Page:United States Statutes at Large Volume 118.djvu/4037

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

118 STAT. 4007 PUBLIC LAW 108–496—DEC. 23, 2004 ‘‘(7) The term ‘State’ includes the District of Columbia. ‘‘§ 8982. Availability of vision benefits ‘‘(a) The Office shall establish and administer a program through which an eligible individual may obtain vision coverage to supplement coverage available through chapter 89. ‘‘(b) The Office shall determine, in the exercise of its reasonable discretion, the financial requirements for qualified companies to participate in the program. ‘‘(c) Nothing in this chapter shall be construed to prohibit the availability of vision benefits provided by health benefits plans under chapter 89. ‘‘§ 8983. Contracting authority ‘‘(a)(1) The Office shall contract with a reasonable number of qualified companies for a policy or policies of benefits described under section 8984 without regard to section 5 of title 41 or any other statute requiring competitive bidding. An employee organiza- tion 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. ‘‘(2) The Office shall ensure that each resulting contract is awarded on the basis of contractor qualifications, price, and reason- able competition. ‘‘(b) Each contract under this section shall contain— ‘‘(1) the requirements under section 8902 (d), (f), and (i) made applicable to contracts under this section by regulations prescribed by the Office; ‘‘(2) the terms of the enrollment period; and ‘‘(3) 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. ‘‘(c) Nothing in this chapter shall, in the case of an individual electing vision 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. ‘‘(d)(1) Each contract under this chapter shall require the quali- fied company to agree— ‘‘(A) to provide payments or benefits to an eligible indi- vidual if such individual is entitled thereto under the terms of the contract; and ‘‘(B) with respect to disputes regarding claims for payments or benefits under the terms of the contract— ‘‘(i) to establish internal procedures designed to expedi- tiously resolve such disputes; and ‘‘(ii) to establish, for disputes not resolved through procedures under clause (i), procedures for 1 or more alter- native means of dispute resolution involving independent third-party review under appropriate circumstances by entities mutually acceptable to the Office and the qualified company. ‘‘(2) A determination by a qualified company as to whether or not a particular individual is eligible to obtain coverage under Procedures. VerDate 11-MAY-2000 13:54 Nov 10, 2005 Jkt 029194 PO 00000 Frm 00541 Fmt 6580 Sfmt 6581 C:\STATUTES\2004\29194PT4.001 APPS10 PsN: 29194PT4