[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 211 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 211

 To amend the Internal Revenue Code of 1986 to assure continued health 
                 insurance coverage of retired workers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 7, 1997

  Mr. Kleczka (for himself, Mr. Stark, Mr. Barrett of Wisconsin, Ms. 
   McKinney, Mr. Waxman, Mr. Hilliard, Mr. Kildee, Mr. Sanders, Mr. 
Martinez, Mr. Evans, Mr. Manton, Mr. LaFalce, Mr. Pallone, Ms. Norton, 
Ms. Slaughter, Mrs. Clayton, Mr. Lewis of Georgia, Mr. Coyne, Mr. Clay, 
 Ms. DeLauro, and Mr. Rangel) introduced the following bill; which was 
  referred to the Committee on Ways and Means, and in addition to the 
Committees on Commerce and Education and the Workforce, 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 amend the Internal Revenue Code of 1986 to assure continued health 
                 insurance coverage of retired workers.

    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 ``Health Care Assurance for Retired 
Employees Act of 1997''.

SEC. 2. ADVANCE NOTICE OF MATERIAL REDUCTIONS IN COVERED SERVICES UNDER 
              GROUP HEALTH PLANS.

    (a) Advance Notice.--
            (1) In general.--Section 104(b)(1) of the Employee 
        Retirement Income Security Act of 1974 (29 U.S.C. 1024(b)(1)) 
        is amended--
                    (A) by redesignating subparagraphs (A) and (B) as 
                clauses (i) and (ii), respectively;
                    (B) by striking ``(1) The administrator'' and 
                inserting ``(1)(A) The administrator'';
                    (C) by striking ``The administrator'' the second 
                place it appears and inserting the following:
    ``(B) The administrator'';
                    (D) by striking ``If there is a modification'' and 
                inserting the following:
    ``(C) If there is a modification''; and
                    (E) by adding at the end the following new 
                subparagraph:
    ``(D) Notwithstanding subparagraph (C), a summary description of 
any material modification described in section 102(a)(1) that is a 
reduction in covered services or benefits provided in the case of a 
group health plan (as defined in section 706(a)(1) relating to retiree 
health benefits shall be furnished to participants and beneficiaries 
not later than 180 days before the effective date of the modification. 
In any case in which an individual first becomes a participant under a 
group health plan during any such 180-day period with respect to such a 
modification or (in the case of any other beneficiary under the plan) 
first receives benefits under the plan during such 180-day period, the 
requirements of the preceding sentence may be met by providing the 
summary description of such modification not later than the date on 
which such individual first becomes a participant or such other 
beneficiary first receives benefits under the plan.''.
            (2) Determination by secretary.--Section 104 of the 
        Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1024) is further amended by redesignating subsection (d) as 
        subsection (e) and by inserting after subsection (c) the 
        following new subsection:
    ``(d) A material modification described in section 102(a)(1) that 
is a reduction in covered services or benefits provided in the case of 
a group health plan (as defined in section 706(a)(1)) relating to 
retiree health benefits that is subject to the requirements of 
subsection (b)(1)(D) may not take effect until after 6 months after the 
Secretary receives written notice of the modification from the 
administrator and after the Secretary determines that such modification 
does not violate the plan, including collective bargaining agreements. 
The determination of whether any such modification constitutes such a 
violation shall be made by the Secretary during such 6-month period, 
and any such modification shall be deemed not to be effective until the 
Secretary issues such determination. Any such determination shall be 
treated as a final order subject to review under section 502(k).''.
            (3) Advance notice to secretary.--Section 104(a)(1)(D) of 
        the Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1024(a)(1)(D)) is amended by inserting before the period the 
        following: ``, or in the case of any such modification that is 
        a reduction in covered services or benefits provided in the 
        case of a group health plan relating to retiree health 
        benefits, not later than 180 days before the effective date of 
        such modification.''.
            (4) Civil penalty.--Section 502(c)(1) of such Act (29 
        U.S.C. 1132(c)(1)) is amended by striking ``or section 
        101(e)(1)'' and inserting ``, section 101(e)(1), or section 
        104(b)(1)(D)''.
    (b) Enforcement.--
            (1) Requirements.--Section 4980B of the Internal Revenue 
        Code of 1986 is amended by redesignating subsection (g) as 
        subsection (h) and by inserting after subsection (f) the 
        following new subsection:
    ``(g) Notice of Modification in Health Benefits.--
            ``(1) In general.--A group health plan meets the 
        requirements of this subsection, in the case of a material 
        modification described in section 102(a)(1) of the Employee 
        Retirement Income Security Act of 1974 that is a reduction in 
        covered services or benefits provided in the case of a group 
        health plan (as defined in section 706(a)(1)) of such Act) 
        relating to retiree health benefits, if--
                    ``(A) the plan sponsor complies with section 
                104(b)(1)(D) of such Act; and
                    ``(B) such modification takes effect only after the 
                Secretary of Labor makes the determination required by 
                section 104(d) of such Act that such modification does 
                not violate the plan, including collective bargaining 
                agreements.
            ``(2) Noncompliance period.--For the purposes of subsection 
        (b), the noncompliance period with respect to this subsection 
        shall be determined without regard to paragraph (2)(B)(ii) of 
        subsection (b).''.
            (2) Conforming amendments.--
                    (A) Subsection (a) of section 4980B of such Code is 
                amended by striking ``subsection (f)'' and inserting 
                ``subsections (f) and (g)''.
                    (B) Clause (iv)(II) of section 4980B(f)(2)(B) of 
                such Code is amended by striking ``subsection 
                (g)(1)(D)'' and inserting ``subsection (h)(1)(D)''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to plan years ending after August 1, 1996.

SEC. 3. CONTINUATION OF COVERAGE FOR PERSONS 55 AND OLDER UNTIL 
              ELIGIBLE FOR MEDICARE.

    (a) In General.--Section 4980B(f)(2) of the Internal Revenue Code 
of 1986 is amended by adding at the end the following:
                    ``(F) Coverage for persons 55 and older until 
                eligible for medicare.--In the case of a covered 
                employee who has attained the age of 55 before a 
                qualifying event described in paragraph (3)(B)--
                            ``(i) in no event shall the period of 
                        continued coverage under subparagraph (B)(i) 
                        with respect to such event end before the 
                        applicable date under subparagraph (B)(iv), and
                            ``(ii) the premium requirements for any 
                        period of continuation of coverage solely by 
                        reason of clause (i) shall by determined by 
                        substituting `110 percent' for `102 percent' in 
                        subparagraph (C)(i), unless the last sentence 
                        of subparagraph (C) otherwise applies.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to plan years ending after August 1, 1996.

SEC. 4. PROTECTIONS UNDER THE MEDICARE PROGRAM FOR RETIRED WORKERS WHO 
              LOSE RETIREE HEALTH BENEFITS.

    (a) No Premium Penalty for Late Enrollment.--The second sentence of 
section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) is 
amended by inserting ``and not pursuant to a special enrollment period 
under section 1837(i)(4)'' after ``section 1837)''.
    (b) Special Medicare Enrollment Period.--
            (1) In general.--Section 1837(i) of such Act (42 U.S.C. 
        1395p(i)) is amended by adding at the end the following new 
        paragraph:
    ``(4)(A) In the case of an individual--
            ``(i) who at the time the individual first satisfies 
        paragraph (1) or (2) of section 1836--
                    ``(I) is enrolled in a group health plan described 
                in section 1862(b)(1)(A)(v) by reason of the 
                individual's (or the individual's spouse's) current 
                employment or otherwise, and
                    ``(II) has elected not to enroll (or to be deemed 
                enrolled) under this section during the individual's 
                initial enrollment period; and
            ``(ii) whose continuous enrollment under such group health 
        plan is involuntarily terminated at a time when the enrollment 
        under the plan is not by reason of the individual's (or the 
        individual's spouse's) current employment,
there shall be a special enrollment period described in subparagraph 
(B).
    ``(B) The special enrollment period referred to in subparagraph (A) 
is the 6-month period beginning on the date of the enrollment 
termination described in subparagraph (A)(ii).''.
            (2) Coverage period.--Section 1838(e) of such Act (42 
        U.S.C. 1395q(e)) is amended--
                    (A) by inserting ``or 1837(i)(4)(B)'' after 
                ``1837(i)(3)'' the first place it appears, and
                    (B) by inserting ``or specified in section 
                1837(i)(4)(A)(i)'' after ``1837(i)(3)'' the second 
                place it appears''.
    (c) Providing for Medigap Open Enrollment Period.--Section 
1882(s)(2)(A) of such Act (42 U.S.C. 1395ss(s)(2)(A)) is amended--
            (1) by inserting ``(i)'' after ``during'', and
            (2) by inserting before the period at the end the 
        following: ``or (ii) in the case of an individual who enrolls 
        in part B pursuant to a special enrollment period provided 
        under section 1837(i)(4), the 6-month period beginning with the 
        first month as of the first day of which the individual is 
        enrolled under part B pursuant to such enrollment''.
    (d) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall take effect on the date of the 
        enactment of this Act and apply to involuntary terminations of 
        coverage under a group health plan occurring on or after August 
        1, 1996.
            (2) Transition.--In the case of an involuntary termination 
        of coverage under a group health plan that occurred during the 
        period beginning on August 1, 1996, and ending on the date of 
        the enactment of this Act, the special enrollment period under 
        section 1837(i)(4)(B) of the Social Security Act (as amended by 
        subsection (b)) is deemed to begin as of the date of the 
        enactment of this Act.
                                 <all>