[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6514 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 6514

   To provide premium assistance for COBRA continuation coverage and 
  furloughed continuation coverage for individuals and their families 
 during the COVID-19 emergency period and 180-days thereafter, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 14, 2020

  Mr. Scott of Virginia (for himself, Mrs. Dingell, and Mr. Horsford) 
 introduced the following bill; which was referred to the Committee on 
 Education and Labor, and in addition to the Committees on Energy and 
     Commerce, and Ways and Means, 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 provide premium assistance for COBRA continuation coverage and 
  furloughed continuation coverage for individuals and their families 
 during the COVID-19 emergency period and 180-days thereafter, and for 
                            other purposes.

    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 ``Worker Health Coverage Protection 
Act''.

SEC. 2. PRESERVING HEALTH BENEFITS FOR WORKERS.

    (a) Premium Assistance for COBRA Continuation Coverage and 
Furloughed Continuation Coverage for Individuals and Their Families.--
            (1) Provision of premium assistance.--
                    (A) Reduction of premiums payable.--
                            (i) COBRA continuation coverage.--In the 
                        case of any premium for a period of coverage 
                        during the period beginning on March 1, 2020, 
                        and ending on the last day of the 180-day 
                        period succeeding the emergency period 
                        described in section 1135(g)(1)(B) of the 
                        Social Security Act (42 U.S.C. 1320b-
                        5(g)(1)(B)) for COBRA continuation coverage 
                        with respect to any assistance eligible 
                        individual described in paragraph (3)(A), such 
                        individual shall be treated for purposes of any 
                        COBRA continuation provision as having paid the 
                        amount of such premium if such individual pays 
                        (or a person other than such individual's 
                        employer pays on behalf of such individual) 0 
                        percent of the amount of such premium (as 
                        determined without regard to this subsection).
                            (ii) Furloughed continuation coverage.--In 
                        the case of any premium for a period of 
                        coverage during the period beginning on March 
                        1, 2020, and ending on the last day of the 180-
                        day period succeeding the emergency period 
                        described in section 1135(g)(1)(B) of the 
                        Social Security Act (42 U.S.C. 1320b-
                        5(g)(1)(B)) for coverage under a group health 
                        plan with respect to any assistance eligible 
                        individual described in paragraph (3)(B), such 
                        individual shall be treated for purposes of 
                        coverage under the plan offered by the employer 
                        involved in which the individual is enrolled as 
                        having paid the amount of such premium if such 
                        individual pays (or a person other than such 
                        individual's employer pays on behalf of such 
                        individual) 0 percent of the amount of such 
                        premium (as determined without regard to this 
                        subsection).
                    (B) Plan enrollment option.--
                            (i) In general.--Notwithstanding the COBRA 
                        continuation provisions, any assistance 
                        eligible individual who is enrolled in a group 
                        health plan offered by a plan sponsor may, not 
                        later than 90 days after the date of notice of 
                        the plan enrollment option described in this 
                        subparagraph, elect to enroll in coverage under 
                        a plan offered by such plan sponsor, that is 
                        different than coverage under the plan in which 
                        such individual was enrolled at the time--
                                    (I) in the case of any assistance 
                                eligible individual described in 
                                paragraph (3)(A), the qualifying event 
                                specified in section 603(2) of the 
                                Employee Retirement Income Security Act 
                                of 1974, section 4980B(f)(3)(B) of the 
                                Internal Revenue Code of 1986, section 
                                2203(2) of the Public Health Service 
                                Act, or section 8905a of title 5, 
                                United States Code, occurred, and such 
                                coverage shall be treated as COBRA 
                                continuation coverage for purposes of 
                                the applicable COBRA continuation 
                                coverage provision; or
                                    (II) in the case of any assistance 
                                eligible individual described in 
                                paragraph (3)(B), such individual was 
                                subject to a furlough.
                            (ii) Requirements.--Any assistance eligible 
                        individual may elect to enroll in different 
                        coverage as described in clause (i) only if--
                                    (I) the employer involved has made 
                                a determination that such employer will 
                                permit such assistance eligible 
                                individual to enroll in different 
                                coverage as provided under this 
                                subparagraph;
                                    (II) the premium for such different 
                                coverage does not exceed the premium 
                                for coverage in which such individual 
                                was enrolled at the time such 
                                qualifying event occurred;
                                    (III) the different coverage in 
                                which the individual elects to enroll 
                                is coverage that is also offered to the 
                                active employees of the employer, who 
                                are not furloughed, at the time at 
                                which such election is made; and
                                    (IV) the different coverage in 
                                which the individual elects to enroll 
                                is not--
                                            (aa) coverage that provides 
                                        only dental, vision, 
                                        counseling, or referral 
                                        services (or a combination of 
                                        such services);
                                            (bb) a qualified small 
                                        employer health reimbursement 
                                        arrangement (as defined in 
                                        section 9831(d)(2) of the 
                                        Internal Revenue Code of 1986);
                                            (cc) a flexible spending 
                                        arrangement (as defined in 
                                        section 106(c)(2) of the 
                                        Internal Revenue Code of 1986); 
                                        or
                                            (dd) coverage that provides 
                                        coverage for services or 
                                        treatments furnished in an on-
                                        site medical facility 
                                        maintained by the employer and 
                                        that consists primarily of 
                                        first-aid services, prevention 
                                        and wellness care, or similar 
                                        care (or a combination of such 
                                        care).
                    (C) Premium reimbursement.--For provisions 
                providing the payment of such premium, see section 6432 
                of the Internal Revenue Code of 1986, as added by 
                paragraph (14).
            (2) Limitation of period of premium assistance.--
                    (A) Eligibility for additional coverage.--Paragraph 
                (1)(A) shall not apply with respect to--
                            (i) any assistance eligible individual 
                        described in paragraph (3)(A) for months of 
                        coverage beginning on or after the earlier of--
                                    (I) the first date that such 
                                individual is covered under any other 
                                group health plan (other than coverage 
                                consisting of only dental, vision, 
                                counseling, or referral services (or a 
                                combination thereof), coverage under a 
                                flexible spending arrangement (as 
                                defined in section 106(c)(2) of the 
                                Internal Revenue Code of 1986), 
                                coverage of treatment that is furnished 
                                in an on-site medical facility 
                                maintained by the employer and that 
                                consists primarily of first-aid 
                                services, prevention and wellness care, 
                                or similar care (or a combination 
                                thereof)), eligible for benefits under 
                                title XVIII of the Social Security Act, 
                                or covered under a qualified health 
                                plan (as defined in section 1301(a) of 
                                the Patient Protection and Affordable 
                                Care Act (42 U.S.C. 18021(a))) offered 
                                through an Exchange established under 
                                title I of the Patient Protection and 
                                Affordable Care Act (42 U.S.C. 18001 et 
                                seq.); or
                                    (II) the earliest of--
                                            (aa) the date which is 15 
                                        months after the first day of 
                                        the first month that paragraph 
                                        (1)(A)(i) applies with respect 
                                        to such individual;
                                            (bb) the date following the 
                                        expiration of the maximum 
                                        period of continuation coverage 
                                        required under the applicable 
                                        COBRA continuation coverage 
                                        provision; or
                                            (cc) the date following the 
                                        expiration of the period of 
                                        continuation coverage allowed 
                                        under paragraph (4)(B)(ii); or
                            (ii) any assistance eligible individual 
                        described in paragraph (3)(B) for months of 
                        coverage beginning on or after the earlier of--
                                    (I) the first date that such 
                                individual is covered under any other 
                                group health plan (other than coverage 
                                consisting of only dental, vision, 
                                counseling, or referral services (or a 
                                combination thereof), coverage under a 
                                flexible spending arrangement (as 
                                defined in section 106(c)(2) of the 
                                Internal Revenue Code of 1986), 
                                coverage of treatment that is furnished 
                                in an on-site medical facility 
                                maintained by the employer and that 
                                consists primarily of first-aid 
                                services, prevention and wellness care, 
                                or similar care (or a combination 
                                thereof)), eligible for benefits under 
                                title XVIII of the Social Security Act, 
                                or covered under a qualified health 
                                plan (as defined in section 1301(a) of 
                                the Patient Protection and Affordable 
                                Care Act (42 U.S.C. 18021(a))) offered 
                                through an Exchange established under 
                                title I of the Patient Protection and 
                                Affordable Care Act (42 U.S.C. 18001 et 
                                seq.);
                                    (II) the date which is 15 months 
                                after the first day of the first month 
                                that paragraph (1)(A)(ii) applies with 
                                respect to such individual; or
                                    (III) the first date that such 
                                individual is not subject to a 
                                furlough.
                    (B) Notification requirement.--Any assistance 
                eligible individual shall notify the group health plan 
                with respect to which paragraph (1)(A) applies if such 
                paragraph ceases to apply by reason of clause (i)(I) or 
                (ii)(I) of subparagraph (A) (as applicable). Such 
                notice shall be provided to the group health plan in 
                such time and manner as may be specified by the 
                Secretary of Labor.
                    (C) Special enrollment period following expiration 
                of premium assistance.--Notwithstanding section 1311 of 
                the Patient Protection and Affordable Care Act (42 
                U.S.C. 18031), the expiration of premium assistance 
                pursuant to a limitation specified under subparagraph 
                (A) shall be treated as a qualifying event for which 
                any assistance eligible individual is eligible to 
                enroll in a qualified health plan offered through an 
                Exchange under title I of such Act (42 U.S.C. 18001 et 
                seq.) during a special enrollment period.
            (3) Assistance eligible individual.--For purposes of this 
        section, the term ``assistance eligible individual'' means, at 
        any time during the period beginning on March 1, 2020, and 
        ending on the last day of the 180-day period succeeding the 
        emergency period described in section 1135(g)(1)(B) of the 
        Social Security Act (42 U.S.C. 1320b-5(g)(1)(B))--
                    (A) any individual that is a qualified beneficiary 
                that--
                            (i) is eligible for COBRA continuation 
                        coverage by reason of a qualifying event 
                        specified in section 603(2) of the Employee 
                        Retirement Income Security Act of 1974, section 
                        4980B(f)(3)(B) of the Internal Revenue Code of 
                        1986, section 2203(2) of the Public Health 
                        Service Act, or section 8905a of title 5, 
                        United States Code; and
                            (ii) elects such coverage; or
                    (B) any individual that is subject to a furlough 
                that remains eligible for coverage under a group health 
                plan.
            (4) Extension of election period and effect on coverage.--
                    (A) In general.--For purposes of applying section 
                605(a) of the Employee Retirement Income Security Act 
                of 1974, section 4980B(f)(5)(A) of the Internal Revenue 
                Code of 1986, section 2205(a) of the Public Health 
                Service Act, and section 8905a(c)(2) of title 5, United 
                States Code, in the case of--
                            (i) an individual who does not have an 
                        election of COBRA continuation coverage in 
                        effect on the date of the enactment of this Act 
                        but who would be an assistance eligible 
                        individual described in paragraph (3)(A) if 
                        such election were so in effect; or
                            (ii) an individual who elected COBRA 
                        continuation coverage on or after March 1, 
                        2020, and discontinued from such coverage 
                        before the date of the enactment of this Act,
                such individual may elect the COBRA continuation 
                coverage under the COBRA continuation coverage 
                provisions containing such sections during the period 
                beginning on the date of the enactment of this Act and 
                ending 60 days after the date on which the notification 
                required under paragraph (7)(C) is provided to such 
                individual.
                    (B) Commencement of cobra continuation coverage.--
                Any COBRA continuation coverage elected by a qualified 
                beneficiary during an extended election period under 
                subparagraph (A)--
                            (i) shall apply as if such qualified 
                        beneficiary had been covered as of the date of 
                        a qualifying event specified in section 603(2) 
                        of the Employee Retirement Income Security Act 
                        of 1974, section 4980B(f)(3)(B) of the Internal 
                        Revenue Code of 1986, section 2203(2) of the 
                        Public Health Service Act, or section 8905a of 
                        title 5, United States Code (including the 
                        treatment of premium payments under paragraph 
                        (1)(A) and any cost-sharing requirements for 
                        items and services under a group health plan); 
                        and
                            (ii) shall not extend beyond the period of 
                        COBRA continuation coverage that would have 
                        been required under the applicable COBRA 
                        continuation coverage provision if the coverage 
                        had been elected as required under such 
                        provision.
            (5) Expedited review of denials of premium assistance.--In 
        any case in which an individual requests treatment as an 
        assistance eligible individual described in subparagraph (A) or 
        (B) of paragraph (3) and is denied such treatment by the group 
        health plan, the Secretary of Labor (or the Secretary of Health 
        and Human Services in connection with COBRA continuation 
        coverage which is provided other than pursuant to part 6 of 
        subtitle B of title I of the Employee Retirement Income 
        Security Act of 1974), in consultation with the Secretary of 
        the Treasury, shall provide for expedited review of such 
        denial. An individual shall be entitled to such review upon 
        application to such Secretary in such form and manner as shall 
        be provided by such Secretary. Such Secretary shall make a 
        determination regarding such individual's eligibility within 15 
        business days after receipt of such individual's application 
        for review under this paragraph. Either Secretary's 
        determination upon review of the denial shall be de novo and 
        shall be the final determination of such Secretary. A reviewing 
        court shall grant deference to such Secretary's determination. 
        The provisions of this paragraph, paragraphs (1) through (4), 
        and paragraphs (7) through (9) shall be treated as provisions 
        of title I of the Employee Retirement Income Security Act of 
        1974 for purposes of part 5 of subtitle B of such title.
            (6) Disregard of subsidies for purposes of federal and 
        state programs.--Notwithstanding any other provision of law, 
        any premium reduction with respect to an assistance eligible 
        individual under this subsection shall not be considered income 
        or resources in determining eligibility for, or the amount of 
        assistance or benefits provided under, any other public benefit 
        provided under Federal law or the law of any State or political 
        subdivision thereof.
            (7) COBRA-specific notice.--
                    (A) General notice.--
                            (i) In general.--In the case of notices 
                        provided under section 606(a)(4) of the 
                        Employee Retirement Income Security Act of 1974 
                        (29 U.S.C. 1166(4)), section 4980B(f)(6)(D) of 
                        the Internal Revenue Code of 1986, section 
                        2206(4) of the Public Health Service Act (42 
                        U.S.C. 300bb-6(4)), or section 8905a(f)(2)(A) 
                        of title 5, United States Code, with respect to 
                        individuals who, during the period described in 
                        paragraph (3), become entitled to elect COBRA 
                        continuation coverage, the requirements of such 
                        sections shall not be treated as met unless 
                        such notices include an additional notification 
                        to the recipient a written notice in clear and 
                        understandable language of--
                                    (I) the availability of premium 
                                reduction with respect to such coverage 
                                under this subsection; and
                                    (II) the option to enroll in 
                                different coverage if the employer 
                                permits assistance eligible individuals 
                                described in paragraph (3)(A) to elect 
                                enrollment in different coverage (as 
                                described in paragraph (1)(B)).
                            (ii) Alternative notice.--In the case of 
                        COBRA continuation coverage to which the notice 
                        provision under such sections does not apply, 
                        the Secretary of Labor, in consultation with 
                        the Secretary of the Treasury and the Secretary 
                        of Health and Human Services, shall, in 
                        consultation with administrators of the group 
                        health plans (or other entities) that provide 
                        or administer the COBRA continuation coverage 
                        involved, provide rules requiring the provision 
                        of such notice.
                            (iii) Form.--The requirement of the 
                        additional notification under this subparagraph 
                        may be met by amendment of existing notice 
                        forms or by inclusion of a separate document 
                        with the notice otherwise required.
                    (B) Specific requirements.--Each additional 
                notification under subparagraph (A) shall include--
                            (i) the forms necessary for establishing 
                        eligibility for premium reduction under this 
                        subsection;
                            (ii) the name, address, and telephone 
                        number necessary to contact the plan 
                        administrator and any other person maintaining 
                        relevant information in connection with such 
                        premium reduction;
                            (iii) a description of the extended 
                        election period provided for in paragraph 
                        (4)(A);
                            (iv) a description of the obligation of the 
                        qualified beneficiary under paragraph (2)(C) to 
                        notify the plan providing continuation coverage 
                        of enrollment in subsequent coverage under 
                        another group health plan or a qualified health 
                        plan or eligibility for benefits under title 
                        XVIII of the Social Security Act and the 
                        penalty provided under section 6720C of the 
                        Internal Revenue Code of 1986 for failure to so 
                        notify the plan;
                            (v) a description, displayed in a prominent 
                        manner, of the qualified beneficiary's right to 
                        a reduced premium and any conditions on 
                        entitlement to the reduced premium;
                            (vi) a description of the option of the 
                        qualified beneficiary to enroll in different 
                        coverage if the employer permits such 
                        beneficiary to elect to enroll in such 
                        different coverage under paragraph (1)(B); and
                            (vii) information regarding any Exchange 
                        established under title I of the Patient 
                        Protection and Affordable Care Act (42 U.S.C. 
                        18001 et seq.) through which a qualified 
                        beneficiary may be eligible to enroll in a 
                        qualified health plan, including--
                                    (I) the publicly accessible 
                                internet website address for such 
                                Exchange;
                                    (II) the publicly accessible 
                                internet website address for the Find 
                                Local Help directory maintained by the 
                                Department of Health and Human Services 
                                on the healthcare.gov internet website 
                                (or a successor website);
                                    (III) a clear explanation that--
                                            (aa) an individual who is 
                                        eligible for continuation 
                                        coverage may also be eligible 
                                        to enroll, with financial 
                                        assistance, in a qualified 
                                        health plan offered through 
                                        such Exchange, but, in the case 
                                        that such individual elects to 
                                        enroll in such continuation 
                                        coverage and subsequently 
                                        elects to terminate such 
                                        continuation coverage before 
                                        the period of such continuation 
                                        coverage expires, such 
                                        termination does not initiate a 
                                        special enrollment period 
                                        (absent a qualifying event 
                                        specified in section 603(2) of 
                                        the Employee Retirement Income 
                                        Security Act of 1974, section 
                                        4980B(f)(3)(B) of the Internal 
                                        Revenue Code of 1986, section 
                                        2203(2) of the Public Health 
                                        Service Act, or section 8905a 
                                        of title 5, United States Code, 
                                        with respect to such 
                                        individual); and
                                            (bb) an individual who 
                                        elects to enroll in 
                                        continuation coverage will 
                                        remain eligible to enroll in a 
                                        qualified health plan offered 
                                        through such Exchange during an 
                                        open enrollment period and may 
                                        be eligible for financial 
                                        assistance with respect to 
                                        enrolling in such a qualified 
                                        health plan;
                                    (IV) information on consumer 
                                protections with respect to enrolling 
                                in a qualified health plan offered 
                                through such Exchange, including the 
                                requirement for such a qualified health 
                                plan to provide coverage for essential 
                                health benefits (as defined in section 
                                1302(b) of such Act (42 U.S.C. 
                                18022(b))) and the requirements 
                                applicable to such a qualified health 
                                plan under part A of title XXVII of the 
                                Public Health Service Act (42 U.S.C. 
                                300gg et seq.);
                                    (V) information on the availability 
                                of financial assistance with respect to 
                                enrolling in a qualified health plan, 
                                including the maximum income limit for 
                                eligibility for a premium tax credit 
                                under section 36B of the Internal 
                                Revenue Code of 1986; and
                                    (VI) information on any special 
                                enrollment periods during which any 
                                assistance eligible individual 
                                described in paragraph (3)(A)(i) may be 
                                eligible to enroll, with financial 
                                assistance, in a qualified health plan 
                                offered through such Exchange 
                                (including a special enrollment period 
                                for which an individual may be eligible 
                                due to the expiration of premium 
                                assistance pursuant to a limitation 
                                specified under paragraph (2)(A)).
                    (C) Notice in connection with extended election 
                periods.--In the case of any assistance eligible 
                individual described in paragraph (3)(A) (or any 
                individual described in paragraph (4)(A)) who became 
                entitled to elect COBRA continuation coverage before 
                the date of the enactment of this Act, the 
                administrator of the group health plan (or other 
                entity) involved shall provide (within 60 days after 
                the date of enactment of this Act) for the additional 
                notification required to be provided under subparagraph 
                (A) and failure to provide such notice shall be treated 
                as a failure to meet the notice requirements under the 
                applicable COBRA continuation provision.
                    (D) Model notices.--Not later than 30 days after 
                the date of enactment of this Act, with respect to any 
                assistance eligible individual described in paragraph 
                (3)(A)--
                            (i) the Secretary of Labor, in consultation 
                        with the Secretary of the Treasury and the 
                        Secretary of Health and Human Services, shall 
                        prescribe models for the additional 
                        notification required under this paragraph 
                        (other than the additional notification 
                        described in clause (ii)); and
                            (ii) in the case of any additional 
                        notification provided pursuant to subparagraph 
                        (A) under section 8905a(f)(2)(A) of title 5, 
                        United States Code, the Office of Personnel 
                        Management shall prescribe a model for such 
                        additional notification.
            (8) Furlough-specific notice.--
                    (A) In general.--With respect to any assistance 
                eligible individual described in paragraph (3)(B) who, 
                during the period described in such paragraph, becomes 
                eligible for assistance pursuant to paragraph 
                (1)(A)(ii), the requirements of section 606(a)(4) of 
                the Employee Retirement Income Security Act of 1974 (29 
                U.S.C. 1166(4)), section 4980B(f)(6)(D) of the Internal 
                Revenue Code of 1986, section 2206(4) of the Public 
                Health Service Act (42 U.S.C. 300bb-6(4)), or section 
                8905a(f)(2)(A) of title 5, United States Code, shall 
                not be treated as met unless the group health plan 
                administrator, in accordance with the timing 
                requirement specified under subparagraph (B), provides 
                to the individual a written notice in clear and 
                understandable language of--
                            (i) the availability of premium reduction 
                        with respect to such coverage under this 
                        subsection;
                            (ii) the option to enroll in different 
                        coverage if the employer permits assistance to 
                        paragraph (1)(B) for coverage under a group 
                        health plan; and
                            (iii) the information specified under 
                        paragraph (7)(B) (as applicable).
                    (B) Timing specified.--For purposes of subparagraph 
                (A), the timing requirement specified in this 
                subparagraph is--
                            (i) with respect to such an individual who 
                        is subject to a furlough during the period 
                        beginning on March 1, 2020, and ending on the 
                        date of the enactment of this Act, 30 days 
                        after the date of such enactment; and
                            (ii) with respect to such an individual who 
                        is subject to a furlough during the period 
                        beginning on the first day after the date of 
                        the enactment of this Act and ending on the 
                        last day of the 180-day period succeeding the 
                        emergency period described in section 
                        1135(g)(1)(B) of the Social Security Act (42 
                        U.S.C. 1320b-5(g)(1)(B)), 30 days after the 
                        date of such furlough.
                    (C) Model notices.--Not later than 30 days after 
                the date of enactment of this Act, with respect to any 
                assistance eligible individual described in paragraph 
                (3)(B)--
                            (i) the Secretary of Labor, in consultation 
                        with the Secretary of the Treasury and the 
                        Secretary of Health and Human Services, shall 
                        prescribe models for the notification required 
                        under this paragraph (other than the 
                        notification described in clause (ii)); and
                            (ii) in the case of any notification 
                        provided pursuant to subparagraph (A) under 
                        section 8905a(f)(2)(A) of title 5, United 
                        States Code, the Office of Personnel Management 
                        shall prescribe a model for such notification.
            (9) Notice of expiration of period of premium assistance.--
                    (A) In general.--With respect to any assistance 
                eligible individual, subject to subparagraph (B), the 
                requirements of section 606(a)(4) of the Employee 
                Retirement Income Security Act of 1974 (29 U.S.C. 
                1166(4)), section 4980B(f)(6)(D) of the Internal 
                Revenue Code of 1986, section 2206(4) of the Public 
                Health Service Act (42 U.S.C. 300bb-6(4)), or section 
                8905a(f)(2)(A) of title 5, United States Code, shall 
                not be treated as met unless the employer of the 
                individual, during the period specified under 
                subparagraph (C), provides to such individual a written 
                notice in clear and understandable language--
                            (i) that the premium assistance for such 
                        individual will expire soon and the prominent 
                        identification of the date of such expiration;
                            (ii) that such individual may be eligible 
                        for coverage without any premium assistance 
                        through--
                                    (I) COBRA continuation coverage; or
                                    (II) coverage under a group health 
                                plan;
                            (iii) that the expiration of premium 
                        assistance is treated as a qualifying event for 
                        which any assistance eligible individual is 
                        eligible to enroll in a qualified health plan 
                        offered through an Exchange under title I of 
                        such Act (42 U.S.C. 18001 et seq.) during a 
                        special enrollment period; and
                            (iv) the information specified in paragraph 
                        (7)(B)(vii);
                    (B) Exception.--The requirement for the group 
                health plan administrator to provide the written notice 
                under subparagraph (A) shall be waived in the case the 
                premium assistance for such individual expires pursuant 
                to clause (i)(I) or (ii)(I) of paragraph (2)(A).
                    (C) Period specified.--For purposes of subparagraph 
                (A), the period specified in this subparagraph is, with 
                respect to the date of expiration of premium assistance 
                for any assistance eligible individual pursuant to a 
                limitation requiring a notice under this paragraph, the 
                period beginning on the day that is 45 days before the 
                date of such expiration and ending on the day that is 
                15 days before the date of such expiration.
                    (D) Model notices.--Not later than 30 days after 
                the date of enactment of this Act, with respect to any 
                assistance eligible individual--
                            (i) the Secretary of Labor, in consultation 
                        with the Secretary of the Treasury and the 
                        Secretary of Health and Human Services, shall 
                        prescribe models for the notification required 
                        under this paragraph (other than the 
                        notification described in clause (ii)); and
                            (ii) in the case of any notification 
                        provided pursuant to subparagraph (A) under 
                        section 8905a(f)(2)(A) of title 5, United 
                        States Code, the Office of Personnel Management 
                        shall prescribe a model for such notification.
            (10) Regulations.--The Secretary of the Treasury and the 
        Secretary of Labor may jointly prescribe such regulations or 
        other guidance as may be necessary or appropriate to carry out 
        the provisions of this subsection, including the prevention of 
        fraud and abuse under this subsection, except that the 
        Secretary of Labor and the Secretary of Health and Human 
        Services may prescribe such regulations (including interim 
        final regulations) or other guidance as may be necessary or 
        appropriate to carry out the provisions of paragraphs (5), (7), 
        (8), (9), and (11).
            (11) Outreach.--The Secretary of Labor, in consultation 
        with the Secretary of the Treasury and the Secretary of Health 
        and Human Services, shall provide outreach consisting of public 
        education and enrollment assistance relating to premium 
        reduction provided under this subsection. Such outreach shall 
        target employers, group health plan administrators, public 
        assistance programs, States, insurers, and other entities as 
        determined appropriate by such Secretaries. Such outreach shall 
        include an initial focus on those individuals electing 
        continuation coverage who are referred to in paragraph (7)(C). 
        Information on such premium reduction, including enrollment, 
        shall also be made available on websites of the Departments of 
        Labor, Treasury, and Health and Human Services.
            (12) Definitions.--For purposes of this section:
                    (A) Administrator.--The term ``administrator'' has 
                the meaning given such term in section 3(16)(A) of the 
                Employee Retirement Income Security Act of 1974.
                    (B) COBRA continuation coverage.--The term ``COBRA 
                continuation coverage'' means continuation coverage 
                provided pursuant to part 6 of subtitle B of title I of 
                the Employee Retirement Income Security Act of 1974 
                (other than under section 609), title XXII of the 
                Public Health Service Act, section 4980B of the 
                Internal Revenue Code of 1986 (other than subsection 
                (f)(1) of such section insofar as it relates to 
                pediatric vaccines), or section 8905a of title 5, 
                United States Code, or under a State program that 
                provides comparable continuation coverage. Such term 
                does not include coverage under a health flexible 
                spending arrangement under a cafeteria plan within the 
                meaning of section 125 of the Internal Revenue Code of 
                1986.
                    (C) COBRA continuation provision.--The term ``COBRA 
                continuation provision'' means the provisions of law 
                described in subparagraph (B).
                    (D) Covered employee.--The term ``covered 
                employee'' has the meaning given such term in section 
                607(2) of the Employee Retirement Income Security Act 
                of 1974.
                    (E) Qualified beneficiary.--The term ``qualified 
                beneficiary'' has the meaning given such term in 
                section 607(3) of the Employee Retirement Income 
                Security Act of 1974.
                    (F) Group health plan.--The term ``group health 
                plan'' has the meaning given such term in section 
                607(1) of the Employee Retirement Income Security Act 
                of 1974.
                    (G) State.--The term ``State'' includes the 
                District of Columbia, the Commonwealth of Puerto Rico, 
                the Virgin Islands, Guam, American Samoa, and the 
                Commonwealth of the Northern Mariana Islands.
                    (H) Period of coverage.--Any reference in this 
                subsection to a period of coverage shall be treated as 
                a reference to a monthly or shorter period of coverage 
                with respect to which premiums are charged with respect 
                to such coverage.
                    (I) Plan sponsor.--The term ``plan sponsor'' has 
                the meaning given such term in section 3(16)(B) of the 
                Employee Retirement Income Security Act of 1974.
                    (J) Furlough.--The term ``furlough'' means, with 
                respect to an individual, a reduction of the number of 
                paid hours by at least 20 percent during any 30-day 
                period as compared to the number of paid hours during 
                the prior 30-day period due to a lack of work, funds, 
                or other nondisciplinary reason and the continued 
                eligibility for coverage of the individual under the 
                group health plan of the employer involved.
            (13) Reports.--
                    (A) Interim report.--The Secretary of the Treasury 
                and the Secretary of Labor shall jointly submit an 
                interim report to the Committee on Education and Labor, 
                the Committee on Ways and Means, and the Committee on 
                Energy and Commerce of the House of Representatives and 
                the Committee on Health, Education, Labor, and Pensions 
                and the Committee on Finance of the Senate regarding 
                the premium reduction provided under this subsection 
                that includes--
                            (i) the number of individuals provided such 
                        assistance as of the date of the report; and
                            (ii) the total amount of expenditures 
                        incurred (with administrative expenditures 
                        noted separately) in connection with such 
                        assistance as of the date of the report.
                    (B) Final report.--As soon as practicable after the 
                last period of COBRA continuation coverage for which 
                premium reduction is provided under this section, the 
                Secretary of the Treasury and the Secretary of Labor 
                shall jointly submit a final report to each Committee 
                referred to in subparagraph (A) that includes--
                            (i) the number of individuals provided 
                        premium reduction under this section;
                            (ii) the average dollar amount (monthly and 
                        annually) of premium reductions provided to 
                        such individuals; and
                            (iii) the total amount of expenditures 
                        incurred (with administrative expenditures 
                        noted separately) in connection with premium 
                        reduction under this section.
            (14) COBRA premium assistance.--
                    (A) In general.--Subchapter B of chapter 65 of the 
                Internal Revenue Code of 1986 is amended by adding at 
                the end the following new section:

``SEC. 6432. CONTINUATION COVERAGE PREMIUM ASSISTANCE.

    ``(a) In General.--The person to whom premiums are payable for 
continuation coverage under section 2(a)(1) of the Worker Health 
Coverage Protection Act shall be reimbursed as provided in subsection 
(c) for the amount of premiums not paid by assistance eligible 
individuals by reason of such section.
    ``(b) Person Entitled to Reimbursement.--For purposes of subsection 
(a), except as otherwise provided by the Secretary, the person to whom 
premiums are payable under such continuation coverage shall be treated 
as being--
            ``(1) in the case of any group health plan which is a 
        multiemployer plan (as defined in section 3(37) of the Employee 
        Retirement Income Security Act of 1974), the plan,
            ``(2) in the case of any group health plan not described in 
        paragraph (1)--
                    ``(A) which is furlough continuation coverage 
                described in section 2(a)(1)(A)(ii) of the Worker 
                Health Coverage Protection Act or subject to the COBRA 
                continuation provisions contained in--
                            ``(i) this title,
                            ``(ii) the Employee Retirement Income 
                        Security Act of 1974,
                            ``(iii) the Public Health Service Act, or
                            ``(iv) title 5, United States Code, or
                    ``(B) under which some or all of the coverage is 
                not provided by insurance,
        the employer maintaining the plan, and
            ``(3) in the case of any group health plan not described in 
        paragraph (1) or (2), the insurer providing the coverage under 
        the group health plan.
    ``(c) Limitation on Reimbursement for Furloughed Employees.--The 
amount of the premiums treated as not paid by an assistance eligible 
individual described in section 2(a)(3)(B) of the Worker Health 
Coverage Protection Act shall not exceed the portion of the annual 
premium which would have been paid by the employee (without regard to 
whether paid through salary reduction or otherwise) for periods of 
coverage under the plan before the date of the enactment of this 
section.
    ``(d) Method of Reimbursement.--Except as otherwise provided by the 
Secretary--
            ``(1) Treatment as payment of payroll taxes.--Each person 
        entitled to reimbursement under subsection (a) (and filing a 
        claim for such reimbursement at such time and in such manner as 
        the Secretary may require) shall be treated for purposes of 
        this title and section 1324(b)(2) of title 31, United States 
        Code, as having paid to the Secretary, on the date that the 
        assistance eligible individual's premium payment would 
        otherwise be due, payroll taxes in an amount equal to the 
        portion of such reimbursement which relates to such premium. To 
        the extent that the amount treated as paid under the preceding 
        sentence exceeds the amount of such person's liability for such 
        taxes, the Secretary shall credit or refund such excess in the 
        same manner as if it were an overpayment of such taxes.
            ``(2) Overstatements.--Any overstatement of the 
        reimbursement to which a person is entitled under this section 
        (and any amount paid by the Secretary as a result of such 
        overstatement) shall be treated as an underpayment of payroll 
        taxes by such person and may be assessed and collected by the 
        Secretary in the same manner as payroll taxes.
    ``(e) Definitions.--For purposes of this section--
            ``(1) Payroll taxes.--The term `payroll taxes' means--
                    ``(A) amounts required to be deducted and withheld 
                for the payroll period under section 3402 (relating to 
                wage withholding),
                    ``(B) amounts required to be deducted for the 
                payroll period under section 3102 (relating to FICA 
                employee taxes), and
                    ``(C) amounts of the taxes imposed for the payroll 
                period under section 3111 (relating to FICA employer 
                taxes).
            ``(2) Person.--The term `person' includes any governmental 
        entity.
    ``(f) Reporting.--Each person entitled to reimbursement under 
subsection (a) for any period shall submit such reports (at such time 
and in such manner) as the Secretary may require, including--
            ``(1) an attestation of involuntary termination of 
        employment, reduction of hours, or furloughing, for each 
        assistance eligible individual on the basis of whose 
        termination, reduction of hours, or furloughing entitlement to 
        reimbursement is claimed under subsection (a),
            ``(2) a report of the amount of payroll taxes offset under 
        subsection (a) for the reporting period and the estimated 
        offsets of such taxes for the subsequent reporting period in 
        connection with reimbursements under subsection (a), and
            ``(3) a report containing the TINs of all covered 
        employees, the amount of subsidy reimbursed with respect to 
        each covered employee and qualified beneficiaries, and a 
        designation with respect to each covered employee as to whether 
        the subsidy reimbursement is for coverage of 1 individual or 2 
        or more individuals.
    ``(g) Regulations.--The Secretary shall issue such regulations or 
other guidance as may be necessary or appropriate to carry out this 
section, including--
            ``(1) the requirement to report information or the 
        establishment of other methods for verifying the correct 
        amounts of reimbursements under this section, and
            ``(2) the application of this section to group health plans 
        that are multiemployer plans (as defined in section 3(37) of 
        the Employee Retirement Income Security Act of 1974).''.
                    (B) Social security trust funds held harmless.--In 
                determining any amount transferred or appropriated to 
                any fund under the Social Security Act, section 6432 of 
                the Internal Revenue Code of 1986 shall not be taken 
                into account.
                    (C) Clerical amendment.--The table of sections for 
                subchapter B of chapter 65 of the Internal Revenue Code 
                of 1986 is amended by adding at the end the following 
                new item:

``Sec. 6432. Continuation coverage premium assistance.''.
                    (D) Effective date.--The amendments made by this 
                paragraph shall apply to premiums to which subsection 
                (a)(1)(A) applies.
                    (E) Special rule.--
                            (i) In general.--In the case of an 
                        assistance eligible individual who pays, with 
                        respect to the first period of continuation 
                        coverage to which subsection (a)(1)(A) applies 
                        or the immediately subsequent period, the full 
                        premium amount for such coverage, the person to 
                        whom such payment is payable shall--
                                    (I) make a reimbursement payment to 
                                such individual for the amount of such 
                                premium paid in excess of the amount 
                                required to be paid under subsection 
                                (a)(1)(A); or
                                    (II) provide credit to the 
                                individual for such amount in a manner 
                                that reduces one or more subsequent 
                                premium payments that the individual is 
                                required to pay under such subsection 
                                for the coverage involved.
                            (ii) Reimbursing employer.--A person to 
                        which clause (i) applies shall be reimbursed as 
                        provided for in section 6432 of the Internal 
                        Revenue Code of 1986 for any payment made, or 
                        credit provided, to the employee under such 
                        clause.
                            (iii) Payment of credits.--Unless it is 
                        reasonable to believe that the credit for the 
                        excess payment in clause (i)(II) will be used 
                        by the assistance eligible individual within 
                        180 days of the date on which the person 
                        receives from the individual the payment of the 
                        full premium amount, a person to which clause 
                        (i) applies shall make the payment required 
                        under such clause to the individual within 60 
                        days of such payment of the full premium 
                        amount. If, as of any day within the 180-day 
                        period, it is no longer reasonable to believe 
                        that the credit will be used during that 
                        period, payment equal to the remainder of the 
                        credit outstanding shall be made to the 
                        individual within 60 days of such day.
            (15) Penalty for failure to notify health plan of cessation 
        of eligibility for premium assistance.--
                    (A) In general.--Part I of subchapter B of chapter 
                68 of the Internal Revenue Code of 1986 is amended by 
                adding at the end the following new section:

``SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH PLAN OF CESSATION OF 
              ELIGIBILITY FOR CONTINUATION COVERAGE PREMIUM ASSISTANCE.

    ``(a) In General.--Any person required to notify a group health 
plan under section 2(a)(2)(B) of the Worker Health Coverage Protection 
Act who fails to make such a notification at such time and in such 
manner as the Secretary of Labor may require shall pay a penalty of 
$250.
    ``(b) Intentional Failure.--In the case of any such failure that is 
fraudulent, such person shall pay a penalty of 110 percent of the 
premium reduction provided under such section after termination of 
eligibility under such subsection.
    ``(c) Reasonable Cause Exception.--No penalty shall be imposed 
under this section with respect to any failure if it is shown that such 
failure is due to reasonable cause and not to willful neglect.''.
                    (B) Clerical amendment.--The table of sections of 
                part I of subchapter B of chapter 68 of such Code is 
                amended by adding at the end the following new item:

``Sec. 6720C. Penalty for failure to notify health plan of cessation of 
                            eligibility for continuation coverage 
                            premium assistance.''.
            (16) Coordination with hctc.--
                    (A) In general.--Section 35(g)(9) of the Internal 
                Revenue Code of 1986 is amended to read as follows:
            ``(9) Continuation coverage premium assistance.--In the 
        case of an assistance eligible individual who receives premium 
        reduction for continuation coverage under section 2(a)(1) of 
        the Worker Health Coverage Protection Act for any month during 
        the taxable year, such individual shall not be treated as an 
        eligible individual, a certified individual, or a qualifying 
        family member for purposes of this section or section 7527 with 
        respect to such month.''.
                    (B) Effective date.--The amendment made by 
                subparagraph (A) shall apply to taxable years ending 
                after the date of the enactment of this Act.
            (17) Exclusion of continuation coverage premium assistance 
        from gross income.--
                    (A) In general.--Part III of subchapter B of 
                chapter 1 of the Internal Revenue Code of 1986 is 
                amended by inserting after section 139H the following 
                new section:

``SEC. 139I. CONTINUATION COVERAGE PREMIUM ASSISTANCE.

    ``In the case of an assistance eligible individual (as defined in 
subsection (a)(3) of section 2 of the Worker Health Coverage Protection 
Act), gross income does not include any premium reduction provided 
under subsection (a)(1) of such section.''.
                    (B) Clerical amendment.--The table of sections for 
                part III of subchapter B of chapter 1 of such Code is 
                amended by inserting after the item relating to section 
                139H the following new item:

``Sec. 139I. Continuation coverage premium assistance.''.
                    (C) Effective date.--The amendments made by this 
                paragraph shall apply to taxable years ending after the 
                date of the enactment of this Act.
    (b) Elimination of Premium Subsidy for High-Income Individuals.--
            (1) Recapture of subsidy for high-income individuals.--If--
                    (A) premium assistance is provided under this 
                section with respect to any continuation coverage which 
                covers the taxpayer, the taxpayer's spouse, or any 
                dependent (within the meaning of section 152 of the 
                Internal Revenue Code of 1986, determined without 
                regard to subsections (b)(1), (b)(2), and (d)(1)(B) 
                thereof) of the taxpayer during any portion of the 
                taxable year, and
                    (B) the taxpayer's modified adjusted gross income 
                for such taxable year exceeds $125,000 ($250,000 in the 
                case of a joint return),
        then the tax imposed by chapter 1 of such Code with respect to 
        the taxpayer for such taxable year shall be increased by the 
        amount of such assistance.
            (2) Phase-in of recapture.--
                    (A) In general.--In the case of a taxpayer whose 
                modified adjusted gross income for the taxable year 
                does not exceed $145,000 ($290,000 in the case of a 
                joint return), the increase in the tax imposed under 
                paragraph (1) shall not exceed the phase-in percentage 
                of such increase (determined without regard to this 
                paragraph).
                    (B) Phase-in percentage.--For purposes of this 
                subsection, the term ``phase-in percentage'' means the 
                ratio (expressed as a percentage) obtained by 
                dividing--
                            (i) the excess of described in subparagraph 
                        (B) of paragraph (1), by
                            (ii) $20,000 ($40,000 in the case of a 
                        joint return).
            (3) Option for high-income individuals to waive assistance 
        and avoid recapture.--Notwithstanding subsection (a)(3), an 
        individual shall not be treated as an assistance eligible 
        individual for purposes of this section and section 6432 of the 
        Internal Revenue Code of 1986 if such individual--
                    (A) makes a permanent election (at such time and in 
                such form and manner as the Secretary of the Treasury 
                may prescribe) to waive the right to the premium 
                assistance provided under this section, and
                    (B) notifies the entity to whom premiums are 
                reimbursed under section 6432(a) of such Code of such 
                election.
            (4) Modified adjusted gross income.--For purposes of this 
        subsection, the term ``modified gross income'' means the 
        adjusted gross income (as defined in section 62 of the Internal 
        Revenue Code of 1986) of the taxpayer for the taxable year 
        increased by any amount excluded from gross income under 
        section 911, 931, or 933 of such Code.
            (5) Credits not allowed against tax, etc.--For purposes 
        determining regular tax liability under section 26(b) of such 
        Code, the increase in tax under this subsection shall not be 
        treated as a tax imposed under chapter 1 of such Code.
            (6) Regulations.--The Secretary of the Treasury shall issue 
        such regulations or other guidance as are necessary or 
        appropriate to carry out this subsection, including 
        requirements that the entity to whom premiums are reimbursed 
        under section 6432(a) of the Internal Revenue Code of 1986 
        report to the Secretary, and to each assistance eligible 
        individual, the amount of premium assistance provided under 
        subsection (a) with respect to each such individual.
            (7) Effective date.--The provisions of this subsection 
        shall apply to taxable years ending after the date of the 
        enactment of this Act.
    (c) Rule of Construction.--In all matters of interpretation, rules, 
and operational procedures, the language of this section shall be 
interpreted broadly for the benefit of workers and their families.
                                 <all>