II 

111TH CONGRESS 

1ST SESSION S. 1149 

To eliminate annual and lifetime aggregate limits imposed by health plans. 

IN THE SENATE OF THE UNITED STATES 

MAY 21, 2009 

Mr. REID (for Mr. ROCKEFELLER) introduced the following bill; which was 

read twice and referred to the Committee on Health, Education, Labor, 

and Pensions 

A BILL 

To eliminate annual and lifetime aggregate limits imposed 

by health plans. 

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 ‘‘Annual and Lifetime 

5 Health Care Limit Elimination Act of 2009’’. 

6 SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN7 COME SECURITY ACT OF 1974. 

8 (a) IN GENERAL.—Subpart B of part 7 of subtitle 

9 B of title I of the Employee Retirement Income Security 

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•S 1149 IS

1 Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add2 ing at the end the following: 

3 ‘‘SEC. 715. ELIMINATION OF ANNUAL OR LIFETIME AGGRE4 GATE LIMITS. 

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

6 insurance issuer providing health insurance coverage in 

7 connection with a group health plan, may not impose an 

8 aggregate dollar annual or lifetime limit with respect to 

9 benefits payable under the plan or coverage. 

10 ‘‘(b) DEFINITION.—In this section, the term ‘aggre11 gate dollar annual or lifetime limit’ means, with respect 

12 to benefits under a group health plan or health insurance 

13 coverage, a dollar limitation on the total amount that may 

14 be paid with respect to such benefits under the plan or 

15 health insurance coverage with respect to an individual or 

16 other coverage unit on an annual or lifetime basis.’’. 

17 (b) CLERICAL AMENDMENT.—The table of contents 

18 in section 1 of such Act, is amended by inserting after 

19 the item relating to section 714 the following new item: 

‘‘Sec. 715. Elimination of annual or lifetime aggregate limits.’’. 

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

21 this section shall apply with respect to plan years begin22 ning on or after the date that is 1 year after the date 

23 of enactment of this Act. 

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1 SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT 

2 RELATING TO THE GROUP MARKET. 

3 (a) IN GENERAL.—Subpart 2 of part A of title 

4 XXVII of the Public Health Service Act (42 U.S.C. 

5 300gg–4 et seq.) is amended by adding at the end the 

6 following: 

7 ‘‘SEC. 2708. ELIMINATION OF ANNUAL OR LIFETIME AGGRE8 GATE LIMITS. 

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

10 insurance issuer providing health insurance coverage in 

11 connection with a group health plan, may not impose an 

12 aggregate dollar annual or lifetime limit with respect to 

13 benefits payable under the plan or coverage. 

14 ‘‘(b) DEFINITION.—In this section, the term ‘aggre15 gate dollar annual or lifetime limit’ means, with respect 

16 to benefits under a group health plan or health insurance 

17 coverage, a dollar limitation on the total amount that may 

18 be paid with respect to such benefits under the plan or 

19 health insurance coverage with respect to an individual or 

20 other coverage unit on an annual or lifetime basis.’’. 

21 (b) INDIVIDUAL MARKET.—Subpart 2 of part B of 

22 title XXVII of the Public Health Service Act (42 U.S.C. 

23 300gg–51 et seq.) is amended by adding at the end the 

24 following: 

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1 ‘‘SEC. 2754. ELIMINATION OF ANNUAL OR LIFETIME AGGRE2 GATE LIMITS. 

3 ‘‘The provisions of section 2708 shall apply to health 

4 insurance coverage offered by a health insurance issuer 

5 in the individual market in the same manner as they apply 

6 to health insurance coverage offered by a health insurance 

7 issuer in connection with a group health plan in the small 

8 or large group market.’’. 

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

10 this section shall apply with respect to plan years begin11 ning on or after the date that is 1 year after the date 

12 of enactment of this Act. 

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