II 

Calendar No. 554 

116TH CONGRESS 

2D SESSION S. 4675 

To amend the Health Insurance Portability and Accountability Act. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 23, 2020 

Mr. TILLIS introduced the following bill; which was read the first time 

SEPTEMBER 24, 2020 

Read the second time and placed on the calendar 

A BILL 

To amend the Health Insurance Portability and 

Accountability Act. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protect Act’’. 

5 SEC. 2. FINDINGS. 

6 Congress finds as follows: 

7 (1) In President Obama’s last year in office, 

8 Obamacare’s high costs exposed working Americans 


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1 to potential health insurance coverage loss, the most 

2 extreme form of lacking pre-existing conditions pro3 tection. That year, there was a 20 percent decrease 

4 in enrollment in plans offered on the Exchange 

5 among working Americans who earned too much to 

6 receive a premium tax credit subsidy, but not 

7 enough to cover the over 105 percent increases in 

8 premiums under Obamacare. 

9 (2) In 2015, nearly 80 percent of the house10 holds who paid the individual mandate tax earned 

11 less than $50,000 per year. 

12 (3) Recognizing this unfair burden, in Decem13 ber 2017, Congress acted to restore freedom and lib14 erty to Americans by eliminating the penalty for 

15 noncompliance with such individual mandate. 

16 (4) Obamacare is not the only way to protect 

17 Americans with pre-existing conditions. 

18 (5) Obamacare’s one-size-fits-all approach un19 dermines States’ ability to care for their populations 

20 and left many Americans unable to afford any health 

21 insurance in the individual market. 

22 (6) Congress will protect individuals with pre23 existing conditions if the Supreme Court ultimately 

24 determines in Texas v. California that Obamacare is 

25 unconstitutional. 


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1 SEC. 3. GUARANTEED AVAILABILITY OF COVERAGE; PRO2 HIBITING DISCRIMINATION. 

3 (a) IN GENERAL.—Subtitle C of title I of the Health 

4 Insurance Portability and Accountability Act of 1996 

5 (Public Law 104–191) is amended by adding at the end 

6 the following: 

7 ‘‘SEC. 196. PROHIBITION OF PRE-EXISTING CONDITION EX8 CLUSIONS. 

9 ‘‘(a) IN GENERAL.—A group health plan and a health 

10 insurance issuer offering group or individual health insur11 ance coverage may not impose any pre-existing condition 

12 exclusion with respect to such plan or coverage. 

13 ‘‘(b) DEFINITIONS.—For purposes of this section: 

14 ‘‘(1) PRE-EXISTING CONDITION EXCLUSION.— 

15 ‘‘(A) IN GENERAL.—The term ‘pre-existing 

16 condition exclusion’ means, with respect to cov17 erage, a limitation or exclusion of benefits relat18 ing to a condition based on the fact that the 

19 condition was present before the enrollment 

20 date for such coverage, whether or not any 

21 medical advice, diagnosis, care, or treatment 

22 was recommended or received before such date. 

23 ‘‘(B) TREATMENT OF GENETIC INFORMA24 TION.—Genetic information shall not be treated 

25 as a condition described in subparagraph (A) in 


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1 the absence of a diagnosis of the condition re2 lated to such information. 

3 ‘‘(2) ENROLLMENT DATE.—The term ‘enroll4 ment date’ means, with respect to an individual cov5 ered under a group health plan or health insurance 

6 coverage, the date of enrollment of the individual in 

7 the plan or coverage or, if earlier, the first day of 

8 the waiting period for such enrollment. 

9 ‘‘(3) WAITING PERIOD.—The term ‘waiting pe10 riod’ means, with respect to a group health plan and 

11 an individual who is a potential participant or bene12 ficiary in the plan, the period that must pass with 

13 respect to the individual before the individual is eli14 gible to be covered for benefits under the terms of 

15 the plan. 

16 ‘‘SEC. 197. GUARANTEED AVAILABILITY OF COVERAGE. 

17 ‘‘(a) GUARANTEED ISSUANCE OF COVERAGE IN THE

18 INDIVIDUAL AND GROUP MARKET.—Subject to sub19 sections (b) through (d), each health insurance issuer that 

20 offers health insurance coverage in the individual or group 

21 market in a State must accept every employer and indi22 vidual in the State that applies for such coverage. 

23 ‘‘(b) ENROLLMENT.— 

24 ‘‘(1) RESTRICTION.—A health insurance issuer 

25 described in subsection (a) may restrict enrollment 


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1 in coverage described in such subsection to open or 

2 special enrollment periods. 

3 ‘‘(2) ESTABLISHMENT.—A health insurance 

4 issuer described in subsection (a) shall, in accord5 ance with the regulations promulgated under para6 graph (3), establish special enrollment periods for 

7 qualifying events (under section 603 of the Em8 ployee Retirement Income Security Act of 1974). 

9 ‘‘(3) REGULATIONS.—The Secretary shall pro10 mulgate regulations with respect to enrollment peri11 ods under paragraphs (1) and (2). 

12 ‘‘(c) SPECIAL RULES FOR NETWORK PLANS.— 

13 ‘‘(1) IN GENERAL.—In the case of a health in14 surance issuer that offers health insurance coverage 

15 in the group and individual market through a net16 work plan, the issuer may— 

17 ‘‘(A) limit the employers that may apply 

18 for such coverage to those with eligible individ19 uals who live, work, or reside in the service area 

20 for such network plan; and 

21 ‘‘(B) within the service area of such plan, 

22 deny such coverage to such employers and indi23 viduals if the issuer has demonstrated, if re24 quired, to the applicable State authority that— 


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1 ‘‘(i) it will not have the capacity to de2 liver services adequately to enrollees of any 

3 additional groups or any additional individ4 uals because of its obligations to existing 

5 group contract holders and enrollees; and 

6 ‘‘(ii) it is applying this paragraph uni7 formly to all employers and individuals 

8 without regard to the claims experience of 

9 those individuals, employers and their em10 ployees (and their dependents), or any 

11 health status-related factor relating to 

12 such individuals, employees, and depend13 ents. 

14 ‘‘(2) 180-DAY SUSPENSION UPON DENIAL OF

15 COVERAGE.—An issuer, upon denying health insur16 ance coverage in any service area in accordance with 

17 paragraph (1)(B), may not offer coverage in the 

18 group or individual market within such service area 

19 for a period of 180 days after the date such cov20 erage is denied. 

21 ‘‘(d) APPLICATION OF FINANCIAL CAPACITY LIM22 ITS.— 

23 ‘‘(1) IN GENERAL.—A health insurance issuer 

24 may deny health insurance coverage in the group or 


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1 individual market if the issuer has demonstrated, if 

2 required, to the applicable State authority that— 

3 ‘‘(A) it does not have the financial reserves 

4 necessary to underwrite additional coverage; 

5 and 

6 ‘‘(B) it is applying this paragraph uni7 formly to all employers and individuals in the 

8 group or individual market in the State con9 sistent with applicable State law and without 

10 regard to the claims experience of those individ11 uals, employers and their employees (and their 

12 dependents) or any health status-related factor 

13 relating to such individuals, employees, and de14 pendents. 

15 ‘‘(2) 180-DAY SUSPENSION UPON DENIAL OF

16 COVERAGE.—A health insurance issuer upon denying 

17 health insurance coverage in connection with group 

18 health plans in accordance with paragraph (1) in a 

19 State may not offer coverage in connection with 

20 group health plans in the group or individual market 

21 in the State for a period of 180 days after the date 

22 such coverage is denied or until the issuer has dem23 onstrated to the applicable State authority, if re24 quired under applicable State law, that the issuer 

25 has sufficient financial reserves to underwrite addiVerDate Sep 11 2014 22:08 Sep 24, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4675.PCS S4675

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1 tional coverage, whichever is later. An applicable 

2 State authority may provide for the application of 

3 this subsection on a service-area-specific basis 

4 ‘‘(e) DEFINITIONS.—In this section and in sections 

5 196 and 198: 

6 ‘‘(1) The term ‘Secretary’ means the Secretary 

7 of Health and Human Services. 

8 ‘‘(2) The terms ‘genetic information’, ‘genetic 

9 test’, ‘group health plan’, ‘group market’, ‘health in10 surance coverage’, ‘health insurance issuer’, ‘group 

11 health insurance coverage’, ‘individual health insur12 ance coverage’, ‘individual market’, and ‘under13 writing purpose’ have the meanings given such terms 

14 in section 2791 of the Public Health Service Act.’’. 

15 ‘‘SEC. 198. PROHIBITING DISCRIMINATION AGAINST INDI16 VIDUAL PARTICIPANTS AND BENEFICIARIES 

17 BASED ON HEALTH STATUS. 

18 ‘‘(a) IN GENERAL.—A group health plan and a health 

19 insurance issuer offering group or individual health insur20 ance coverage may not establish rules for eligibility (in21 cluding continued eligibility) of any individual to enroll 

22 under the terms of the plan or coverage based on any of 

23 the following health status-related factors in relation to 

24 the individual or a dependent of the individual: 

25 ‘‘(1) Health status. 


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1 ‘‘(2) Medical condition (including both physical 

2 and mental illnesses). 

3 ‘‘(3) Claims experience. 

4 ‘‘(4) Receipt of health care. 

5 ‘‘(5) Medical history. 

6 ‘‘(6) Genetic information. 

7 ‘‘(7) Evidence of insurability (including condi8 tions arising out of acts of domestic violence). 

9 ‘‘(8) Disability. 

10 ‘‘(9) Any other health status-related factor de11 termined appropriate by the Secretary. 

12 ‘‘(b) IN PREMIUM CONTRIBUTIONS.— 

13 ‘‘(1) IN GENERAL.—A group health plan, and a 

14 health insurance issuer offering group or individual 

15 health insurance coverage, may not require any indi16 vidual (as a condition of enrollment or continued en17 rollment under the plan) to pay a premium or con18 tribution which is greater than such premium or 

19 contribution for a similarly situated individual en20 rolled in the plan on the basis of any health status21 related factor in relation to the individual or to an 

22 individual enrolled under the plan as a dependent of 

23 the individual. 

24 ‘‘(2) CONSTRUCTION.—Nothing in paragraph 

25 (1) shall be construed— 


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1 ‘‘(A) to restrict the amount that an em2 ployer or individual may be charged for cov3 erage under a group health plan except as pro4 vided in paragraph (3) or individual health cov5 erage, as the case may be; or 

6 ‘‘(B) to prevent a group health plan, and 

7 a health insurance issuer offering group health 

8 insurance coverage, from establishing premium 

9 discounts or rebates or modifying otherwise ap10 plicable copayments or deductibles in return for 

11 adherence to programs of health promotion and 

12 disease prevention. 

13 ‘‘(3) NO GROUP-BASED DISCRIMINATION ON

14 BASIS OF GENETIC INFORMATION.— 

15 ‘‘(A) IN GENERAL.—For purposes of this 

16 section, a group health plan, and health insur17 ance issuer offering group health insurance cov18 erage in connection with a group health plan, 

19 may not adjust premium or contribution 

20 amounts for the group covered under such plan 

21 on the basis of genetic information. 

22 ‘‘(B) RULE OF CONSTRUCTION.—Nothing 

23 in subparagraph (A) or in paragraphs (1) and 

24 (2) of subsection (d) shall be construed to limit 

25 the ability of a health insurance issuer offering 


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1 group or individual health insurance coverage to 

2 increase the premium for an employer based on 

3 the manifestation of a disease or disorder of an 

4 individual who is enrolled in the plan. In such 

5 case, the manifestation of a disease or disorder 

6 in one individual cannot also be used as genetic 

7 information about other group members and to 

8 further increase the premium for the employer. 

9 ‘‘(c) GENETIC TESTING.— 

10 ‘‘(1) LIMITATION ON REQUESTING OR REQUIR11 ING GENETIC TESTING.—A group health plan, and a 

12 health insurance issuer offering health insurance 

13 coverage in connection with a group health plan, 

14 shall not request or require an individual or a family 

15 member of such individual to undergo a genetic test. 

16 ‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) 

17 shall not be construed to limit the authority of a 

18 health care professional who is providing health care 

19 services to an individual to request that such indi20 vidual undergo a genetic test. 

21 ‘‘(3) RULE OF CONSTRUCTION REGARDING PAY22 MENT.— 

23 ‘‘(A) IN GENERAL.—Nothing in paragraph 

24 (1) shall be construed to preclude a group 

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1 ing health insurance coverage in connection 

2 with a group health plan, from obtaining and 

3 using the results of a genetic test in making a 

4 determination regarding payment (as such term 

5 is defined for the purposes of applying the regu6 lations promulgated by the Secretary under 

7 part C of title XI of the Social Security Act and 

8 section 264 of this Act, as may be revised from 

9 time to time) consistent with subsection (a). 

10 ‘‘(B) LIMITATION.—For purposes of sub11 paragraph (A), a group health plan, or a health 

12 insurance issuer offering health insurance cov13 erage in connection with a group health plan, 

14 may request only the minimum amount of in15 formation necessary to accomplish the intended 

16 purpose. 

17 ‘‘(4) RESEARCH EXCEPTION.—Notwithstanding 

18 paragraph (1), a group health plan, or a health in19 surance issuer offering health insurance coverage in 

20 connection with a group health plan, may request, 

21 but not require, that a participant or beneficiary un22 dergo a genetic test if each of the following condi23 tions is met: 

24 ‘‘(A) The request is made pursuant to re25 search that complies with part 46 of title 45, 


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1 Code of Federal Regulations, or equivalent Fed2 eral regulations, and any applicable State or 

3 local law or regulations for the protection of 

4 human subjects in research. 

5 ‘‘(B) The plan or issuer clearly indicates to 

6 each participant or beneficiary, or in the case of 

7 a minor child, to the legal guardian of such 

8 beneficiary, to whom the request is made that— 

9 ‘‘(i) compliance with the request is 

10 voluntary; and 

11 ‘‘(ii) noncompliance will have no effect 

12 on enrollment status or premium or con13 tribution amounts. 

14 ‘‘(C) No genetic information collected or 

15 acquired under this paragraph shall be used for 

16 underwriting purposes. 

17 ‘‘(D) The plan or issuer notifies the Sec18 retary in writing that the plan or issuer is con19 ducting activities pursuant to the exception pro20 vided for under this paragraph, including a de21 scription of the activities conducted. 

22 ‘‘(E) The plan or issuer complies with such 

23 other conditions as the Secretary may by regu24 lation require for activities conducted under this 

25 paragraph. 


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1 ‘‘(d) PROHIBITION ON COLLECTION OF GENETIC IN2 FORMATION.— 

3 ‘‘(1) IN GENERAL.—A group health plan, and a 

4 health insurance issuer offering health insurance 

5 coverage in connection with a group health plan, 

6 shall not request, require, or purchase genetic infor7 mation for underwriting purposes. 

8 ‘‘(2) PROHIBITION ON COLLECTION OF GE9 NETIC INFORMATION PRIOR TO ENROLLMENT.—A 

10 group health plan, and a health insurance issuer of11 fering health insurance coverage in connection with 

12 a group health plan, shall not request, require, or 

13 purchase genetic information with respect to any in14 dividual prior to such individual’s enrollment under 

15 the plan or coverage in connection with such enroll16 ment. 

17 ‘‘(3) INCIDENTAL COLLECTION.—If a group 

18 health plan, or a health insurance issuer offering 

19 health insurance coverage in connection with a group 

20 health plan, obtains genetic information incidental to 

21 the requesting, requiring, or purchasing of other in22 formation concerning any individual, such request, 

23 requirement, or purchase shall not be considered a 

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1 ment, or purchase is not in violation of paragraph 

2 (1). 

3 ‘‘(e) GENETIC INFORMATION OF A FETUS OR EM4 BRYO.—Any reference in this part to genetic information 

5 concerning an individual or family member of an indi6 vidual shall— 

7 ‘‘(1) with respect to such an individual or fam8 ily member of an individual who is a pregnant 

9 woman, include genetic information of any fetus car10 ried by such pregnant woman; and 

11 ‘‘(2) with respect to an individual or family 

12 member utilizing an assisted reproductive tech13 nology, include genetic information of any embryo le14 gally held by the individual or family member. 

15 ‘‘(f) PROGRAMS OF HEALTH PROMOTION OR DIS16 EASE PREVENTION.— 

17 ‘‘(1) GENERAL PROVISIONS.— 

18 ‘‘(A) GENERAL RULE.—For purposes of 

19 subsection (b)(2)(B), a program of health pro20 motion or disease prevention (referred to in this 

21 subsection as a ‘wellness program’) shall be a 

22 program offered by an employer that is de23 signed to promote health or prevent disease 

24 that meets the applicable requirements of this 

25 subsection. 


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1 ‘‘(B) NO CONDITIONS BASED ON HEALTH

2 STATUS FACTOR.—If none of the conditions for 

3 obtaining a premium discount or rebate or 

4 other reward for participation in a wellness pro5 gram is based on an individual satisfying a 

6 standard that is related to a health status fac7 tor, such wellness program shall not violate this 

8 section if participation in the program is made 

9 available to all similarly situated individuals 

10 and the requirements of paragraph (2) are com11 plied with. 

12 ‘‘(C) CONDITIONS BASED ON HEALTH STA13 TUS FACTOR.—If any of the conditions for ob14 taining a premium discount or rebate or other 

15 reward for participation in a wellness program 

16 is based on an individual satisfying a standard 

17 that is related to a health status factor, such 

18 wellness program shall not violate this section if 

19 the requirements of paragraph (3) are complied 

20 with. 

21 ‘‘(2) WELLNESS PROGRAMS NOT SUBJECT TO

22 REQUIREMENTS.—If none of the conditions for ob23 taining a premium discount or rebate or other re24 ward under a wellness program as described in para25 graph (1)(B) are based on an individual satisfying 


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1 a standard that is related to a health status factor 

2 (or if such a wellness program does not provide such 

3 a reward), the wellness program shall not violate 

4 this section if participation in the program is made 

5 available to all similarly situated individuals. The 

6 following programs shall not have to comply with the 

7 requirements of paragraph (3) if participation in the 

8 program is made available to all similarly situated 

9 individuals: 

10 ‘‘(A) A program that reimburses all or 

11 part of the cost for memberships in a fitness 

12 center. 

13 ‘‘(B) A diagnostic testing program that 

14 provides a reward for participation and does 

15 not base any part of the reward on outcomes. 

16 ‘‘(C) A program that encourages preven17 tive care related to a health condition through 

18 the waiver of the copayment or deductible re19 quirement under group health plan for the costs 

20 of certain items or services related to a health 

21 condition (such as prenatal care or well-baby 

22 visits). 

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1 grams without regard to whether the individual 

2 quits smoking. 

3 ‘‘(E) A program that provides a reward to 

4 individuals for attending a periodic health edu5 cation seminar. 

6 ‘‘(3) WELLNESS PROGRAMS SUBJECT TO RE7 QUIREMENTS.—If any of the conditions for obtaining 

8 a premium discount, rebate, or reward under a 

9 wellness program as described in paragraph (1)(C) 

10 is based on an individual satisfying a standard that 

11 is related to a health status factor, the wellness pro12 gram shall not violate this section if the following re13 quirements are complied with: 

14 ‘‘(A) The reward for the wellness program, 

15 together with the reward for other wellness pro16 grams with respect to the plan that requires 

17 satisfaction of a standard related to a health 

18 status factor, shall not exceed 30 percent of the 

19 cost of employee-only coverage under the plan. 

20 If, in addition to employees or individuals, any 

21 class of dependents (such as spouses or spouses 

22 and dependent children) may participate fully 

23 in the wellness program, such reward shall not 

24 exceed 30 percent of the cost of the coverage in 

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1 pendents are enrolled. For purposes of this 

2 paragraph, the cost of coverage shall be deter3 mined based on the total amount of employer 

4 and employee contributions for the benefit 

5 package under which the employee is (or the 

6 employee and any dependents are) receiving 

7 coverage. A reward may be in the form of a dis8 count or rebate of a premium or contribution, 

9 a waiver of all or part of a cost-sharing mecha10 nism (such as deductibles, copayments, or coin11 surance), the absence of a surcharge, or the 

12 value of a benefit that would otherwise not be 

13 provided under the plan. The Secretaries of 

14 Labor, Health and Human Services, and the 

15 Treasury may increase the reward available 

16 under this subparagraph to up to 50 percent of 

17 the cost of coverage if the Secretaries determine 

18 that such an increase is appropriate. 

19 ‘‘(B) The wellness program shall be rea20 sonably designed to promote health or prevent 

21 disease. A program complies with the preceding 

22 sentence if the program has a reasonable 

23 chance of improving the health of, or preventing 

24 disease in, participating individuals and it is 

25 not overly burdensome, is not a subterfuge for 


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1 discriminating based on a health status factor, 

2 and is not highly suspect in the method chosen 

3 to promote health or prevent disease. 

4 ‘‘(C) The plan shall give individuals eligible 

5 for the program the opportunity to qualify for 

6 the reward under the program at least once 

7 each year. 

8 ‘‘(D) The full reward under the wellness 

9 program shall be made available to all similarly 

10 situated individuals. For such purpose, among 

11 other things: 

12 ‘‘(i) The reward is not available to all 

13 similarly situated individuals for a period 

14 unless the wellness program allows— 

15 ‘‘(I) for a reasonable alternative 

16 standard (or waiver of the otherwise 

17 applicable standard) for obtaining the 

18 reward for any individual for whom, 

19 for that period, it is unreasonably dif20 ficult due to a medical condition to 

21 satisfy the otherwise applicable stand22 ard; and 

23 ‘‘(II) for a reasonable alternative 

24 standard (or waiver of the otherwise 

25 applicable standard) for obtaining the 


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1 reward for any individual for whom, 

2 for that period, it is medically inadvis3 able to attempt to satisfy the other4 wise applicable standard. 

5 ‘‘(ii) If reasonable under the cir6 cumstances, the plan or issuer may seek 

7 verification, such as a statement from an 

8 individual’s physician, that a health status 

9 factor makes it unreasonably difficult or 

10 medically inadvisable for the individual to 

11 satisfy or attempt to satisfy the otherwise 

12 applicable standard. 

13 ‘‘(E) The plan or issuer involved shall dis14 close in all plan materials describing the terms 

15 of the wellness program the availability of a 

16 reasonable alternative standard (or the possi17 bility of waiver of the otherwise applicable 

18 standard) required under subparagraph (D). If 

19 plan materials disclose that such a program is 

20 available, without describing its terms, the dis21 closure under this subparagraph shall not be re22 quired.’’. 

23 (b) CONFORMING AMENDMENT.—The table of con24 tents under section 1(b) of the Health Insurance Port25 ability and Accountability Act of 1996 (Public Law 104– 


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1 191) is amended by inserting after the item relating to 

2 section 195 the following: 

‘‘Sec. 196. Prohibition of pre-existing condition exclusions. 

‘‘Sec. 197. Guaranteed Availability of Coverage. 

‘‘Sec. 198. Prohibiting Discrimination against individual participants and beneficiaries based on health status.’’. 

3 (c) ENFORCEMENT.— 

4 (1) PHSA.—Section 2723 of the Public Health 

5 Service Act (42 U.S.C. 300gg–22) is amended— 

6 (A) in subsection (a)— 

7 (i) in paragraph (1), by inserting 

8 ‘‘and sections 196 ,197, and 198 of the 

9 Health Insurance Portability and Account10 ability Act of 1996’’ after ‘‘this part’’; and 

11 (ii) in paragraph (2), by inserting ‘‘or 

12 section 196, 197, or 198 of the Health In13 surance Portability and Accountability Act 

14 of 1996’’ after ‘‘this part’’; and 

15 (B) in subsection (b), by inserting ‘‘or sec16 tion 196, 197, or 198 of the Health Insurance 

17 Portability and Accountability Act of 1996’’ 

18 after ‘‘this part’’ each place such term appears. 

19 (2) ERISA.—Section 715 of the Employee Re20 tirement Income Security Act of 1974 (29 U.S.C. 

21 1185d) is amended by adding at the end the fol22 lowing: 


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1 ‘‘(c) ADDITIONAL PROVISIONS.—Section 197 of the 

2 Health Insurance Portability and Accountability Act of 

3 1996 shall apply to health insurance issuers providing 

4 health insurance coverage in connection with group health 

5 plans, and sections 196 and 198 of such Act shall apply 

6 to group health plans and health insurance issuers pro7 viding health insurance coverage in connection with group 

8 health plans, as if included in this subpart, and to the 

9 extent that any provision of this part conflicts with a pro10 vision of such section 197 with respect to health insurance 

11 issuers providing health insurance coverage in connection 

12 with group health plans or of such section 196 or 198 

13 with respect to group health plans or health insurance 

14 issuers providing health insurance coverage in connection 

15 with group health plans, the provisions of such sections 

16 196, 197, and 198, as applicable, shall apply.’’. 

17 (3) IRC.—Section 9815 of the Internal Rev18 enue Code of 1986 is amended by adding at the end 

19 the following: 

20 ‘‘(c) ADDITIONAL PROVISIONS.—Section 197 of the 

21 Health Insurance Portability and Accountability Act of 

22 1996 shall apply to health insurance issuers providing 

23 health insurance coverage in connection with group health 

24 plans, and section 196 and 198 of such Act shall apply 

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1 viding health insurance coverage in connection with group 

2 health plans, as if included in this subchapter, and to the 

3 extent that any provision of this chapter conflicts with a 

4 provision of such section 197 with respect to health insur5 ance issuers providing health insurance coverage in con6 nection with group health plans or of such section 196 

7 or 198 with respect to group health plans or health insur8 ance issuers providing health insurance coverage in con9 nection with group health plans, the provisions of such 

10 sections 196, 197, and 198, as applicable, shall apply.’’. 

11 (d) EFFECTIVE DATE.—This amendments made by 

12 this section shall take effect one day after the date of en13 actment of this Act. 


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Calendar No. 554 

116TH CONGRESS 

2D SESSION S. 4675 

A BILL 

To amend the Health Insurance Portability and 

S

Accountability Act. 

EPTEMBER 24, 2020 

Read the second time and placed on the calendar 


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