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SEC. 707. REGULATIONS.

                                                                                                                                                                                                                                                                                                                        

 Title[ Title I\Subtitle A\Sec. 101                                               Contents

                                                                                                                                                                                                                                                                                                                       


 <<NOTE: 29 USC 1187.>>  


    ``The Secretary, consistent with section 104 of the Health Care

Portability and Accountability Act of 1996, may promulgate such

regulations as may be necessary or appropriate to carry out the

provisions of this part. The Secretary may promulgate any interim final

rules as the Secretary determines are appropriate to carry out this

part.''.


    (b) Enforcement With Respect to Health Insurance Issuers.--Section

502(b) of such Act (29 U.S.C. 1132(b)) is amended by adding at the end

the following new paragraph:


    ``(3) The Secretary is not authorized to enforce under this part any

requirement of part 7 against a health insurance issuer offering health

insurance coverage in connection with a group health plan (as defined in

section 706(a)(1)). Nothing in this paragraph shall affect the authority

of the Secretary to issue regulations to carry out such part.''.


     (c) Disclosure of Information to Participants and Beneficiaries.--

            (1) In general.--Section 104(b)(1) of such Act (29 U.S.C.

        1024(b)(1)) is amended in the matter following subpara-

        graph (B)--


                    (A) by striking ``102(a)(1),'' and inserting

                ``102(a)(1) (other than a material reduction in covered

                services or benefits provided in the case of a group

                health plan (as defined in section 706(a)(1))),''; and


                    (B) by adding at the end the following new

                sentences: ``If there is a modification or change

                described in section 102(a)(1) that is a material

                reduction in covered services or benefits provided under

                a group health plan (as defined in section 706(a)(1)), a

                summary description of such modification or change shall

                be furnished to participants and beneficiaries not later

                than 60 days after the date of the adoption of the

                modification or change. In the alternative, the plan

                sponsors may provide such description at regular

                intervals of not more than 90 days. The Secretary shall

                issue regulations within 180 days after the date of

                enactment of the Health Insurance Portability and

                Accountability Act of 1996, providing alternative

                mechanisms to

                delivery by mail through which group health plans (as so

                defined) may notify participants and beneficiaries of

                material reductions in covered services or benefits.''.


            (2) Plan description and summary.--Section 102(b) of such

        Act (29 U.S.C. 1022(b)) is amended--

                    (A) by inserting ``in the case of a group health

                plan (as defined in section 706(a)(1)), whether a health

                insurance issuer (as defined in section 706(b)(2)) is

                responsible for the financing or administration

                (including payment of claims) of the plan and (if so)

                the name and address of such issuer;'' after ``type of

                administration of the plan;''; and


                    (B) by inserting ``including the office at the

                Department of Labor through which participants and

                beneficiaries may seek assistance or information

                regarding their rights under this Act and the Health

                Insurance Portability and Accountability Act of 1996

                with respect to health benefits that are offered through

                a group health plan (as defined in section 706(a)(1))''

                after ``benefits under the plan''.


    (d) Treatment of Health Insurance Issuers Offering Health Insurance

Coverage to Noncovered Plans.--Section 4(b) of such Act (29 U.S.C.

1003(b)) is amended by adding at the end (after and below paragraph (5))

the following:


``The provisions of part 7 of subtitle B shall not apply to a health

insurance issuer (as defined in section 706(b)(2)) solely by reason of

health insurance coverage (as defined in section 706(b)(1)) provided by

such issuer in connection with a group health plan (as defined in

section 706(a)(1)) if the provisions of this title do not apply to such

group health plan.''.


    (e) Reporting and Enforcement With Respect to Certain

Arrangements.--

            (1) In general.--Section 101 of such Act (29 U.S.C. 1021) is

        amended--

                    (A) by redesignating subsection (g) as subsection

                (h), and

                    (B) by inserting after subsection (f) the following

                new subsection:


    ``(g) Reporting by Certain Arrangements.--The Secretary may, by

regulation, require multiple employer welfare arrangements providing

benefits consisting of medical care (within the meaning of section

706(a)(2)) which are not group health plans to report, not more

frequently than annually, in such form and such manner as the Secretary

may require for the purpose of determining the extent to which the

requirements of part 7 are being carried out in connection with such

benefits.''.


            (2) Enforcement.--

                    (A) In general.--Section 502 of such Act (29 U.S.C.

                1132) is amended--

                          (i) in subsection (a)(6), by striking ``under

                      subsection (c)(2) or (i) or (l)'' and inserting

                      ``under paragraph (2), (4), or (5) of subsection

                      (c) or under

                      subsection (i) or (l)''; and


                          (ii) in the last 2 sentences of subsection

                      (c), by striking ``For purposes of this

                      paragraph'' and all that follows through ``The

                      Secretary and'' and inserting the following:


    ``(5) The Secretary may assess a civil penalty against any person of

up to $1,000 a day from the date of the person's failure or refusal to

file the information required to be filed by such person with the

Secretary under regulations prescribed pursuant to section 101(g).


    ``(6) The Secretary and''.

                    (B) Technical and conforming amendment.--Section

                502(c)(1) of such Act (29 U.S.C. 1132(c)(1)) is amended

                by adding at the end the following sentence: ``For

                purposes of this paragraph, each violation described in

                subparagraph (A) with respect to any single participant,

                and each violation described in subparagraph (B) with

                respect to any single participant or beneficiary, shall

                be treated as a separate violation.''.


            (3) Coordination.--Section 506 of such Act (29 U.S.C. 1136)

        is amended by adding at the end the following new subsection:


    ``(c) Coordination of Enforcement With States With Respect to

Certain Arrangements.--A State may enter into an agreement with the

Secretary for delegation to the State of some or all of the Secretary's

authority under sections 502 and 504 to enforce the requirements under

part 7 in connection with multiple employer welfare arrangements,

providing medical care (within the meaning of section 706(a)(2)), which

are not group health plans.''.


    (f) Conforming Amendments.--

            (1) Section 514(b) of such Act (29 U.S.C. 1144(b)) is

        amended by adding at the end the following new paragraph:


    ``(9) For additional provisions relating to group health plans, see

section 704.''.


            (2)(A) Part 6 of subtitle B of title I of such Act (29

        U.S.C. 1161 et seq.) is amended by striking the heading and

        inserting the following:


   ``Part 6--Continuation Coverage and Additional Standards for Group

                             Health Plans''.


            (B) The table of contents in section 1 of such Act is

        amended by striking the item relating to the heading for part 6

        of subtitle B of title I and inserting the following:


   ``Part 6--Continuation Coverage and Additional Standards for Group

                             Health Plans''.


            (3) The table of contents in section 1 of such Act (as

        amended by the preceding provisions of this section) is amended

        by inserting after the items relating to part 6 the following

        new items:


   ``Part 7--Group Health Plan Portability, Access, and Renewability

                              Requirements


``Sec. 701. Increased portability through limitation on preexisting

                      condition exclusions.

``Sec. 702. Prohibiting discrimination against individual participants

                      and beneficiaries based on health status.

``Sec. 703. Guaranteed renewability in multiemployer plans and multiple

                      employer welfare arrangements.

``Sec. 704. Preemption; State flexibility; construction.

``Sec. 705. Special rules relating to group health plans.

``Sec. 706. Definitions.

``Sec. 707. Regulations.''.


    (g) Effective <<NOTE: 29 USC 1181 note.>>  Dates.--

            (1) In general.--Except as provided in this section, this

        section (and the amendments made by this section) shall apply

        with respect to group health plans for plan years beginning

        after June 30, 1997.


            (2) Determination of creditable coverage.--

                    (A) Period of coverage.--


                          (i) In general.--Subject to clause (ii), no

                      period before July 1, 1996, shall be taken into

                      account under part 7 of subtitle B of title I of

                      the Employee Retirement Income Security Act of

                      1974 (as added by this section) in determining

                      creditable coverage.


                          (ii) Special rule for certain periods.--The

                      Secretary of Labor, consistent with section 104,

                      shall provide for a process whereby individuals

                      who need to establish creditable coverage for

                      periods before July 1, 1996, and who would have

                      such coverage credited but for clause (i) may be

                      given credit for creditable coverage for such

                      periods through the presentation of documents or

                      other means.


                    (B) Certifications, etc.--

                          (i) In general.--Subject to clauses (ii) and

                      (iii), subsection (e) of section 701 of the

                      Employee Retirement Income Security Act of 1974

                      (as added by this section) shall apply to events

                      occurring after June 30, 1996.


                          (ii) No certification required to be provided

                      before june 1, 1997.--In no case is a

                      certification required to be provided under such

                      subsection before June 1, 1997.


                          (iii) Certification only on written request

                      for events occurring before october 1, 1996.--In

                      the case of an event occurring after June 30,

                      1996, and before October 1, 1996, a certification

                      is not required to be provided under such

                      subsection unless an individual (with respect to

                      whom the certification is otherwise required to be

                      made) requests such certification in writing.


                    (C) Transitional rule.--In the case of an individual

                who seeks to establish creditable coverage for any

                period for which certification is not required because

                it relates to an event occurring before June 30, 1996--


                          (i) the individual may present other credible

                      evidence of such coverage in order to establish

                      the period of creditable coverage; and


                          (ii) a group health plan and a health

                      insurance issuer shall not be subject to any

                      penalty or enforcement action with respect to the

                      plan's or issuer's crediting (or not crediting)

                      such coverage if the plan or issuer has sought to

                      comply in good faith with the applicable

                      requirements under the amendments made by this

                      section.


            (3) Special rule for collective bargaining agreements.--

        Except as provided in paragraph (2), in the case of a group

        health plan maintained pursuant to one or more collective

        bargaining agreements between employee representatives and one

        or more employers ratified before the date of the enactment of

        this Act, part 7 of subtitle B of title I of Employee Retirement

        Income Security Act of 1974 (other than section 701(e) thereof)

        shall not apply to plan years beginning before the later of--


                    (A) the date on which the last of the collective

                bargaining agreements relating to the plan terminates

                (determined without regard to any extension thereof

                agreed to after the date of the enactment of this Act),

                or

                    (B) July 1, 1997.


        For purposes of subparagraph (A), any plan amendment made

        pursuant to a collective bargaining agreement relating to the

        plan which amends the plan solely to conform to any requirement

        of such part shall not be treated as a termination of such

        collective bargaining agreement.


            (4) Timely regulations.--The Secretary of Labor, consistent

        with section 104, shall first issue by not later than April 1,

        1997, such regulations as may be necessary to carry out the

        amendments made by this section.


            (5) Limitation on actions.--No enforcement action shall be

        taken, pursuant to the amendments made by this section, against

        a group health plan or health insurance issuer with respect to a

        violation of a requirement imposed by such amendments before

        January 1, 1998, or, if later, the date of issuance of

        regulations referred to in paragraph (4), if the plan or issuer

        has sought to comply in good faith with such requirements.


 

                                                                                                                                                                                                                                                                                                                                                                        

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