Working Families Health Access Act of 1995

Summary

Working Families Health Access Act of 1995 - Amends the Internal Revenue Code to impose an excise tax on a health insurance policy issuer (or, in the case of a self-insured plan, the sponsor) equal to a specified percentage of premiums received (or, in the case of a self-insured plan, of expenditures) under the policy or plan during the calendar year for failure to meet the standards specified in this Act. Prohibits the establishment or imposition by group health plans or carriers offering health insurance coverage in connection with a plan, or for individuals with qualifying previous coverage, of eligibility, continuation, enrollment, or contribution requirements based on factors directly related to health status, medical condition, claims experience, receipt of health care, medical history, disability, or evidence of insurability. Requires the use of preexisting condition limitations or exclusions to be limited to a three-month period before the date of enrollment during which the condition was diagnosed or treated. Limits the period of limitation or exclusion relating to treatment of the condition to no more than six months and credits periods of qualifying previous coverage to reduce that period. Makes exceptions to the limitation or exclusion period for treatment related to pregnancy, newborns, and adopted children. Prohibits a carrier from refusing to renew health insurance coverage except for specified reasons, including premium nonpayment or fraud by the insured. Details allowable nondiscriminatory conditions for discontinuation of coverage, geographic limitations, and minimum participation requirements. Allows States to establish, implement, or continue in effect health insurance coverage standards that are at least as stringent as those established by this Act. Qualifies, for purposes of the provisions imposing an excise tax for the failure of group health plans to meet continuation coverage requirements, coverage that meets certain general availability and preexisting condition limitation requirements and that has an actuarial value of at least two-thirds or one-half of the costliest continuation coverage available under the plan (excluding that in which an insignificant proportion of eligible individuals is enrolled) at respectively reduced premiums. Treats, with certain exceptions, divorce (or annulment) or separation of a covered employee from the employee's spouse, if the employee disenrolls a qualified beneficiary within the 12-month period preceding the date of such divorce or separation, as a qualifying event (allowing the election of continuation coverage) and the loss of coverage a result (and by reason) of such event. Excludes eligibility under part B of Medicare on the basis of end stage renal disease as a condition that terminates continuation coverage (under current law, becoming eligible under Medicare terminates such coverage).

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 10 May 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 10 May 1995

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• Introduced in House

  summary · EN · 10 May 1995

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