 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 7-year period described in [section 9003(d)(2)(B)](/usc/5/9003.md?p=d-2-B).
    - (B) **Reimbursement requirement.—** Each master contract under this chapter shall include appropriate provisions under which the carrier involved shall, during each year, make such periodic contributions to the Long-Term Care Administrative [Account](/usc/5/8401.md?p=1) as necessary to ensure that the reasonable anticipated expenses of the Office in administering this chapter during such year (adjusted to reconcile for any earlier overestimates or underestimates under this subparagraph) are defrayed.

## Source credit

(Added Pub. L. 106–265, title I, § 1002(a), Sept. 19, 2000, 114 Stat. 766.)