[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6384 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 6384
To amend the Employee Retirement Income Security Act of 1974, title
XXII of the Public Health Service Act, and the Internal Revenue Code of
1986 to improve certain notifications provided to qualified
beneficiaries by group health plans in the case of COBRA qualifying
events.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 12, 2022
Mr. Harder of California (for himself and Mr. Courtney) introduced the
following bill; which was referred to the Committee on Education and
Labor, and in addition to the Committees on Energy and Commerce, and
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974, title
XXII of the Public Health Service Act, and the Internal Revenue Code of
1986 to improve certain notifications provided to qualified
beneficiaries by group health plans in the case of COBRA qualifying
events.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Awareness of Health
Coverage Options Act of 2022''.
SEC. 2. IMPROVEMENT OF CERTAIN NOTIFICATIONS PROVIDED TO QUALIFIED
BENEFICIARIES BY GROUP HEALTH PLANS IN THE CASE OF COBRA
QUALIFYING EVENTS.
(a) Employee Retirement Income Security Act of 1974.--
(1) In general.--Section 606 of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1166) is amended--
(A) in subsection (a)(4), in the matter following
subparagraph (B), by striking ``under this subsection''
and inserting ``under this part in accordance with the
notification requirements under subsection (c)''; and
(B) in subsection (c)--
(i) by striking ``For purposes of
subsection (a)(4), any notification'' and
inserting ``For purposes of subsection (a)(4)--
``(1) any notification'';
(ii) by striking ``, whichever is
applicable, and any such notification'' and
inserting ``of subsection (a), whichever is
applicable;
``(2) any such notification''; and
(iii) by striking ``such notification is
made'' and inserting ``such notification is
made; and
``(3) any such notification shall, with respect to each
qualified beneficiary with respect to whom such notification is
made, include information regarding any Exchange established
under title I of the Patient Protection and Affordable Care Act
through which such a qualified beneficiary may be eligible to
enroll in a qualified health plan (as defined in section 1301
of the Patient Protection and Affordable Care Act), including--
``(A) the publicly accessible Internet website
address for such Exchange;
``(B) the publicly accessible Internet website
address for the Find Local Help directory maintained by
the Department of Health and Human Services on the
healthcare.gov Internet website (or a successor
website);
``(C) a clear explanation that--
``(i) an individual who is eligible for
continuation coverage may be eligible to enroll
instead, with financial assistance, in a
qualified health plan offered through such
Exchange, but, in the case that such individual
elects to enroll in such continuation coverage
and subsequently elects to terminate such
continuation coverage before the period of such
continuation coverage expires, such individual
may not be eligible to enroll in a qualified
health plan offered through such Exchange
during a special enrollment period if more than
60 days have elapsed since the individual's
loss of coverage as an employee;
``(ii) an individual who elects to enroll
in continuation coverage will remain eligible
to enroll in a qualified health plan offered
through such Exchange during an open enrollment
period or another special enrollment period for
which the individual is eligible and may be
eligible for financial assistance with respect
to enrolling in such a qualified health plan;
and
``(iii) an individual may apply for, and if
eligible, enroll in Medicaid or the Children's
Health Insurance Program (CHIP), at any time,
with no special enrollment period required;
``(D) information on consumer protections with
respect to enrolling in a qualified health plan offered
through such Exchange, including the requirement for
such a qualified health plan to provide coverage for
essential health benefits (as defined in section
1302(b) of the Patient Protection and Affordable Care
Act) and the requirements applicable to such a
qualified health plan under part A of title XXVII of
the Public Health Service Act; and
``(E) information on the availability of financial
assistance with respect to enrolling in a qualified
health plan.''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply with respect to qualifying events occurring on or
after the date that is 90 days after the date of the enactment
of this Act.
(b) Public Health Service Act.--
(1) In general.--Section 2206 of the Public Health Service
Act (42 U.S.C. 300bb-6) is amended--
(A) by striking ``In accordance'' and inserting the
following:
``(a) In General.--In accordance'';
(B) by striking ``of such beneficiary's rights
under this subsection'' and inserting ``of such
beneficiary's rights under this title in accordance
with the notification requirements under subsection
(b)''; and
(C) by striking ``For purposes of paragraph (4),''
and all that follows through ``such notification is
made.'' and inserting the following:
``(b) Rules Relating to Notification of Qualified Beneficiaries by
Plan Administrator.--For purposes of subsection (a)(4)--
``(1) any notification shall be made within 14 days of the
date on which the plan administrator is notified under
paragraph (2) or (3) of subsection (a), whichever is
applicable;
``(2) any such notification to an individual who is a
qualified beneficiary as the spouse of the covered employee
shall be treated as notification to all other qualified
beneficiaries residing with such spouse at the time such
notification is made; and
``(3) any such notification shall, with respect to each
qualified beneficiary with respect to whom such notification is
made, include information regarding any Exchange established
under title I of the Patient Protection and Affordable Care Act
through which such a qualified beneficiary may be eligible to
enroll in a qualified health plan (as defined in section 1301
of the Patient Protection and Affordable Care Act), including--
``(A) the publicly accessible Internet website
address for such Exchange;
``(B) the publicly accessible Internet website
address for the Find Local Help directory maintained by
the Department of Health and Human Services on the
healthcare.gov Internet website (or a successor
website);
``(C) a clear explanation that--
``(i) an individual who is eligible for
continuation coverage may be eligible to enroll
instead, with financial assistance, in a
qualified health plan offered through such
Exchange, but, in the case that such individual
elects to enroll in such continuation coverage
and subsequently elects to terminate such
continuation coverage before the period of such
continuation coverage expires, such individual
may not be eligible to enroll in a qualified
health plan offered through such Exchange
during a special enrollment period if more than
60 days have elapsed since the individual's
loss of coverage as an employee;
``(ii) an individual who elects to enroll
in continuation coverage will remain eligible
to enroll in a qualified health plan offered
through such Exchange during an open enrollment
period or another special enrollment period for
which the individual is eligible and may be
eligible for financial assistance with respect
to enrolling in such a qualified health plan;
and
``(iii) an individual may apply for, and if
eligible, enroll in Medicaid or the Children's
Health Insurance Program (CHIP), at any time,
with no special enrollment period required;
``(D) information on consumer protections with
respect to enrolling in a qualified health plan offered
through such Exchange, including the requirement for
such a qualified health plan to provide coverage for
essential health benefits (as defined in section
1302(b) of the Patient Protection and Affordable Care
Act) and the requirements applicable to such a
qualified health plan under part A of title XXVII; and
``(E) information on the availability of financial
assistance with respect to enrolling in a qualified
health plan.''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply with respect to qualifying events occurring on or
after the date that is 90 days after the date of the enactment
of this Act.
(c) Internal Revenue Code of 1986.--
(1) In general.--Section 4980B(f)(6) of the Internal
Revenue Code of 1986 is amended--
(A) in subparagraph (D)--
(i) in clause (ii), by striking ``under
subparagraph (C)'' and inserting ``under clause
(iii)''; and
(ii) by redesignating clauses (i) and (ii)
as subclauses (I) and (II), respectively, and
moving the margin of each such subclause, as so
redesignated, 2 ems to the right;
(B) by redesignating subparagraphs (A) through (D)
as clauses (i) through (iv), respectively, and moving
the margin of each such clause, as so redesignated, 2
ems to the right;
(C) by striking ``In accordance'' and inserting the
following:
``(A) In general.--In accordance'';
(D) by inserting after ``of such beneficiary's
rights under this subsection'' the following: ``in
accordance with the notification requirements under
subparagraph (C)''; and
(E) by striking ``The requirements of subparagraph
(B)'' and all that follows through ``such notification
is made.'' and inserting the following:
``(B) Alternative means of compliance with
requirement for notification of multiemployer plans by
employers.--The requirements of subparagraph (A)(ii)
shall be considered satisfied in the case of a
multiemployer plan in connection with a qualifying
event described in paragraph (3)(B) if the plan
provides that the determination of the occurrence of
such qualifying event will be made by the plan
administrator.
``(C) Rules relating to notification of qualified
beneficiaries by plan administrator.--For purposes of
subparagraph (A)(iv)--
``(i) any notification shall be made within
14 days (or, in the case of a group health plan
which is a multiemployer plan, such longer
period of time as may be provided in the terms
of the plan) of the date on which the plan
administrator is notified under clause (ii) or
(iii) of subparagraph (A), whichever is
applicable;
``(ii) any such notification to an
individual who is a qualified beneficiary as
the spouse of the covered employee shall be
treated as notification to all other qualified
beneficiaries residing with such spouse at the
time such notification is made; and
``(iii) any such notification shall, with
respect to each qualified beneficiary with
respect to whom such notification is made,
include information regarding any Exchange
established under title I of the Patient
Protection and Affordable Care Act through
which such a qualified beneficiary may be
eligible to enroll in a qualified health plan
(as defined in section 1301 of the Patient
Protection and Affordable Care Act),
including--
``(I) the publicly accessible
Internet website address for such
Exchange;
``(II) the publicly accessible
Internet website address for the Find
Local Help directory maintained by the
Department of Health and Human Services
on the healthcare.gov Internet website
(or a successor website);
``(III) a clear explanation that--
``(aa) an individual who is
eligible for continuation
coverage may be eligible to
enroll instead, with financial
assistance, in a qualified
health plan offered through
such Exchange, but, in the case
that such individual elects to
enroll in such continuation
coverage and subsequently
elects to terminate such
continuation coverage before
the period of such continuation
coverage expires, such
individual may not be eligible
to enroll in a qualified health
plan offered through such
Exchange during a special
enrollment period if more than
60 days have elapsed since the
individual's loss of coverage
as an employee;
``(bb) an individual who
elects to enroll in
continuation coverage will
remain eligible to enroll in a
qualified health plan offered
through such Exchange during an
open enrollment period or
another special enrollment
period for which the individual
is eligible and may be eligible
for financial assistance with
respect to enrolling in such a
qualified health plan; and
``(cc) an individual may
apply for, and if eligible,
enroll in Medicaid or the
Children's Health Insurance
Program (CHIP), at any time,
with no special enrollment
period required;
``(IV) information on consumer
protections with respect to enrolling
in a qualified health plan offered
through such Exchange, including the
requirement for such a qualified health
plan to provide coverage for essential
health benefits (as defined in section
1302(b) of the Patient Protection and
Affordable Care Act) and the
requirements applicable to such a
qualified health plan under part A of
title XXVII of the Public Health
Service Act; and
``(V) information on the
availability of financial assistance
with respect to enrolling in a
qualified health plan.''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply with respect to qualifying events occurring on or
after the date that is 90 days after the date of the enactment
of this Act.
(d) Model Notices.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of the Labor, in consultation with
the Secretary of the Treasury and the Secretary of Health and Human
Services, shall--
(1) update the model Consolidated Omnibus Budget
Reconciliation Act of 1985 (referred to in this subsection as
``COBRA'') continuation coverage general notice and the model
COBRA continuation coverage election notice developed by the
Secretary of Labor for purposes of facilitating compliance of
group health plans with the notification requirements under
section 606 of the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1166) to include the information described in
paragraph (3) of subsection (c) of such section 606, as added
by subsection (a)(1);
(2) provide an opportunity for consumer testing of each
such notice, as so updated, to ensure that each such notice is
clear and understandable to the average participant or
beneficiary of a group health plan; and
(3) rename the model COBRA continuation coverage general
notice and the model COBRA continuation coverage election
notice as the ``model COBRA continuation coverage and
Affordable Care Act coverage general notice'' and the ``model
COBRA continuation coverage and Affordable Care Act coverage
election notice'', respectively.
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