DEATH STATISTICS STAFF EMPLOYEES AND STAFF AGENTS FOR CIA AND STAFF EMPLOYEES FOR STATE AND AGRICULTURE
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CIA-RDP80-01826R000600160006-7
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December 9, 2016
Document Release Date:
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DEATH STATISTICS
STAFF EMPLOYEES AND STAFF AGENTS FOR CIA
AND STAFF EMPLOYEES FOR STATE AND AGRICULTURE
11100.10.111[Marlianke.0.1. ws:00.0?40.41%,..11111111meresampt.1.14.8.11.14.01.11.1010114.4..
TAB A
10 A Comparison of death incidence with the Foreign Service, and Departaantal,
Department of State; and with Department of Agriculture Beneficial Association;
and with U. S. mortality tables.
CIA 1/
Total in service deaths
Av. Monthly Strength
Deaths per 1000
(physical given)
Averago
194 1948 / 9 lge 1252 3:251
State 11/ . Foreign -Servo
MIT in Service deaths - 10 15 8 5 8 7
Av. Monthly Strength . . 5373 7898 8692 8993 7562 8416
Deaths per 1000 . 1.86 1.90 .92 .50 1.06 .83
(physical given)
State . Departmental
WEIZE in Service deaths . 7 18
Av. monthly strength . - 10630 7870
Deaths per 1000 . - .66 2.29
(no physical exam
A riculture Ben. Assn. 2.1
$
ReiriOr
Total deaths incl. septd . .!, 182 234
Strength of Anson. . . 1612216193
Deaths per 1000 - 11.3 14.5
(no physical exam)
174/ 19
9316-10046
1.824/1.82
12
8166
1.47
16
9176
1075
(1.29)-
(1.54)
190 217
232
213
16161 16045
16080
16095
11.8
13.5
14.4
13.2
11.21,_2milation as a whole (deaths per 1000)
(1) Estimate for 1951 by the World Almanac . 907
(2) U.S. Public Health Service for 1952 . ? . 0 et 9 906
?
and - See TaL E for sources.
ontains 5 deaths fro; single plane crash. If not includedsthe ratio is shown in
2/ Not separated from service. ( ) above.
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(CIA):
Heart
Cancer
Suicide ki/
Ulcers, Obstructions Peritoniils
Polio (3) Diphtheria (I)
Complications following operation
Accident not in line of duty
By fire while trysting 1
BY air crash on WO? 1
By mountain climbing 1
By auto collisions 2
Accident in performance of duty
By explosion of gasoline 1
By air crash (Sched.) 3
By air crash (HonmSohed.) 1
By boom of crane 1
By ship sinldng 1
By shooting (2nd party) 1
25 (355)
11 (165)
6 (:9%)
6 ( 9%)
4
2
5 ( 7%)
8 (12%)
TAB A
L. By enemy action 2
TOTAL 69
(FERFORMANCE OF DUTY TOTAL: 10 (1407%) .111)
U. S, Public Health Service 1948 Vital Statistics for U. S. Population
as to death from "selected causes" (most). Rates per 1:000 of mid.
year population,
All Causes,
All Ages
9.885
Heart
H
3.227
Cancer
1.349
Suicide
H
0112
Ages
152gk
251,4k
1.11:511
i!661.1
All Causes
1;424
1.9771
3..976
9.048
19.5513 44035
Heart
.085
6208
.854
2.918
7.259 17.908
Cancer
.056
.168
.598
1.718
3.789 7.347
Suicide
.047
.090
.147
.208
.255 .288
fU. S. public Health Service 1948
f 5 'suicides in MOD
tej l Performanle of Duty in DD/P
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7 CIA ages at death for all cases (49)
ACE
IA/3 A
in to ? years 1951, 1952, 1953
Cumulative Percent of
Totals an Total
Under
25
4 cases
8
"
30
14
28
II
35
19
38
"
40
23
46
r
145
29
58
n
50
33
66
a
55
40
80
"
60
44
88
"
65
47
94
"70
U
75
47
49 '
94
100
8.
CIA ages related to total deaths for the same age groups (Cumulative
% to total in both oases)
Age Death
Distribution il Distribution I/
Under
25
16%
8%
p
30
4,2%
28%
n
35
64%
38%
n
40
72%
46%
a,
45
89,1
58%
n
ft
50
55
95%
97%
66%
80%
n
60
99%
88%
ej
As of 30 June 1953 (no significant change as of Jan. 154)
Ej
3.0year totals - 195/4 1954 1953.
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Note: Total or 42
okr1:73gorlos is 62%
at death in 3 categories (5.1otal Agency S.E? & 5.A.147-'539 incl.)
in them 3 Heat
of grand total)
Cancer
1
25X1A6a
Suicide - (Location)
70-
FE US
11
25X1A
LO
-5
.x.
3.1
1
OTR US
FE. US
1
1
L.
11
LW
1
1
1
111
1
1
1
60
QL
1
1
62;
1
1
66
70
k,
1
1.
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BB
0
Facto in respect to death - as to existing available protective features
in beneficiary coverage, These are:
a, Commercial crdielaztjW2.22142.144*
(1)
Most importantly for us- is the matter of exclnsions from cover.
age - and the policies vary considerably, However, same
aspects which are generally common are .these:
(a) The incontestibility period for all features of the policy
is 2 years (all of these listed except Now York Life,
which is I year).
(b) The Basic (Face amount) Policy contains atrflightexolu-
sion as follows:
Any flight operated for milita pees or where the
a- ?
insured individual acts as a crew ma- r, has duties
2241ES parachutes or p.a.L...ti_eijat4e_sainJirgri"IWA
testfatc_exesiment4 or traininzasrees.
Non-Scheduled Airlines are not dealt with explicitly
as each except by Prudential which monot cover any
st-Ternght.
(c) Invariably, all flights as a passenger in ccemercial
scheduled airlines of any country are covered risks
tether, *a
(d) The Basic (Face amount) Policy contains war exclusions
(declared or undeclared war) as tollowss
Death arising from an act of marewhiIe in either mili-
tary or civilian serviee'eutside the Home Areas or
within 6 menthe after return to Home Areas. **a
* Examination was rade of sample policies from: Acacia, John Hancock,
N, Y. Life, Omaha Un. Ben. Life, Guardian, Prudential, Travelers,
Lincoln Nat'l', Penn Mutual.
"Scheduled Airlines" are commonly defined as follows: "Aircraft operated.
94 schedule for oonstorcielpurpoves by an incorporated and governmentally
certified Scheduled.Commerclal Air Carrier over an eetablished routs -
between specified airports."
The Hone Areas are commonly defined as the U.S., Canada, Panama, D.-000
T.H., Puerto Rice and Virgin Islands.
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(e)
TAB B
The Double Indemnity (twice the Face Amount) accidental
death feature contains all the foregoing exclusions plus
self-inflicted cause, illness or disease, gas or filmes,
assault or felony, war, insurrection, riot,militare ser-
vice during time of war, and air flight in non-scheduled
airlines,
(2) The risks of Agency hazardous and saga-hazardous duty not
covered by Ordinary Life policies are:
(a) In respect to the Basic (Face Amount) policy:
1. Air flight in military or non-scheduled planes
- for the purpose of teseing or training (ISS and
IRS), for military purposes ((PS), acting as a
crew meeber or with duties aboard, parachuting
(OPS), and in some cases as a passenger in non-
soheds (IRS, ISS? OPS).
2 Exposure to an act of war (declared or net), mili-
tary or civilians while Outside hoes areas or dur-
ing six months after return.
(b) In respect to the Double Indemnity Accidental Death
feature:
(3)
1 All of the above plus exposure to disease, illness,
gas or flames, assault, felony, riot, insurrection,
military service, and air flight in non-scheds aa
a passenger.
It is to be noted that in addition to the above listed risks?
there are 16 hazardous duty risks which, if revealed in the
candidate's application for insurance or ferreted out by the
agent, would probably either exclude acceptance or provide
coverage, in tem cases, at an exoessive premium. However,
given acceptance of the candidate on a non-hazardous occupa-
tion description, the policy is insecure for two years (the
contestibility period). The insurance companies are already
suspicious alas,
b. National Service Life Insurance or U. S. Government Life Insurance
(1) Both of these policies are GI - the latter available in
World War 19 and since, to that veteran if in active service, gind
NSLI during and since World War II without previous service. The
Only difference is that Up S. Government Life has a double
ability feature for a small additional premium . NSLI doss noLe
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eee:e
TAB B
(2) Both of these policieSere incontestitae from date of issue
for any cause exeept fraud, in both death7721770WITIF-a.
features. isep, NO exclusions?
Co /22.40,Mta...nA21
(1) This act provides compensation for disabilitys death and medical
care (including hospitalisation) resulting from injuries suffered
in performance of duties or from diseases ppxiinate1 caused by
eql?rit 0'.clusione from coverage are ffi?s or ath
resulting from willful misconduct, self-inflicted actions or
irtoxication?
(2) FECA as to death benefits *
(a) Burial expenses up to 3400000 plus transportation of
remains to home,
(3)
(b) Widow no other de ndents. 45% of pay 4N(' not to anew/
mon y un 1 her death or remarriage,
Widow with 2 unmarried children under 18 ars of
roraTir-O-Tinilliswo?Wreiriraralii to ) not
to exceed (75% of 1347 in any case) $525?00 total per month
until death or remarriage of widow and until children marry,
dies or reach 18 years of age as to their part?
Bo widow 2 unmarried childreatumder 16 ars of .
of my for onrmra;-Trcmrls-7;- er notto exceed
(75% of gay in any case)total of $525000 per month until
children marry, dies or reach 18 years of age?
In summary, continuing death benefits to beneficiaries arising
from injuries suffered in performance of duty or from disease
oximatel caused by employment are these . for the situations
ate*
(0)
(d)
The statement of benefits below, is translated leer here with chosen examples,
** The pay or salary rate for this purpose includes all amounts withheld for tax
and retirement purposes 21.a.Ls value of auSIMNBIT, quarters and other consider-
ations as part of ggy,
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TAB B
05.11
tinpi jouidiets
EmlabYte
25X 1 A6a
EtealtsZ dies in U. S.
(a)
(b)
(c)
Widow may$256.50
Nidelf Srkd 2 04-1441M4
2 children enly::.28500
$222075
328,10
?9e105
39900
(monthly)
(monthly)
(monthly)
(4) This act is an exelneive remedre but doe; not prevent the beneficiary
(5)
from ?looting to receive the benefits of the Civil Service Retirement
Act if she so desires, but she cannot receive such benefits concur.
ently with those under FECA..
All hazardous duty or semi...hazardous duty risks run by Agency employees
are covered by MA under the conditions of performance of duty dr
prazimate cause !sating in employment.
d. Civil Service Retirement Act
(1)
This Act provides death and disability benefits to employees of the
U. So Government with and without .= formance or line of duty qualim
fication provided iho emp oyee nas ad ..iresr1wn5ria .
TR7A-IN7five years of civilian service ** m intermittent or otherwise*
As noted in the previous analysis of FECA, no continuing benefit under
this Act can run concurrently with FECA benefits. The individual
concerned (employee or beneficiary) ray choose.
Exclusions from coverage are common with FEU, i.e., willful misoone
duct, vicious habits and intemperanee, with respect to disability
only.
The continuing benefits are annuity, in nature, computed as a per.
centage of the highest five.year average base salary medified by the
years of creditable service. Military service can be edded,to. the
civilian years for this computation. No additions fareivereeas allow-
ances aro pormitted as ilethe cameo.: FSCA.
"Poe includes the addition Of $900.00 quarters allowance annually.
Under 5 year of service, or more than 5 years with no widow or
dependent children, the Act provides for a lump BUM of amount
paid-in, plus interest.
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TAB B
(4) As to death benefits: *
(a) Mdow . no other dppepdentEr.
50 % of employee's then annuity benefit, attainable when
widow reaches age 50, and terminable when she dies or
remarries.
(b)
Widow and 2 children.
Immediately payable.
50% of employee's then annuity benefit, plus to each child
.50% of the widow's annuity, not to exceed .900.00 ennually9
divided by the number of children, or $360.00 annually,
whichever is lesser . terminable to each child on death
or marriage or attainment Of age 18, except that if such
child is incapable of self.support, terminable on death,
or marriage or recovery. Upon death of widow, recompute
as in (c) below.
No widow1.11.EhiLdrel..21.21EL Inuredietely payable
50% of employee's than anumiuy benefit to each child not to
exceed $1200.00 annually divided by the nGRF of children or
$480.00 annually* whichever is lesser . tersainab3e as above
in (b) and, in case of termination to one child, recompute
as if that child had not survived the ennuitent, i.e.,
case of one child only.
(d) In summery, as to continuing benefits to dependents.:
EmPlcree Employee
G5-11 GS.11
________ 2.X221-2212. 15 yrs, eve.
Wicks: only $33042 $55.69 monthly (at
age 50)
Widow plus 2 children 66.84 111.39 monthly '
(immediately)
2 children only 66.84 80.00 monthly . max.
(immediately)
* The statement of benefits below is translated later
here with chosen examples.
5
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e. Public Law 110 ae to death . on PCS abroad
(1) Pay the cost of preparing and transporting the remains
of an employee, or member of hie family, who may die in
travel statue or abroad se's* to appropriate place of
interMent
fo War Agencies Employees Protective Association (NWA)
??????????...6r1.40111EINS???,...
TA,73 B
(1) This is a non.profit association independent of the U. S.
Government, which provides death benefits only, in two (2)
categories - terra life insurance and accidental death, and
only to civilian employees of the U. S. Government.
-(2) This insurance is effective only when the -individual is actively
employed, not including terminal leave. Eligibility extends to
age 60 and meMbership in the Association terminates at age 6.5
or upon entry into the Armed Forces of any country. MeMbership
is open to any employee of this Agency "who may go overseas at
some future time." (see Appendix II) and without a medical
examination, if he applies within 60 days "after becoming
eligible." If application is later than these 60 days a "state-
ment of health!' is reggired. Eligibility extends to any indivi-
dual paid from appropriated funds of this Goverment (see
Appendix III). On termination of government service the term
.life feature may be converted into one of the Underwriters
standard ordinary life policies, without medical examination.
(3) The policy is effective on the date of application if the appli-
cation is acceptable to the Association There is no conbestible
period as in ordinary Life policies and in respect to the tarn
insurance part of the policy, no exclusions of a47 kind. The
accidental death feature has these five (5) exclusions:
(a). Bacterial infections (except pyogenic infection arising
from accidental wound).
(b) Any kind of diseases
(c) Medical treatment (except from accidental injuries).
(d) Suicide
(e) Air flight in non-scheduled flight, unless under orders of
the U. S. Government1 and in any flight as a crew =goer of
the plane (see NAEPA letter 15 January 1953, Appendix I
herewith).
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(4)
Death benefits now are:
TAB B
2115m* Term Lif.e Ina, Accidental Death Iota
3200 or over 1200O 15.000 27.000
(5) Coats are:
Age up to 41 18,33 per month 25.00 Quarterly
Age 41 to 51 10.42 per month 31,25 il
Age 51 to 65 12.50 per month 37.50 "
(6) The underwriters are:
(a) Equitable Life Assurance Society of the U. S. as to the term
feature.
(b) American Casualty Company of Reading. Pa0 as to the accidental
death benefit.
Our experience with VAEPA is as folloWs:.
Premiuss Paid Benefits; Paid
Total
(7)
100.00 Annually-
125.00?: "
MOO n
(a)
(b)
1947 7,915025
1948 11,630.00
1949 14,615.50
1950 20,299.43
1951 551,400.82
1952 117,437.29
1953 6,5147.IL6
Premiums Paid.
1947 791.00
1948 969,00
1949 1.218000
1950 1.691,00
1951 ' 4.616.00
1952 98786.00
1953 13,045.00
0
0
0
27,000.00 1 dea;:l
12.000.00 1 death
18403.00 3 deaths
Rate of Coverage
persons years
79.00
116.00
146000
203000
554.00
1,174.00
1,565.00
* This salary is about GS.04; for salaries below this figure ($3200), the benefits
and costs are approxiimtely one?half of the amounts shown above, See rates in
Brochure.-
** Persons ? years: astniming ages up to 41 premium is $100.00 for an individual
for g year.
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(8)
(c) Length of time contracts in force 1947;4953 inclusive.
Up to 3 mos.
ft n 7 n
n n 15
" " 19
" 25
tt ti
11 Ti 37 ft
't3 "
" 4it
9
TiIV 55 "
u 61 "
" 67 II
ft tt 73 ft
ii VI 79
n 85
Total.
Cancelled Contracts
56 (10%)
169 (30%)
119 (22%)
70 (13%)
60(W)
45 ( 8%)
20 (3.6%)
7
1.0
3
2
1
0
553
TAB B
Existing contracts in
force as otl Jan. 195/4
Velloara?Masilwmeefl?E
113 (7.7%) .
201 (13.7%)
197 (1.3.5%)
259 (17,7%)
258 (17.7%)
201 (13.7%)
127 ( 897%)
73 (
9
5
7
I.
1461
1,4) lodifying factors in the above are:
1. in 1950 Wan added $2000 to the term coverage
2. in 1951 " added $15.000 accidental death coverage
2. in 1953 INIEPA added eligibility liberalization to reads
000 available to anyone (in CIA) who mu go overseas at
some future time." Previously, oversegn orders had to
be cut.
4. Bad Agency publicity.
DPI reports no interest in risk coverage on the part of his people
but a good interest in group life (term) coverage. They feel that
with 99% of theta not going overseas at any time, they would be
straining the truth to apply for WAWA.
(a) He also reports that they don't know the exclusions in their
0. L. policies. Nor do they know anything about F.E.C.A.
Recapitulation as to continuing benefits after death.
(1) In order to assess practically the asset values to the beneficiary
in existing available protective measures, certain assumptions as
to asset (or proceeds) disposition...methods are utilized as follows:
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SHURE It' TAB is
(a)
The widow's age is assumed at 30 years (because of the
general youth of the Agency employees) in both examples
to follow, i.e., widow is the only beneficiary in the
first case, and widow and 2 children in the second e
ages 5 avd 6 years.
(b) As to Ordinary Life Insurance. There is assumed a policy
of $107560-rarfrETIV=Indemnity for accidental death,
The widow Chooees to receive the proceeds immediately in
the form of a monthly life income (20 years certain) in
both examples. Disposal of these proceeds is illustrated
by utilising option 4, under. an Ordinary Life policy
written by United Benefit Life Insurance Co. of Omahas
Nebraska. The benefit is $30.50 per month for the faoe
of policy, or $61.00 per month with the Double Indemnity
feature.
(a)
(a)
1. The proceeds of this policy are not taxable as income
unless left with the compage at intereete Such interest
is taxable.
As to FECA, in the stneaary- following herae the examples
shown in the analysis heretofore are used.
1. The benefits here are not taxable as income.
As to Oa, it is seen that its value is small e is of
no consideration in the case of death in performance of
duty, and is applicable under lineeofeduty or not, to a
Ado alone only when she reaches 50 years. To a widow
with children benefits are applicable imediately but
are smile
le The benefits here are taxable as imam under the
annuity rule. (3%. of total Weary deduction until tax
equals deduction, then all taXable.)
As to 1;?1AEPA in the termfeature, it is aesumed that the
employee Chose prooeeds disposal on the basis or monthly
installments parable irmedietely on his death for the 15!
year period. This peirs $6053 per month per $1,000 of
policy few ($12,000 um), dee.? a total of 0806*
1. The proceeds here are not taxable as inceem,in the
same wayeas Oritleum, life.
(f) As to WAEPA, in the asoide*al death feature, which must
be paid in a lump ume ($15"10360 now), it is assumed that
the single beneficiary (wife only, age 30) is better
served by her purchase of a single premium Deferred,
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SURE T TAB B
Refunding Life Annuity payable in 20 years ether then
age of 50 years (or earlier for less amount if she
chooses or needs),. On this basis, Guardian Life of
N.Y.c1 will, in 20 years, ad-Cumulate-a cash value
for her of $24M5 and then pay her 394.13 monthly
for life end also refund the enueeid balance to her
specified benetic.iaries?
However, under this feature, in respedt to the second
example (the employees beneficiariee are Wife and 2
children, ages 5 and 6), it is deemed the part of
darn 'for her to use the principal as she chooses under
a Trust ?Lind arrangement, for a minimum of 12 years
(until the children are 18 years old), The trusts
now pay about h% average on the investment and charge
5% on the fund earnings. This will net the beneficiary
additional earnings over 12 years Of about $3,000 total,
or an average earning of about $250 per year. She takes
out =5.00 per month average for 12 years and uses up
the principal. ? . ?
1. The proceeds under WAtPA accidental death feature
are not taxable as income, except as to interest
. earnings.
(g) An to =A (Civil Service RetdrementAct) benefits, r
even though the beneficiary can choose as between OBRA
and MA, there is really no competition between the
two. Each was designed for a different purpeee.
Fever, outside of performance of Ink:death, the sole
beneficiary (widow enTy17;iite unta-iffe is 50 years or
age to benefit in a small way under 0SRk he widow -
with 2 children secures somewhat larger, .though
tively smells, benefits immediately following death,
under CSRA.: Here again themes no ceepetition with FECA0
hence, the great importance of interpretation as to ',per's
formence of duty." The two cases used in the analysis
proper are again utilized in the ftalowing enmity.
1. The proceeds are teXahle as income under the annuity
rule.
(h) In respect to national Service Life Insurance (veteran),
the 15..year installment method of paying proceeds is
ChOOSOn 436,11 monthly per $1000 of policy face. This
is $61.10 menthly.
1, Theue proceeds are not taxable as tncom0*
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SUMMARY OF EXISTING AVAILWE PROTECTiVE ASSETS IN TERMS OF THE PROCEEDS - DISPOSAL PLANS CHOSEN
(MONTHLY PAYWNTS)
BENEFICIARY ASSET .
WIFE
ONLY
WIFE AND
TWO CHILDREN
lt
Any DEATH OUTSIDE OF
PERFORMANCE OF DM -
WITH ORDINARY.LIFE WITHOUT ORD;NARY LIFE
ORDINARV LIFE INSURANCE (FACE) 30.50
n n it (0,L) 30.50
FEU 25X1A6a 222.75
CSRA
WAEPA treRml
" (ACCIDENTAL DEATH)
TOTAL 25X1 A6a
ItS1.1
TOTAL 25X1A6a
76.36
362.11
423.21
ORDINARY LIFE INSURANCE (FACE) 30.50
ft 20.50
FEGA 25X1A6a 328.16
CSRA
WAEPA (TERM)
" (ACCIDENTAL DEATH)
25X1A6a
TOTAL
TOTAL 25X1A6a
ERFORMANOE OF DUTY
Approved For Release 200'
78.36
125.00
599.59
61.0
653.62
(+ 34.00)
(4 34.00)
(+ 34.00)
(-4- 71.00)
71.00)
(+ 71.00)
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222.75
(+ 34.00)
78.36
201.11
(+ 34.00)
61.10
362.21
(* 34.00)
228.16
i+ 71.00)
?.44r
LINE Of DUTY OR NOi
WITH ORD. LIFE WITHOUT ORD:
tIFE
30.50
30.50
76,36
139.36
61.10
200.46
30.50
30.50
66.64
78.36 78.26
125.00 - 125.00
521.52 221.20
. 1.00)
61.10
592.62
0600160006-7
(+ 71.00)
61.10
392.30
78.36
78,36
61:10
139.46
ASSUMPTIONS:
1. DEATH OF A GS-11 WT
9 YEARS SERVICE
2. BENEFICIARY - ACE 30
+ 33.42 AT AGE 50
+ 94.43 AT AGE 50
*127.55 AT AGE 50.
+127.55 AT AGE 50
66.64I IMMEDIATELY AT DEATH
78.36
125.00 TRUST FUND
270.20
61.10 '
331.30
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APPENDICES
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APPENDIX 111
WAR AGENCIES EMPLOVAS
PROTECTIVE ASSOCIATION
Room 1040.1043 Washington Bldg,
35th- &.? New York Ave.,
Washington 5p Do Co
Address Cors Be;g1?i.ziuni
November 29, 1950
The Central Intelligence Mem)"
Gerrtleresn:
You have inquired about the definition a aligie
bility relating to the term oemployee."I The question is
raised, we believe, because there are certain personnel
connected with your agenoy which do not olear throutil the
normal precedures or Government employment. I we tleirefore
quoting an excerpt fro m an wrendment to War Agencies
Employees" Protective Aseociation contract No. 7671, dated
July 21, 1949, as follows:
n The term 'employee' as used herein shall an
an individual whose compensation or expenses are derived
in whole or in part directly from the United States
Government for services performed diract4 for the United
States Government in any capacity."
We believe this definition is broad enough to
cover all of the questions which you have posed to us.
Very truly yours,
Ali
? ?
STACEY K. BEEBE
General Manager
SKBles
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SECHR T
APPZNDIX V
EMCEE TWITS
DEia Ma Ws By CIA regulation the tollowieg :our 25X1A
categories of employuent are111WRIPIWa u, 3. Government, and no
employee rights as spec:11114d I gis tion can be denied them.
1. Staff Employees
2, Staff Agents
31 Career Agents
L Contract Employees
The Contract Agent ie not an employee =les? control of bie
activities is olcee and contimous in which case he might be
able, to prove qualification,
In respect to Career Agents - deductions from ealeW 1 A
are made for Civil Service Retirement Act and ,,..the Career
Agent ....,nmill automatically come under the coverage of
FECA and PL 110. Dements of the leasing ears= Act may
alma be granted, and where compatible with saaurity and
oporationel standsrds, tweeter agents mgr subscribe, if eligi-
ble, to hospetaliaateon and lefe inevanne plans which are
available to Agency emploiees." * 1
In respoot to the Contract no deductioaX1A
will be made from salary under the Civil Serrioc Retirement
Act... .however, ?such periods of service would be available as
creditable service for retirement purposes upon depoait br
the indivedual oe a sum equalling the deductions based upon.
salary paid during that period," Also,.. (the Contract Employ-
ee) 'Nell he entitled to the befits of ieCA and PL 110,
and his contract shall ac state. Dements of the e.ssing Per-
cons Act may also be grantealeid, where compatible with security
and operational otandarde, the Centraot Employee may subscribei,
eligible, to hospitalisaticu and life irsuranoo plans which
are available to Agency ertployees." * 1
*leer COPS DD/P.January t54, all four. categories eligible for life
insuranee; only Staff Employees and Staff Agonte eligible for Agency
hospitalization,-
SeCeET
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c. It ia most important that U. S. Contract Agents should
be covered by such a policy, In their case the risks are frequently
greater and insurance coverage available to them is less,,
d. I rftentioned to you in our conversation that it might
be advantageous to provide that the decision of the Agency regarding
the date of death should be final if this can be legally achieved,.
Deputr Chief, La
C
2
ssakaT
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kftpid
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APPENDIX IX
0
October 1953
Miseellaneous Expressions of Interest in Insurance from. Random
Selection of DD/P Officers
1, Good hospital and surgies1 benefits plans for oversees
dependents - this inclusive of proprietary companies, ....1115X1A9a
2, Raise WAEPA btu:vie limits of group insurance coverage.
0 Policy to cover transportation risks per se e all kinds*
4. Ehtual type insurance group operated by Agency
to that of Army and Navy .0 would be best as far as security breaches
go re Covert Personnel.
50 Investigate Blue Cross believes Offers morecoverage over
-
Seas than coreparerwe now subscribe to.
6, Something to cover hazardous duty. (He never heard of FECA)
7, Protection for injury or death in line of duty which would
provide living expense for family in the states.
C. Sonething similar to Trip Insurance Obtainable at Airport r
at reasonable rate; would be benefit to have included in regular
processing routine, stirs fox get to pick ep at Airport . methed
to be as simple as possible.
9. Accidental death and injury in line of duty.
10. Health, phyeical? mental and injury coverage overseas other
than in line of duty - CIA unlike the State Department does not
cover empat7ees for illness or injury incurred other than in line of
duty.
U. Travel insurance, short term.
12, Transportation insurance e employees should not have to
afford this.
13, Re "NeEPA - Teo high for short period; too long animum period.
Followeup on return for possible interest inkeeping MASA. Have MAEPA
also cover peerennel who do net enticipate travel. MAEPA -requires too
maer forma being filled. out.
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25X1A
25X1A
25X1A9a
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FROURE AND SCURC IN OBTAMNG
CIA AND OTHER DEATH AND TWBILITY nue
The method of arriving at the CIA figures is note 'cr the record
as follows:
With respect to death, a clerical task force (ep to 4 people)
siperisod fulletiaa by a borrownf intelligence off. 4.73r from PP
exarnized every card in Inactive Sere Record Card file,
to spot postings of ntermination ly death", Thentl! if each person
so terminated wes noted on an inv:etory sheet (saophe attached) to-
gether with other personal data eleen as cafled for 1v the invent
sheet. (Data calsi for was speefAed
Cause and place of death . not sh(hing ere, WAS Uc,,le, n vi
dualls personnel folder (whore foz the most part it didntt show eittor).
Search then went to the offices at i division. The eaventory sheets
uere all completed*
In respect to the statistics Nn death$ in one heaven case the
personnel file (the card file of le rsonnel actions) showed no card at
all for the employee* (This was c 1953 death). In another instance,
the card showed fireeignationP. TO:_e? of course, refees the question
of other possible missing or mis-3eading cards, mo aL specially far
the earlier years. In another cas ths clerical tr.v'k force missed
the record entirely because the ne-eLtion of termin.:t.on by death showed
on a second attached card underneall the first, in Epite of plenty of
posting room remaining on the uppe card. Of couroe -,12e task force
weld have missed for other reason too.
As to disability, the same taek force and supseTteor examined
all records of he:vitalization and surgical instanees as shown in
the Omaha and OHI files of the Ineerence Brandh of na Personnel
Office. Desired information as cealed for on a dielity inventory
-i posted (epecificetioms oa this sheet Obteleed from Mr.
. each case to a separate sheet. (Sample ettached) Than
these sheets -were coded for IBM.
All of this disability work oes under the gens'al supervision
of Chief, Research 7eoench, Plans, Reseamh Development
Staff, Par onnee Office.
With respect to Staff Agents, the records wero zo7; up properly
in February 153. Previous to thee,. for a little tize at least, on
the occasion of death, a dummy Sereice Record Card ees supposed to
have been nada end sent to the Ineetive Service RsecA file. Of four
known Staff Agent, deaths, only one each card was Then, at
another time, the Service Record Geed held by the Paff.'connel Office
reeponsible for its original creatJon, was sent with the individualos
personnel folder to archives, hence is buried with thonsands of others,
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25X1A9a
f
thc arc inadti 2.C*.' IZT
For the yea-cs desired, 19474;53 inclusive (in ?aspect to death),
depandonce had to Iva placod on Dairmiese Four norttyi cao from COG were
subsbantiabd: The Ageml. S3C12 it Office, Yolicttl (2..trica and Divisions
of DD/P were circularized* and b*caght forward up 113w names?
In additionl the action file 7,f Fiscal() to tho Otvil Service Cove.
mission), was checked. This process Foduced ten fow(r =mos than Per.
sonnol"e Inactive Service filo but included two mu ?nest,
In addition, Personnel's Inactive Service file was thoroughly
'checked through again? Si ow' records of deatl mere turned up
against the original sixty.two, but, this included ccrrections made
since the first effort? (Xe new rue was turned up, (but this pro..
case pissed four nas caught ori,7a1,04!) This ro.chack was super-.
vied personally
employeasl personnel fol&rs are in genemny poor shapes
filled with duplicate papers, sot hat inconsistent, in arrangerent of
material, and incoluplete as to cam e and place of dc nth. In many cases
the information as to cause and pl.;:se of death had to be obtained from
individual memories or records within the operating'.2?ranched., SuCh
1113MOrier3 uere accepted, because in oadh cede an infezlamt was found.
who Could assert vith =piste cortadonce of accur247, With due use
of cryptonyms in those few eases wl,era necessary, th:-Ire is no reason
1447 the nterrdnation by deathr raord on Form 50 car .it show pause
and place. (This has been inforAy agreed to by T.)rsonnel Relations
Section),
? 2 ?
SECRET.
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mer- CONFIDENTIAL
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Sources of Figures for CIA, Dept. of Agriculture
and Department of State
CIA . Average Monthly strengthfb the year. This eethod was specified
30 December 1953. The figures
cane from Reearohsearch and Development Staff,
Personnel Office.
In respect to the CIA strength reports, one can take the years
1951, 1952 and 1953. as solid and cermet. For the earlier yeare shown,
there is unquestionable e..probably smalle-variatian as to what is
included and what not and when. All figures come from official reports.
State . These figures are from Howard Mace Chief a the Plaeement
and Career Development Branch, Personnel Operations Division, Office
of Personnel, Department of State.
The population or strength figures for the Foreign Service are
averaged for the year from menthIly figures except for 1949 - which year
a "budget average." Tae Departmental yearly averages are also "bud.
get averages" except 1953 which is averaged from monthly postings.
Agriculture e These figures are from me. J. M. Kemper, Secretary-
asurer of the Department of Agriculture Beneficial Association.
The "strength" is total membership as of 15 September of each year.
("Deaths" include 10-12 cases of permanent and total disability which
Kemper estimates is correct for the total in these 5 years and also
include meMbership and deaths of retirees who kept their policies.)
T. Roy lads Personnel Director of the Department, estimates that
Agriculture has about 56,000 employees - thus making Kemperts member.
ship 29% of the total eligible group. This fact, plus inclusion of ree
tires a, plus the =hanging yearly level of memberships, leads, to the
suspicion that the age level of this membership is high. (Kemper was
uncooperative when asked if he could supply age data,)
oregill?111?.?
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DENTIAL
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Re : Deaths (Staff Employees)
Name
Date of Employment
Last Office
Last Assignment (nature)
When so assigned ow many others so assigned
Date of birth
Date of' death
Place of death (count?)
Cause Of death
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POLICY* NO.
Het Hospitalisation & Surgical (Staff BAplayee & S.Ae C 13)
Nam
Assigrassnt (Mice)
SOX
Date of Birth
Nataire of inIZIOS
Place of Illneso COcanizy)
Period or names
Benefits Paid 13y
Hospital
Surgical
Extras
WADI NO.
VOUOREii
...eanerilentilUftsarMAM.P..1206.4116.3.4??
Actual Cost
ea.1,20.11.1.1~Alid9.0
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Appendix XI
.14 January 1954
NEMORANDUM FOR: Members of the Insurance Task Face
SUBJECT Exploratory discussion With representatives from 0NAR6 on
January 3.954 by 25X1A9a
l. In regard to dMAHAts matching OBI surgical benefits, the
actuary stated thtt their -premium rates would change as follows:
From
To
Additional
Single Contract
31.60
31,70
$.16
Individual and Spouse
4.75
5.64
.89
Family
6.00
6080
.80
2. Fleece note that the increase in the family rate is leas than
that for an individual ani spouse. This is due to the fact that previous
rates were inoormot, and the actUary wiped out the inconsistency in pro.
posing us the new rates*
3* In regard to 03AHAts complete matching of OHI, they need oar.
tam n dependency figures for overseas, now in process of preparation by
Research Branch, PRDS. This information will be given in percentages
only (approved by the Director of Security personal-170
25X1A9a
Air(
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Approved
Dr. George Baehr, Medical Director of the
Health Insurance Plan of Greater New
York, Testifies Before the House Inter-
state and Foreign Commerce Committee
EXTENSION OF REMARKS
or
HON. CHARLES A. WOLVERTON
OF NEW JERSEY
IN THE ROUSE OF REPRESENTATIVES
Thursday, January 14, 1954
Mr. WOLVERTON. Mr. Speaker, the
testimony of Dr. George Baehr before the
Committee on Interstate and Foreign
Commerce at its hearing to develop a
health program is very important Dr.
Baehr was chief of medical service and
director of clinical research at Mt. Sinai
Hospital in New York City. He was
chairman of the technical advisory com-
mittee, Department of Health, New York
City, 1933-41, and consultant, Depart-
ment of Hospitals, New York City, 1933-
45. He has been a member of the pub-
lic health council of the State of New
York since 1935 and is past president of
the New York Academy of Medicine.
Dr. Baehr made the following state-
ment on prepaid medical care plans and
the health-insurance plan of Greater
New York:
TESTIMONY PRESENTED BEFORE HOUSE COM-
MITTEE ON INTERSTATE AND FOREIGN COM-
MERCE ON JANUARY 14, 1954, BY GEORGE
BAEHER, M. D., PRESMENT AND MEDICAL Ds-
RECTOR, HEALTH INSURANCE PLAN op
GREATER NEW YORK
In all considerations of health insurance,
the basic and interrelated issues are (1)
the method of providing medical services to
the insured, (2) the scope and quality of the
services, and (3) the method of payment to
physicians.
LIMITED COVERAGE BY MEDICAL EXPENSE
INDEMNITY INSURANCE
Medical expense indemnity plans pay indi-
vidual physicians on a fee-for-service basis,
For this reason, they must limit the scope
of their benefit coverage for the most part
to diseases requiring admission to a hospital,
the frequency of which is 'Predictable within
reasonable limits. Benefits outside of a hos-
pital are generally excluded because the
number of professional and laboratory serv-
ices which physicians may choose to render
outside of a hospital is unpredictable when
physicians are paid a fee for each service by
a third party. Even when some medical
benefits outside of a hospital are included
under medical expense indemnity contracts,
they are sharply limited in amount and
leave the insured families widely exposed to
additional nfedical bills. Comprehensive
benefit coverage is impossible under these
indemnity, fee-for-service plans because it
inevitably results in a rapid increase in
medical bills and the progressive pyramiding
of costs to the insurance company.
The inadequacy of in-hospital medical cov-
erage as a means of protecting the family
budget is revealed by the experience of such
comprehensive programs of medical care as
" the health-insurance plan of Greater New
York, which find that only 10.7 percent of
all professional services are rendered to such
insured persons in hospitals and 89 percent
in their homes and doctor's offices. With
fees for home and office visits and for X-rays,
technical laboratory work, and other diag-
nostic and therapeutic procedures now ris-
ing to the point that care even for ambula-
ihospital medical care is continually being
needed by all families; hospital care is often
not required for 20 or 30 years.
COMPREHENSIVE MEDICAL CARE THROUGH PREPAID
GROUP PRACTICE
During the past 25 years, local plans for
providing comprehensive medical care on a
prepaid basis have been established in van-
out parts of the country under the sponsor-
ship of medical groups, industrial organiza-
tions, labor unions, farm cooperatives, and
other local agencies. These independent
plans are able to provide medical care of
comprehensive scope in return for the col-
lective per capita premium income only be-
cause the services are rendered to the in-
sured by physicians engaged in organized
group practice, who together comprise all
the required professional, laboratory. X-ray,
and other specialty branches of medicine and
surgery. Under this system of completely
prepaid group practice, financial barriers to
prompt utilization of the needed medical,
laboratory, and X-ray services can be elimi-
nated and the insured families are able to
enjoy all the major benefits of modern medi-
cine, including prevention and early disease
detection. In our aging population, disease
prevention and early disease detection as
well as medical care during chronic illness
must be included in a medical-insurance
program if it is to meet the needs of the
public.
In this age of highly specialized profes-
sional skills and medical technology, the
total medical needs of an insured popula-
tion can best be met by such balanced teams
of physicians, specialists, and technicians
trained in the the great variety of skills
and technics which today constitute modern
medicine. The comprehensive-prepayment
plans combine these medical skills and tech-
nics in the form of group practice and place
them freely at the disposal of people of
moderate means in return for the per capita
Income derived from insurance premiums.
Each insured family has a family doctor who
has been selected by the subscriber from the
family physicians on the staff of a medical
group. The clinical laboratory, X-ray diag-
nosis and therapy services, pathology, physi-
cal therapy, and visiting nurse services of
the group are freely at the disposal of the
family physicians as are all the consulting
services of the group's specialists in the
various branches of medicine and surgery
without financial deterrents to their full
use.
An argument commonly advanced by op-
ponents of prepaid group practice is that it
does not give subscribers free choice of any
licensed physician in the community. From
the standpoint of a subscriber, this has abso-
lutely no validity, for he exercises his choice
when he decides to join the plan as a mem-
ber of his enrolled group of insurees and
he is at liberty to drop out of the plan at
any time. He is also at liberty to consult
any other physician at any time that he
wishes. It is certainly desirable that fami-
lies of low and moderate income be given
the opportunity to enjoy the benefits of
comprehensive-medical care through prepaid
group practice if they prefer it to so-called
free choice of individual physicians and
specialists whose services they cannot afford
on a fee-for-service basis.
Families that receive all their medical
services from a prepaid medical group can
completely budget the costs of their total
medical care throughout the year. If satis-
fied with the full scope and quality of the
care provided for them by the medical group,
the insured population has no need to pur-
chase medical care from any other physician.
Therein lies the cause of complaint and re-
sistance by the opponents of prepaid group
practice in every part of the country in which
it has been established.
FoLoggittgambmitivuls_wages there Local medical societies consist largely of
EIAft 0414326R0609110eam resent the
ambulatory as well as hospital care. Extra- economic an pro ess on o wetition of
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group practice and will tolerate only a fee-
for-service method of solo medical practice
in insurance plans. Medical societies are
therefore prevented by their membership
from taking any part in modernizing the
organization of medical care into group prac-
tice even though it is required by the high
degree of specialization characteristic of the
times in which we live., Because of local re-
sistance to progress, programa of compre-
hensive medical care through prepaid medi-
cal group practice have grown very slowly
and have as yet reached only 4 million people.
At the national level, the American Medi-
cal Association has accepted the principle
that independent groups of physicians and
community leaders should be permitted to
experiment with newer patterns of prepaid
medical care and group practice. State and
county medical societies cannot or will not
initiate or operate such experiments because
of their political composition. A widespread
spirit.of intolerance to change pervades the
thinking and actions of their leaders and in
some States laws have been enacted at the
Instigation of medical societies which actu-
ally prohibit prepaid group practice. Some
local physicians are even now seeking to alter
or reinterpret the Code of Professional Ethics
for the purpose of obstructing the develop-
ment of the only form of voluntary health
insurance which has thus far been able to
provide comprehensive medical care at a cost
which people of low and moderate income
can afford on a prepaid basis.
On July 16, 2946, an editorial in the Jour-
nal of the American Medical Association
warned that such obstructive behavior by
physicians may itself be unethical., In spite
of these pronouncements, the conflict at the
local level remains unchanged and now Calls
for more positive action by national author-
ities within the profession itself or else In-
tervention by Government in the public in-
terest.
ORIGIN OF HIP
In 1947, after a 4-year study of the prob-
lems of medical care, the New York Academy
of Medicine concluded that prepaid group
practice is the logical and evolutionary de-
velopment of medicine in the changing or-
der. Tri 1942 and 1944, the mayor of the city
of New York, the Honorable Fiorello H. La-
Guardia, announced that the city would pay
half the premiums of nonprofit group health
insurance for municipal employees and their
families if insurance coverage could be made
truly comprehensive and employees and
their families would be protected against
additional medical bills. In order to make
It possible for the city to pay half the pre-
mium cost, permissive legislation was en-
acted by the State legislature in 1946. Fol-
lowing a prolonged study of nonprofit medi-
cal insurance plans in various parts of the
country, the founders of the health-insur-
ance plan of Greater New York were con-
vinced that medical society sponsored plans,
because of the current political structure of
the societies, could not change the current
pattern of medical practice so as to provide
the public with an opportunity to purchase
comprehensive medical care. HIP was there-
fore established on March 1, 1947, as an inde-
pendent nonprofit medical insurance plan
under a board of directors composed of rep-
resentative community leaders from labor,
business and industry. Government, and the
medical profession. It was designed to serve
wage earners employed in private business
and industry as well as governmental em-
ployees. The board of directors operates the
plan as a community trusteeship. As in the
case of voluntary hospitals, the entire re-
sponsibility for medical matters and the de-
termination of all professional standards axe
delegated to a medical board and the medical physical therapy, visiting nurse services, and
aspects of the program are supervised by a even ambulance transportation without
medical director and_his
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Footnotes at end of speech. Footnotes at end of speech.
Working capital was required during its
formative period and the first year of op-
eration. As this was the first experimental
demonstration of comprehensive medical
care under community-wide sponsorship,
several philanthropic foundations supplied
loans, which are being rapidly repaid out of
premium income. From our experience it
is evident that similar projects cannot be
established without financial aid in the form
of grants or loans either from industry,
labor groups, consumer, or farm coopera-
tives, or, if it is to be under community
sponsorship, from government. The role of
government in the promotion of plans for
comprerensive medical care through prepaid
group practice was suggested in the 1947 Re-
port on Medicine in the Changing Order of
the New York Academy of Medicinea Once
established, such plans can become self-
supporting, paying adequate remuneration
to their physicians and repaying the initial
loans.
After 7 years of operation, the health-in-
surance plan of Greater New York is provid-
ing comprehensive medical care to almost
400,000 insured persons. As a nonprofit
agency established under the State's insur-
ance law, it is operated in the black and has
accumulated ample financial reserves as re-
quired by the State's superintendent of in-
surance. The services are provided by 30
medical groups, 29 of which are located in
various sections of the city and 1 in an ad-
jacent county. The medical groups are au-
tonomous and are independent contractors.
Each group includes an adequate number of
family physicians proportionate to its en-
rollment size and a complete roster of quali-
fied specialists representing the 12 basic
specialties of medicine and surgery. They
comprise altogether about 1,000 physicans,
of whom about 450 are family doctors and
about 550 are qualified specialists. The re-
quired professional qualifications for mem-
bership in a group are determined by an im-
partial medical control board of 15 repre-
sentative physicians. The quality of medi-
cal care is supervised by the medical de-
partment of HIP.
Under a faanily-type contract, the cost for
an individual subscriber without dependents
is $42.72 a year, for a couple $85.44 a year,
and for a family of any size $128.16 a yea.'
A family with 12 children pays no more than
a family with 1 child. Allowing for large
families, the average cost per individual is
$36.36 a year. Employers are required to pay
at least half the premium so that the week-
ly contribution of a single employee is $0.41,
of a couple $0.82, and of a family of 3 or
more, $1.23.
For providing all the care which may be
needed by the insured families, HIP pays
each medical group a capitation of $29.40
per annum for all persons on its rolls. After
deduction of the cost of operating its medi-
cal group center and of retirement benefits,
the remainder of the capitation income is
available to a group for the payment of sal-
aries of its participating physicians, most
of whom are partners in the group. When
a group reaehes an average enrollment
(14,000), the remuneration of its physicians
is at least as high as the average reported
incomes of other physicians and specialists
in the community and the physicians enjoy
added benefits of security not possible for
the solo practitioner.
There are no deterring extra charges for
any medical services which the insured may
require in their homes,4 in physicians' offices,
medical group centers, or in hospitals.
Every kind of medical and surgical service is
available to them, including X-ray diag-
nosis and therapy, radium and radio-isotope
therapy, diagnostic laboratory services,
The plan erects no barriers by reason of
age, sex, or preexisting illness, injury, physi-
cal defect, or pregnancy, either to admission
to its rolls or to utilization of services there-
after. There are no waiting periods for med-
ical care for preexisting illness or preg-
nancy. Reliance is placed solely upon_ffeup
enrollment
ex ei_rilaFfi?
'Trade enrol men wou ex ose .
--Eristr,117111"-r's day of oph of the
plan, a division of research and statistics in
HIP has recorded every medical service to
every enrollee. By means of modern statis-
tical machinery, these data can be thorough-
ly recorded, analyzed, and evaluated. The
utilization rates of medical, surgical, and
laboratory services by all age groups and
especially the plan's experience with old peo-
ple and with maternal and infant care will
provide valuable data for future programs
of medical care. An intensive study of the
experience of the plan during its first 5
years is now being made by a special com-
mittee of impartial experts under the chair-
manship of Dr. Lowell Reed, president of
Johns Hopkins University, which is being
financed jointly by the commonwealth fund
and the Rockefeller Foundation. In addi-
tion to a longitudinal study of the plan's ex-
perience with its insured population, the
special research project conducted by Dr.
Reed's committee has included an investiga-
.tion of the sickness and medical-care expe-
rience of large and representative samples of
households in New York City and in the HIP
population, totaling more than 25,000 per-
sons. The publications emanating from the
research division are available to you as well
as all of the plan's recorded experience.
HIP also maintains a division of pre-
ventive medicine and health education as
one of its important activities. It is the
responsibility of the expert staff of this divi-
sion to promote adequate utilization of
medical services by the insured population,
especially preventive services and those con-
cerned with early disease detection. The
objective is to have every family select a
family doctor and use him and the special-
ists and laboratories of their medical group
for the prevention and the early detection
and treatment of illness. The effect of this
Wide exposure of the insured population to
medical care can be measured by the fact
that at least 74 percent of the enrolled mem-
bers of the insured families are now using
their physicians' services within a year and
this rate is rising as our health education
program takes hold. The average rate of
utilization of physicians' services by the en-
tire insured population is 5.3 services per
year per person. The lack of financial bar-
riers to complete medical care has not led to
any significant amount of needless use of the
services by the insured. Subscriber abuse is
minimal and easily corrected.
The experience of HIP and of many similar
plans throughout the country is now suffici-
ently voluminous to demonstrate that com-
prehensive medical care through prepaid
group practice is professionally feasible and
financially practical from the standpoint of
both the doctors and the public:. There can
also be no question of the importance of
prepaid Comprehensive medical care to pub-
lic health.
To facilitate its growth, two things are
necessary: ? (la Elimination of interference
by local professional societies with prepaid
group practice: (2) financial assistance by
Government through loans to encourage the
wider extension of prepaid comprehensive
medical care throughout the country under
local community sponsorship.
Government at all levels may also help
through the purchase of prepaid medical
care for its own employees and wards. It
should follow the accepted practice of pur-
600.0.8a7med1cal care under group contract
from the prepayment Organization which
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produces the best values for the price
charged.
ROLE OF FEDERAL GOVERNMENV
The role which the Federal Government
should take in promoting and extending ade-
quate medical care to the insurable popu-
lation of the country might well follow that
which it has already taken to promote and
extend adequate hospital care under the
Hill-Burton Hospital Survey and Construc-
tion Act. Federal assistance to the States
might first be limited to grants-in-aid to
encourage the States to survey existing de-
ficiencies in medical care within the State
and to determine:
1. The extent to which the Insurable popu-
lation is not covered by prepayment for
medical and for hospital care.
2. The gaps in benefit provisions under
existing prepayment programs.
8. The means whereby the gaps in popu-
lation coverage and the gaps in benefit pro-
visions under existing programs may be elim-
inated.
4. The availability of voluntary insurance
plans which provide comprehensive benefits
for medical care in the homes, in doctors'
offices, in diagnostic laboratories and X-ray
services, as well as in hospitals.
5. The desire of the public for prepayment
plans which will provide comprehensive
medical services.
6. The existence of State laws which pro-
hibit or make it impossible for physicians
to provide such comprehensive medical care
through prepaid group practice of medicine.
The State surveys should also include:
1. A determination of the nonwage and
low-income group in the population Which
cannot afford to prepay their medical care
through the purchase of voluntary, health
insurance.
2. The possibilities of experimentation by
State and local governments with coverage
of some or all of this group by voluntary
medical-insurance plans.
8. The degree to which Federal assistance
might be required to enable State and local
governments to provide medical and hos-
pital care to persons in the nonwage and
low-income groups (the medically indigent).
through prepayment.
4. The possibilities of experimentation by
State unemployment funds or other State
agencies with the provision of medical care
for temporarily unemployed persons and
their dependents through continuing the
prepayment of premiums for the unem-
ployed for care which may be needed during
periods of temporary unemployment.
Small Federal grants could be employed
most effectively to assist States in carrying
out experimental programs designed to ex-
tend prepayment plans and comprehensive
coverage under these plans to the part of
the population within the State which is
at present not covered or inadequately cov-
ered under such plans. In recognition of
the fact that comprehensive medical service
coverage under any voluntary prepayment
plan requires economies and increased effi-
ciency in operation which can be achieved
only by organization of medical services as
group practice, Federal aid to State and
local communities is needed to encourage
the establishment of prepaid group practice
of medicine under local community spon-
sorship.
The organization of medical practice along
such modern and more efficient lines requires
loans to medical groups for the construction
of the required physical facilities, to be
repaid by them out of future earnings. Such
loans for the purpose of encouraging local
prepayment programs for comprehensive
medical care should be limited to the acqui-
sition of medical group centers, the purchase
of X-ray, laboratory, and other professional
equipment required for group practice, and
the administrative expenses of the medical
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operation. The annual appropriations for
this purpose need not be large nor would
they be needed for more than 5 or 10 years,
for as the loans are repaid they may be
used as a revolving fund.
It can be predicted that rapid progress in
the extension of prepaid comprehensive med-
ical care will not be made until (1) such
loans are made available, (2) hampering
State laws are repealed wherever they exist,
and (3) effective .steps are taken by higher
professional authorities to eliminate inter-
ference by members of the local medical
profession in restraint of change from the
present costly and disorganized methods of
medical practice to a more modern and more
economical pattern,
1 "Instances have occurred in which physi-
cians, for political, commercial, or emotional
reasons, have endeavored to utilize the prin-
ciples of medical ethics as a means of pro-
clueing embarrassment, distress, or loss of
reputation of other physicians whom they
envy or whose open competition they fear.
The principles of medical ethics were not
designed for any such purpose, and the at-
tempt to utilize the principles of ethics for
such purposes may well be in itself un-
ethical." Editorial, JAMA July 16, 10491
(vol. 140, No. 11), p. 980.
1 "The committee recommends that com-
prehensive medical services be extended by
the use of voluntary, nonprofit insurance,
using group practice units wherever feasible.
and Government subsidy wherever neces-
sary." Aleiclicine in the Changing Order,
Commonwealth Fund, 1947, p. 58.
Subscribers to the health insurance plan
must also have plue Cross or other hospital
insurance.
Except a permissible $2 charge for night
calls requested and made between 10 p. m.
and 7 a. m.
CPYRGHT
0
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T
APPENDIX XIII
Excerpt from Tolay's Woman, 1953 (Fawcett Publications, In
Written, by Jack garrison Pollack
"Perhaps the most satisfactory health insurance today is found
in the seventy odd comprehensive non-profit plans throughout the
United States, Usually sponsored by cceioperatives and built around
the grempmedical-cractice idea which made the Mayo Clinic famouov
they furnish in a single package virtually all of the medical and
surgical care you and your family may require. Men held along
with Blue Cross they offer nearly complete health coverage. .
"From thcepatient"s point of view they're better because they
emphasize preventive medicine0 a top doctor told me.
Tepical of these plans are San Francisco's Pernanente Health
Plan; the Seattle and St. Louis Group Health Associations; the Elk
City, Oklahoma Farmers* Co-operative Plan; New York City's bustling
Health Insurance Plan (HIP).
HIP is America's outstanding comprehensive prepaid medical
plan. Terming it "the finest experiment of its kind," The New
York Times editorialised: "For actuarial and medical soundnesel
HIP has no superior. It is unique, a model for the country." In
1951 HIP received the Lasker Award for distinguished public-health
service.
Dnsignad mainly for families with incomes under $6,500, HIP
meMbors never see a doctor's bill nor are they saddled with extra
charges. lhere are no age limits or waiting periods and you can be
treated for anything from a common cold to the most complicated
surgery. MP's 400,000 members include employees of the City of
New York, the United Nations and over 300 business firms 3 unione
and social agencies - and their .eamilies. tare employers pay half
the cost, employees per the rest lhe total cost ranges from ;A2.72
a year for one person tt) $126015 'a year for three or more pereons."
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THE CIA CAREER COUNCIL AND THE CAREER SERVICES
Rencissionst CIAR111111111111 0 Nay25 MILY 1953
NotLoe N Nay 1953
CONTENTS
Page
GENERAL 0 ? ? ? ? . ? ? ? ? ? ?
POLICY. . . e? a m. a. ts00?00 L.
PURPOSE . ? ? , ? . . ? ? ? ? ? ?
ADMINISTRATION,. . . ? ? . ? e ? ?
25X1A
1, GENERAL
This Regulation establishes the overall policy and the organizational
structure and responsibilities for admieistering the career program within
the Central Intelligence Agency,
2. Polacr
The beep personnel management policy of the Central Intelligence Agency
contemplates a progressive program that Identifies, develops, effectively
uses and rewards individuals who have qualifications required by the
Agency; motivates them toward rendering maxima service to the Agency;
and eliminates from the service, in an equitable manner, those who fail
to perform as effective members of the Agencyo This policy will be
implemented through the career program which is applicable to all U. So
citizens who are Staff Employees or Staff Agents of the Agency, whether
on duty in headquartere or in the field.
PUAPOSE
The purpose of the career program is to establisd personnel management
prectioes whidt will develop people to the Nilen extent to meet present
e
DOCUMENT NO.
HO CHANGE IN CLASS
p DECLASSIFIED
VLASS. CH U/DED TO: IS S
2.-6/1
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Career Service
Training
Communications
Personnel
Office, Deputy
Director (Plans)
DD/P Clerical
Foreign Intelligence
Political and
Psychological Warfare
Paramilitary Operations
Technical Services
Office, Deputy Director
(Intelligence)
National Estimates
Collection and
Dissemination
Research and Reports
Current Intelligence
Scientific Intelligence
Operaticns
Office Dapaty Director
(AdLnistration)
Budget and Finance
Logistics
Medical
Security
Career Service Head
Director of Training
Assistant Director for
Communications
Assistant Director for Personnel
Deputy Director (Plans)
Chief of Administration, DD/P
Chief, Foreign Intelligence Staff
Chief, Political and Psychological
Warfare Staff
Chief, Paramilitary Operations Staff
Chief, Technioal Services Staff
Deputy Director (Intelligence)
Assistant Director for National
Estimates
Assistant Director for Collection
and Dissemination
Assistant Director for Research
and Reports
Assistant Director for Current
Intelligence
Assistant Director for
Scientific Intelligence
Assistant Director for Operations
Deputy Director (Administration)
Comptroller
Chief, Logistics Office
Chief, Medical Staff
Direator of Security
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CONFIDENTIAL
.arsor
During discussion of responsibilitios of the Assistant Director
for Personnel in connection with proposed changes in the administration
of the Creer Service Program, the Deputy Director and the Inspector
General approved the following change in the statement of the responsi-
bilities of the Assistant Director for Personnel as stated in paragraph
2f(7) of Regulation
From
To
"(7) Staff assistance to Agency officials in the administration
of the Agency Career Service Fromm, including secretariat and
other administrative services for the CIA Career Service Board."
"(7) Administering and Monitoring the Agency Career Service
Program. Developing and recommending the establishment of
policies and procedures for the management of Career Hoards
and, through review of their activities, periodically advising
the Director as to the effectiveness and accomplishments of the
program."
"ler
AlTACHMENT B
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MIULATION
47 May i.161;
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and anticipated perecnnel needs of the Agenoy an to aucouralsof
long-tere service with the Agency*
G. ADMINISTRATION
so THE ASSISTANT DIRECTOR FOR PERSONNEL
The Assistant Direotor for Personneluill direct the 'ivitiee or
ena. Boards and Panels as are astablishet. at the Agency Ixtvel to
implement the caner prtwen and will advise and *east the Beads
of Career Servicec in carrying 4ut se:pelts at their responsibilities
for personnel. career nausgement0
TRE CIA CAREER COUNCIL
(1)
(2)
Orgsniestion'
Assistant Director far Personnel - aairman
Inspector General - Mester
Deputy Director (Administration) - Member
Deputy Director (1;itelligence) - Mester
Deputy Director '(Piane) - Merber
Director or Trainirg - Mambee
Assistant Director for Communication& - Menber
Responsibilities and Functions
ta) General fteporsibilities and fevautionis
The CIA Career Council mill function 4.5 an sava4ry gro)4p
to the Assistant Director for ker90037Ati3 TOs lAsaltmen
will seek the opinions of Um; Coati as the tvasiatiity
and advisability of major OP SIguirkant ?bingos ia, ar
additions too Agency persanoel pokier, 1tN4ADT1 OX the
Qounsil sili tring to it proposa13 for OA re41.010P a
F401016r--
A
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ittot 11
Agency perste- - policy or problem which might effeet
baste pee maned polieyo The Assistent Director for
Personnel will give care/Nu coneideratien to such opini
in reernmentting ehanges or edditions for the approval of
the Director and in the implemerktetion of approved personnel
throughout the Ageneyo
(b) Specific Respeusi.bilities and Functiormt
The Cooneil *11 be reaponelble for the tenoning tasks
(1)
Recommending to the Assistant Director for Personae:II,
the establishment of such
bey Boards and Panels 4W
ere neceesary to implement the personnel progreno
(1,) Petraish Information ar3d advice so that the Aseletant
Director for Par normal may prepare and submit
periodically te the Dieectier a swear/ of .the verse
time of the Agency os persennel pregrare
Co) Meetings
The Council will meet at the call of the Chair either
on his initiettive or wen the request of any membereif
mether cannot be presente,? w.sw be -represented by his
Deeentyo Agenlie of soheduled mteli Up ili be distributek
in advance and stenogrephie reotve of met-Uwe W. he
prepared at the dieeretion of the Cela:Inap
t
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iiiiiiIIIII
REGULATION
PERSONNEL
15 June 1954
c. CAREER SERVICES
Career Services are established within CIA as listed in Attachment
A0 under the direction of the officials indicated. An appropriate
Service Designation, as shown, will be used to identify each Staff
EMpleyee and Staff Agent with the Career Service to which he is
assigned.
(1) Responsibilities of Heads of Career Services
The Heads of Career Services, as shown above, are responsible
for monitoring the application and functioning of the Agency
personnel program as it applies to the members of their Career
Service, including:
(a) Improving and strengthening personnel administration within
that Career $ervide;
(b) Planning the utilization and development of such individuals,
including their training, assignments rotation and advance-
ment;
(c) Reviewing fitness reports of such individuals;
(d) Planning the rotation and reassignment of such individuals
so ea to enable that Career Service to meet lonoprunge per.,
sonnel requirements through orderly processes;
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PERSONNEL
35 June 1954
(e) Reviewing requests for personnel actions to reassign,
promote, demote or separate such individuals and recommending
appropriate action to the Assistant Director for Personnel;
CO Reviewing proposals for the training of such indivicklals
and recommending their participation in Agency-sponsored
training.
(2) Career Boards
The Read of each Career Service will establish a Career Board to
advise him on personnel management matters and, as he directs,
to monitor the application and functioning of the personnel program
as it affects the members of that Career Service.
(a) Organisation
Each Career Board will be composed of The following
officials:
(1..) The Read of the Career Service ex-officio;
(2) Three or more Staff or Division Chiefs or off/dials
of comparable responsibility;
(2) A Senior Personnel or Administrative Officer who will
be responsible for providing technical advice and
assistance to the Board.
do ASSIMMINT OF SERVICE DESIONATICHS
The Posistant Director for Personnel will assign a basic Service
Designation to each Staff Employee and Staff Agent in the Agency which
will identify him with an appropriate Career Service. In so doing,
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REGULATICH
sow'
PERSQUEL
15 June 1954
25X1A
the Aesistant Director for Personnel will give full consideration to
the Head of the Career Service involved, the individaalls desires,
and to his qualifications for assignment to a particular Career.
Service, An individual may later hold other or additional appropriate
Service DesignationMo
.6.
oiWittrir?
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NOTICE PMSONEL
ND. thew 1954
MINING FOR REASSIGNMENT
PC.1107
It shall be the policy of the Agency to afford reasonable training to any
individual Trhose services have been satisfactory and whose zieaseleei ent
within the same or to another Agency ccmponent is desirable? Specific
training shall be provided when there is reasonable expectancy that such
training will qualify the individual for another assignment in an allied or
different line of work,
CM
;:a
UI
UI
III
UI
RESPONSIBILITIES
A:19ISTANT DIRECTOR FOR PERSONNEL
The Assistant Director for Personnel will identify placement possibilities
sal desirebilities for intlividuale and will cause the individual to be
ineediately reassigned to the table of organization of the gaining
catiponsat. The Assistant Director for Personnel will participate with
the head of the career service and the Director of Training in establishing
a training program which will be consistent with the education; experience;
end oetireated work potential of each individual concerned,
HEADS OF CAREER SERVICES
If the individnel fails to perform acceptably in his new assietereent, the
head of that career service will take action in accordance with existing
regilations either to effect a new assigament or to Urininate the services
of the employee,
a, DIRECTOR OF TRAINING
(1) The Director of Training will provide such formal training as is
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(2)
F'ERS CLUE,
June 1994
determined to be necessary, and is determined to be feasible
through training processes, in order to prepare the individual
for the neu assignment?
At the completion of such training the Director of Training will
submit an appropriate evaluation.
- 2 -
ZOWEBiallighlrom
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