Health Insurance Reform Act of 1996

Summary

TABLE OF CONTENTS: Title I: Health Care Access, Portability, and Renewability Subtitle A: Group Market Rules Subtitle B: Individual Market Rules Subtitle C: COBRA Clarifications Subtitle D: Private Health Plan Purchasing Cooperatives Subtitle E: Application and Enforcement of Standards Subtitle F: Miscellaneous Provisions Title II: Increase in Deduction for Health Insurance Costs of Self-Employed Individuals Subtitle A: Increase in Deduction For Health Insurance Costs of Self-Employed Individuals Subtitle B: Revenue Offsets Health Insurance Reform Act of 1996 - Title I: Health Care Access, Portability, and Renewability - Subtitle A: Group Market Rules - Prohibits insurers from declining to offer whole group coverage to a group purchaser. Allows plans to establish eligibility, continuation, enrollment, or premium requirements, provided the requirements are not based on health status, medical condition, or similar factors. (Sec. 102) Mandates plan renewability, except for premium nonpayment, material misrepresentation, plan termination, or other specified reasons. (Sec. 103) Specifies circumstances in which a plan may impose a benefit limitation or exclusion of up to 12 months because of a preexisting condition with certain exceptions. Allows (unless preempted under the Employee Retirement Income Security Act of 1974 (ERISA)) State laws that: (1) impose limitation or exclusion periods for preexisting conditions of shorter maximum periods than 12 months; or (2) recognize previous qualifying coverage for individuals experiencing a lapse period of longer than 30 days. (Sec. 104) Mandates special enrollment periods for individuals who have certain types of changes in family composition or employment status. (Sec. 105) Prescribes guidelines for disclosures an insurer must make to a small employer (as defined in State law or, if not defined in State law, employers with not more than 50 employees). Amends ERISA to modify requirements regarding disclosures to plan participants and beneficiaries. Subtitle B: Individual Market Rules - Prohibits an insurer (for an individual in a period of previous qualifying coverage) from declining to offer coverage or denying enrollment based on health status, including: (1) medical condition; (2) claims experience; (3) receipt of health care; (4) medical history; (5) genetic information; (6) evidence of insurability (including conditions arising out of acts of domestic violence); or (7) disability. (Sec. 111) Mandates renewability of coverage for individuals, except for nonpayment of premiums, material misrepresentation, or plan termination. (Sec. 112) Requires that State law in effect on or after enactment of this Act apply in lieu of the standards of this subtitle unless the Secretary of Health and Human Services determines that the State law does not achieve mandated access goals. Allows States to meet those goals by using a National Association of Insurance Commissioners (NAIC) model adopted using a consultation process the Secretary approves. Subtitle C: COBRA Clarifications - Amends the Public Health Service Act, ERISA, and the Internal Revenue Code to modify continuation coverage requirements. Subtitle D: Private Health Plan Purchasing Cooperatives - Requires a State to certify private health plan purchasing cooperatives (HPPCs) meeting certain requirements, or the Secretary of Labor to certify any a State fails to. Subtitle E: Application and Enforcement of Standards - Deems a requirement or standard imposed on a plan under this Act to be imposed on the issuer. (Sec. 202) (sic) Requires each State to mandate that each plan in the State meet the standards under this Act pursuant to an enforcement plan filed by the State with the Secretary of Labor, with employee plans enforced in the same manner as under specified ERISA provisions. Requires Federal enforcement if a State fails to do so. Subtitle F: Miscellaneous Provisions - Mandates a study and report to appropriate congressional committees on: (1) mechanisms to ensure the availability of reasonably priced health coverage to employers purchasing group and individuals purchasing non-group coverage; and (2) whether standards limiting premium variation will further the purposes of this Act. Title II: Increase in Deduction for Health Insurance Costs of Self-Employed Individuals - Subtitle A: Increase in Deduction For Health Insurance Costs of Self-Employed Individuals - Amends the Internal Revenue Code to increase the deductible percentage of the self-employed individuals' health insurance costs. Subtitle B: Revenue Offsets - Chapter 1: Treatment of Individuals Who Expatriate - Sets forth tax responsibilities relating to expatriation. Treats the expatriate's property as sold on the expatriation date, subject to an exclusion for certain gain. Sets forth reporting requirements. Chapter 2: Foreign Trust Tax Compliance - Revises or establishes provisions regarding: (1) informational filings regarding certain foreign trusts and the penalties for failing to file; (2) foreign trusts having one or more U.S. beneficiaries; (3) the circumstances in which a foreign grantor will be treated as an owner; (4) reporting gifts from foreign persons; (5) the interest charge on accumulation distributions from foreign trusts; (6) loans from foreign trusts; (7) the definitions of "United States person" (as it relates to estates or trusts), "foreign estate," and "foreign trust;" and (8) the treatment of a domestic trust that becomes a foreign trust with regard to a tax on transfers to avoid tax and a penalty for failure to file a related return. Chapter 3: Repeal of Bad Debt Reserve Method for Thrift Savings Associations - Declares that bad debt reserve banking provisions shall not apply after a specified date. Provides for the resulting accounting method change.

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3 official files

• Introduced in House (text)

  Introduced in House · EN · 28 March 1996

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• Introduced in House (PDF)

  Introduced in House · EN · 28 March 1996

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• Introduced in House

  summary · EN · 28 March 1996

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