I 

114TH CONGRESS 

1ST SESSION H. R. 2712 

To streamline the employer reporting process and strengthen the eligibility 

verification process for the health care premium tax credit and costsharing subsidy, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 10, 2015 

Mrs. BLACK (for herself and Mr. THOMPSON of California) introduced the following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committee on Energy and Commerce, 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 streamline the employer reporting process and strengthen 

the eligibility verification process for the health care premium tax credit and cost-sharing subsidy, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Commonsense Reporting and Verification Act of 2015’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents of 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Prospective reporting system. 

Sec. 4. Protection of dependent privacy. 

Sec. 5. Electronic statements. 

Sec. 6. GAO studies. 

Sec. 7. Eligibility verification process for ACA subsidies. 

3 SEC. 2. FINDINGS. 

4 Congress finds the following: 

5 (1) The Department of the Treasury and the 

6 Internal Revenue Service should work together with 

7 other relevant departments and agencies to identify 

8 and implement methods to minimize compliance bur9 dens on businesses, insurance carriers, and individ10 uals under provisions of the Patient Protection and 

11 Affordable Care Act. 

12 (2) Such collaboration should strike an appro13 priate balance between sufficient reporting to en14 force the law and protecting the privacy of individ15 uals. 

16 SEC. 3. PROSPECTIVE REPORTING SYSTEM. 

17 (a) IN GENERAL.—Not later than 180 days after the 

18 enactment of this Act, the Secretary of the Treasury, in 

19 consultation with the Secretary of Health and Human 

20 Services, the Secretary of Labor, and the Administrator 

21 of the Small Business Administration, shall implement a 

22 voluntary prospective reporting system meeting the reVerDate Sep 11 2014 06:43 Jun 11, 2015 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2712.IH H2712

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1 quirements of subsection (b). Such system shall be estab2 lished not later than September 2, 2016, and shall be 

3 available for use by employers with respect to plan years 

4 beginning after December 31, 2015. 

5 (b) REQUIREMENTS.—The system created under sub6 section (a) shall be maintained by the Secretary of the 

7 Treasury and shall include— 

8 (1) a process whereby employers may volun9 tarily report— 

10 (A) the name and employer identification 

11 number of the employer; 

12 (B) a certification of— 

13 (i) whether coverage meeting the defi14 nition of minimum essential coverage in 

15 section 5000A(f) of the Internal Revenue 

16 Code of 1986 is offered to the full-time 

17 employees; 

18 (ii) whether such coverage is offered 

19 to dependents of such employees; 

20 (iii) whether such coverage is offered 

21 to spouses of such employees; 

22 (iv) whether such coverage is offered 

23 to part-time employees; 


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1 (v) whether such coverage meets the 

2 minimum value requirement of section 

3 36B(c)(2)(C)(ii) of such Code; and 

4 (vi) whether such coverage satisfies 

5 the requirements to qualify for one of the 

6 affordability safe harbors promulgated by 

7 the Secretary of the Treasury for purposes 

8 of section 4980H of such Code; 

9 (C) the months during the prospective re10 porting period that such coverage is available to 

11 full time employees of the employer; and 

12 (D) whether any waiting periods apply 

13 with respect to such coverage; 

14 to be reported not later than 60 days before the 

15 start of the open enrollment period under section 

16 1311(c)(6)(B) of the Patient Protection and Afford17 able Care Act with respect to each such calendar 

18 year; 

19 (2) a process to ensure that Exchanges, the 

20 Federal Marketplace Data Services Hub, and the In21 ternal Revenue Service can securely and confiden22 tially access the information described in paragraph 

23 (1) as necessary to carry out their respective mis24 sions, and to provide to the Secretary of Health and 

25 Human Services additional information relating to 


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1 eligibility determinations for advance payment of the 

2 premium tax credits under section 36B of such Code 

3 and the cost-sharing subsidies under section 1402 of 

4 the Patient Protection and Affordable Care Act 

5 (Public Law 111–148); 

6 (3) a process to allow the appropriate agency 

7 described in subsection (a) to follow up with employ8 ers in order to obtain additional necessary informa9 tion relating to an employee’s eligibility for such ad10 vance payment or such cost-sharing subsidies, and to 

11 allow an employee to receive notification of any 

12 problem in verifying such eligibility; and 

13 (4) a process to allow employers using the sys14 tem to provide timely updates to the Federal Mar15 ketplace Data Services Hub regarding any cancella16 tion of coverage or significant change in availability 

17 of coverage for participating employees. 

18 (c) EXEMPTION FROM REPORTING REQUIREMENT

19 UNDER INTERNAL REVENUE CODE OF 1986.—If, 

20 through the system created under subsection (a), an em21 ployer provides prospective reporting for a calendar year 

22 in which a plan year ends that meets the requirements 

23 of subsection (b)(1)— 

24 (1) such employer shall be treated as satisfying 

25 the return requirements of subsections (a) and (b) 


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1 of section 6056 of the Internal Revenue Code of 

2 1986 for the calendar year in which such plan year 

3 ends; and 

4 (2) such employer shall be treated as satisfying 

5 the requirements of section 6056(c) of such Code for 

6 the calendar year in which such plan year ends if the 

7 employer furnishes the statement described in such 

8 section to the Internal Revenue Service and to those 

9 employees of the employer for whom the employer 

10 has received a notice under section 

11 1411(e)(4)(B)(iii) of the Patient Protection and Af12 fordable Care Act (42 U.S.C. 18081) from the Ex13 change (established under section 1311 or 1321 of 

14 the Patient Protection and Affordable Care Act (42 

15 U.S.C. 18031, 18041)) that the employee, or the 

16 spouse or dependent of the employee, has enrolled in 

17 a qualified health plan (as defined in section 1301 

18 of such Act (42 U.S.C. 18021)) through the Ex19 change or been deemed eligible for an advance pay20 ment of premium tax credits under section 36B of 

21 such Code or cost-sharing subsidies under section 

22 1402 of the Patient Protection and Affordable Care 

23 Act (42 U.S.C. 18071). 

24 (d) THIRD-PARTY FILING.—Employers may use 

25 third parties to complete the filing described in subsection 


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1 (b)(1). Use of such a third party to complete the filing 

2 does not affect an employer’s liability under sections 6055 

3 or 6056 of the Internal Revenue Code of 1986. 

4 (e) EMPLOYER NOTIFICATION OF EMPLOYEE EN5 ROLLMENTS.—Each Exchange established under title I of 

6 the Patient Protection and Affordable Care Act shall pro7 vide notice to each employer at the time an employee (or 

8 dependent of an employee) is enrolled under a qualified 

9 health plan through the Exchange. 

10 SEC. 4. PROTECTION OF DEPENDENT PRIVACY. 

11 (a) IN GENERAL.—Section 6055(b) of the Internal 

12 Revenue Code of 1986 is amended by adding at the end 

13 the following new paragraph: 

14 ‘‘(3) TINs NOT COLLECTED OR MAINTAINED.— 

15 For purposes of subparagraph (B)(i), in the case of 

16 an individual other than the primary insured, if, be17 fore January 1, 2014, the health insurance issuer or 

18 the employer did not collect or maintain information 

19 on the TINs of such individuals (other than for pur20 poses of this section), the individual’s name and date 

21 of birth may be substituted for the name and TIN.’’. 

22 (b) EFFECTIVE DATE.—The amendment made by 

23 this section shall apply to returns the due date for which 

24 is after the date that is 60 days after the date of the enact25 ment of this Act. 


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1 SEC. 5. ELECTRONIC STATEMENTS. 

2 (a) IN GENERAL.—Section 6056(c) of the Internal 

3 Revenue Code of 1986 is amended by adding at the end 

4 the following new paragraph: 

5 ‘‘(3) ELECTRONIC DELIVERY.—An individual 

6 shall be deemed to have consented to receive the 

7 statement under this section in electronic form if 

8 such individual has consented at any prior time, to 

9 the person who is the employer of the individual dur10 ing the calendar year or the preceding plan year to 

11 which the statement relates, to receive such state12 ment in electronic form. The preceding sentence 

13 shall not apply if the individual refuses consent in 

14 writing with respect to the statement under this sec15 tion.’’. 

16 (b) STATEMENTS RELATING TO HEALTH INSURANCE

17 COVERAGE.—Section 6055(c) of such Code, as amended 

18 by this Act, is amended by adding at the end the following 

19 new paragraph: 

20 ‘‘(4) ELECTRONIC DELIVERY.—An individual 

21 shall be deemed to have consented to receive the 

22 statement under this subsection in electronic form if 

23 such individual has consented at any prior time to 

24 receive in electronic form any private health infor25 mation (such as electronic health records) furnished 

26 to such individual by the person required to make 


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1 such statement, unless the individual refuses such 

2 consent in writing.’’. 

3 (c) EFFECTIVE DATE.—The amendments made by 

4 this section shall apply to statements the due date for 

5 which is after December 31, 2015. 

6 SEC. 6. GAO STUDIES. 

7 (a) STUDY OF FIRST YEARS OF EMPLOYER REPORT8 ING.— 

9 (1) IN GENERAL.—The Comptroller General of 

10 the United States shall conduct a study that evalu11 ates, with respect to the period beginning on Janu12 ary 1, 2014, and ending on December 31, 2016— 

13 (A) the notification of employers by Ex14 changes established under title I of the Patient 

15 Protection and Affordable Care Act (Public 

16 Law 111–148) that a full-time employee of the 

17 employer has been determined eligible for ad18 vance payment of premium tax credits under 

19 section 36B of the Internal Revenue Code of 

20 1986 or cost-sharing subsidies under section 

21 1402 of such Act (42 U.S.C. 18071), including 

22 information regarding— 

23 (i) the data elements included in the 

24 employer notification; 


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1 (ii) the process by which the notifica2 tion forms were developed and sent to em3 ployers, including whether the process pro4 vided for a formal notice and comment pe5 riod; 

6 (iii) whether employers report that 

7 such notifications provided sufficient and 

8 relevant information for them to make ap9 propriate decisions about whether to utilize 

10 the appeals process; 

11 (iv) the total number of notifications 

12 sent to employers and the timeline of when 

13 such notifications were sent; 

14 (v) differences in the notification proc15 ess between the marketplace facilitated by 

16 the Federal Government and the State17 Based Marketplaces; and 

18 (vi) challenges that have arisen in the 

19 notification process, and recommendations 

20 to address these challenges; and 

21 (B) the extent to which the Secretary of 

22 Health and Human Services has established a 

23 separate appeals process for employers who re24 ceived such a notification to challenge the eligi25 bility determination, as required by section 


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1 1411(f)(2) of the Patient Protection and Af2 fordable Care Act (42 U.S..C. 18081(f)(2)). 

3 (2) REPORT.—Not later than 1 year after the 

4 date of the enactment of this Act, the Comptroller 

5 General shall submit to the Committees on Finance 

6 and Health, Education, Labor, and Pensions of the 

7 Senate and the Committees on Ways and Means, 

8 Energy and Commerce, and Education and the 

9 Workforce of the House of Representatives a report 

10 on the results of the study conducted under para11 graph (1). 

12 (b) STUDY OF PROSPECTIVE REPORTING SYSTEM.— 

13 (1) IN GENERAL.—The Comptroller General of 

14 the United States shall conduct a study that evalu15 ates, with respect to the period beginning on Janu16 ary 1, 2017, and ending on December 31, 2017, the 

17 functionality of the prospective reporting system es18 tablished under section 3, including the accuracy of 

19 information collected, the number of employers elect20 ing to report under such system, and any challenges 

21 that have arisen in implementing such system. 

22 (2) REPORT.—Not later than July 1, 2018, the 

23 Comptroller General shall submit to the Committees 

24 on Finance and Health, Education, Labor, and Pen25 sions of the Senate and the Committees on Ways 


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1 and Means, Energy and Commerce, and Education 

2 and the Workforce of the House of Representatives 

3 a report on the results of the study conducted under 

4 paragraph (1). 

5 SEC. 7. ELIGIBILITY VERIFICATION PROCESS FOR ACA SUB6 SIDIES. 

7 (a) IN GENERAL.—Except as specified in subsection 

8 (b), a marketplace (as defined in subsection (d)) may 

9 automatically reenroll an individual into a qualified health 

10 plan (as defined for purposes of title I of the Patient Pro11 tection and Affordable Care Act) so long as the market12 place— 

13 (1) redetermines on an annual basis the eligi14 bility of the individual for any advanced premium 

15 tax credit or a cost-sharing reduction pursuant to 

16 section 1412 of the Patient Protection and Afford17 able Care Act (42 U.S.C. 18082); and 

18 (2) takes into account, in making such redeter19 minations, annual changes in premiums and in the 

20 Federal poverty level as well as the most recent in21 come data available with respect to the individual in22 volved. 

23 (b) REENROLLMENT LIMITATIONS.—If a market24 place does not follow the processes specified under the sec25 tion with respect to an individual, then the marketplace 


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1 may not automatically reenroll the individual into a quali2 fied health plan with an advanced premium tax credit or 

3 a cost-sharing reduction until the individual provides cur4 rent income information to the marketplace so that eligi5 bility for a credit or reduction can be redetermined. 

6 (c) COMPREHENSIVE GUIDANCE BASED ON CUR7 RENT GUIDANCE.—The provisions of this section are in8 tended to generally reflect and be consistent with the guid9 ance on annual eligibility redeterminations and reenroll10 ments for marketplace coverage issued by the Centers for 

11 Medicare and Medicaid Services on April 22, 2015. In car12 rying out this section, the Secretary shall apply rules 

13 (whether through guidance or otherwise) regarding the an14 nual eligibility redeterminations and reenrollments for cov15 erage and for tax credits and cost-sharing reduction for 

16 individuals through a marketplace that are consistent with 

17 this section and are at least as comprehensive as the guid18 ance (issued on April 22, 2015) applied for coverage for 

19 2016. Such guidance shall include provisions that ensure 

20 that— 

21 (1) enrollees eligible to be automatically re22 enrolled in a qualified health plan and to continue 

23 provision of such a tax credit or cost-sharing reduc24 tion shall maintain on file with the marketplace (or 

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1 tion for disclosure of information verifying eligibility 

2 for such a credit or cost-sharing reduction; 

3 (2) the marketplace annually requests updated 

4 income information to verify such eligibility; and 

5 (3) enrollees are provided timely and appro6 priate notices of the rules regarding annual redeter7 minations and reenrollments. 

8 (d) MARKETPLACE DEFINED.—In this section, the 

9 term ‘‘marketplace’’ means State Based Exchanges and 

10 the Federally Facilitated Exchange established under sec11 tions 1311 and 1321 of the Patient Protection and Afford12 able Care Act (42 U.S.C. 18031, 18041), respectively. 

Æ 


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