[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1293 Introduced in House (IH)]

  1st Session
                                H. R. 1293

   To amend the Employee Retirement Income Security Act of 1974 with 
    respect to rules governing litigation contesting termination or 
                 reduction of retiree health benefits.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 22, 1995

 Mr. Johnson of South Dakota (for himself and Mr. Costello) introduced 
the following bill; which was referred to the Committee on Economic and 
                       Educational Opportunities

_______________________________________________________________________

                                 A BILL


 
   To amend the Employee Retirement Income Security Act of 1974 with 
    respect to rules governing litigation contesting termination or 
                 reduction of retiree health benefits.

    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 ``Retiree Health Benefits Protection 
Act''.

SEC. 2. RULES GOVERNING LITIGATION INVOLVING RETIREE HEALTH BENEFITS.

    (a) In General.--Part 5 of subtitle B of title I of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1131 et seq.) is 
amended by adding at the end the following new section:

``SEC. 516. RULES GOVERNING LITIGATION INVOLVING RETIREE HEALTH 
              BENEFITS.

    ``(a) Maintenance of Benefits.--
            ``(1) In general.--If--
                    ``(A) retiree health benefits or plan or plan 
                sponsor payments in connection with such benefits are 
                to be or have been terminated or reduced under an 
                employee welfare benefit plan; and
                    ``(B) an action is brought by any participant or 
                beneficiary to enjoin or otherwise modify such 
                termination or reduction,
        the court without requirement of any additional showing shall 
        promptly order the plan and plan sponsor to maintain the 
        retiree health benefits and payments at the level in effect 
        immediately before the termination or reduction while the 
        action is pending in any court. No security or other 
        undertaking shall be required of any participant or beneficiary 
        as a condition for issuance of such relief. An order requiring 
        such maintenance of benefits may be refused or dissolved only 
        upon determination by the court, on the basis of clear and 
        convincing evidence, that the action is clearly without merit.
            ``(2) Exceptions.--Paragraph (1) shall not apply to any 
        action if--
                    ``(A) the termination or reduction of retiree 
                health benefits is substantially similar to a 
                termination or reduction in health benefits (if any) 
                provided to current employees which occurs either 
                before, or at or about the same time as, the 
                termination or reduction of retiree health benefits, or
                    ``(B) the changes in benefits are in connection 
                with the addition, expansion, or clarification of the 
                delivery system, including utilization review 
                requirements and restrictions, requirements that goods 
                or services be obtained through managed care entities 
                or specified providers or categories of providers, or 
                other special major case management restrictions.
            ``(3) Modifications.--Nothing in this section shall 
        preclude a court from modifying the obligation of a plan or 
        plan sponsor to the extent retiree benefits are otherwise being 
        paid by the plan sponsor.
    ``(b) Burden of Proof.--In addition to the relief authorized in 
subsection (a) or otherwise available, if, in any action to which 
subsection (a)(1) applies, the terms of the employee welfare benefit 
plan summary plan description or, in the absence of such description, 
other materials distributed to employees at the time of a participant's 
retirement or disability, are silent or are ambiguous, either on their 
face or after consideration of extrinsic evidence, as to whether 
retiree health benefits and payments may be terminated or reduced for a 
participant and his or her beneficiaries after the participant's 
retirement or disability, then the benefits and payments shall not be 
terminated or reduced for the participant and his or her beneficiaries 
unless the plan or plan sponsor establishes by a preponderance of the 
evidence that the summary plan description or other materials about 
retiree benefits--
            ``(1) were distributed to the participant at least 90 days 
        in advance of retirement or disability;
            ``(2) did not promise retiree health benefits for the 
        lifetime of the participant and his or her spouse; and
            ``(3) clearly and specifically disclosed that the plan 
        allowed such termination or reduction as to the participant 
        after the time of his or her retirement or disability.
The disclosure described in paragraph (3) must have been made 
prominently and in language which can be understood by the average plan 
participant.
    ``(c) Representation.--Notwithstanding any other provision of law, 
an employee representative of any retired employee or the employee's 
spouse or dependents may--
            ``(1) bring an action described in this section on behalf 
        of such employee, spouse, or dependents; or
            ``(2) appear in such an action on behalf of such employee, 
        spouse or dependents.
    ``(d) Retiree Health Benefits.--For the purposes of this section, 
the term `retiree health benefits' means health benefits (including 
coverage) which are provided to--
            ``(1) retired or disabled employees who, immediately before 
        the termination or reduction, have a reasonable expectation to 
        receive such benefits upon retirement or becoming disabled; and
            ``(2) their spouses or dependents.''
    (b) Conforming Amendment.--The table of contents in section 1 of 
such Act is amended by inserting after the item relating to section 515 
the following new item:

``Sec. 516. Rules governing litigation involving retiree health 
                            benefits.''
    (c) Effective Date.--The amendments made by this section shall 
apply to actions relating to terminations or reductions of retiree 
health benefits which are pending or brought, on or after March 23, 
1995.
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