IB 
Union Calendar No. 328 
110TH CONGRESS 
2D SESSION 
H. R. 1424 
[Report No. 110–374, Parts I, II, and III] 
To amend section 712 of the Employee Retirement Income Security Act 
of 1974, section 2705 of the Public Health Service Act, and section 
9812 of the Internal Revenue Code of 1986 to require equity in the 
provision of mental health and substance-related disorder benefits under 
group health plans. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2007 
Mr. KENNEDY (for himself, Mr. RAMSTAD, Mr. ABERCROMBIE, Mr. ACKER-
MAN, Mr. ALEXANDER, Mr. ALLEN, Mr. ANDREWS, Mr. ARCURI, Mr. 
BACA, Mr. BACHUS, Mr. BAIRD, Ms. BALDWIN, Mr. BARROW, Ms. BEAN, 
Mr. BECERRA, Ms. BERKLEY, Mr. BERMAN, Mr. BERRY, Mr. BISHOP of 
Georgia, Mr. BISHOP of New York, Mr. BLUMENAUER, Ms. BORDALLO, 
Mr. BOREN, Mr. BOSWELL, Mr. BOUCHER, Mr. BOYD of Florida, Mr. 
BRADY of Pennsylvania, Mr. BRALEY of Iowa, Ms. CORRINE BROWN of 
Florida, Mr. BUTTERFIELD, Mrs. CAPPS, Mr. CAPUANO, Mr. CARDOZA, 
Mr. CARNAHAN, Mr. CARNEY, Ms. CARSON, Ms. CASTOR, Mr. CHAN-
DLER, Mrs. CHRISTENSEN, Ms. CLARKE, Mr. CLAY, Mr. CLEAVER, Mr. 
CLYBURN, Mr. COHEN, Mr. CONYERS, Mr. COOPER, Mr. COSTA, Mr. 
COSTELLO, Mr. COURTNEY, Mr. CROWLEY, Mrs. CUBIN, Mr. CUELLAR, 
Mr. CUMMINGS, Mr. DAVIS of Alabama, Mr. DAVIS of Illinois, Mrs. 
DAVIS of California, Mr. LINCOLN DAVIS of Tennessee, Mr. DEFAZIO, 
Ms. DEGETTE, Mr. DELAHUNT, Ms. DELAURO, Mr. DICKS, Mr. 
DOGGETT, Mr. DONNELLY, Mr. DOYLE, Mr. EDWARDS, Mr. ELLISON, 
Mr. ELLSWORTH, Mr. EMANUEL, Mrs. EMERSON, Mr. ENGEL, Mr. 
ENGLISH
of 
Pennsylvania, 
Ms. 
ESHOO, 
Mr. 
ETHERIDGE, 
Mr. 
FALEOMAVAEGA, Mr. FARR, Mr. FATTAH, Mr. FERGUSON, Mr. FILNER, 
Mr. FRANK of Massachusetts, Mr. FRELINGHUYSEN, Ms. GIFFORDS, Mr. 
GILCHREST, Mrs. GILLIBRAND, Mr. GONZALEZ, Mr. GORDON of Ten-
nessee, Mr. AL GREEN of Texas, Mr. GENE GREEN of Texas, Mr. 
GRIJALVA, Mr. GUTIERREZ, Mr. HALL of New York, Mr. HARE, Ms. 
HARMAN, Mr. HASTINGS of Florida, Ms. HERSETH, Mr. HIGGINS, Mr. 
HINCHEY, Mr. HINOJOSA, Ms. HIRONO, Mr. HODES, Mr. HOLDEN, Mr. 
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HOLT, Mr. HONDA, Ms. HOOLEY, Mr. HOYER, Mr. INSLEE, Mr. ISRAEL, 
Mr. JACKSON of Illinois, Ms. JACKSON-LEE of Texas, Mr. JEFFERSON, 
Ms. EDDIE BERNICE JOHNSON of Texas, Mr. JOHNSON of Georgia, Mrs. 
JONES of Ohio, Mr. KAGEN, Mr. KANJORSKI, Ms. KAPTUR, Mr. KELLER 
of Florida, Mr. KILDEE, Ms. KILPATRICK, Mr. KIND, Mr. KING of New 
York, Mr. KIRK, Mr. KLEIN of Florida, Mr. KUCINICH, Mr. LAHOOD, 
Mr. LAMPSON, Mr. LANGEVIN, Mr. LANTOS, Mr. LARSEN of Washington, 
Mr. LARSON of Connecticut, Mr. LATOURETTE, Ms. LEE, Mr. LEVIN, 
Mr. LEWIS of Georgia, Mr. LIPINSKI, Mr. LOBIONDO, Mr. LOEBSACK, 
Ms. ZOE LOFGREN of California, Mrs. LOWEY, Mr. LYNCH, Mrs. 
MALONEY of New York, Mr. MARKEY, Mr. MARSHALL, Mr. MATHESON, 
Ms. MATSUI, Mrs. MCCARTHY of New York, Ms. MCCOLLUM of Min-
nesota, Mr. MCDERMOTT, Mr. MCGOVERN, Mr. MCHUGH, Mr. MCIN-
TYRE, Mr. MCNERNEY, Mr. MCNULTY, Mr. MEEHAN, Mr. MEEK of Flor-
ida, Mr. MEEKS
of New York, Mr. MICA, Mr. MICHAUD, Ms. 
MILLENDER-MCDONALD, Mr. GEORGE MILLER of California, Mr. MOL-
LOHAN, Mr. MOORE of Kansas, Ms. MOORE of Wisconsin, Mr. MORAN 
of Virginia, Mr. MURPHY of Connecticut, Mr. TIM MURPHY of Pennsyl-
vania, Mr. MURTHA, Mr. NADLER, Mrs. NAPOLITANO, Mr. NEAL of Mas-
sachusetts, Ms. NORTON, Mr. OBERSTAR, Mr. OBEY, Mr. OLVER, Mr. 
ORTIZ, Mr. PALLONE, Mr. PASCRELL, Mr. PASTOR, Mr. PAYNE, Mr. 
PERLMUTTER, Mr. PETERSON
of Minnesota, Mr. PICKERING, Mr. 
PLATTS, Mr. POMEROY, Mr. PRICE of North Carolina, Mr. RAHALL, Mr. 
RANGEL, Mr. RENZI, Mr. REYES, Mr. RODRIGUEZ, Ms. ROS-LEHTINEN, 
Mr. ROSS, Mr. ROTHMAN, Ms. ROYBAL-ALLARD, Mr. RUPPERSBERGER, 
Mr. RUSH, Mr. RYAN of Ohio, Mr. SALAZAR, Ms. LINDA T. SA´NCHEZ 
of California, Ms. LORETTA SANCHEZ of California, Mr. SARBANES, Mr. 
SAXTON, Ms. SCHAKOWSKY, Mr. SCHIFF, Mrs. SCHMIDT, Ms. 
WASSERMAN SCHULTZ, Ms. SCHWARTZ, Mr. SCOTT of Georgia, Mr. 
SCOTT of Virginia, Mr. SERRANO, Mr. SESTAK, Mr. SHAYS, Ms. SHEA- 
PORTER, Mr. SHERMAN, Mr. SIRES, Mr. SKELTON, Ms. SLAUGHTER, Mr. 
SMITH of Washington, Mr. SMITH of New Jersey, Mr. SNYDER, Ms. 
SOLIS, Mr. SPACE, Mr. SPRATT, Mr. STARK, Mr. STUPAK, Mr. SUL-
LIVAN, Ms. SUTTON, Mr. TANNER, Mrs. TAUSCHER, Mr. THOMPSON of 
Mississippi, Mr. THOMPSON of California, Mr. TIERNEY, Mr. TOWNS, Mr. 
UDALL of Colorado, Mr. UDALL of New Mexico, Mr. UPTON, Mr. VAN 
HOLLEN, Ms. VELA´ZQUEZ, Mr. VISCLOSKY, Mr. WALSH of New York, 
Mr. WALZ of Minnesota, Mr. WAMP, Ms. WATERS, Ms. WATSON, Mr. 
WATT, Mr. WAXMAN, Mr. WEINER, Mr. WELCH of Vermont, Mr. 
WEXLER, Mr. WILSON of Ohio, Mr. WILSON of South Carolina, Ms. 
WOOLSEY, Mr. WU, Mr. WYNN, Mr. YARMUTH, and Mr. YOUNG of Alas-
ka) introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on Education 
and Labor and Ways and Means, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
OCTOBER 15, 2007 
Reported from the Committee on Education and Labor with an amendment 
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[Strike out all after the enacting clause and insert the part printed in italic] 
OCTOBER 15, 2007 
Reported from the Committee on Ways and Means with an amendment 
[Stike out all after the enacting clause and insert the part printed in boldface roman] 
MARCH 4, 2008 
Additional sponsors: Mrs. BONO MACK, Mr. DINGELL, Mr. ALTMIRE, Mr. 
GERLACH, Mr. EHLERS, Mr. GILLMOR, Mr. DENT, Mr. PATRICK MUR-
PHY of Pennsylvania, Mrs. BOYDA of Kansas, Mr. MITCHELL, Mrs. 
CAPITO, Mr. MILLER of North Carolina, Mr. CRAMER, Mr. BONNER, Mr. 
WOLF, Mr. HILL, Mr. MELANCON, Mr. SHULER, and Mr. SMITH of 
Texas 
MARCH 4, 2008 
Reported from the Committee on Energy and Commerce with an amendment; 
committed to the Committee of the Whole House on the State of the 
Union and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in boldface italic] 
[For text of introduced bill, see copy of bill as introduced on March 9, 2007] 
A BILL 
To amend section 712 of the Employee Retirement Income 
Security Act of 1974, section 2705 of the Public Health 
Service Act, and section 9812 of the Internal Revenue 
Code of 1986 to require equity in the provision of mental 
health and substance-related disorder benefits under 
group health plans. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Paul Wellstone Mental Health and Addiction Equity Act 
of 2007’’. 
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(b) TABLE OF CONTENTS.—The table of contents of this 
Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Amendments to the Employee Retirement Income Security Act of 1974. 
Sec. 3. Amendments to the Public Health Service Act relating to the group mar-
ket. 
Sec. 4. Amendments to the Internal Revenue Code of 1986. 
Sec. 5. Government Accountability Office studies and reports. 
SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) EXTENSION OF PARITY TO TREATMENT LIMITS 
AND BENEFICIARY FINANCIAL REQUIREMENTS.—Section 
712 of the Employee Retirement Income Security Act of 
1974 (29 U.S.C. 1185a) is amended— 
(1) in subsection (a), by adding at the end the 
following new paragraphs: 
‘‘(3) TREATMENT LIMITS.— 
‘‘(A) NO TREATMENT LIMIT.—If the plan or 
coverage does not include a treatment limit (as 
defined in subparagraph (D)) on substantially 
all medical and surgical benefits in any category 
of items or services, the plan or coverage may 
not impose any treatment limit on mental health 
or substance-related disorder benefits that are 
classified in the same category of items or serv-
ices. 
‘‘(B) TREATMENT
LIMIT.—If the plan or 
coverage includes a treatment limit on substan-
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tially all medical and surgical benefits in any 
category of items or services, the plan or coverage 
may not impose such a treatment limit on men-
tal health or substance-related disorder benefits 
for items and services within such category that 
is more restrictive than the predominant treat-
ment limit that is applicable to medical and sur-
gical benefits for items and services within such 
category. 
‘‘(C) CATEGORIES OF ITEMS AND SERVICES 
FOR APPLICATION OF TREATMENT LIMITS AND 
BENEFICIARY
FINANCIAL
REQUIREMENTS.—For 
purposes of this paragraph and paragraph (4), 
there shall be the following five categories of 
items and services for benefits, whether medical 
and surgical benefits or mental health and sub-
stance-related disorder benefits, and all medical 
and surgical benefits and all mental health and 
substance related benefits shall be classified into 
one of the following categories: 
‘‘(i) INPATIENT, IN-NETWORK.—Items 
and services not described in clause (v) fur-
nished on an inpatient basis and within a 
network of providers established or recog-
nized under such plan or coverage. 
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‘‘(ii) INPATIENT, OUT-OF-NETWORK.— 
Items and services not described in clause 
(v) furnished on an inpatient basis and out-
side any network of providers established or 
recognized under such plan or coverage. 
‘‘(iii) 
OUTPATIENT, 
IN-NETWORK.— 
Items and services not described in clause 
(v) furnished on an outpatient basis and 
within a network of providers established or 
recognized under such plan or coverage. 
‘‘(iv) 
OUTPATIENT, 
OUT-OF-NET-
WORK.—Items and services not described in 
clause (v) furnished on an outpatient basis 
and outside any network of providers estab-
lished or recognized under such plan or cov-
erage. 
‘‘(v) EMERGENCY
CARE.—Items and 
services, whether furnished on an inpatient 
or outpatient basis or within or outside any 
network of providers, required for the treat-
ment of an emergency medical condition 
(including an emergency condition relating 
to mental health and substance-related dis-
orders). 
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‘‘(D) TREATMENT
LIMIT
DEFINED.—For 
purposes of this paragraph, the term ‘treatment 
limit’ means, with respect to a plan or coverage, 
limitation on the frequency of treatment, number 
of visits or days of coverage, or other similar 
limit on the duration or scope of treatment 
under the plan or coverage. 
‘‘(E) PREDOMINANCE.—For purposes of this 
subsection, a treatment limit or financial re-
quirement with respect to a category of items 
and services is considered to be predominant if 
it is the most common or frequent of such type 
of limit or requirement with respect to such cat-
egory of items and services. 
‘‘(4) BENEFICIARY FINANCIAL REQUIREMENTS.— 
‘‘(A) NO BENEFICIARY FINANCIAL REQUIRE-
MENT.—If the plan or coverage does not include 
a beneficiary financial requirement (as defined 
in subparagraph (C)) on substantially all med-
ical and surgical benefits within a category of 
items and services (specified under paragraph 
(3)(C)), the plan or coverage may not impose 
such a beneficiary financial requirement on 
mental health or substance-related disorder bene-
fits for items and services within such category. 
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‘‘(B) BENEFICIARY
FINANCIAL
REQUIRE-
MENT.— 
‘‘(i) TREATMENT
OF
DEDUCTIBLES, 
OUT-OF-POCKET
LIMITS, AND
SIMILAR
FI-
NANCIAL
REQUIREMENTS.—If the plan or 
coverage includes a deductible, a limitation 
on out-of-pocket expenses, or similar bene-
ficiary financial requirement that does not 
apply separately to individual items and 
services on substantially all medical and 
surgical benefits within a category of items 
and services (as specified in paragraph 
(3)(C)), the plan or coverage shall apply 
such requirement (or, if there is more than 
one such requirement for such category of 
items and services, the predominant re-
quirement for such category) both to med-
ical and surgical benefits within such cat-
egory and to mental health and substance- 
related disorder benefits within such cat-
egory and shall not distinguish in the ap-
plication of such requirement between such 
medical and surgical benefits and such 
mental health and substance-related dis-
order benefits. 
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‘‘(ii) 
OTHER
FINANCIAL
REQUIRE-
MENTS.—If the plan or coverage includes a 
beneficiary financial requirement not de-
scribed in clause (i) on substantially all 
medical and surgical benefits within a cat-
egory of items and services, the plan or cov-
erage may not impose such financial re-
quirement on mental health or substance-re-
lated disorder benefits for items and services 
within such category in a way that results 
in greater out-of-pocket expenses to the par-
ticipant or beneficiary than the predomi-
nant beneficiary financial requirement ap-
plicable to medical and surgical benefits for 
items and services within such category. 
‘‘(iii) 
CONSTRUCTION.—Nothing 
in 
this subparagraph shall be construed as pro-
hibiting the plan or coverage from waiving 
the application of any deductible for mental 
health benefits or substance-related disorder 
benefits or both. 
‘‘(C) BENEFICIARY
FINANCIAL
REQUIRE-
MENT
DEFINED.—For purposes of this para-
graph, the term ‘beneficiary financial require-
ment’ includes, with respect to a plan or cov-
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erage, any deductible, coinsurance, co-payment, 
other cost sharing, and limitation on the total 
amount that may be paid by a participant or 
beneficiary with respect to benefits under the 
plan or coverage, but does not include the appli-
cation of any aggregate lifetime limit or annual 
limit.’’; and 
(2) in subsection (b)— 
(A) by striking ‘‘construed—’’ and all that 
follows through ‘‘(1) as requiring’’ and inserting 
‘‘construed as requiring’’; 
(B) by striking ‘‘; or’’ and inserting a pe-
riod; and 
(C) by striking paragraph (2). 
(b) EXPANSION TO SUBSTANCE-RELATED DISORDER 
BENEFITS AND REVISION OF DEFINITION.—Such section is 
further amended— 
(1) by striking ‘‘mental health benefits’’ and in-
serting ‘‘mental health or substance-related disorder 
benefits’’ each place it appears; and 
(2) in paragraph (4) of subsection (e)— 
(A) by striking ‘‘MENTAL HEALTH BENE-
FITS’’ and inserting ‘‘MENTAL
HEALTH
AND 
SUBSTANCE-RELATED DISORDER BENEFITS’’; 
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(B) by striking ‘‘benefits with respect to 
mental health services’’ and inserting ‘‘benefits 
with respect to services for mental health condi-
tions or substance-related disorders’’; and 
(C) by striking ‘‘, but does not include bene-
fits with respect to treatment of substance abuse 
or chemical dependency’’. 
(c) AVAILABILITY OF PLAN INFORMATION ABOUT CRI-
TERIA FOR MEDICAL NECESSITY.—Subsection (a) of such 
section, as amended by subsection (a)(1), is further amend-
ed by adding at the end the following new paragraph: 
‘‘(5) AVAILABILITY OF PLAN INFORMATION.—The 
criteria for medical necessity determinations made 
under the plan with respect to mental health and sub-
stance-related disorder benefits (or the health insur-
ance coverage offered in connection with the plan 
with respect to such benefits) shall be made available 
in accordance with regulations by the plan adminis-
trator (or the health insurance issuer offering such 
coverage) to any current or potential participant, 
beneficiary, or contracting provider upon request. The 
reason for any denial under the plan (or coverage) of 
reimbursement or payment for services with respect to 
mental health and substance-related disorder benefits 
in the case of any participant or beneficiary shall, 
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upon request, be made available in accordance with 
regulations by the plan administrator (or the health 
insurance issuer offering such coverage) to the partici-
pant or beneficiary.’’. 
(d) MINIMUM BENEFIT REQUIREMENTS.—Subsection 
(a) of such section is further amended by adding at the end 
the following new paragraph: 
‘‘(6) MINIMUM SCOPE OF COVERAGE AND EQUITY 
IN OUT-OF-NETWORK BENEFITS.— 
‘‘(A) MINIMUM SCOPE OF MENTAL HEALTH 
AND
SUBSTANCE-RELATED
DISORDER
BENE-
FITS.—In the case of a group health plan (or 
health insurance coverage offered in connection 
with such a plan) that provides any mental 
health or substance-related disorder benefits, the 
plan or coverage shall include benefits for any 
mental health condition and substance-related 
disorder for which benefits are provided under 
the benefit plan option offered under chapter 89 
of title 5, United States Code, with the highest 
average enrollment as of the beginning of the 
most recent year beginning on or before the be-
ginning of the plan year involved. 
‘‘(B) EQUITY IN COVERAGE OF OUT-OF-NET-
WORK BENEFITS.— 
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‘‘(i) IN GENERAL.—In the case of a 
plan or coverage that provides both medical 
and surgical benefits and mental health or 
substance-related disorder benefits, if med-
ical and surgical benefits are provided for 
substantially all items and services in a 
category specified in clause (ii) furnished 
outside any network of providers established 
or recognized under such plan or coverage, 
the mental health and substance-related dis-
order benefits shall also be provided for 
items and services in such category fur-
nished outside any network of providers es-
tablished or recognized under such plan or 
coverage in accordance with the require-
ments of this section. 
‘‘(ii) CATEGORIES
OF
ITEMS
AND 
SERVICES.—For purposes of clause (i), there 
shall be the following three categories of 
items and services for benefits, whether med-
ical and surgical benefits or mental health 
and substance-related disorder benefits, and 
all medical and surgical benefits and all 
mental health and substance-related dis-
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order benefits shall be classified into one of 
the following categories: 
‘‘(I) 
EMERGENCY.—Items 
and 
services, whether furnished on an inpa-
tient or outpatient basis, required for 
the treatment of an emergency medical 
condition (including an emergency 
condition relating to mental health or 
substance-related disorders). 
‘‘(II) 
INPATIENT.—Items 
and 
services not described in subclause (I) 
furnished on an inpatient basis. 
‘‘(III) OUTPATIENT.—Items and 
services not described in subclause (I) 
furnished on an outpatient basis.’’. 
(e) CONSTRUCTION.—Subsection (a) of such section is 
further amended by adding at the end the following new 
paragraph: 
‘‘(7) CONSTRUCTION.—Nothing in this section 
shall be construed to limit a group health plan (or 
health insurance offered in connection with such a 
plan) from managing the provision of medical, sur-
gical, mental health or substance-related disorder ben-
efits through any of the following methods: 
‘‘(A) the application of utilization review; 
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‘‘(B) the application of authorization or 
management practices; 
‘‘(C) the application of medical necessity 
and appropriateness criteria; or 
‘‘(D) other processes intended to ensure that 
beneficiaries receive appropriate care and medi-
cally necessary services for covered benefits; 
to the extent such methods are recognized both by in-
dustry and by providers and are not prohibited under 
applicable State laws.’’. 
(f) REVISION
OF INCREASED COST EXEMPTION.— 
Paragraph (2) of subsection (c) of such section is amended 
to read as follows: 
‘‘(2) INCREASED COST EXEMPTION.— 
‘‘(A) IN GENERAL.—With respect to a group 
health plan (or health insurance coverage offered 
in connection with such a plan), if the applica-
tion of this section to such plan (or coverage) re-
sults in an increase for the plan year involved 
of the actual total costs of coverage with respect 
to medical and surgical benefits and mental 
health and substance-related disorder benefits 
under the plan (as determined and certified 
under subparagraph (C)) by an amount that ex-
ceeds the applicable percentage described in sub-
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paragraph (B) of the actual total plan costs, the 
provisions of this section shall not apply to such 
plan (or coverage) during the following plan 
year, and such exemption shall apply to the plan 
(or coverage) for 1 plan year. 
‘‘(B) APPLICABLE PERCENTAGE.—With re-
spect to a plan (or coverage), the applicable per-
centage described in this paragraph shall be— 
‘‘(i) 2 percent in the case of the first 
plan year which begins after the effective 
date of the amendments made by section 
101 of the Paul Wellstone Mental Health 
and Addiction Equity Act of 2007; and 
‘‘(ii) 1 percent in the case of each sub-
sequent plan year. 
‘‘(C) DETERMINATIONS
BY
ACTUARIES.— 
Determinations as to increases in actual costs 
under a plan (or coverage) for purposes of this 
subsection shall be made and certified by a 
qualified and licensed actuary who is a member 
in good standing of the American Academy of 
Actuaries. 
‘‘(D) 6-MONTH
DETERMINATIONS.—If a 
group health plan (or a health insurance issuer 
offering coverage in connection with such a plan) 
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seeks an exemption under this paragraph, deter-
minations under subparagraph (A) shall be 
made after such plan (or coverage) has complied 
with this section for the first 6 months of the 
plan year involved. 
‘‘(E) NOTIFICATION.—An election to modify 
coverage of mental health and substance-related 
disorder benefits as permitted under this para-
graph shall be treated as a material modification 
in the terms of the plan as described in section 
102(a) and notice of which shall be provided a 
reasonable period in advance of the change. 
‘‘(F) NOTIFICATION OF APPROPRIATE AGEN-
CY.— 
‘‘(i) IN
GENERAL.—A group health 
plan that, based on upon a certification de-
scribed under subparagraph (C), qualifies 
for an exemption under this paragraph, 
and elects to implement the exemption, shall 
notify the Department of Labor of such elec-
tion. 
‘‘(ii) REQUIREMENT.—A notification 
under clause (i) shall include— 
‘‘(I) a description of the number 
of covered lives under the plan (or cov-
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erage) involved at the time of the noti-
fication, and as applicable, at the time 
of any prior election of the cost-exemp-
tion under this paragraph by such 
plan (or coverage); 
‘‘(II) for both the plan year upon 
which a cost exemption is sought and 
the year prior, a description of the ac-
tual total costs of coverage with respect 
to medical and surgical benefits and 
mental health and substance-related 
disorder benefits under the plan; and 
‘‘(III) for both the plan year upon 
which a cost exemption is sought and 
the year prior, the actual total costs of 
coverage with respect to mental health 
and substance-related disorder benefits 
under the plan. 
‘‘(iii) CONFIDENTIALITY.—A notifica-
tion under clause (i) shall be confidential. 
The Department of Labor shall make avail-
able, upon request to the appropriate com-
mittees of Congress and on not more than 
an annual basis, an anonymous itemization 
of such notifications, that includes— 
VerDate Aug 31 2005 
03:33 Mar 05, 2008
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