Health Insurance Lemon Law Act
This bill establishes a 60-day special enrollment period for individuals enrolled in health insurance plans that are not in compliance with certain standards of coverage under current law.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8875 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 8875
To amend the Patient Protection and Affordable Care Act and the
Employee Retirement Income Security Act of 1974 to establish a special
enrollment period for eligible individuals who are enrolled in non-
compliant health plans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 4, 2020
Mr. Kennedy 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 the Patient Protection and Affordable Care Act and the
Employee Retirement Income Security Act of 1974 to establish a special
enrollment period for eligible individuals who are enrolled in non-
compliant health plans, 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 ``Health Insurance Lemon Law Act''.
SEC. 2. ESTABLISHMENT OF A SPECIAL ENROLLMENT PERIOD FOR ELIGIBLE
INDIVIDUALS WHO ARE ENROLLED IN A NON-COMPLIANT HEALTH
PLAN.
(a) Special Enrollment Periods for Individuals Enrolled in Non-
Compliant Health Plans.--
(1) Option for eligible individuals to enroll in exchange
plans through a special enrollment period.--Section 1311(c) of
the Patient Protection and Affordable Care Act (42 U.S.C.
18031(c)) is amended--
(A) in paragraph (6)--
(i) in subparagraph (C), by striking at the
end ``and'';
(ii) in subparagraph (D), by striking the
period at the end and inserting ``; and''; and
(iii) by adding at the end the following
new subparagraph:
``(E) special enrollment periods described in
paragraph (8)(A).''; and
(B) by adding at the end the following new
paragraph:
``(8) Special enrollment period for individuals enrolled in
non-compliant exchange plans to enroll in different exchange
plans.--
``(A) In general.--A special enrollment period
described in this subparagraph is, beginning 60 days
after the date of the enactment of this paragraph, the
60-day period beginning on the date an eligible
individual confirms receiving a notification that the
health plan in which the eligible individual is
enrolled is a non-compliant health plan.
``(B) Self-attestation.--For purposes of qualifying
for the special enrollment period described in
subparagraph (A), the receipt of a notification that
the health plan in which the eligible individual is
enrolled is a non-compliant health plan shall be
determined by the self-attestation of an eligible
individual.
``(C) Definitions.--In this paragraph:
``(i) Eligible individual.--
``(I) In general.--The term
`eligible individual' means a qualified
individual who is enrolled in a non-
compliant health plan.
``(II) Inclusion.--Such term
includes a covered employee (as defined
in section 607(2) of the Employee
Retirement Income Security Act of 1974)
who is enrolled in a non-compliant
health plan.
``(ii) Non-compliant health plan.--The term
`non-compliant health plan' means a group
health plan or health insurance coverage
offered by a health insurance issuer in the
individual or small group market that is not so
in compliance (as applicable) with any of--
``(I) sections 2701, 2702, 2703,
2704, 2705, 2706, 2708, 2709, 2711,
2712, 2713, 2714, 2715, 2716, 2717,
2718, 2719, 2719A, 2725, 2726, 2727,
2728, or 2794 of the Public Health
Service Act;
``(II) sections 1302 or 1312 of the
Patient Protection and Affordable Care
Act;
``(III) section 105 of the Internal
Revenue Code of 1986; or
``(IV) sections 601 through 608 of
the Employee Retirement Income Security
Act of 1974.''.
(2) Option for covered employees enrolled in non-compliant
group health plans to enroll in a different group health
plan.--Section 701 of the Employee Retirement Income Security
Act (29 U.S.C. 1181) is amended by inserting after paragraph
(6) the following new paragraph:
``(7) Special enrollment period for covered employees
enrolled in non-compliant group health plans to enroll in a
different group health plan.--
``(A) In general.--Beginning 60 days after the date
of the enactment of this paragraph, a group health plan
shall permit an employee who is enrolled in the group
health plan that is not in compliance with a
requirement specified under clause (C)(ii) of section
1311(c)(8) of the Patient Protection and Affordable
Care Act (as applicable) to enroll in a different group
health plan offered by the employer for a 60-day period
beginning on the date the employee confirms receiving a
notification that the group health plan in which the
employee is not so in compliance.
``(B) Self-attestation.--For purposes of qualifying
for the special enrollment period described in
subparagraph (A), the receipt of a notification that
the group health plan in which the eligible individual
is enrolled is a non-compliant health plan shall be
determined by the self-attestation of an eligible
individual.''.
(b) Requirement for First Day of Coverage for Eligible Individuals
Enrolling During the Special Enrollment Period.--
(1) Non-compliant exchange plans.--Section 1303 of the
Patient Protection and Affordable Care Act (42 U.S.C. 18023) is
amended by adding at the end the following new subsection:
``(e) Requirement for First Day of Coverage for Eligible
Individuals Enrolling During the Special Enrollment Period.--
``(1) Notification requirement.--
``(A) In general.--With respect to health insurance
coverage in the individual or small group market group
offered by a health insurance issuer, any health
insurance issuer of such coverage that is not in
compliance with a requirement specified under clause
(C)(ii) of section 1311(c)(8) of the Patient Protection
and Affordable Care Act shall--
``(i) for the 30-day period beginning on
the date the issuer receives a notice from the
Secretary of Health and Human Services that
such coverage is not so in compliance, attempt
to receive confirmation that each enrollee of
such coverage is eligible for the special
enrollment period described in section
subparagraph (A) of such section; and
``(ii) not later than 60 days after the
date the issuer receives the notice described
in clause (i), in the case the coverage does
not receive confirmation for an enrollee
pursuant to such clause, submit to the
Secretary of Health and Human Services the name
of the enrollee and efforts to notify and
receive confirmation from the enrollee.
``(B) Privacy considerations.--In carrying out this
paragraph, the health insurance issuer shall take
measures to ensure that information as may be
specifically permitted or required under other
applicable provisions of law, including HIPAA privacy
and security law as defined in section 3009(a) of the
Public Health Service Act (42 U.S.C. 300jj-19(a)) is
not made public under this paragraph.
``(2) Requirement for first day of coverage.--In the case
of an eligible individual (as defined in subparagraph (C) of
section 1311(c)(8)) who enrolls in a qualified health plan
through an Exchange during a month during the special
enrollment period described in subparagraph (A) of such
section--
``(A) coverage under health insurance coverage
offered a health insurance issuer in the individual or
small group market shall terminate on the last day of
the such month in which the eligible individual so
enrolls in the qualified health plan; and
``(B) coverage under the qualified health plan
shall be effective beginning on the first day of the
first month succeeding the month termination of
coverage described in subparagraph (A).''.
(2) Non-compliant group health plans.--Section 701(7) of
the Employee Retirement Income Security Act of 1974 (29 U.S.C.
1181(7)), as amended by subsection (a)(2), is further amended,
by inserting after subparagraph (B) the following new
subparagraphs:
``(C) Notification requirement.--
``(i) In general.--A group health plan that
is not in compliance with a requirement
specified under subparagraph (C)(ii) of section
1311(c)(8) of the Patient Protection and
Affordable Care Act shall--
``(I) for the 30-day period
beginning after the date the plan
receives a notice from the Secretary of
Labor that such plan is not in
compliance, attempt to receive
confirmation that each enrollee of such
plan was so notified of the special
enrolled period described in
subparagraph (A) of such section and
the special enrollment period described
in subparagraph (A); and
``(II) not later than 60 days after
the date the plan receives the notice
described in clause (i), in the case
the plan does not receive confirmation
for an enrollee pursuant to such
clause, submit to the Secretary of
Labor the name of the enrollee and
efforts to notify and receive
confirmation from the enrollee.
``(ii) Privacy considerations.--In carrying
out this subparagraph, the group health plan
shall take measures to ensure that information
as may be specifically permitted or required
under other applicable provisions of law,
including HIPAA privacy and security law as
defined in section 3009(a) of the Public Health
Service Act (42 U.S.C. 300jj-19(a)) is not made
public under this subparagraph.
``(D) Requirement for first day of coverage.--In
the case of an eligible individual (as defined in
subparagraph (C) of section 1311(c)(8) of the Patient
Protection and Affordable Care Act) who is a covered
employee and who--
``(i) enrolls in a qualified health plan
through an Exchange during a month during the
special enrollment period described in
subparagraph (A) of such section--
``(I) coverage under a group health
plan shall terminate on the last day of
the such month in which the eligible
individual so enrolls in the qualified
health plan; and
``(II) coverage under the qualified
health plan shall be determined in
accordance with section 1303(e)(2) of
such Act; or
``(ii) enrolls in a different group health
plan offered by the employer of the covered
employee pursuant to the special enrollment
period described in subparagraph (A)--
``(I) coverage under a group health
plan shall terminate on the last day of
the such month in which the eligible
individual so enrolls in the qualified
health plan; and
``(II) coverage under the different
group health plan offered by the
employer of the qualified beneficiary
shall be effective beginning on the
first day of the first month succeeding
the month of termination of coverage
described in subclause (I).''.
<all>
Introduced in House
Introduced in House
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.
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.
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