I 111th CONGRESS 1st Session H. R. 323 IN THE HOUSE OF REPRESENTATIVES January 8, 2009 Mr. Gene Green of Texas introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, 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 title XXVII of the Public Health Service Act and title I of the Employee Retirement Income Security Act of 1974 to require that group and individual health insurance coverage and group health plans provide comprehensive coverage for childhood immunization.

1.

Short title

This Act may be cited as the Comprehensive Insurance Coverage of Childhood Immunization Act of 2009.

2.

Comprehensive coverage for childhood immunization by group health plans and health insurance issuers

(a)

Group Health Plans

(1)

Public health service act amendments

Subpart 2 of part A of title XXVII of the Public Health Service Act is amended by adding at the end the following new section:

2708.

Standard relating to coverage of childhood immunization

(a)

In General

A group health plan, and a health insurance issuer offering group health insurance coverage, shall provide for each plan year comprehensive coverage for routine immunizations for each individual who is a dependent of a participant or beneficiary under the plan and is under 19 years of age. (b)

Comprehensive Coverage

For purposes of this section, comprehensive coverage for routine immunizations for a plan year consists of coverage, without deductibles, coinsurance, or other cost-sharing, for immunizations (including the vaccine itself) in accordance with the most recent version of the Recommended Childhood Immunization Schedule issued prior to such plan year by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

. (2)

ERISA amendments

(A)

In general

Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 is amended by adding at the end the following new section:

715.

Standard relating to coverage of childhood immunization

(a)

In General

A group health plan, and a health insurance issuer offering group health insurance coverage, shall provide for each plan year comprehensive coverage for routine immunizations for each individual who is a dependent of a participant or beneficiary under the plan and is under 19 years of age. (b)

Comprehensive Coverage

For purposes of this section, comprehensive coverage for routine immunizations for a plan year consists of coverage, without deductibles, coinsurance, or other cost-sharing, for immunizations (including the vaccine itself) in accordance with the most recent version of the Recommended Childhood Immunization Schedule issued prior to such plan year by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

. (B)

Clerical amendment

The table of contents in section 1 of such Act is amended by inserting after the item relating to section 714 the following new item: 715. Standard relating to coverage of childhood immunization. . (b)

Individual Health Insurance

Part B of title XXVII of the Public Health Service Act is amended by inserting after section 2753 the following new section:

2754.

Standard relating to coverage of childhood immunization

The provisions of section 2708 shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as they apply to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.

.

3.

Coordination of administration

The Secretary of Health and Human Services and the Secretary of Labor shall ensure, through the execution of an interagency memorandum of understanding among such Secretaries, that— (1)regulations, rulings, and interpretations issued by such Secretaries relating to the same matter over which both such Secretaries have responsibility under the provisions of this Act (and the amendments made thereby) are administered so as to have the same effect at all times; and (2)coordination of policies relating to enforcing the same requirements through such Secretaries in order to have a coordinated enforcement strategy that avoids duplication of enforcement efforts and assigns priorities in enforcement.

4.

Effective dates

(a)

Group Health Plans and Group Health Insurance Coverage

Subject to subsection (c), the amendments made by section 2(a) apply with respect to group health plans for plan years beginning on or after January 1, 2010. (b)

Individual Health Insurance Coverage

The amendment made by section 2(b) applies with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after such date. (c)

Collective Bargaining Exception

In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified before the date of enactment of this Act, the amendments made by section 2(a) shall not apply to plan years beginning before the later of— (1)the earliest date as of which all such collective bargaining agreements relating to the plan have terminated (determined without regard to any extension thereof agreed to after the date of enactment of this Act); or (2)January 1, 2010. For purposes of paragraph (1), any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by section 2(a) shall not be treated as a termination of such collective bargaining agreement.