I 

117TH CONGRESS 

2D SESSION H. R. 6384 

To amend the Employee Retirement Income Security Act of 1974, title 

XXII of the Public Health Service Act, and the Internal Revenue Code 

of 1986 to improve certain notifications provided to qualified beneficiaries 

by group health plans in the case of COBRA qualifying events. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 12, 2022 

Mr. HARDER of California (for himself and Mr. COURTNEY) introduced the 

following bill; which was referred to the Committee on Education and 

Labor, and in addition to the Committees on Energy and Commerce, and 

Ways and Means, 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 amend the Employee Retirement Income Security Act 

of 1974, title XXII of the Public Health Service Act, 

and the Internal Revenue Code of 1986 to improve certain notifications provided to qualified beneficiaries by 

group health plans in the case of COBRA qualifying 

events. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Improving Awareness 

3 of Health Coverage Options Act of 2022’’. 

4 SEC. 2. IMPROVEMENT OF CERTAIN NOTIFICATIONS PRO5 VIDED TO QUALIFIED BENEFICIARIES BY 

6 GROUP HEALTH PLANS IN THE CASE OF 

7 COBRA QUALIFYING EVENTS. 

8 (a) EMPLOYEE RETIREMENT INCOME SECURITY ACT

9 OF 1974.— 

10 (1) IN GENERAL.—Section 606 of the Employee 

11 Retirement Income Security Act of 1974 (29 U.S.C. 

12 1166) is amended— 

13 (A) in subsection (a)(4), in the matter fol14 lowing subparagraph (B), by striking ‘‘under 

15 this subsection’’ and inserting ‘‘under this part 

16 in accordance with the notification requirements 

17 under subsection (c)’’; and 

18 (B) in subsection (c)— 

19 (i) by striking ‘‘For purposes of sub20 section (a)(4), any notification’’ and insert21 ing ‘‘For purposes of subsection (a)(4)— 

22 ‘‘(1) any notification’’; 

23 (ii) by striking ‘‘, whichever is applica24 ble, and any such notification’’ and insert25 ing ‘‘of subsection (a), whichever is appli26 cable; 


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1 ‘‘(2) any such notification’’; and 

2 (iii) by striking ‘‘such notification is 

3 made’’ and inserting ‘‘such notification is 

4 made; and 

5 ‘‘(3) any such notification shall, with respect to 

6 each qualified beneficiary with respect to whom such 

7 notification is made, include information regarding 

8 any Exchange established under title I of the Pa9 tient Protection and Affordable Care Act through 

10 which such a qualified beneficiary may be eligible to 

11 enroll in a qualified health plan (as defined in sec12 tion 1301 of the Patient Protection and Affordable 

13 Care Act), including— 

14 ‘‘(A) the publicly accessible Internet 

15 website address for such Exchange; 

16 ‘‘(B) the publicly accessible Internet 

17 website address for the Find Local Help direc18 tory maintained by the Department of Health 

19 and Human Services on the healthcare.gov 

20 Internet website (or a successor website); 

21 ‘‘(C) a clear explanation that— 

22 ‘‘(i) an individual who is eligible for 

23 continuation coverage may be eligible to 

24 enroll instead, with financial assistance, in 

25 a qualified health plan offered through 


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1 such Exchange, but, in the case that such 

2 individual elects to enroll in such continu3 ation coverage and subsequently elects to 

4 terminate such continuation coverage be5 fore the period of such continuation cov6 erage expires, such individual may not be 

7 eligible to enroll in a qualified health plan 

8 offered through such Exchange during a 

9 special enrollment period if more than 60 

10 days have elapsed since the individual’s 

11 loss of coverage as an employee; 

12 ‘‘(ii) an individual who elects to enroll 

13 in continuation coverage will remain eligi14 ble to enroll in a qualified health plan of15 fered through such Exchange during an 

16 open enrollment period or another special 

17 enrollment period for which the individual 

18 is eligible and may be eligible for financial 

19 assistance with respect to enrolling in such 

20 a qualified health plan; and 

21 ‘‘(iii) an individual may apply for, and 

22 if eligible, enroll in Medicaid or the Chil23 dren’s Health Insurance Program (CHIP), 

24 at any time, with no special enrollment pe25 riod required; 


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1 ‘‘(D) information on consumer protections 

2 with respect to enrolling in a qualified health 

3 plan offered through such Exchange, including 

4 the requirement for such a qualified health plan 

5 to provide coverage for essential health benefits 

6 (as defined in section 1302(b) of the Patient 

7 Protection and Affordable Care Act) and the re8 quirements applicable to such a qualified health 

9 plan under part A of title XXVII of the Public 

10 Health Service Act; and 

11 ‘‘(E) information on the availability of fi12 nancial assistance with respect to enrolling in a 

13 qualified health plan.’’. 

14 (2) EFFECTIVE DATE.—The amendments made 

15 by paragraph (1) shall apply with respect to quali16 fying events occurring on or after the date that is 

17 90 days after the date of the enactment of this Act. 

18 (b) PUBLIC HEALTH SERVICE ACT.— 

19 (1) IN GENERAL.—Section 2206 of the Public 

20 Health Service Act (42 U.S.C. 300bb–6) is amend21 ed— 

22 (A) by striking ‘‘In accordance’’ and in23 serting the following: 

24 ‘‘(a) IN GENERAL.—In accordance’’; 


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1 (B) by striking ‘‘of such beneficiary’s 

2 rights under this subsection’’ and inserting ‘‘of 

3 such beneficiary’s rights under this title in ac4 cordance with the notification requirements 

5 under subsection (b)’’; and 

6 (C) by striking ‘‘For purposes of para7 graph (4),’’ and all that follows through ‘‘such 

8 notification is made.’’ and inserting the fol9 lowing: 

10 ‘‘(b) RULES RELATING TO NOTIFICATION OF QUALI11 FIED BENEFICIARIES BY PLAN ADMINISTRATOR.—For 

12 purposes of subsection (a)(4)— 

13 ‘‘(1) any notification shall be made within 14 

14 days of the date on which the plan administrator is 

15 notified under paragraph (2) or (3) of subsection 

16 (a), whichever is applicable; 

17 ‘‘(2) any such notification to an individual who 

18 is a qualified beneficiary as the spouse of the cov19 ered employee shall be treated as notification to all 

20 other qualified beneficiaries residing with such 

21 spouse at the time such notification is made; and 

22 ‘‘(3) any such notification shall, with respect to 

23 each qualified beneficiary with respect to whom such 

24 notification is made, include information regarding 

25 any Exchange established under title I of the PaVerDate Sep 11 2014 21:46 Jan 14, 2022 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6384.IH H6384

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1 tient Protection and Affordable Care Act through 

2 which such a qualified beneficiary may be eligible to 

3 enroll in a qualified health plan (as defined in sec4 tion 1301 of the Patient Protection and Affordable 

5 Care Act), including— 

6 ‘‘(A) the publicly accessible Internet 

7 website address for such Exchange; 

8 ‘‘(B) the publicly accessible Internet 

9 website address for the Find Local Help direc10 tory maintained by the Department of Health 

11 and Human Services on the healthcare.gov 

12 Internet website (or a successor website); 

13 ‘‘(C) a clear explanation that— 

14 ‘‘(i) an individual who is eligible for 

15 continuation coverage may be eligible to 

16 enroll instead, with financial assistance, in 

17 a qualified health plan offered through 

18 such Exchange, but, in the case that such 

19 individual elects to enroll in such continu20 ation coverage and subsequently elects to 

21 terminate such continuation coverage be22 fore the period of such continuation cov23 erage expires, such individual may not be 

24 eligible to enroll in a qualified health plan 

25 offered through such Exchange during a 


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1 special enrollment period if more than 60 

2 days have elapsed since the individual’s 

3 loss of coverage as an employee; 

4 ‘‘(ii) an individual who elects to enroll 

5 in continuation coverage will remain eligi6 ble to enroll in a qualified health plan of7 fered through such Exchange during an 

8 open enrollment period or another special 

9 enrollment period for which the individual 

10 is eligible and may be eligible for financial 

11 assistance with respect to enrolling in such 

12 a qualified health plan; and 

13 ‘‘(iii) an individual may apply for, and 

14 if eligible, enroll in Medicaid or the Chil15 dren’s Health Insurance Program (CHIP), 

16 at any time, with no special enrollment pe17 riod required; 

18 ‘‘(D) information on consumer protections 

19 with respect to enrolling in a qualified health 

20 plan offered through such Exchange, including 

21 the requirement for such a qualified health plan 

22 to provide coverage for essential health benefits 

23 (as defined in section 1302(b) of the Patient 

24 Protection and Affordable Care Act) and the reVerDate Sep 11 2014 21:46 Jan 14, 2022 Jkt 029200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6384.IH H6384

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1 quirements applicable to such a qualified health 

2 plan under part A of title XXVII; and 

3 ‘‘(E) information on the availability of fi4 nancial assistance with respect to enrolling in a 

5 qualified health plan.’’. 

6 (2) EFFECTIVE DATE.—The amendments made 

7 by paragraph (1) shall apply with respect to quali8 fying events occurring on or after the date that is 

9 90 days after the date of the enactment of this Act. 

10 (c) INTERNAL REVENUE CODE OF 1986.— 

11 (1) IN GENERAL.—Section 4980B(f)(6) of the 

12 Internal Revenue Code of 1986 is amended— 

13 (A) in subparagraph (D)— 

14 (i) in clause (ii), by striking ‘‘under 

15 subparagraph (C)’’ and inserting ‘‘under 

16 clause (iii)’’; and 

17 (ii) by redesignating clauses (i) and 

18 (ii) as subclauses (I) and (II), respectively, 

19 and moving the margin of each such sub20 clause, as so redesignated, 2 ems to the 

21 right; 

22 (B) by redesignating subparagraphs (A) 

23 through (D) as clauses (i) through (iv), respec24 tively, and moving the margin of each such 

25 clause, as so redesignated, 2 ems to the right; 


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1 (C) by striking ‘‘In accordance’’ and in2 serting the following: 

3 ‘‘(A) IN GENERAL.—In accordance’’; 

4 (D) by inserting after ‘‘of such bene5 ficiary’s rights under this subsection’’ the fol6 lowing: ‘‘in accordance with the notification re7 quirements under subparagraph (C)’’; and 

8 (E) by striking ‘‘The requirements of sub9 paragraph (B)’’ and all that follows through 

10 ‘‘such notification is made.’’ and inserting the 

11 following: 

12 ‘‘(B) ALTERNATIVE MEANS OF COMPLI13 ANCE WITH REQUIREMENT FOR NOTIFICATION

14 OF MULTIEMPLOYER PLANS BY EMPLOYERS.— 

15 The requirements of subparagraph (A)(ii) shall 

16 be considered satisfied in the case of a multiem17 ployer plan in connection with a qualifying 

18 event described in paragraph (3)(B) if the plan 

19 provides that the determination of the occur20 rence of such qualifying event will be made by 

21 the plan administrator. 

22 ‘‘(C) RULES RELATING TO NOTIFICATION

23 OF QUALIFIED BENEFICIARIES BY PLAN ADMIN24 ISTRATOR.—For purposes of subparagraph 

25 (A)(iv)— 


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1 ‘‘(i) any notification shall be made 

2 within 14 days (or, in the case of a group 

3 health plan which is a multiemployer plan, 

4 such longer period of time as may be pro5 vided in the terms of the plan) of the date 

6 on which the plan administrator is notified 

7 under clause (ii) or (iii) of subparagraph 

8 (A), whichever is applicable; 

9 ‘‘(ii) any such notification to an indi10 vidual who is a qualified beneficiary as the 

11 spouse of the covered employee shall be 

12 treated as notification to all other qualified 

13 beneficiaries residing with such spouse at 

14 the time such notification is made; and 

15 ‘‘(iii) any such notification shall, with 

16 respect to each qualified beneficiary with 

17 respect to whom such notification is made, 

18 include information regarding any Ex19 change established under title I of the Pa20 tient Protection and Affordable Care Act 

21 through which such a qualified beneficiary 

22 may be eligible to enroll in a qualified 

23 health plan (as defined in section 1301 of 

24 the Patient Protection and Affordable Care 

25 Act), including— 


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1 ‘‘(I) the publicly accessible Inter2 net website address for such Ex3 change; 

4 ‘‘(II) the publicly accessible 

5 Internet website address for the Find 

6 Local Help directory maintained by 

7 the Department of Health and 

8 Human Services on the healthcare.gov 

9 Internet website (or a successor 

10 website); 

11 ‘‘(III) a clear explanation that— 

12 ‘‘(aa) an individual who is 

13 eligible for continuation coverage 

14 may be eligible to enroll instead, 

15 with financial assistance, in a 

16 qualified health plan offered 

17 through such Exchange, but, in 

18 the case that such individual 

19 elects to enroll in such continu20 ation coverage and subsequently 

21 elects to terminate such continu22 ation coverage before the period 

23 of such continuation coverage ex24 pires, such individual may not be 

25 eligible to enroll in a qualified 


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1 health plan offered through such 

2 Exchange during a special enroll3 ment period if more than 60 days 

4 have elapsed since the individ5 ual’s loss of coverage as an em6 ployee; 

7 ‘‘(bb) an individual who 

8 elects to enroll in continuation 

9 coverage will remain eligible to 

10 enroll in a qualified health plan 

11 offered through such Exchange 

12 during an open enrollment period 

13 or another special enrollment pe14 riod for which the individual is 

15 eligible and may be eligible for fi16 nancial assistance with respect to 

17 enrolling in such a qualified 

18 health plan; and 

19 ‘‘(cc) an individual may 

20 apply for, and if eligible, enroll in 

21 Medicaid or the Children’s 

22 Health Insurance Program 

23 (CHIP), at any time, with no 

24 special enrollment period re25 quired; 


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1 ‘‘(IV) information on consumer 

2 protections with respect to enrolling in 

3 a qualified health plan offered 

4 through such Exchange, including the 

5 requirement for such a qualified 

6 health plan to provide coverage for es7 sential health benefits (as defined in 

8 section 1302(b) of the Patient Protec9 tion and Affordable Care Act) and the 

10 requirements applicable to such a 

11 qualified health plan under part A of 

12 title XXVII of the Public Health 

13 Service Act; and 

14 ‘‘(V) information on the avail15 ability of financial assistance with re16 spect to enrolling in a qualified health 

17 plan.’’. 

18 (2) EFFECTIVE DATE.—The amendments made 

19 by paragraph (1) shall apply with respect to quali20 fying events occurring on or after the date that is 

21 90 days after the date of the enactment of this Act. 

22 (d) MODEL NOTICES.—Not later than 90 days after 

23 the date of the enactment of this Act, the Secretary of 

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1 ury and the Secretary of Health and Human Services, 

2 shall— 

3 (1) update the model Consolidated Omnibus 

4 Budget Reconciliation Act of 1985 (referred to in 

5 this subsection as ‘‘COBRA’’) continuation coverage 

6 general notice and the model COBRA continuation 

7 coverage election notice developed by the Secretary 

8 of Labor for purposes of facilitating compliance of 

9 group health plans with the notification require10 ments under section 606 of the Employee Retire11 ment Income Security Act of 1974 (29 U.S.C. 1166) 

12 to include the information described in paragraph 

13 (3) of subsection (c) of such section 606, as added 

14 by subsection (a)(1); 

15 (2) provide an opportunity for consumer testing 

16 of each such notice, as so updated, to ensure that 

17 each such notice is clear and understandable to the 

18 average participant or beneficiary of a group health 

19 plan; and 

20 (3) rename the model COBRA continuation 

21 coverage general notice and the model COBRA con22 tinuation coverage election notice as the ‘‘model 

23 COBRA continuation coverage and Affordable Care 

24 Act coverage general notice’’ and the ‘‘model 


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1 COBRA continuation coverage and Affordable Care 

2 Act coverage election notice’’, respectively. 

Æ 


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