For purposes of clause (i), any plan amendment made pur-
suant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any re-
quirement added by subsection (a) or (b) shall not be
treated as a termination of such collective bargaining
agreement.
(2) The amendments made by subsections (a), (c),
(d)(2), and (e) shall apply with respect to individual health
insurance coverage offered, sold, issued, renewed, in effect,
or operated in the individual market on or after the gen-
eral effective date.
SEC. 3. PATIENT PROTECTION STANDARDS UNDER THE EM-
PLOYEE 
RETIREMENT 
INCOME 
SECURITY
ACT OF 1974.
(a) IN GENERAL.—Subpart B of part 7 of subtitle
B of title I of the Employee Retirement Income Security
Act of 1974 is amended by adding at the end the following
new section:
‘‘SEC. 713. PATIENT PROTECTION STANDARDS.
‘‘(a) IN GENERAL.—Subject to subsection (b), a
group health plan (and a health insurance issuer offering
group health insurance coverage in connection with such
a plan) shall comply with the requirements of part C of
title XXVII of the Public Health Service Act.
‘‘(b) REFERENCES
IN APPLICATION.—In applying
subsection (a) under this part, any reference in such part
C—
‘‘(1) to a health insurance issuer and health in-
surance coverage offered by such an issuer is
deemed to include a reference to a group health plan
and coverage under such plan, respectively;
‘‘(2) to the Secretary is deemed a reference to
the Secretary of Labor;
‘‘(3) to an applicable State authority is deemed
a reference to the Secretary of Labor; and
‘‘(4) to an enrollee with respect to health insur-
ance coverage is deemed to include a reference to a
participant or beneficiary with respect to a group
health plan.
‘‘(c) ASSURING COORDINATION.—The Secretary of
Health and Human Services and the Secretary of Labor
shall ensure, through the execution of an interagency
memorandum of understanding between such Secretaries,
that—
‘‘(1) regulations, rulings, and interpretations is-
sued by such Secretaries relating to the same matter
over which such Secretaries have responsibility
under such part C (and section 2706 of the Public
Health Service Act) and this section are adminis-
tered so as to have the same effect at all times; and
‘‘(2) coordination of policies relating to enforc-
ing the same requirements through such Secretaries
in order to have a coordinated enforcement strategy
that avoids duplication of enforcement efforts and
assigns priorities in enforcement.’’.
(b) MODIFICATION OF PREEMPTION STANDARDS.—
Section 731 of such Act (42 U.S.C. 1191) is amended—
(1) in subsection (a)(1), by striking ‘‘subsection
(b)’’ and inserting ‘‘subsections (b) and (c)’’;
(2) by redesignating subsections (c) and (d) as
subsections (d) and (e), respectively; and
(3) by inserting after subsection (b) the follow-
ing new subsection:
‘‘(c) SPECIAL RULES IN CASE OF PATIENT PROTEC-
TION REQUIREMENTS.—Subject to subsection (a)(2), the
provisions of section 713 and part C of title XXVII of
the Public Health Service Act, and subpart C insofar as
it applies to section 713 or such part, shall not be con-
strued to preempt any State law, or the enactment or im-
plementation of such a State law, that provides protections
for individuals that are equivalent to or stricter than the
protections provided under such provisions.’’.
(c) CONFORMING
AMENDMENTS.— (1) Section
732(a) of such Act (29 U.S.C. 1185(a)) is amended by
striking ‘‘section 711’’ and inserting ‘‘sections 711 and
713’’.
(2) The table of contents in section 1 of such Act
is amended by inserting after the item relating to section
712 the following new item:
‘‘Sec. 713. Patient protection standards.’’.
(3) Section 734 of such Act (29 U.S.C. 1187) is
amended by inserting ‘‘and section 713(d)’’ after ‘‘of
1996’’.
(d) EFFECTIVE DATE.—(1) Subject to paragraph
(2), the amendments made by this section shall apply with
respect to group health plans for plan years beginning on
or after July 1, 1998 (in this subsection referred to as
the ‘‘general effective date’’) and also shall apply to por-
tions of plan years occurring on and after January 1,
1999.
(2) In the case of a group health plan maintained
pursuant to 1 or more collective bargaining agreements
between employee representatives and 1 or more employ-
ers ratified before the date of enactment of this Act, the
amendments made by this section shall not apply to plan
years beginning before the later of—
(A) the date on which the last collective bar-
gaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of enactment of this Act),
or
(B) the general effective date.
For purposes of subparagraph (A), any plan amendment
made pursuant to a collective bargaining agreement relat-
ing to the plan which amends the plan solely to conform
to any requirement added by subsection (a) shall not be
treated as a termination of such collective bargaining
agreement.
SEC. 4. NON-PREEMPTION OF STATE LAW RESPECTING LI-
ABILITY OF GROUP HEALTH PLANS.
(a) IN GENERAL.—Section 514(b) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C.
1144(b)) is amended by redesignating paragraph (9) as
paragraph (10) and inserting the following new para-
graph:
‘‘(9) Subsection (a) of this section shall not be
construed to preclude any State cause of action to
recover damages for personal injury or wrongful
death against any person that provides insurance or
administrative services to or for an employee welfare
benefit plan maintained to provide health care bene-
fits.’’.