ERISA Targeted Health Insurance Reform Act of 1996

Summary

ERISA Targeted Health Insurance Reform Act of 1995 - Title I: Improved Access to Affordable Health Plan Coverage - Subtitle A: Increased Availability and Continuity of Group Health Plan Coverage for Employees and Their Families - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for access to, and continuity of, group health plan coverage. (Sec. 1001) Provides for: (1) nondiscrimination and limitations on preexisting condition exclusions; (2) portability; (3) requirements for renewability of coverage; and (4) group health plan participation standards. Encourages private standards-setting organizations for provider networks and utilization review under group health plans. Establishes standards applicable to insurers offering health insurance coverage to group health plans. Provides for enforcement with respect to insurers offering health insurance coverage to group health plans. Preempts State laws that differ from such uniform national standards under ERISA. Subtitle B: Requirements for Insurers Offering Health Insurance Coverage to Group Health Plans of Small Employers - Establishes ERISA requirements for insurers offering health insurance coverage to group health plans of small employers. (Sec. 1101) Requires insurers to offer general, catastrophic, and optional medisave coverage to small employers. Requires use of fair rating, uniform marketing materials, and miscellaneous consumer protections. Authorizes States to implement and enforce such uniform national standards. Grants States that elect to implement such standards the exclusive authority to enforce them as they apply to insurers only, and not to the group health plans purchasing health insurance coverage. Allows a three-year phase-in period during which States can conform existing standards with such uniform standards. Preempts differing standards after such period. Subtitle C: Encouragement of Multiple Employer Health Plans and Preemption - Limits the scope of State regulation. Prohibits: (1) State benefit mandates for group health plans; and (2) State prohibition of employer groups purchasing health insurance. Preempts State anti-managed care laws. (Sec. 1202) Preempts State laws for multiple employer health plans meeting Federal standards. Relieves exempted multiple employer health plans of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Sets forth an exemption procedure and eligibility requirements, as well as additional requirements applicable to exempted multiple employer health plans. Requires: (1) disclosure to participating employers by arrangements providing medical care; (2) maintenance of reserves; and (3) notice for voluntary termination. Sets forth provisions for: (1) corrective actions and mandatory termination; (2) expiration, suspension, or revocation of exemption; and (3) review of actions of the Secretary of Labor. (Sec. 1203) Revises provisions relating to: (1) the scope of preemption rules; (2) treatment of single employer arrangements; and (3) treatment of certain collectively bargained arrangements. (Sec. 1206) Sets forth requirements for employee leasing health care arrangements. (Sec. 1207) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1208) Sets forth filing requirements for multiple employer welfare arrangements offering health benefits. (Sec. 1209) Provides for cooperation between Federal and State authorities. (Sec. 1210) Revises provisions for treatment of employer health coalitions and health maintenance organizations. (Sec. 1211) Requires a single annual filing for all participating employers. Subtitle D: Remedies and Enforcement with Respect to Group Health Plans - Sets forth a claims procedure for group health plans, as well as court remedies for claims disputes. Subtitle E: Funding and Plan Termination Requirements for Self-Insured Group Health Plans - Sets forth special rules for funding and plan termination for self-insured group health plans. Subtitle F: General Provisions - Declares that nothing in this Act may be construed to require the coverage of any specific procedure, treatment, or service as part of a group health plan or health insurance coverage under this Act or through regulation.

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Documents

6 official files

• Reported in House (text)

  Reported in House · EN · 29 March 1996

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• Reported in House (PDF)

  Reported in House · EN · 29 March 1996

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• Reported to House amended, Part I

  summary · EN · 25 March 1996

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• Introduced in House (text)

  Introduced in House · EN · 21 March 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 21 March 1995

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• Introduced in House

  summary · EN · 21 February 1995

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