[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3030 Introduced in House (IH)]







104th CONGRESS
  2d Session
                                H. R. 3030

   To establish a minimum amount that may be applied as an aggregate 
   lifetime limit with respect to coverage under an employee health 
                 benefits plan or a group health plan.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 6, 1996

  Ms. Eshoo introduced the following bill; which was referred to the 
Committee on Economic and Educational Opportunities, and in addition to 
 the Committee on Commerce, for a period to be subsequently determined 
 by the Speaker, in each case for consideration of such provisions as 
        fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To establish a minimum amount that may be applied as an aggregate 
   lifetime limit with respect to coverage under an employee health 
                 benefits plan or a group health plan.

    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 ``Christopher Reeve Health Insurance 
Reform Act of 1996''.

SEC. 2. LIMITATION ON LIFETIME AGGREGATE LIMITS FOR GROUP HEALTH PLANS.

    (a) In General.--Except as provided in subsection (b), an employee 
health benefit plan or a health plan issuer offering a group health 
plan may not impose an aggregate dollar lifetime limit of less than 
$10,000,000 with respect to coverage under the plan. The dollar amount 
specified in the previous sentence shall be adjusted for inflation in 
fiscal years after the fiscal year in which this section becomes 
effective.
    (b) Small Employer Exception.--Subsection (a) shall not apply to a 
group health plan offered to or maintained for employees of a single 
employer that employs 20 or fewer employees.
    (c) Rule of Construction.--Subsection (a) shall not be construed as 
prohibiting the application by an employee health benefit plan or a 
health plan issuer offering a group health plan of any limits, 
exclusions, or other forms of cost containment mechanisms with respect 
to coverage under the plan other than the aggregate limit permitted 
under subsection (a).
    (d) Disclosure.--Any limits, exclusions, or other cost containment 
mechanisms permitted under subsection (c) shall be disclosed under 
section 3.
    (e) Application of Section.--This section shall not apply to a 
health maintenance organization that meets the requirements of title 
XIV of the Public Health Service Act.
    (f) Effective Date.--This section shall become effective with 
respect to health plans on the date that is 2 years after the date of 
the enactment of this Act.

SEC. 3. DISCLOSURE OF LIMITS AND EXCLUSIONS.

    An employee health benefit plan or a health plan issuer offering a 
group health plan shall disclose, as part of its solicitation and sales 
materials and in a form and manner that is conspicuous and 
understandable to a reasonable individual, any limits, exclusions, or 
cost containment mechanisms with respect to coverage provided under the 
plan.

SEC. 4. INCORPORATION OF DEFINITIONS AND OTHER TERMS.

    For purposes of this Act--
            (1) the definitions contained in section 2 of the Health 
        Insurance Reform Act of 1996 (H.R. 2893) shall apply to this 
        Act; and
            (2) the provisions of title II and sections 303 and 304 of 
        such Health Insurance Reform Act of 1996 (relating to 
        enforcement, effective dates, and severability) shall apply to 
        the provisions of sections 2 and 3 of this Act in the same 
        manner as if they were parts of sections 103 and 105, 
        respectively, of such Act.
                                 <all>