Patients Right to Know Act of 2013

Summary: Patients Right to Know Act of 2013 - Amends the Public Health Service Act to require health plans to include in their annual summary of benefits and coverage explanations: (1) the annual fee on health insurance providers under the Patient Protection and Affordable Care Act, (2) the annual fees imposed on health insurance policies, (3) required contributions by health plans to the reinsurance program, (4) user fees on health plans participating in health insurance exchanges, (5) payments by health plans whose costs are lower than the target amount (premiums collected minus administrative costs), and (6) charges assessed by states on health plans whose enrollees have a lower actuarial risk than the average actuarial risk of all enrollees in a state. Allows such costs to be calculated separately for individual, small group, or large group markets. Requires the Comptroller General (GAO) to study the methods of calculating the impact on average premium costs associated with: (1) guaranteed issuance of coverage and community rated premiums, (2) limitations on age rating, (3) required coverage of women's preventive services, and (4) the requirement that plans cover at least 60% of the actuarial value of essential health benefits.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patients Right to Know Act of 
2013''.

SEC. 2. PROTECTION OF CERTAIN HEALTH INSURANCE DISCLOSURES.

    (a) In General.--Section 2715 of the Public Health Service Act (42 
U.S.C. 300gg-15) is amended by adding at the end the following new 
subsection:
    ``(h) Protection of Disclosure of Fee and Other Additional 
Information.--
            ``(1) In general.--A health insurance issuer or sponsor of 
        a group health plan, with respect to its annual summary of 
        benefits and coverage explanation provided under subsection 
        (d)--
                    ``(A) shall include (effective for plan years 
                beginning on or after January 1, 2016, and in addition 
                to the information required to be disclosed under this 
                section)--
                            ``(i) the applicable additional information 
                        relating to fees described in paragraph (2); 
                        and
                            ``(ii) the applicable additional 
                        information included under paragraph (3)(D); 
                        and
                    ``(B) shall not be subject to any administrative 
                action by the Secretary or by a State authority with 
                respect to any disclosure made on or after the date of 
                the enactment of this subsection of such applicable 
                additional information if the disclosure is made based 
                upon a good faith estimate of such information and is 
                in accordance with such standards as the Secretary may 
                establish to carry out this subsection.
            ``(2) Fee information.--The additional information 
        described in this paragraph, with respect to a health insurance 
        issuer issuing health insurance coverage in the individual, 
        small, or large group market and with respect to the sponsor of 
        a group health plan, is as follows:
                    ``(A) Fee on health insurance providers.--The 
                annual fee on health insurance providers under section 
                9010 of the Patient Protection and Affordable Care Act 
                (26 U.S.C. 4001 note).
                    ``(B) PCORI tax.--Fees imposed under subchapter B 
                of chapter 34 of the Internal Revenue Code of 1986 
                (relating to funding the Patient-Centers Outcome 
                Research Institute).
                    ``(C) Reinsurance contributions.--Reinsurance 
                contributions required under section 1341(b) of the 
                Patient Protection and Affordable Care Act (42 U.S.C. 
                18061(b)).
                    ``(D) Proposed health insurance exchange user 
                fee.--Fees imposed on health plans relating to 
                participation in an Exchange under subtitle D of title 
                I of the Patient Protection and Affordable Care Act (42 
                U.S.C. 18021 et seq.).
                    ``(E) Risk corridor payments.--Risk corridor 
                payments required under section 1342(b)(2) of the 
                Patient Protection and Affordable Care Act (42 U.S.C. 
                18062(b)(2)).
                    ``(F) Risk adjustment charges.--Risk adjustment 
                charges imposed under section 1343(a)(1) of the Patient 
                Protection and Affordable Care Act (42 U.S.C. 
                18063(a)(1)).
        In the case of health insurance coverage, such costs may be 
        calculated separately for such coverage in the individual 
        market, in the small group market, and in the large group 
        market for the health insurance issuer involved.
            ``(3) Other information.--
                    ``(A) Study.--The Comptroller General of the United 
                States shall conduct a study of methods of calculating 
                the impact on average premium costs associated with 
                each of the following:
                            ``(i) Market impact of guaranteed issue and 
                        community rating.--The requirement for 
                        guaranteed issuance of coverage under section 
                        2702 and community rated premiums under section 
                        2701.
                            ``(ii) Age rating impact.--The requirement 
                        of section 2701(a)(1)(A)(iii) (relating to 
                        limitations on age rating).
                            ``(iii) Women's preventive services.--The 
                        requirement for coverage of women's preventive 
                        services under section 2713.
                            ``(iv) Minimum essential health benefits 
                        coverage.--The requirement that coverage 
                        provide for at least 60 percent of the 
                        actuarial value of essential health benefits 
                        under section 1302(d) of the Patient Protection 
                        and Affordable Care Act. (42 U.S.C. 18022(d)).
                    ``(B) Consultation.--In conducting such study, the 
                Comptroller General shall consult with health insurance 
                issuers and State health insurance commissioners.
                    ``(C) Report.--Not later than October 1, 2014, the 
                Comptroller General shall submit to each House of 
                Congress and the Secretary a report on the study 
                conducted under subparagraph (A).
                    ``(D) Inclusion of additional information.--After 
                submission of such report, the Secretary may also 
                include in the information required to be disclosed 
                under paragraph (1)(A)(ii) information on the impact on 
                premiums of each of the requirements described in 
                subparagraph (A).
            ``(4) Retention of state rate setting authority.--Nothing 
        in this subsection shall be construed to preempt State 
        authority to regulate, reject, alter, or require additional 
        information in support of rates for health insurance coverage 
        or oversight authority of the Secretary.''.