5 U.S.C. § 8906 — Contributions

(a)(1) By October 1 each year, OPM must figure the weighted average of the subscription charges that will apply during the following contract year, separately for self-only, self-plus-one, and self-and-family enrollments. (2) In figuring each weighted average, a particular plan's (or option's) charge is weighted based on how many people were enrolled in it as of March 31 of the year the calculation is made. (3) For this purpose, "enrollee" means anyone who will be eligible for a Government contribution for health benefits during the relevant contract year.

(b)(1) Except as covered in paragraphs (2) through (4), the biweekly Government contribution for an employee or annuitant equals 72 percent of the relevant weighted average from subsection (a)(1)(A) or (B). For an employee, this adjustment starts with their first pay period of the year; for an annuitant, with their first annuity payment period of the year. (2) The biweekly Government contribution can never be more than 75 percent of the subscription charge. (3) For an employee working a part-time career schedule (as section 3401(2) defines it), the Government contribution percentage is scaled down to match the ratio between their scheduled part-time hours and the hours of a comparable full-time employee, as OPM regulations set out. (4) For people enrolled in a health plan under the section 1108 (title 10) demonstration project, the Government contribution follows the limit set in that section instead.

(c) An amount is withheld from each enrolled employee's pay, and (except as covered in subsection (i)) from each enrolled annuitant's annuity, matched by a Government contribution in the same ratio as the contributions under subsection (b), to cover the administrative costs and reserves required by section 8909(b).

(d) Whatever is left of the full enrollment charge, after the Government's contribution, is withheld from each enrolled employee's pay and (except as covered in subsection (i)) from each enrolled annuitant's annuity. An annuitant's withholding matches what an employee in the same plan and benefit level would pay.

(e)(1)(A) An employee on leave without pay may keep their own coverage, and their family's, going for up to 1 year, under OPM regulations. (B) During each pay period that this coverage continues: (i) employee and Government contributions must be paid on a current basis; and (ii) if needed, the agency head may approve an advance of basic pay, recoverable the same way as under section 5524a(c), to cover the employee's current contributions. (C) Each agency must set up a way to accept direct payment of employee contributions for this purpose. (2) An employee who takes approved leave without pay to work full-time for an employee organization (as section 8901 defines it) may, within 60 days of starting that leave, file an election with their agency to keep their coverage and currently pay, through the agency, both the employee's and the agency's contributions from the start of the unpaid leave; the agency forwards that money to the Fund. If the employee does not make this election, their coverage continues during the unpaid period and ends as described in paragraph (1) and its regulations. (3)(A) An agency may pay both the employee and Government contributions, and related administrative expenses otherwise charged to the employee, for the health coverage of a covered employee (described in subparagraph (B)) and that employee's family. (B) A covered employee here is someone who: (i) is enrolled in a chapter health plan; (ii) is a member of a reserve component of the armed forces; (iii) is called to active duty in support of a contingency operation; (iv) is placed on leave without pay or separated from service to perform that duty; and (v) serves more than 30 straight days. (C) Despite the normal 1-year limit in paragraph (1)(A), payments under this paragraph can run for up to 24 months.

(f) The Government's contribution for an employee's health benefits — and any extra payment under subsection (e)(3)(A) — is paid: (1) generally, from the appropriation or fund that pays the employee; (2) for an elected official, from an appropriation or fund available for other salaries in the same office; (3) for an employee of the legislative branch paid by the Chief Administrative Officer of the House of Representatives, from the applicable House accounts; and (4) for an employee on leave without pay, from the appropriation or fund that would pay them if they were in pay status.

(g)(1) Except as covered in paragraphs (2) and (3), the Government contribution for an annuitant's health benefits is paid from yearly appropriations authorized for that purpose, which can stay available until spent. (2)(A) For someone who first became an annuitant by retiring from the United States Postal Service on or after July 1, 1971, or for a survivor of such a person or of someone who died on or after that date while working for the Postal Service, the Government contribution was paid by the Postal Service through September 30, 2016; after that, it is paid first from the Postal Service Retiree Health Benefits Fund, up to what is in the Fund, with the Postal Service paying any remaining amount. (B) The Postal Service's share is prorated to reflect only the portion of total service performed after June 30, 1971, as OPM estimates. (3) For people enrolled under the section 1108 (title 10) demonstration project, the Government contribution follows that section's own rule instead.

(h) OPM must provide a way to convert the biweekly contribution rates in this section into rates for employees and annuitants paid on a schedule other than biweekly, and may adjust the converted rate to the nearest cent.

(i) An annuitant whose annuity is too small to cover the normal withholding for a particular health plan may still enroll, or stay enrolled, in that plan if they agree, under OPM's conditions, to currently pay into the Employees Health Benefits Fund — through the retirement system that manages their health enrollment — an amount equal to what would otherwise be withheld under this section.