‘‘(d) APPLICATION TO ALL PLANS.—The provisions 
of subsections (a)(1)(F), (b)(3), and (c) shall apply to 
group health plans and health insurance issuers without 
regard to section 732(a).’’. 
(c) REMEDIES AND ENFORCEMENT.—Section 502 of 
the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1132) is amended by adding at the end the 
following: 
‘‘(n) ENFORCEMENT OF GENETIC NONDISCRIMINA-
TION REQUIREMENTS.— 
‘‘(1) INJUNCTIVE
RELIEF
FOR
IRREPARABLE 
HARM.—With respect to any violation of subsection 
(a)(1)(F), (b)(3), or (c) of section 702, a participant 
or beneficiary may seek relief under subsection 
502(a)(1)(B) prior to the exhaustion of available ad-
ministrative remedies under section 503 if it is dem-
onstrated to the court, by a preponderance of the 
evidence, that the exhaustion of such remedies would 
cause irreparable harm to the health of the partici-
pant or beneficiary. Any determinations that already 
have been made under section 503 in such case, or 
that are made in such case while an action under 
this paragraph is pending, shall be given due consid-
eration by the court in any action under this sub-
section in such case. 
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‘‘(2) EQUITABLE RELIEF FOR GENETIC NON-
DISCRIMINATION.— 
‘‘(A) 
REINSTATEMENT
OF
BENEFITS 
WHERE EQUITABLE RELIEF HAS BEEN AWARD-
ED.—The recovery of benefits by a participant 
or beneficiary under a civil action under this 
section may include an administrative penalty 
under subparagraph (B) and the retroactive re-
instatement of coverage under the plan involved 
to the date on which the participant or bene-
ficiary was denied eligibility for coverage if— 
‘‘(i) the civil action was commenced 
under subsection (a)(1)(B); and 
‘‘(ii) the denial of coverage on which 
such civil action was based constitutes a 
violation of subsection (a)(1)(F), (b)(3), or 
(c) of section 702. 
‘‘(B) ADMINISTRATIVE PENALTY.— 
‘‘(i) IN GENERAL.—An administrator 
who fails to comply with the requirements 
of subsection (a)(1)(F), (b)(3), or (c) of 
section 702 with respect to a participant or 
beneficiary may, in an action commenced 
under subsection (a)(1)(B), be personally 
liable in the discretion of the court, for a 
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penalty in the amount not more than $100 
for each day in the noncompliance period. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For 
purposes of clause (i), the term ‘non-
compliance period’ means the period— 
‘‘(I) beginning on the date that a 
failure described in clause (i) occurs; 
and 
‘‘(II) ending on the date that 
such failure is corrected. 
‘‘(iii) PAYMENT TO PARTICIPANT OR 
BENEFICIARY.—A penalty collected under 
this subparagraph shall be paid to the par-
ticipant or beneficiary involved. 
‘‘(3) SECRETARIAL
ENFORCEMENT
AUTHOR-
ITY.— 
‘‘(A) GENERAL RULE.—The Secretary has 
the authority to impose a penalty on any failure 
of a group health plan to meet the requirements 
of subsection (a)(1)(F), (b)(3), or (c) of section 
702. 
‘‘(B) AMOUNT.— 
‘‘(i) IN
GENERAL.—The amount of 
the penalty imposed by subparagraph (A) 
shall be $100 for each day in the non-
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compliance period with respect to each in-
dividual to whom such failure relates. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For 
purposes of this paragraph, the term ‘non-
compliance period’ means, with respect to 
any failure, the period— 
‘‘(I) beginning on the date such 
failure first occurs; and 
‘‘(II) ending on the date such 
failure is corrected. 
‘‘(C) MINIMUM PENALTIES WHERE FAIL-
URE DISCOVERED.—Notwithstanding clauses (i) 
and (ii) of subparagraph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or 
more failures with respect to an indi-
vidual— 
‘‘(I) which are not corrected be-
fore the date on which the plan re-
ceives a notice from the Secretary of 
such violation; and 
‘‘(II) which occurred or continued 
during the period involved; 
the amount of penalty imposed by subpara-
graph (A) by reason of such failures with 
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respect to such individual shall not be less 
than $2,500. 
‘‘(ii) 
HIGHER
MINIMUM
PENALTY 
WHERE VIOLATIONS ARE MORE THAN DE 
MINIMIS.—To the extent violations for 
which any person is liable under this para-
graph for any year are more than de mini-
mis, clause (i) shall be applied by sub-
stituting ‘$15,000’ for ‘$2,500’ with re-
spect to such person. 
‘‘(D) LIMITATIONS.— 
‘‘(i) PENALTY NOT TO APPLY WHERE 
FAILURE
NOT
DISCOVERED
EXERCISING 
REASONABLE
DILIGENCE.—No 
penalty 
shall be imposed by subparagraph (A) on 
any failure during any period for which it 
is established to the satisfaction of the 
Secretary that the person otherwise liable 
for such penalty did not know, and exer-
cising reasonable diligence would not have 
known, that such failure existed. 
‘‘(ii) PENALTY
NOT
TO
APPLY
TO 
FAILURES
CORRECTED
WITHIN
CERTAIN 
PERIODS.—No penalty shall be imposed by 
subparagraph (A) on any failure if— 
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‘‘(I) such failure was due to rea-
sonable cause and not to willful ne-
glect; and 
‘‘(II) such failure is corrected 
during the 30-day period beginning on 
the first date the person otherwise lia-
ble for such penalty knew, or exer-
cising reasonable diligence would have 
known, that such failure existed. 
‘‘(iii) OVERALL LIMITATION FOR UN-
INTENTIONAL FAILURES.—In the case of 
failures which are due to reasonable cause 
and not to willful neglect, the penalty im-
posed by subparagraph (A) for failures 
shall not exceed the amount equal to the 
lesser of— 
‘‘(I) 10 percent of the aggregate 
amount paid or incurred by the em-
ployer (or predecessor employer) dur-
ing the preceding taxable year for 
group health plans; or 
‘‘(II) $500,000. 
‘‘(E) WAIVER BY SECRETARY.—In the case 
of a failure which is due to reasonable cause 
and not to willful neglect, the Secretary may 
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waive part or all of the penalty imposed by sub-
paragraph (A) to the extent that the payment 
of such penalty would be excessive relative to 
the failure involved.’’. 
(d) DEFINITIONS.—Section 733(d) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1191b(d)) is amended by adding at the end the following: 
‘‘(5) FAMILY
MEMBER.—The term ‘family 
member’ means with respect to an individual— 
‘‘(A) the spouse of the individual; 
‘‘(B) a dependent child of the individual, 
including a child who is born to or placed for 
adoption with the individual; and 
‘‘(C) all other individuals related by blood 
to the individual or the spouse or child de-
scribed in subparagraph (A) or (B). 
‘‘(6) GENETIC INFORMATION.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘genetic informa-
tion’ means information about— 
‘‘(i) an individual’s genetic tests; 
‘‘(ii) the genetic tests of family mem-
bers of the individual; or 
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‘‘(iii) the occurrence of a disease or 
disorder in family members of the indi-
vidual. 
‘‘(B) EXCLUSIONS.—The term ‘genetic in-
formation’ shall not include information about 
the sex or age of an individual. 
‘‘(7) GENETIC TEST.— 
‘‘(A) IN
GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that de-
tects genotypes, mutations, or chromosomal 
changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic 
test’ does not mean— 
‘‘(i) an analysis of proteins or metabo-
lites that does not detect genotypes, 
mutations, or chromosomal changes; or 
‘‘(ii) an analysis of proteins or me-
tabolites that is directly related to a mani-
fested disease, disorder, or pathological 
condition that could reasonably be detected 
by a health care professional with appro-
priate training and expertise in the field of 
medicine involved. 
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‘‘(8) GENETIC
SERVICES.—The term ‘genetic 
services’ means— 
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (such as obtaining, 
interpreting, or assessing genetic information); 
or 
‘‘(C) genetic education.’’. 
(e) REGULATIONS AND EFFECTIVE DATE.— 
(1) REGULATIONS.—Not later than 1 year after 
the date of enactment of this title, the Secretary of 
Labor shall issue final regulations in an accessible 
format to carry out the amendments made by this 
section. 
(2) EFFECTIVE DATE.—The amendments made 
by this section shall apply with respect to group 
health plans for plan years beginning after the date 
that is 18 months after the date of enactment of 
this title. 
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) AMENDMENTS RELATING TO THE GROUP MAR-
KET.— 
(1) PROHIBITION OF HEALTH DISCRIMINATION 
ON THE BASIS OF GENETIC INFORMATION OR GE-
NETIC SERVICES.— 
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(A) NO
ENROLLMENT
RESTRICTION
FOR 
GENETIC SERVICES.—Section 2702(a)(1)(F) of 
the Public Health Service Act (42 U.S.C. 
300gg–1(a)(1)(F)) is amended by inserting be-
fore the period the following: ‘‘(including infor-
mation about a request for or receipt of genetic 
services by an individual or family member of 
such individual)’’. 
(B) NO DISCRIMINATION IN GROUP PRE-
MIUMS
BASED
ON
GENETIC
INFORMATION.— 
Section 2702(b) of the Public Health Service 
Act (42 U.S.C. 300gg–1(b)) is amended— 
(i) in paragraph (2)(A), by inserting 
before the semicolon the following: ‘‘, ex-
cept as provided in paragraph (3)’’; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(3) NO DISCRIMINATION IN GROUP PREMIUMS 
BASED ON GENETIC INFORMATION.—For purposes 
of this section, a group health plan, or a health in-
surance issuer offering group health insurance cov-
erage in connection with a group health plan, shall 
not adjust premium or contribution amounts for a 
group on the basis of genetic information concerning 
an individual in the group or a family member of the 
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individual (including information about a request for 
or receipt of genetic services by an individual or 
family member of such individual).’’. 
(2) LIMITATIONS ON GENETIC TESTING.—Sec-
tion 2702 of the Public Health Service Act (42 
U.S.C. 300gg–1) is amended by adding at the end 
the following: 
‘‘(c) GENETIC TESTING.— 
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan, or a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this part shall be construed to— 
‘‘(A) limit the authority of a health care 
professional who is providing health care serv-
ices with respect to an individual to request 
that such individual or a family member of such 
individual undergo a genetic test; 
‘‘(B) limit the authority of a health care 
professional who is employed by or affiliated 
with a group health plan or a health insurance 
issuer and who is providing health care services 
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to an individual as part of a bona fide wellness 
program to notify such individual of the avail-
ability of a genetic test or to provide informa-
tion to such individual regarding such genetic 
test; or 
‘‘(C) authorize or permit a health care pro-
fessional to require that an individual undergo 
a genetic test. 
‘‘(d) APPLICATION TO ALL PLANS.—The provisions 
of subsections (a)(1)(F), (b)(3), and (c) shall apply to 
group health plans and health insurance issuers without 
regard to section 2721(a).’’. 
(3) REMEDIES
AND
ENFORCEMENT.—Section 
2722(b) of the Public Health Service Act (42 U.S.C. 
300gg–22(b)) is amended by adding at the end the 
following: 
‘‘(3) ENFORCEMENT AUTHORITY RELATING TO 
GENETIC DISCRIMINATION.— 
‘‘(A) GENERAL RULE.—In the cases de-
scribed in paragraph (1), notwithstanding the 
provisions of paragraph (2)(C), the following 
provisions shall apply with respect to an action 
under this subsection by the Secretary with re-
spect to any failure of a health insurance issuer 
in connection with a group health plan, to meet 
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the 
requirements 
of 
subsection 
(a)(1)(F), 
(b)(3), or (c) of section 2702. 
‘‘(B) AMOUNT.— 
‘‘(i) IN
GENERAL.—The amount of 
the penalty imposed under this paragraph 
shall be $100 for each day in the non-
compliance period with respect to each in-
dividual to whom such failure relates. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For 
purposes of this paragraph, the term ‘non-
compliance period’ means, with respect to 
any failure, the period— 
‘‘(I) beginning on the date such 
failure first occurs; and 
‘‘(II) ending on the date such 
failure is corrected. 
‘‘(C) MINIMUM PENALTIES WHERE FAIL-
URE DISCOVERED.—Notwithstanding clauses (i) 
and (ii) of subparagraph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or 
more failures with respect to an indi-
vidual— 
‘‘(I) which are not corrected be-
fore the date on which the plan re-
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ceives a notice from the Secretary of 
such violation; and 
‘‘(II) which occurred or continued 
during the period involved; 
the amount of penalty imposed by subpara-
graph (A) by reason of such failures with 
respect to such individual shall not be less 
than $2,500. 
‘‘(ii) 
HIGHER
MINIMUM
PENALTY 
WHERE VIOLATIONS ARE MORE THAN DE 
MINIMIS.—To the extent violations for 
which any person is liable under this para-
graph for any year are more than de mini-
mis, clause (i) shall be applied by sub-
stituting ‘$15,000’ for ‘$2,500’ with re-
spect to such person. 
‘‘(D) LIMITATIONS.— 
‘‘(i) PENALTY NOT TO APPLY WHERE 
FAILURE
NOT
DISCOVERED
EXERCISING 
REASONABLE
DILIGENCE.—No 
penalty 
shall be imposed by subparagraph (A) on 
any failure during any period for which it 
is established to the satisfaction of the 
Secretary that the person otherwise liable 
for such penalty did not know, and exer-
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cising reasonable diligence would not have 
known, that such failure existed. 
‘‘(ii) PENALTY
NOT
TO
APPLY
TO 
FAILURES
CORRECTED
WITHIN
CERTAIN 
PERIODS.—No penalty shall be imposed by 
subparagraph (A) on any failure if— 
‘‘(I) such failure was due to rea-
sonable cause and not to willful ne-
glect; and 
‘‘(II) such failure is corrected 
during the 30-day period beginning on 
the first date the person otherwise lia-
ble for such penalty knew, or exer-
cising reasonable diligence would have 
known, that such failure existed. 
‘‘(iii) OVERALL LIMITATION FOR UN-
INTENTIONAL FAILURES.—In the case of 
failures which are due to reasonable cause 
and not to willful neglect, the penalty im-
posed by subparagraph (A) for failures 
shall not exceed the amount equal to the 
lesser of— 
‘‘(I) 10 percent of the aggregate 
amount paid or incurred by the em-
ployer (or predecessor employer) dur-
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ing the preceding taxable year for 
group health plans; or 
‘‘(II) $500,000. 
‘‘(E) WAIVER BY SECRETARY.—In the case 
of a failure which is due to reasonable cause 
and not to willful neglect, the Secretary may 
waive part or all of the penalty imposed by sub-
paragraph (A) to the extent that the payment 
of such penalty would be excessive relative to 
the failure involved.’’. 
(4) DEFINITIONS.—Section 2791(d) of the Pub-
lic Health Service Act (42 U.S.C. 300gg–91(d)) is 
amended by adding at the end the following: 
‘‘(15) FAMILY
MEMBER.—The term ‘family 
member’ means with respect to an individual— 
‘‘(A) the spouse of the individual; 
‘‘(B) a dependent child of the individual, 
including a child who is born to or placed for 
adoption with the individual; and 
‘‘(C) all other individuals related by blood 
to the individual or the spouse or child de-
scribed in subparagraph (A) or (B). 
‘‘(16) GENETIC INFORMATION.— 
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‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘genetic informa-
tion’ means information about— 
‘‘(i) an individual’s genetic tests; 
‘‘(ii) the genetic tests of family mem-
bers of the individual; or 
‘‘(iii) the occurrence of a disease or 
disorder in family members of the indi-
vidual. 
‘‘(B) EXCLUSIONS.—The term ‘genetic in-
formation’ shall not include information about 
the sex or age of an individual. 
‘‘(17) GENETIC TEST.— 
‘‘(A) IN
GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, RNA, 
chromosomes, proteins, or metabolites, that de-
tects genotypes, mutations, or chromosomal 
changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic 
test’ does not mean— 
‘‘(i) an analysis of proteins or metabo-
lites that does not detect genotypes, 
mutations, or chromosomal changes; or 
‘‘(ii) an analysis of proteins or me-
tabolites that is directly related to a mani-
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fested disease, disorder, or pathological 
condition that could reasonably be detected 
by a health care professional with appro-
priate training and expertise in the field of 
medicine involved. 
‘‘(18) GENETIC SERVICES.—The term ‘genetic 
services’ means— 
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (such as obtaining, 
interpreting, or assessing genetic information); 
or 
‘‘(C) genetic education.’’. 
(b) AMENDMENT RELATING
TO
THE INDIVIDUAL 
MARKET.— 
(1) IN GENERAL.—The first subpart 3 of part 
B of title XXVII of the Public Health Service Act 
(42 U.S.C. 300gg–51 et seq.) (relating to other re-
quirements) is amended— 
(A) by redesignating such subpart as sub-
part 2; and 
(B) by adding at the end the following: 
‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON 
THE BASIS OF GENETIC INFORMATION. 
‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A 
CONDITION OF ELIGIBILITY.—A health insurance issuer 
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