Health Insurance Equity Act of 1995

Summary

Health Insurance Equity Act of 1995 - Amends the Social Security Act to add a new title XXI (Standards for Health Coverage). Prohibits an insurer or group health plan providing health coverage from denying, limiting, or conditioning health services coverage or benefits, or varying premiums, based on an individual's health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability. Permits coverage exclusion of a preexisting condition for the first six months only. Prohibits such exclusion for: (1) services to newborns covered at the time of birth; or (2) treatment of conditions relating to pregnancy. Provides for the crediting of previous coverage. Specifies terms under which a health insurer providing coverage to individuals or small employers may cease from enrolling new individuals or small employers because the insurer's financial or provider capacity to serve current beneficiaries will be impaired if required to enroll additional beneficiaries. Defines small employer as one with fewer than 50 employees who normally perform, on a monthly basis, at least 30 hours of service per week. Prohibits: (1) denial of coverage renewal except for specified, non-health-related reasons; and (2) market reentry for five years for any insurer which elects not to renew any health insurance coverage for individuals or small employers. Makes each State responsible for establishing a program to enforce the requirements of this Act. Authorizes appropriations for grants to States for such enforcement programs. Provides for Federal enforcement in the event that an annual review of a State enforcement program shows such program to be inadequate. Requires the Secretary of Health and Human Services to provide for procedures for the imposition of specified civil money penalties on any noncomplying insurer in a State which fails to provide for adequate enforcement of the requirements of this Act. Provides for enforcement of such requirements by the Department of Labor for group health plans under the Employee Retirement Income Security Act of 1974 (ERISA).

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 9 January 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 9 January 1995

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• Introduced in House

  summary · EN · 9 January 1995

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