[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4829 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4829

 To require equal coverage under a health plan for all children under 
 the age of 27 of an individual who enrolls in the plan under a family 
                          class of enrollment.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 26, 1994

   Mr. Baker of California introduced the following bill; which was 
 referred jointly to the Committees on Energy and Commerce, Education 
                      and Labor, and the Judiciary

_______________________________________________________________________

                                 A BILL


 
 To require equal coverage under a health plan for all children under 
 the age of 27 of an individual who enrolls in the plan under a family 
                          class of enrollment.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Family Health Care Coverage Act''.

SEC. 2. FAMILY COVERAGE OF CHILDREN.

    (a) In General.--In the case of an individual enrolled in a health 
plan under a family class of enrollment, the carrier providing the 
plan, or the plan sponsor sponsoring or maintaining the plan, shall 
offer and provide equal coverage under the plan to any child of the 
individual, if the child elects to receive coverage pursuant to such 
family enrollment.
    (b) Definitions.--For purposes of this section:
            (1) Carrier.--The term ``carrier'' means a licensed 
        insurance company, a hospital or medical service corporation 
        (including an existing Blue Cross or Blue Shield organization, 
        within the meaning of section 833(c)(2) of the Internal Revenue 
        Code of 1986), a health maintenance organization, or any other 
        entity (other than a plan sponsor) licensed or certified by a 
        State to provide health insurance or health benefits.
            (2) Child.--
                    (A) In general.--The term ``child'' means an 
                individual who--
                            (i) is less than 27 years of age;
                            (ii) has never been married;
                            (iii) has no dependents; and
                            (iv) has a parent-child relationship with 
                        another individual who is eligible to enroll in 
                        a health plan under a family class of 
                        enrollment.
                    (B) Application of state law.--Determination of 
                whether a child has a parent-child relationship with 
                another individual shall be made in accordance with 
                applicable State law.
            (3) Family class of enrollment.--The terms ``family class 
        of enrollment'' and ``family enrollment'' mean enrollment in a 
        health plan under a class of enrollment that provides coverage 
        for--
                    (A) An unmarried individual and 1 or more children; 
                or
                    (B) A married couple and 1 or more children.
            (4) Group health plan.--The term ``group health plan'' 
        means an employee welfare benefit plan (as defined in section 
        3(1) of the Employee Retirement Income Security Act of 1974) 
        providing medical care (as defined in section 213(d) of the 
        Internal Revenue Code of 1986) to participants or beneficiaries 
        (as defined in section 3 of the Employee Retirement Income 
        Security Act of 1974) directly or through insurance, 
        reimbursement, or otherwise.
            (5) Health plan.--The term ``health plan'' means--
                    (A) any contract of health insurance, including any 
                hospital or medical service policy or certificate, 
                hospital or medical service plan contract, or health 
                maintenance organization group contract, that is 
                provided by a carrier; or
                    (B) a group health plan, an employee welfare 
                benefit plan, a multiple employer welfare arrangement, 
                or other arrangement insofar as the plan or arrangement 
                provides health benefits and is funded in a manner 
                other than through the purchase of one or more policies 
                or contracts described in subparagraph (A).
            (6) Plan sponsor.--The term ``plan sponsor'' means--
                    (A) a plan sponsor described in section 
                3(16)(B)(iii) of Employee Retirement Income Security 
                Act of 1974, but only with respect to a group health 
                plan that is maintained by the sponsor;
                    (B) an employer of an employee covered under a 
                health plan that is a multiple employer welfare 
                arrangement (as defined in section 3(40) of the 
                Employee Retirement Income Security Act); or
                    (C) an employee organization that sponsors such a 
                health plan.

SEC. 3. CIVIL MONEY PENALTY.

    (a) Violation.--Any individual who, or entity that, the Secretary 
of Health and Human Services determines has failed to comply with 
section 1 shall be subject, in addition to any other penalties that may 
be prescribed by law, to a civil money penalty of not more than $500 
for each such violation.
    (b) Procedures for Imposition of Penalties.--The provisions of 
section 1128A of the Social Security Act (other than subsections (a) 
and (b) and the second sentence of subsection (f)) shall apply to the 
imposition of a civil monetary penalty under this section in the same 
manner as such provisions apply with respect to the imposition of a 
penalty under section 1128A of such Act.

SEC. 4. INAPPLICABILITY OF MCCARRAN-FERGUSON ACT.

    For purposes of section 2(b) of the Act of March 9, 1945 (15 U.S.C. 
1012(b); commonly known as the McCarran-Ferguson Act), this Act shall 
be considered to specifically relate to the business of insurance.

SEC. 5. REGULATIONS.

    The Secretary of Health and Human Services may issue regulations to 
carry out this Act.
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