II 

113TH CONGRESS 

1ST SESSION S. 764 

To amend title XXVII of the Public Health Service Act to require the 

disclosure of information regarding how certain taxes and fees impact 

the amount of premiums, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 18, 2013 

Mr. CORNYN introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend title XXVII of the Public Health Service Act 

to require the disclosure of information regarding how 

certain taxes and fees impact the amount of premiums, 

and for other purposes. 

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 ‘‘Patients’ Right to 

5 Know Act of 2013’’. 


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1 SEC. 2. DISCLOSURE OF HEALTH INSURANCE INFORMA2 TION TO CONSUMERS. 

3 (a) IN GENERAL.—Section 2715 of the Public Health 

4 Service Act (42 U.S.C. 300gg–15) is amended by adding 

5 at the end the following new subsection: 

6 ‘‘(h) DISCLOSURE OF HEALTH INSURANCE INFORMA7 TION TO CONSUMERS.— 

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

9 or sponsor of a group health plan, through its an10 nual summary of benefits and coverage explanation 

11 provided under subsection (d), through an Internet 

12 website, or through some other written means of 

13 communication with the consumer such as a printed 

14 mailing— 

15 ‘‘(A) shall include the disclosure (effective 

16 for plan years beginning on or after January 1, 

17 2016, and in addition to the information re18 quired to be disclosed under this section) of— 

19 ‘‘(i) the applicable additional informa20 tion relating to fees described in paragraph 

21 (2); and 

22 ‘‘(ii) the applicable additional infor23 mation included under paragraph (3)(D); 

24 and 

25 ‘‘(B) shall not be subject to any adminis26 trative action by the Secretary or by a State 


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1 authority with respect to any disclosure made 

2 on or after the date of the enactment of this 

3 subsection of such applicable additional infor4 mation if the disclosure is made based upon a 

5 good faith estimates of such information and is 

6 in accordance with such standards as the Sec7 retary may establish to carry out this sub8 section. 

9 ‘‘(2) FEE INFORMATION.—The additional infor10 mation described in this paragraph, with respect to 

11 a health insurance issuer issuing health insurance 

12 coverage in the individual, small, or large group 

13 market and with respect to the sponsor of a group 

14 health plan, is as follows: 

15 ‘‘(A) FEE ON HEALTH INSURANCE PRO16 VIDERS.—The annual fee on health insurance 

17 providers under section 9010 of the Patient 

18 Protection and Affordable Care Act (26 U.S.C. 

19 4001 note). 

20 ‘‘(B) PCORI TAX.—Fees imposed under 

21 subchapter B of chapter 34 of the Internal Rev22 enue Code of 1986 (relating to funding the Pa23 tient-Centered Outcome Research Institute). 

24 ‘‘(C) REINSURANCE CONTRIBUTIONS.—Re25 insurance contributions required under section 


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1 1341(b) of the Patient Protection and Afford2 able Care Act (42 U.S.C. 18061(b)). 

3 ‘‘(D) PROPOSED HEALTH INSURANCE EX4 CHANGE USER FEE.—Fees imposed on health 

5 plans relating to participation in an Exchange 

6 under subtitle D of title I of the Patient Protec7 tion and Affordable Care Act (42 U.S.C. 18021 

8 et seq.). 

9 ‘‘(E) RISK CORRIDOR PAYMENTS.—Risk 

10 corridor payments required under section 

11 1342(b)(2) of the Patient Protection and Af12 fordable Care Act (42 U.S.C. 18062(b)(2)). 

13 ‘‘(F) RISK ADJUSTMENT CHARGES.—Risk 

14 adjustment charges imposed under section 

15 1343(a)(1) of the Patient Protection and Af16 fordable Care Act (42 U.S.C. 18063(a)(1)). 

17 In the case of health insurance coverage, such costs 

18 may be calculated separately for such coverage in 

19 the individual market, in the small group market, 

20 and in the large group market for the health insur21 ance issuer involved. 

22 ‘‘(3) OTHER INFORMATION.— 

23 ‘‘(A) STUDY.—The Comptroller General of 

24 the United States shall conduct a study of 

25 methods of calculating the impact on average 


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1 premium costs associated with each of the fol2 lowing: 

3 ‘‘(i) MARKET IMPACT OF GUARAN4 TEED ISSUE AND COMMUNITY RATING.— 

5 The requirement for guaranteed issuance 

6 of coverage under section 2702 and com7 munity rated premiums under section 

8 2701. 

9 ‘‘(ii) AGE RATING IMPACT.—The re10 quirement of section 2701(a)(1)(A)(iii) (re11 lating to limitations on age rating). 

12 ‘‘(iii) PREVENTIVE SERVICES.—The 

13 requirement for coverage of preventive 

14 services under section 2713. 

15 ‘‘(iv) MINIMUM ESSENTIAL HEALTH

16 BENEFITS COVERAGE.—The requirement 

17 that coverage provide for at least 60 per18 cent of the actuarial value of essential 

19 health benefits under section 1302(d) of 

20 the Patient Protection and Affordable Care 

21 Act (42 U.S.C. 18022(d)). 

22 ‘‘(B) CONSULTATION.—In conducting such 

23 study, the Comptroller General shall consult 

24 with health insurance issuers and State health 

25 insurance commissioners. 


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1 ‘‘(C) REPORT.—Not later than October 1, 

2 2014, the Comptroller General shall submit to 

3 each House of Congress and the Secretary a re4 port on the study conducted under subpara5 graph (A). 

6 ‘‘(D) INCLUSION OF ADDITIONAL INFOR7 MATION.—After submission of such report, the 

8 Secretary may also include in the information 

9 required to be disclosed under paragraph 

10 (1)(A)(ii) information on the impact on pre11 miums of each of the requirements described in 

12 subparagraph (A). 

13 ‘‘(4) RETENTION OF STATE RATE SETTING AU14 THORITY.—Nothing in this subsection shall be con15 strued to preempt State authority to regulate, reject, 

16 alter, or require additional information in support of 

17 rates for health insurance coverage or oversight au18 thority of the Secretary. 

19 ‘‘(5) DISCLOSURE TO THE GENERAL PUBLIC.— 

20 The Secretary shall make the information provided 

21 by a health insurance issuer or sponsor of a group 

22 health plan as specified in paragraph (2) and addi23 tional information included under paragraph (3)(D) 

24 available to the general public through an Internet 

25 website. In addition, such website shall include inforVerDate Mar 15 2010 00:25 Apr 24, 2013 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S764.IS S764

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1 mation provided in the report submitted under para2 graph (3)(A).’’. 

Æ 


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