II 111th CONGRESS 1st Session S. 1149 IN THE SENATE OF THE UNITED STATES May 21, 2009 Mr. Reid (for Mr. Rockefeller) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To eliminate annual and lifetime aggregate limits imposed by health plans.

1.

Short title

This Act may be cited as the Annual and Lifetime Health Care Limit Elimination Act of 2009.

2.

Amendments to the Employee Retirement Income Security Act of 1974

(a)

In General

Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:

715.

Elimination of annual or lifetime aggregate limits

(a)

In General

A group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not impose an aggregate dollar annual or lifetime limit with respect to benefits payable under the plan or coverage. (b)

Definition

In this section, the term aggregate dollar annual or lifetime limit means, with respect to benefits under a group health plan or health insurance coverage, a dollar limitation on the total amount that may be paid with respect to such benefits under the plan or health insurance coverage with respect to an individual or other coverage unit on an annual or lifetime basis.

. (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: Sec. 715. Elimination of annual or lifetime aggregate limits. . (c)

Effective Date

The amendments made by this section shall apply with respect to plan years beginning on or after the date that is 1 year after the date of enactment of this Act.

3.

Amendment to the Public Health Service Act relating to the group market

(a)

In General

Subpart 2 of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–4 et seq.) is amended by adding at the end the following:

2708.

Elimination of annual or lifetime aggregate limits

(a)

In General

A group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not impose an aggregate dollar annual or lifetime limit with respect to benefits payable under the plan or coverage. (b)

Definition

In this section, the term aggregate dollar annual or lifetime limit means, with respect to benefits under a group health plan or health insurance coverage, a dollar limitation on the total amount that may be paid with respect to such benefits under the plan or health insurance coverage with respect to an individual or other coverage unit on an annual or lifetime basis.

. (b)

Individual market

Subpart 2 of part B of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–51 et seq.) is amended by adding at the end the following:

2754.

Elimination of annual or lifetime aggregate limits

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.

. (c)

Effective Date

The amendments made by this section shall apply with respect to plan years beginning on or after the date that is 1 year after the date of enactment of this Act.