II 

117TH CONGRESS 

1ST SESSION S. 263 

To preserve health benefits for workers. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 4, 2021 

Mr. DURBIN (for himself, Ms. CORTEZ MASTO, Mrs. SHAHEEN, Mr. 

MERKLEY, Mr. BENNET, Ms. DUCKWORTH, Mr. BLUMENTHAL, Mr. 

MENENDEZ, Mr. REED, Mr. BROWN, Ms. ROSEN, Ms. SMITH, and Ms. 

KLOBUCHAR) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To preserve health benefits for workers. 

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 ‘‘Worker Health Cov5 erage Protection Act’’. 

6 SEC. 2. PRESERVING HEALTH BENEFITS FOR WORKERS. 

7 (a) PREMIUM ASSISTANCE FOR COBRA CONTINU8 ATION COVERAGE AND FURLOUGHED CONTINUATION

9 COVERAGE FOR INDIVIDUALS AND THEIR FAMILIES.— 

10 (1) PROVISION OF PREMIUM ASSISTANCE.— 


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1 (A) REDUCTION OF PREMIUMS PAY2 ABLE.— 

3 (i) COBRA CONTINUATION COV4 ERAGE.—In the case of any premium for a 

5 period of coverage during the period begin6 ning on March 1, 2020, and ending on 

7 September 30, 2021 for COBRA continu8 ation coverage with respect to any assist9 ance eligible individual described in para10 graph (3)(A), such individual shall be 

11 treated for purposes of any COBRA con12 tinuation provision as having paid the 

13 amount of such premium if such individual 

14 pays (and any person other than such indi15 vidual’s employer pays on behalf of such 

16 individual) 0 percent of the amount of 

17 such premium owed by such individual (as 

18 determined without regard to this sub19 section). 

20 (ii) FURLOUGHED CONTINUATION

21 COVERAGE.—In the case of any premium 

22 for a period of coverage during the period 

23 beginning on March 1, 2020, and ending 

24 on September 30, 2021, for coverage under 

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1 sistance eligible individual described in 

2 paragraph (3)(B), such individual shall be 

3 treated for purposes of coverage under the 

4 plan offered by the plan sponsor in which 

5 the individual is enrolled as having paid 

6 the amount of such premium if such indi7 vidual pays (and any person other than 

8 such individual’s employer pays on behalf 

9 of such individual) 0 percent of the 

10 amount of such premium owed by such in11 dividual (as determined without regard to 

12 this subsection). 

13 (B) PLAN ENROLLMENT OPTION.— 

14 (i) IN GENERAL.—Notwithstanding 

15 the COBRA continuation provisions, any 

16 assistance eligible individual who is en17 rolled in a group health plan offered by a 

18 plan sponsor, not later than 90 days after 

19 the date of notice of the plan enrollment 

20 option described in this subparagraph, may 

21 elect to enroll in coverage under a plan of22 fered by such plan sponsor that is different 

23 than coverage under the plan in which 

24 such individual was enrolled at the time— 


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1 (I) in the case of any assistance 

2 eligible individual described in para3 graph (3)(A), the qualifying event 

4 specified in section 603(2) of the Em5 ployee Retirement Income Security 

6 Act of 1974 (29 U.S.C. 1163(2)), sec7 tion 4980B(f)(3)(B) of the Internal 

8 Revenue Code of 1986, section 

9 2203(2) of the Public Health Service 

10 Act (42 U.S.C. 300bb–3(2)), or sec11 tion 8905a of title 5, United States 

12 Code (except for the voluntary termi13 nation of such individual’s employ14 ment by such individual), occurred, 

15 and such coverage shall be treated as 

16 COBRA continuation coverage for 

17 purposes of the applicable COBRA 

18 continuation coverage provision; or 

19 (II) in the case of any assistance 

20 eligible individual described in para21 graph (3)(B), the furlough period 

22 began with respect to such individual. 

23 (ii) REQUIREMENTS.—Any assistance 

24 eligible individual may elect to enroll in 


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1 different coverage as described in clause (i) 

2 only if— 

3 (I) the employer involved has 

4 made a determination that such em5 ployer will permit such assistance eli6 gible individual to enroll in different 

7 coverage as provided under this sub8 paragraph; 

9 (II) the premium for such dif10 ferent coverage does not exceed the 

11 premium for coverage in which such 

12 individual was enrolled at the time 

13 such qualifying event occurred or im14 mediately before such furlough began; 

15 (III) the different coverage in 

16 which the individual elects to enroll is 

17 coverage that is also offered to the ac18 tive employees of the employer, who 

19 are not in a furlough period, at the 

20 time at which such election is made; 

21 and 

22 (IV) the different coverage in 

23 which the individual elects to enroll is 

24 not— 


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1 (aa) coverage that provides 

2 only dental, vision, counseling, or 

3 referral services (or a combina4 tion of such services); 

5 (bb) a qualified small em6 ployer health reimbursement ar7 rangement (as defined in section 

8 9831(d)(2) of the Internal Rev9 enue Code of 1986); 

10 (cc) a flexible spending ar11 rangement (as defined in section 

12 106(c)(2) of the Internal Rev13 enue Code of 1986); or 

14 (dd) benefits that provide 

15 coverage for services or treat16 ments furnished in an on-site 

17 medical facility maintained by 

18 the employer and that consists 

19 primarily of first-aid services, 

20 prevention and wellness care, or 

21 similar care (or a combination of 

22 such care). 

23 (C) PREMIUM REIMBURSEMENT.—For pro24 visions providing the payment of such premium, 


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1 see section 6432 of the Internal Revenue Code 

2 of 1986, as added by paragraph (14). 

3 (2) LIMITATION OF PERIOD OF PREMIUM AS4 SISTANCE.— 

5 (A) ELIGIBILITY FOR ADDITIONAL COV6 ERAGE.—Paragraph (1)(A) shall not apply with 

7 respect to— 

8 (i) any assistance eligible individual 

9 described in paragraph (3)(A) for months 

10 of coverage beginning on or after the ear11 lier of— 

12 (I) the first date that such indi13 vidual is eligible for coverage under 

14 any other group health plan (other 

15 than coverage consisting of only den16 tal, vision, counseling, or referral serv17 ices (or a combination thereof), cov18 erage under a flexible spending ar19 rangement (as defined in section 

20 106(c)(2) of the Internal Revenue 

21 Code of 1986), coverage of treatment 

22 that is furnished in an on-site medical 

23 facility maintained by the employer 

24 and that consists primarily of first-aid 

25 services, prevention and wellness care, 


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1 or similar care (or a combination 

2 thereof)), or eligible for benefits under 

3 the Medicare program under title 

4 XVIII of the Social Security Act (42 

5 U.S.C. 1395 et seq.); or 

6 (II) the earlier of— 

7 (aa) the date following the 

8 expiration of the maximum pe9 riod of continuation coverage re10 quired under the applicable 

11 COBRA continuation coverage 

12 provision; or 

13 (bb) the date following the 

14 expiration of the period of con15 tinuation coverage allowed under 

16 paragraph (4)(B)(ii); or 

17 (ii) any assistance eligible individual 

18 described in paragraph (3)(B) for months 

19 of coverage beginning on or after the ear20 lier of— 

21 (I) the first date that such indi22 vidual is eligible for coverage under 

23 any other group health plan (other 

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1 ices (or a combination thereof), cov2 erage under a flexible spending ar3 rangement (as defined in section 

4 106(c)(2) of the Internal Revenue 

5 Code of 1986), coverage of treatment 

6 that is furnished in an on-site medical 

7 facility maintained by the employer 

8 and that consists primarily of first-aid 

9 services, prevention and wellness care, 

10 or similar care (or a combination 

11 thereof)), or eligible for benefits under 

12 the Medicare program under title 

13 XVIII of the Social Security Act (42 

14 U.S.C. 1395 et seq.); or 

15 (II) the first date that such indi16 vidual is no longer in the furlough pe17 riod. 

18 (B) NOTIFICATION REQUIREMENT.—Any 

19 assistance eligible individual shall notify the 

20 group health plan with respect to which para21 graph (1)(A) applies if such paragraph ceases 

22 to apply by reason of clause (i)(I) or (ii)(I) of 

23 subparagraph (A) (as applicable). Such notice 

24 shall be provided to the group health plan in 


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1 such time and manner as may be specified by 

2 the Secretary of Labor. 

3 (C) SPECIAL ENROLLMENT PERIOD FOL4 LOWING EXPIRATION OF PREMIUM ASSIST5 ANCE.—Notwithstanding section 1311 of the 

6 Patient Protection and Affordable Care Act (42 

7 U.S.C. 18031), the expiration of premium as8 sistance pursuant to a limitation specified 

9 under subparagraph (A) shall be treated as a 

10 qualifying event for which any assistance eligi11 ble individual is eligible to enroll in a qualified 

12 health plan offered through an Exchange under 

13 title I of such Act (42 U.S.C. 18001 et seq.) 

14 during a special enrollment period. 

15 (3) ASSISTANCE ELIGIBLE INDIVIDUAL.—For 

16 purposes of this section, the term ‘‘assistance eligible 

17 individual’’ means, with respect to a period of cov18 erage during the period beginning on March 1, 

19 2020, and ending on September 30, 2021— 

20 (A) any individual that is a qualified bene21 ficiary that— 

22 (i) is eligible for COBRA continuation 

23 coverage by reason of a qualifying event 

24 specified in section 603(2) of the Employee 

25 Retirement Income Security Act of 1974 


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1 (29 U.S.C. 1163(2)), section 

2 4980B(f)(3)(B) of the Internal Revenue 

3 Code of 1986, section 2203(2) of the Pub4 lic Health Service Act (42 U.S.C. 300bb– 

5 3(2)), or section 8905a of title 5, United 

6 States Code (except for the voluntary ter7 mination of such individual’s employment 

8 by such individual); and 

9 (ii) elects such coverage; or 

10 (B) any covered employee that is in a fur11 lough period that remains eligible for coverage 

12 under a group health plan offered by the em13 ployer of such covered employee. 

14 (4) EXTENSION OF ELECTION PERIOD AND EF15 FECT ON COVERAGE.— 

16 (A) IN GENERAL.—For purposes of apply17 ing section 605(a) of the Employee Retirement 

18 Income Security Act of 1974 (29 U.S.C. 

19 1165(a)), section 4980B(f)(5)(A) of the Inter20 nal Revenue Code of 1986, section 2205(a) of 

21 the Public Health Service Act (42 U.S.C. 

22 300bb–5(a)), and section 8905a(c)(2) of title 5, 

23 United States Code, in the case of— 

24 (i) an individual who does not have an 

25 election of COBRA continuation coverage 


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1 in effect on the date of the enactment of 

2 this Act but who would be an assistance el3 igible individual described in paragraph 

4 (3)(A) if such election were so in effect; or 

5 (ii) an individual who elected COBRA 

6 continuation coverage on or after March 1, 

7 2020, and discontinued from such coverage 

8 before the date of the enactment of this 

9 Act, 

10 such individual may elect the COBRA continu11 ation coverage under the COBRA continuation 

12 coverage provisions containing such provisions 

13 during the period beginning on the date of the 

14 enactment of this Act and ending 60 days after 

15 the date on which the notification required 

16 under paragraph (7)(C) is provided to such in17 dividual. 

18 (B) COMMENCEMENT OF COBRA CONTINU19 ATION COVERAGE.—Any COBRA continuation 

20 coverage elected by a qualified beneficiary dur21 ing an extended election period under subpara22 graph (A)— 

23 (i) shall apply as if such qualified ben24 eficiary had been covered as of the date of 

25 a qualifying event specified in section 


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1 603(2) of the Employee Retirement In2 come Security Act of 1974 (29 U.S.C. 

3 1163(2)), section 4980B(f)(3)(B) of the 

4 Internal Revenue Code of 1986, section 

5 2203(2) of the Public Health Service Act 

6 (42 U.S.C. 300bb–3(2)), or section 8905a 

7 of title 5, United States Code, except for 

8 the voluntary termination of such bene9 ficiary’s employment by such beneficiary, 

10 that occurs no earlier than March 1, 2020 

11 (including the treatment of premium pay12 ments under paragraph (1)(A) and any 

13 cost-sharing requirements for items and 

14 services under a group health plan); and 

15 (ii) shall not extend beyond the period 

16 of COBRA continuation coverage that 

17 would have been required under the appli18 cable COBRA continuation coverage provi19 sion if the coverage had been elected as re20 quired under such provision. 

21 (5) EXPEDITED REVIEW OF DENIALS OF PRE22 MIUM ASSISTANCE.—In any case in which an indi23 vidual requests treatment as an assistance eligible 

24 individual described in subparagraph (A) or (B) of 

25 paragraph (3) and is denied such treatment by the 


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1 group health plan, the Secretary of Labor (or the 

2 Secretary of Health and Human Services in connec3 tion with COBRA continuation coverage which is 

4 provided other than pursuant to part 6 of subtitle B 

5 of title I of the Employee Retirement Income Secu6 rity Act of 1974 (29 U.S.C. 1161 et seq.)), in con7 sultation with the Secretary of the Treasury, shall 

8 provide for expedited review of such denial. An indi9 vidual shall be entitled to such review upon applica10 tion to such Secretary in such form and manner as 

11 shall be provided by such Secretary, in consultation 

12 with the Secretary of Treasury. Such Secretary shall 

13 make a determination regarding such individual’s 

14 eligibility within 15 business days after receipt of 

15 such individual’s application for review under this 

16 paragraph. Either Secretary’s determination upon 

17 review of the denial shall be de novo and shall be the 

18 final determination of such Secretary. A reviewing 

19 court shall grant deference to such Secretary’s deter20 mination. The provisions of this paragraph, para21 graphs (1) through (4), and paragraphs (7) through 

22 (9) shall be treated as provisions of title I of the 

23 Employee Retirement Income Security Act of 1974 

24 (29 U.S.C. 1001 et seq.) for purposes of part 5 of 

25 subtitle B of such title. 


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1 (6) DISREGARD OF SUBSIDIES FOR PURPOSES

2 OF FEDERAL AND STATE PROGRAMS.—Notwith3 standing any other provision of law, any premium 

4 assistance with respect to an assistance eligible indi5 vidual under this subsection shall not be considered 

6 income, in-kind support, or resources for purposes of 

7 determining the eligibility of the recipient (or the re8 cipient’s spouse or family) for benefits or assistance, 

9 or the amount or extent of benefits or assistance, or 

10 any other benefit provided under any Federal pro11 gram or any program of a State or political subdivi12 sion thereof financed in whole or in part with Fed13 eral funds. 

14 (7) COBRA-SPECIFIC NOTICE.— 

15 (A) GENERAL NOTICE.— 

16 (i) IN GENERAL.—In the case of no17 tices provided under section 606(a)(4) of 

18 the Employee Retirement Income Security 

19 Act of 1974 (29 U.S.C. 1166(4)), section 

20 4980B(f)(6)(D) of the Internal Revenue 

21 Code of 1986, section 2206(4) of the Pub22 lic Health Service Act (42 U.S.C. 300bb– 

23 6(4)), or section 8905a(f)(2)(A) of title 5, 

24 United States Code, with respect to indi25 viduals who, during the period described in 


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1 paragraph (3), become entitled to elect 

2 COBRA continuation coverage, the re3 quirements of such provisions shall not be 

4 treated as met unless such notices include 

5 an additional notification to the recipient a 

6 written notice in clear and understandable 

7 language of— 

8 (I) the availability of premium 

9 assistance with respect to such cov10 erage under this subsection; and 

11 (II) the option to enroll in dif12 ferent coverage if the employer per13 mits assistance eligible individuals de14 scribed in paragraph (3)(A) to elect 

15 enrollment in different coverage (as 

16 described in paragraph (1)(B)). 

17 (ii) ALTERNATIVE NOTICE.—In the 

18 case of COBRA continuation coverage to 

19 which the notice provision under such sec20 tions does not apply, the Secretary of 

21 Labor, in consultation with the Secretary 

22 of the Treasury and the Secretary of 

23 Health and Human Services, shall, in con24 sultation with administrators of the group 

25 health plans (or other entities) that provide 


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1 or administer the COBRA continuation 

2 coverage involved, provide rules requiring 

3 the provision of such notice. 

4 (iii) FORM.—The requirement of the 

5 additional notification under this subpara6 graph may be met by amendment of exist7 ing notice forms or by inclusion of a sepa8 rate document with the notice otherwise 

9 required. 

10 (B) SPECIFIC REQUIREMENTS.—Each ad11 ditional notification under subparagraph (A) 

12 shall include— 

13 (i) the forms necessary for estab14 lishing eligibility for premium assistance 

15 under this subsection; 

16 (ii) the name, address, and telephone 

17 number necessary to contact the plan ad18 ministrator and any other person main19 taining relevant information in connection 

20 with such premium assistance; 

21 (iii) a description of the extended elec22 tion period provided for in paragraph 

23 (4)(A); 

24 (iv) a description of the obligation of 

25 the qualified beneficiary under paragraph 


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1 (2)(B) and the penalty provided under sec2 tion 6720C of the Internal Revenue Code 

3 of 1986 for failure to carry out the obliga4 tion; 

5 (v) a description, displayed in a 

6 prominent manner, of the qualified bene7 ficiary’s right to a reduced premium and 

8 any conditions on entitlement to the re9 duced premium; 

10 (vi) a description of the option of the 

11 qualified beneficiary to enroll in different 

12 coverage if the employer permits such ben13 eficiary to elect to enroll in such different 

14 coverage under paragraph (1)(B); and 

15 (vii) information regarding any Ex16 change established under title I of the Pa17 tient Protection and Affordable Care Act 

18 (42 U.S.C. 18001 et seq.) through which a 

19 qualified beneficiary may be eligible to en20 roll in a qualified health plan, including— 

21 (I) the publicly accessible inter22 net website address for such Ex23 change; 

24 (II) the publicly accessible inter25 net website address for the Find 


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1 Local Help directory maintained by 

2 the Department of Health and 

3 Human Services on the healthcare.gov 

4 internet website (or a successor 

5 website); 

6 (III) a clear explanation that— 

7 (aa) an individual who is eli8 gible for continuation coverage 

9 may also be eligible to enroll, 

10 with financial assistance, in a 

11 qualified health plan offered 

12 through such Exchange, but, in 

13 the case that such individual 

14 elects to enroll in such continu15 ation coverage and subsequently 

16 elects to terminate such continu17 ation coverage before the period 

18 of such continuation coverage ex19 pires, such termination does not 

20 initiate a special enrollment pe21 riod (absent a qualifying event 

22 specified in section 603(2) of the 

23 Employee Retirement Income Se24 curity Act of 1974 (29 U.S.C. 

25 1163(2)), section 4980B(f)(3)(B) 


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1 of the Internal Revenue Code of 

2 1986, section 2203(2) of the 

3 Public Health Service Act (42 

4 U.S.C. 300bb–3(2)), or section 

5 8905a of title 5, United States 

6 Code, with respect to such indi7 vidual); and 

8 (bb) an individual who elects 

9 to enroll in continuation coverage 

10 will remain eligible to enroll in a 

11 qualified health plan offered 

12 through such Exchange during 

13 an open enrollment period and 

14 may be eligible for financial as15 sistance with respect to enrolling 

16 in such a qualified health plan; 

17 (IV) information on consumer 

18 protections with respect to enrolling in 

19 a qualified health plan offered 

20 through such Exchange, including the 

21 requirement for such a qualified 

22 health plan to provide coverage for es23 sential health benefits (as defined in 

24 section 1302(b) of such Act (42 

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1 ments applicable to such a qualified 

2 health plan under part A of title 

3 XXVII of the Public Health Service 

4 Act (42 U.S.C. 300gg et seq.); 

5 (V) information on the avail6 ability of financial assistance with re7 spect to enrolling in a qualified health 

8 plan, including the maximum income 

9 limit for eligibility for the premium 

10 tax credit under section 36B of the 

11 Internal Revenue Code of 1986; and 

12 (VI) information on any special 

13 enrollment periods during which any 

14 assistance eligible individual described 

15 in paragraph (3)(A)(i) may be eligible 

16 to enroll, with financial assistance, in 

17 a qualified health plan offered 

18 through such Exchange (including a 

19 special enrollment period for which an 

20 individual may be eligible due to the 

21 expiration of premium assistance pur22 suant to a limitation specified under 

23 paragraph (2)(A)). 

24 (C) NOTICE IN CONNECTION WITH EX25 TENDED ELECTION PERIODS.—In the case of 


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1 any assistance eligible individual described in 

2 paragraph (3)(A) (or any individual described 

3 in paragraph (4)(A)) who became entitled to 

4 elect COBRA continuation coverage before the 

5 date of the enactment of this Act, the adminis6 trator of the applicable group health plan (or 

7 other entity) shall provide (within 60 days after 

8 the date of enactment of this Act) for the addi9 tional notification required to be provided under 

10 subparagraph (A) and failure to provide such 

11 notice shall be treated as a failure to meet the 

12 notice requirements under the applicable 

13 COBRA continuation provision. 

14 (D) MODEL NOTICES.—Not later than 30 

15 days after the date of enactment of this Act, 

16 with respect to any assistance eligible individual 

17 described in paragraph (3)(A)— 

18 (i) the Secretary of Labor, in con19 sultation with the Secretary of the Treas20 ury and the Secretary of Health and 

21 Human Services, shall prescribe models for 

22 the additional notification required under 

23 this paragraph (other than the additional 

24 notification described in clause (ii)); and 


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1 (ii) in the case of any additional noti2 fication provided pursuant to subpara3 graph (A) under section 8905a(f)(2)(A) of 

4 title 5, United States Code, the Office of 

5 Personnel Management shall prescribe a 

6 model for such additional notification. 

7 (8) FURLOUGH-SPECIFIC NOTICE.— 

8 (A) IN GENERAL.—With respect to any as9 sistance eligible individual described in para10 graph (3)(B) who, during the period described 

11 in such paragraph, becomes eligible for assist12 ance pursuant to paragraph (1)(A)(ii), the re13 quirements of section 606(a)(4) of the Em14 ployee Retirement Income Security Act of 1974 

15 (29 U.S.C. 1166(4)), section 4980B(f)(6)(D) of 

16 the Internal Revenue Code of 1986, section 

17 2206(4) of the Public Health Service Act (42 

18 U.S.C. 300bb–6(4)), or section 8905a(f)(2)(A) 

19 of title 5, United States Code, shall not be 

20 treated as met unless the group health plan ad21 ministrator, in accordance with the timing re22 quirement specified under subparagraph (B), 

23 provides to the individual a written notice in 

24 clear and understandable language of— 


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1 (i) the availability of premium assist2 ance with respect to such coverage under 

3 this subsection; 

4 (ii) the option of the qualified bene5 ficiary to enroll in different coverage if the 

6 employer permits such beneficiary to elect 

7 to enroll in such different coverage under 

8 paragraph (1)(B); and 

9 (iii) the information specified under 

10 paragraph (7)(B) (as applicable). 

11 (B) TIMING SPECIFIED.—For purposes of 

12 subparagraph (A), the timing requirement spec13 ified in this subparagraph is— 

14 (i) with respect to such an individual 

15 who is within a furlough period during the 

16 period beginning on March 1, 2020, and 

17 ending on the date of the enactment of this 

18 Act, 30 days after the date of such enact19 ment; and 

20 (ii) with respect to such an individual 

21 who is within a furlough period during the 

22 period beginning on the first day after the 

23 date of the enactment of this Act and end24 ing on September 30, 2021, 30 days after 


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1 the date of the beginning of such furlough 

2 period. 

3 (C) MODEL NOTICES.—Not later than 30 

4 days after the date of enactment of this Act, 

5 with respect to any assistance eligible individual 

6 described in paragraph (3)(B)— 

7 (i) the Secretary of Labor, in con8 sultation with the Secretary of the Treas9 ury and the Secretary of Health and 

10 Human Services, shall prescribe models for 

11 the notification required under this para12 graph (other than the notification de13 scribed in clause (ii)); and 

14 (ii) in the case of any notification pro15 vided pursuant to subparagraph (A) under 

16 section 8905a(f)(2)(A) of title 5, United 

17 States Code, the Office of Personnel Man18 agement shall prescribe a model for such 

19 notification. 

20 (9) NOTICE OF EXPIRATION OF PERIOD OF

21 PREMIUM ASSISTANCE.— 

22 (A) IN GENERAL.—With respect to any as23 sistance eligible individual, subject to subpara24 graph (B), the requirements of section 

25 606(a)(4) of the Employee Retirement Income 


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1 Security Act of 1974 (29 U.S.C. 1166(4)), sec2 tion 4980B(f)(6)(D) of the Internal Revenue 

3 Code of 1986, section 2206(4) of the Public 

4 Health Service Act (42 U.S.C. 300bb–6(4)), or 

5 section 8905a(f)(2)(A) of title 5, United States 

6 Code, shall not be treated as met unless the 

7 employer of the individual, during the period 

8 specified under subparagraph (C), provides to 

9 such individual a written notice in clear and un10 derstandable language— 

11 (i) that the premium assistance for 

12 such individual will expire soon and the 

13 prominent identification of the date of 

14 such expiration; 

15 (ii) that such individual may be eligi16 ble for coverage without any premium as17 sistance through— 

18 (I) COBRA continuation cov19 erage; or 

20 (II) coverage under a group 

21 health plan; 

22 (iii) that the expiration of premium 

23 assistance is treated as a qualifying event 

24 for which any assistance eligible individual 

25 is eligible to enroll in a qualified health 


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1 plan offered through an Exchange under 

2 title I of such Act (42 U.S.C. 18001 et 

3 seq.) during a special enrollment period; 

4 and 

5 (iv) the information specified in para6 graph (7)(B)(vii). 

7 (B) EXCEPTION.—The requirement for the 

8 group health plan administrator to provide the 

9 written notice under subparagraph (A) shall be 

10 waived in the case the premium assistance for 

11 such individual expires pursuant to clause (i)(I) 

12 or (ii)(I) of paragraph (2)(A). 

13 (C) PERIOD SPECIFIED.—For purposes of 

14 subparagraph (A), the period specified in this 

15 subparagraph is, with respect to the date of ex16 piration of premium assistance for any assist17 ance eligible individual pursuant to a limitation 

18 requiring a notice under this paragraph, the pe19 riod beginning on the day that is 45 days before 

20 the date of such expiration and ending on the 

21 day that is 15 days before the date of such ex22 piration. 

23 (D) MODEL NOTICES.—Not later than 30 

24 days after the date of enactment of this Act, 


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1 with respect to any assistance eligible indi2 vidual— 

3 (i) the Secretary of Labor, in con4 sultation with the Secretary of the Treas5 ury and the Secretary of Health and 

6 Human Services, shall prescribe models for 

7 the notification required under this para8 graph (other than the notification de9 scribed in clause (ii)); and 

10 (ii) in the case of any notification pro11 vided pursuant to subparagraph (A) under 

12 section 8905a(f)(2)(A) of title 5, United 

13 States Code, the Office of Personnel Man14 agement shall prescribe a model for such 

15 notification. 

16 (10) REGULATIONS.—The Secretary of the 

17 Treasury and the Secretary of Labor may jointly 

18 prescribe such regulations or other guidance as may 

19 be necessary or appropriate to carry out the provi20 sions of this subsection, including the prevention of 

21 fraud and abuse under this subsection, except that 

22 the Secretary of Labor and the Secretary of Health 

23 and Human Services may prescribe such regulations 

24 (including interim final regulations) or other guid25 ance as may be necessary or appropriate to carry 


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1 out the provisions of paragraphs (5), (7), (8), (9), 

2 and (11). 

3 (11) OUTREACH.— 

4 (A) IN GENERAL.—The Secretary of 

5 Labor, in consultation with the Secretary of the 

6 Treasury and the Secretary of Health and 

7 Human Services, shall provide outreach con8 sisting of public education and enrollment as9 sistance relating to premium assistance pro10 vided under this subsection. Such outreach shall 

11 target employers, group health plan administra12 tors, public assistance programs, States, insur13 ers, and other entities as determined appro14 priate by such Secretaries. Such outreach shall 

15 include an initial focus on those individuals 

16 electing continuation coverage who are referred 

17 to in paragraph (7)(C). Information on such 

18 premium assistance, including enrollment, shall 

19 also be made available on websites of the De20 partments of Labor, Treasury, and Health and 

21 Human Services. 

22 (B) ENROLLMENT UNDER MEDICARE.— 

23 The Secretary of Health and Human Services 

24 shall provide outreach consisting of public edu25 cation. Such outreach shall target individuals 


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1 who lose health insurance coverage. Such out2 reach shall include information regarding en3 rollment for benefits under title XVIII of the 

4 Social Security Act (42 U.S.C. 1395 et seq.) for 

5 purposes of preventing mistaken delays of such 

6 enrollment by such individuals, including life7 time penalties for failure of timely enrollment. 

8 (12) DEFINITIONS.—For purposes of this sec9 tion: 

10 (A) ADMINISTRATOR.—The term ‘‘admin11 istrator’’ has the meaning given such term in 

12 section 3(16)(A) of the Employee Retirement 

13 Income Security Act of 1974. 

14 (B) COBRA CONTINUATION COVERAGE.— 

15 The term ‘‘COBRA continuation coverage’’ 

16 means continuation coverage provided pursuant 

17 to part 6 of subtitle B of title I of the Em18 ployee Retirement Income Security Act of 1974 

19 (other than under section 609), title XXII of 

20 the Public Health Service Act, section 4980B of 

21 the Internal Revenue Code of 1986 (other than 

22 subsection (f)(1) of such section insofar as it 

23 relates to pediatric vaccines), or section 8905a 

24 of title 5, United States Code, or under a State 

25 program that provides comparable continuation 


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1 coverage. Such term does not include coverage 

2 under a health flexible spending arrangement 

3 under a cafeteria plan within the meaning of 

4 section 125 of the Internal Revenue Code of 

5 1986. 

6 (C) COBRA CONTINUATION PROVISION.— 

7 The term ‘‘COBRA continuation provision’’ 

8 means the provisions of law described in sub9 paragraph (B). 

10 (D) COVERED EMPLOYEE.—The term 

11 ‘‘covered employee’’ has the meaning given such 

12 term in section 607(2) of the Employee Retire13 ment Income Security Act of 1974. 

14 (E) QUALIFIED BENEFICIARY.—The term 

15 ‘‘qualified beneficiary’’ has the meaning given 

16 such term in section 607(3) of the Employee 

17 Retirement Income Security Act of 1974. 

18 (F) GROUP HEALTH PLAN.—The term 

19 ‘‘group health plan’’ has the meaning given 

20 such term in section 607(1) of the Employee 

21 Retirement Income Security Act of 1974. 

22 (G) STATE.—The term ‘‘State’’ includes 

23 the District of Columbia, the Commonwealth of 

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1 ican Samoa, and the Commonwealth of the 

2 Northern Mariana Islands. 

3 (H) PERIOD OF COVERAGE.—Any ref4 erence in this subsection to a period of coverage 

5 shall be treated as a reference to a monthly or 

6 shorter period of coverage with respect to which 

7 premiums are charged with respect to such cov8 erage. 

9 (I) PLAN SPONSOR.—The term ‘‘plan 

10 sponsor’’ has the meaning given such term in 

11 section 3(16)(B) of the Employee Retirement 

12 Income Security Act of 1974. 

13 (J) FURLOUGH PERIOD.— 

14 (i) IN GENERAL.—The term ‘‘furlough 

15 period’’ means, with respect to an indi16 vidual and an employer of such individual, 

17 a period— 

18 (I) beginning with the first 

19 month beginning on or after March 1, 

20 2020 and before September 30, 2021, 

21 during which such individual’s em22 ployer reduces such individual’s work 

23 hours (due to a lack of work, funds, 

24 or other nondisciplinary reason) to an 


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1 amount that is less than 70 percent of 

2 the base month amount; and 

3 (II) ending with the earlier of— 

4 (aa) the first month begin5 ning after September 30, 2021; 

6 or 

7 (bb) the month following the 

8 first month during which work 

9 hours of such employee are great10 er than 80 percent of work hours 

11 of the base month amount. 

12 (ii) BASE MONTH AMOUNT.—For pur13 poses of clause (i), the term ‘‘base month 

14 amount’’ means, with respect to an indi15 vidual and an employer of such individual, 

16 the greater of— 

17 (I) such individual’s work hours 

18 in the month prior (or in the case 

19 such individual had no work hours in 

20 the month prior and had work hours 

21 in the 3 months prior, the last month 

22 with work hours within the prior 3 

23 months); and 

24 (II) such individual’s work hours 

25 during the period beginning January 


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1 1, 2020 and ending January 31, 

2 2020. 

3 (13) REPORTS.— 

4 (A) INTERIM REPORT.—The Secretary of 

5 the Treasury and the Secretary of Labor shall 

6 jointly submit an interim report to the Com7 mittee on Education and Labor, the Committee 

8 on Ways and Means, and the Committee on En9 ergy and Commerce of the House of Represent10 atives and the Committee on Health, Edu11 cation, Labor, and Pensions and the Committee 

12 on Finance of the Senate regarding the pre13 mium assistance provided under this subsection 

14 that includes— 

15 (i) the number of individuals provided 

16 such assistance as of the date of the re17 port; and 

18 (ii) the total amount of expenditures 

19 incurred (with administrative expenditures 

20 noted separately) in connection with such 

21 assistance as of the date of the report. 

22 (B) FINAL REPORT.—As soon as prac23 ticable after the last period of COBRA continu24 ation coverage for which premium assistance is 

25 provided under this section, the Secretary of the 


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1 Treasury and the Secretary of Labor shall 

2 jointly submit a final report to each Committee 

3 referred to in subparagraph (A) that includes— 

4 (i) the number of individuals provided 

5 premium assistance under this section; 

6 (ii) the average dollar amount 

7 (monthly and annually) of premium assist8 ance provided to such individuals; and 

9 (iii) the total amount of expenditures 

10 incurred (with administrative expenditures 

11 noted separately) in connection with pre12 mium assistance under this section. 

13 (14) COBRA PREMIUM ASSISTANCE.— 

14 (A) IN GENERAL.—Subchapter B of chap15 ter 65 of the Internal Revenue Code of 1986 is 

16 amended by adding at the end the following 

17 new section: 

18 ‘‘SEC. 6432. CONTINUATION COVERAGE PREMIUM ASSIST19 ANCE. 

20 ‘‘(a) IN GENERAL.—The person to whom premiums 

21 are payable for continuation coverage under section 

22 2(a)(1) of the Worker Health Coverage Protection Act 

23 shall be allowed as a credit against the tax imposed by 

24 section 3111(a), or so much of the taxes imposed under 

25 section 3221(a) as are attributable to the rate in effect 


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1 under section 3111(a), for each calendar quarter an 

2 amount equal to the premiums not paid by assistance eligi3 ble individuals for such coverage by reason of such section 

4 2(a)(1) with respect to such calendar quarter. 

5 ‘‘(b) PERSON TO WHOM PREMIUMS ARE PAYABLE.— 

6 For purposes of subsection (a), except as otherwise pro7 vided by the Secretary, the person to whom premiums are 

8 payable under such continuation coverage shall be treated 

9 as being— 

10 ‘‘(1) in the case of any group health plan which 

11 is a multiemployer plan (as defined in section 3(37) 

12 of the Employee Retirement Income Security Act of 

13 1974), the plan, 

14 ‘‘(2) in the case of any group health plan not 

15 described in paragraph (1)— 

16 ‘‘(A) which provides furlough continuation 

17 coverage described in section 2(a)(1)(A)(ii) of 

18 the Worker Health Coverage Protection Act or 

19 subject to the COBRA continuation provisions 

20 contained in— 

21 ‘‘(i) this title, 

22 ‘‘(ii) the Employee Retirement Income 

23 Security Act of 1974, 

24 ‘‘(iii) the Public Health Service Act, 

25 or 


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1 ‘‘(iv) title 5, United States Code, or 

2 ‘‘(B) under which some or all of the cov3 erage is not provided by insurance, 

4 the employer maintaining the plan, and 

5 ‘‘(3) in the case of any group health plan not 

6 described in paragraph (1) or (2), the insurer pro7 viding the coverage under the group health plan. 

8 ‘‘(c) LIMITATIONS AND REFUNDABILITY.— 

9 ‘‘(1) CREDIT LIMITED TO CERTAIN EMPLOY10 MENT TAXES.—The credit allowed by subsection (a) 

11 with respect to any calendar quarter shall not exceed 

12 the tax imposed by section 3111(a), or so much of 

13 the taxes imposed under section 3221(a) as are at14 tributable to the rate in effect under section 

15 3111(a), for such calendar quarter (reduced by any 

16 credits allowed under subsections (e) and (f) of sec17 tion 3111, sections 7001 and 7003 of the Families 

18 First Coronavirus Response Act, section 2301 of the 

19 CARES Act, and sections 20204 and 20212 of the 

20 COVID–19 Tax Relief Act of 2020 for such quarter) 

21 on the wages paid with respect to the employment 

22 of all employees of the employer. 

23 ‘‘(2) REFUNDABILITY OF EXCESS CREDIT.— 

24 ‘‘(A) CREDIT IS REFUNDABLE.—If the 

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1 ceeds the limitation of paragraph (1) for any 

2 calendar quarter, such excess shall be treated 

3 as an overpayment that shall be refunded under 

4 sections 6402(a) and 6413(b). 

5 ‘‘(B) CREDIT MAY BE ADVANCED.—In an6 ticipation of the credit, including the refundable 

7 portion under subparagraph (A), the credit may 

8 be advanced, according to forms and instruc9 tions provided by the Secretary, up to an 

10 amount calculated under subsection (a) through 

11 the end of the most recent payroll period in the 

12 quarter. 

13 ‘‘(C) TREATMENT OF DEPOSITS.—The 

14 Secretary shall waive any penalty under section 

15 6656 for any failure to make a deposit of the 

16 tax imposed by section 3111(a), or so much of 

17 the taxes imposed under section 3221(a) as are 

18 attributable to the rate in effect under section 

19 3111(a), if the Secretary determines that such 

20 failure was due to the anticipation of the credit 

21 allowed under this section. 

22 ‘‘(D) TREATMENT OF PAYMENTS.—For 

23 purposes of section 1324 of title 31, United 

24 States Code, any amounts due to an employer 

25 under this paragraph shall be treated in the 


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1 same manner as a refund due from a credit 

2 provision referred to in subsection (b)(2) of 

3 such section. 

4 ‘‘(3) LIMITATION ON REIMBURSEMENT FOR

5 FURLOUGHED EMPLOYEES.—In the case of an indi6 vidual who for any month is an assistance eligible 

7 individual described in section 2(a)(3)(B) of the 

8 Worker Health Coverage Protection Act with respect 

9 to any coverage, the credit determined with respect 

10 to such individual under subsection (a) for any such 

11 month ending during a calendar quarter shall not 

12 exceed the amount of premium the individual would 

13 have paid for a full month of such coverage for the 

14 month preceding the first month for which an indi15 vidual is such an assistance eligible individual. 

16 ‘‘(d) GOVERNMENTAL ENTITIES.—For purposes of 

17 this section, the term ‘person’ includes any governmental 

18 entity or Indian tribal government (as defined in section 

19 139E(c)(1)). 

20 ‘‘(e) DENIAL OF DOUBLE BENEFIT.—For purposes 

21 of chapter 1, the gross income of any person allowed a 

22 credit under this section shall be increased for the taxable 

23 year which includes the last day of any calendar quarter 

24 with respect to which such credit is allowed by the amount 

25 of such credit. No amount for which a credit is allowed 


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1 under this section shall be taken into account as qualified 

2 wages under section 2301 of the CARES Act or as quali3 fied health plan expenses under section 7001(d) or 

4 7003(d) of the Families First Coronavirus Response Act. 

5 ‘‘(f) REPORTING.—Each person entitled to reim6 bursement under subsection (a) for any period shall sub7 mit such reports (at such time and in such manner) as 

8 the Secretary may require, including— 

9 ‘‘(1) an attestation of involuntary termination 

10 of employment, reduction of hours, or furloughing, 

11 for each assistance eligible individual on the basis of 

12 whose termination, reduction of hours, or fur13 loughing entitlement to reimbursement is claimed 

14 under subsection (a), 

15 ‘‘(2) a report of the amount of payroll taxes off16 set under subsection (a) for the reporting period, 

17 and 

18 ‘‘(3) a report containing the TINs of all covered 

19 employees, the amount of subsidy reimbursed with 

20 respect to each employee, and a designation with re21 spect to each employee as to whether the subsidy re22 imbursement is for coverage of 1 individual or 2 or 

23 more individuals. 


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1 ‘‘(g) REGULATIONS.—The Secretary shall issue such 

2 regulations or other guidance as may be necessary or ap3 propriate to carry out this section, including— 

4 ‘‘(1) the requirement to report information or 

5 the establishment of other methods for verifying the 

6 correct amounts of reimbursements under this sec7 tion, 

8 ‘‘(2) the application of this section to group 

9 health plans that are multiemployer plans (as de10 fined in section 3(37) of the Employee Retirement 

11 Income Security Act of 1974), 

12 ‘‘(3) to allow the advance payment of the credit 

13 determined under subsection (a), subject to the limi14 tations provided in this section, based on such infor15 mation as the Secretary shall require, 

16 ‘‘(4) to provide for the reconciliation of such 

17 advance payment with the amount of the credit at 

18 the time of filing the return of tax for the applicable 

19 quarter or taxable year, and 

20 ‘‘(5) with respect to the application of the cred21 it to third party payors (including professional em22 ployer organizations, certified professional employer 

23 organizations, or agents under section 3504).’’. 

24 (B) SOCIAL SECURITY TRUST FUNDS HELD

25 HARMLESS.—There are hereby appropriated to 


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1 the Federal Old-Age and Survivors Insurance 

2 Trust Fund and the Federal Disability Insur3 ance Trust Fund established under section 201 

4 of the Social Security Act (42 U.S.C. 401) and 

5 the Social Security Equivalent Benefit Account 

6 established under section 15A(a) of the Rail7 road Retirement Act of 1974 (45 U.S.C. 231n– 

8 1(a)) amounts equal to the reduction in reve9 nues to the Treasury by reason of this section 

10 (without regard to this subparagraph). 

11 Amounts appropriated by the preceding sen12 tence shall be transferred from the general fund 

13 at such times and in such manner as to rep14 licate to the extent possible the transfers which 

15 would have occurred to such Trust Fund or Ac16 count had this section not been enacted. 

17 (C) CLERICAL AMENDMENT.—The table of 

18 sections for subchapter B of chapter 65 of the 

19 Internal Revenue Code of 1986 is amended by 

20 adding at the end the following new item: 

‘‘Sec. 6432. Continuation coverage premium assistance.’’. 

21 (D) EFFECTIVE DATE.—The amendments 

22 made by this paragraph shall apply to pre23 miums to which paragraph (1)(A) applies. 


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1 (E) SPECIAL RULE IN CASE OF EMPLOYEE

2 PAYMENT THAT IS NOT REQUIRED UNDER THIS

3 SECTION.— 

4 (i) IN GENERAL.—In the case of an 

5 assistance eligible individual who pays, 

6 with respect any period of coverage to 

7 which paragraph (1)(A) applies, the 

8 amount of the premium for such coverage 

9 that the individual would have (but for this 

10 Act) been required to pay, the person to 

11 whom such payment is payable shall reim12 burse such individual for the amount of 

13 such premium paid. 

14 (ii) CREDIT OF REIMBURSEMENT.—A 

15 person to which clause (i) applies shall be 

16 allowed a credit in the manner provided 

17 under section 6432 of the Internal Rev18 enue Code of 1986 for any payment made 

19 to the employee under such clause. 

20 (iii) PAYMENT OF CREDITS.—Any 

21 person to which clause (i) applies shall 

22 make the payment required under such 

23 clause to the individual not later than 60 

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1 vidual elects continuation coverage under 

2 paragraph (1). 

3 (15) PENALTY FOR FAILURE TO NOTIFY

4 HEALTH PLAN OF CESSATION OF ELIGIBILITY FOR

5 PREMIUM ASSISTANCE.— 

6 (A) IN GENERAL.—Part I of subchapter B 

7 of chapter 68 of the Internal Revenue Code of 

8 1986 is amended by adding at the end the fol9 lowing new section: 

10 ‘‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH 

11 PLAN OF CESSATION OF ELIGIBILITY FOR 

12 CONTINUATION COVERAGE PREMIUM ASSIST13 ANCE. 

14 ‘‘(a) IN GENERAL.—Except in the case of failure de15 scribed in subsection (b) or (c), any person required to 

16 notify a group health plan under section 2(a)(2)(B) of the 

17 Worker Health Coverage Protection Act who fails to make 

18 such a notification at such time and in such manner as 

19 the Secretary of Labor may require shall pay a penalty 

20 of $250. 

21 ‘‘(b) INTENTIONAL FAILURE.—In the case of any 

22 such failure that is fraudulent, such person shall pay a 

23 penalty equal to the greater of— 

24 ‘‘(1) $250, or 


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1 ‘‘(2) 110 percent of the premium assistance 

2 provided under section 2(a)(1)(A) of such Act after 

3 termination of eligibility under such section. 

4 ‘‘(c) REASONABLE CAUSE EXCEPTION.—No penalty 

5 shall be imposed under this section with respect to any 

6 failure if it is shown that such failure is due to reasonable 

7 cause and not to willful neglect.’’. 

8 (B) CLERICAL AMENDMENT.—The table of 

9 sections of part I of subchapter B of chapter 68 

10 of such Code is amended by adding at the end 

11 the following new item: 

‘‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility 

for continuation coverage premium assistance.’’. 

12 (16) COORDINATION WITH HCTC.— 

13 (A) IN GENERAL.—Section 35(g)(9) of the 

14 Internal Revenue Code of 1986 is amended to 

15 read as follows: 

16 ‘‘(9) CONTINUATION COVERAGE PREMIUM AS17 SISTANCE.—In the case of an assistance eligible in18 dividual who receives premium assistance for con19 tinuation coverage under section 2(a)(1) of the 

20 Worker Health Coverage Protection Act for any 

21 month during the taxable year, such individual shall 

22 not be treated as an eligible individual, a certified 

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1 poses of this section or section 7527 with respect to 

2 such month.’’. 

3 (B) EFFECTIVE DATE.—The amendment 

4 made by subparagraph (A) shall apply to tax5 able years ending after the date of the enact6 ment of this Act. 

7 (17) EXCLUSION OF CONTINUATION COVERAGE

8 PREMIUM ASSISTANCE FROM GROSS INCOME.— 

9 (A) IN GENERAL.—Part III of subchapter 

10 B of chapter 1 of the Internal Revenue Code of 

11 1986 is amended by inserting after section 

12 139H the following new section: 

13 ‘‘SEC. 139I. CONTINUATION COVERAGE PREMIUM ASSIST14 ANCE. 

15 ‘‘In the case of an assistance eligible individual (as 

16 defined in subsection (a)(3) of section 2 of the Worker 

17 Health Coverage Protection Act), gross income does not 

18 include any premium assistance provided under subsection 

19 (a)(1) of such section.’’. 

20 (B) CLERICAL AMENDMENT.—The table of 

21 sections for part III of subchapter B of chapter 

22 1 of such Code is amended by inserting after 

23 the item relating to section 139H the following 

24 new item: 

‘‘Sec. 139I. Continuation coverage premium assistance.’’. 


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1 (C) EFFECTIVE DATE.—The amendments 

2 made by this paragraph shall apply to taxable 

3 years ending after the date of the enactment of 

4 this Act. 

5 (18) DEADLINES WITH RESPECT TO NO6 TICES.—Notwithstanding section 518 of the Em7 ployee Retirement Income Security Act of 1974 (29 

8 U.S.C. 1148) and section 7508A of the Internal 

9 Revenue Code of 1986, the Secretary of Labor and 

10 the Secretary of the Treasury, respectively, may not 

11 waive or extend any deadline with respect to the pro12 vision of notices described in paragraphs (7), (8), 

13 and (9). 

14 (b) RULE OF CONSTRUCTION.—In all matters of in15 terpretation, rules, and operational procedures, the lan16 guage of this section shall be interpreted broadly for the 

17 benefit of workers and their families. 

Æ 


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