I 

111TH CONGRESS 

1ST SESSION H. R. 323 

To amend title XXVII of the Public Health Service Act and title I of 

the Employee Retirement Income Security Act of 1974 to require that 

group and individual health insurance coverage and group health plans 

provide comprehensive coverage for childhood immunization. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 8, 2009 

Mr. GENE GREEN of Texas introduced the following bill; which was referred 

to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, 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 title XXVII of the Public Health Service Act 

and title I of the Employee Retirement Income Security 

Act of 1974 to require that group and individual health 

insurance coverage and group health plans provide comprehensive coverage for childhood immunization. 

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 ‘‘Comprehensive Insur5 ance Coverage of Childhood Immunization Act of 2009’’. 


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1 SEC. 2. COMPREHENSIVE COVERAGE FOR CHILDHOOD IM2 MUNIZATION BY GROUP HEALTH PLANS AND 

3 HEALTH INSURANCE ISSUERS. 

4 (a) GROUP HEALTH PLANS.— 

5 (1) PUBLIC HEALTH SERVICE ACT AMEND6 MENTS.—Subpart 2 of part A of title XXVII of the 

7 Public Health Service Act is amended by adding at 

8 the end the following new section: 

9 ‘‘SEC. 2708. STANDARD RELATING TO COVERAGE OF CHILD10 HOOD IMMUNIZATION. 

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

12 health insurance issuer offering group health insurance 

13 coverage, shall provide for each plan year comprehensive 

14 coverage for routine immunizations for each individual 

15 who is a dependent of a participant or beneficiary under 

16 the plan and is under 19 years of age. 

17 ‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 

18 this section, comprehensive coverage for routine immuni19 zations for a plan year consists of coverage, without 

20 deductibles, coinsurance, or other cost-sharing, for immu21 nizations (including the vaccine itself) in accordance with 

22 the most recent version of the Recommended Childhood 

23 Immunization Schedule issued prior to such plan year by 

24 the Advisory Committee on Immunization Practices of the 

25 Centers for Disease Control and Prevention.’’. 

26 (2) ERISA AMENDMENTS.— 


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1 (A) IN GENERAL.—Subpart B of part 7 of 

2 subtitle B of title I of the Employee Retirement 

3 Income Security Act of 1974 is amended by 

4 adding at the end the following new section: 

5 ‘‘SEC. 715. STANDARD RELATING TO COVERAGE OF CHILD6 HOOD IMMUNIZATION. 

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

8 health insurance issuer offering group health insurance 

9 coverage, shall provide for each plan year comprehensive 

10 coverage for routine immunizations for each individual 

11 who is a dependent of a participant or beneficiary under 

12 the plan and is under 19 years of age. 

13 ‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 

14 this section, comprehensive coverage for routine immuni15 zations for a plan year consists of coverage, without 

16 deductibles, coinsurance, or other cost-sharing, for immu17 nizations (including the vaccine itself) in accordance with 

18 the most recent version of the Recommended Childhood 

19 Immunization Schedule issued prior to such plan year by 

20 the Advisory Committee on Immunization Practices of the 

21 Centers for Disease Control and Prevention.’’. 

22 (B) CLERICAL AMENDMENT.—The table of 

23 contents in section 1 of such Act is amended by 

24 inserting after the item relating to section 714 

25 the following new item: 

‘‘715. Standard relating to coverage of childhood immunization.’’. 


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1 (b) INDIVIDUAL HEALTH INSURANCE.—Part B of 

2 title XXVII of the Public Health Service Act is amended 

3 by inserting after section 2753 the following new section: 

4 ‘‘SEC. 2754. STANDARD RELATING TO COVERAGE OF CHILD5 HOOD IMMUNIZATION. 

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

7 insurance coverage offered by a health insurance issuer 

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

9 to health insurance coverage offered by a health insurance 

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

11 or large group market.’’. 

12 SEC. 3. COORDINATION OF ADMINISTRATION. 

13 The Secretary of Health and Human Services and the 

14 Secretary of Labor shall ensure, through the execution of 

15 an interagency memorandum of understanding among 

16 such Secretaries, that— 

17 (1) regulations, rulings, and interpretations 

18 issued by such Secretaries relating to the same mat19 ter over which both such Secretaries have responsi20 bility under the provisions of this Act (and the 

21 amendments made thereby) are administered so as 

22 to have the same effect at all times; and 

23 (2) coordination of policies relating to enforcing 

24 the same requirements through such Secretaries in 

25 order to have a coordinated enforcement strategy 


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1 that avoids duplication of enforcement efforts and 

2 assigns priorities in enforcement. 

3 SEC. 4. EFFECTIVE DATES. 

4 (a) GROUP HEALTH PLANS AND GROUP HEALTH IN5 SURANCE COVERAGE.—Subject to subsection (c), the 

6 amendments made by section 2(a) apply with respect to 

7 group health plans for plan years beginning on or after 

8 January 1, 2010. 

9 (b) INDIVIDUAL HEALTH INSURANCE COVERAGE.— 

10 The amendment made by section 2(b) applies with respect 

11 to health insurance coverage offered, sold, issued, re12 newed, in effect, or operated in the individual market on 

13 or after such date. 

14 (c) COLLECTIVE BARGAINING EXCEPTION.—In the 

15 case of a group health plan maintained pursuant to 1 or 

16 more collective bargaining agreements between employee 

17 representatives and 1 or more employers ratified before 

18 the date of enactment of this Act, the amendments made 

19 by section 2(a) shall not apply to plan years beginning 

20 before the later of— 

21 (1) the earliest date as of which all such collec22 tive bargaining agreements relating to the plan have 

23 terminated (determined without regard to any exten24 sion thereof agreed to after the date of enactment of 

25 this Act); or 


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1 (2) January 1, 2010. 

2 For purposes of paragraph (1), any plan amendment made 

3 pursuant to a collective bargaining agreement relating to 

4 the plan which amends the plan solely to conform to any 

5 requirement added by section 2(a) shall not be treated as 

6 a termination of such collective bargaining agreement. 

Æ 


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