434 
first month beginning after the date of the 
enactment of this Act, and 
(ii) shall not extend beyond the period 
of COBRA continuation coverage that 
would have been required under the appli-
cable COBRA continuation coverage provi-
sion if the coverage had been elected as re-
quired under such provision. 
(5) EXPEDITED REVIEW OF DENIALS OF PRE-
MIUM ASSISTANCE.—In any case in which an indi-
vidual requests treatment as an assistance eligible 
individual described in paragraph (3) and is denied 
such treatment by the group health plan, the Sec-
retary of Labor (or the Secretary of Health and 
Human Services in connection with COBRA con-
tinuation coverage which is provided other than pur-
suant to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974), in 
consultation with the Secretary of the Treasury, 
shall provide for expedited review of such denial. An 
individual shall be entitled to such review upon ap-
plication to such Secretary in such form and manner 
as shall be provided by such Secretary, in consulta-
tion with the Secretary of the Treasury. Such Sec-
retary shall make a determination regarding such in-
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435 
dividual’s eligibility within 15 business days after re-
ceipt of such individual’s application for review 
under this paragraph. Such Secretary’s determina-
tion upon review of the denial shall be de novo and 
shall be the final determination of such Secretary. A 
reviewing court shall grant deference to such Sec-
retary’s determination. The provisions of this para-
graph, paragraphs (1) through (4), and paragraphs 
(6) through (7) shall be treated as provisions of title 
I of the Employee Retirement Income Security Act 
of 1974 for purposes of part 5 of subtitle B of such 
title. 
(6) NOTICES TO INDIVIDUALS.— 
(A) GENERAL NOTICE.— 
(i) IN GENERAL.—In the case of no-
tices provided under section 606(a)(4) of 
the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1166(4)), section 
4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the 
Public Health Service Act (42 U.S.C. 
300bb–6(4)), with respect to individuals 
who, during the period described in para-
graph (3), become entitled to elect COBRA 
continuation coverage, the requirements of 
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436 
such provisions shall not be treated as met 
unless such notices include an additional 
written notification to the recipient in clear 
and understandable language of— 
(I) the availability of premium 
assistance with respect to such cov-
erage under this subsection; and 
(II) the option to enroll in dif-
ferent coverage if the employer per-
mits assistance eligible individuals de-
scribed in paragraph (3) to elect en-
rollment in different coverage (as de-
scribed in paragraph (1)(B)). 
(ii) ALTERNATIVE
NOTICE.—In the 
case of COBRA continuation coverage to 
which the notice provision under such sec-
tions does not apply, the Secretary of 
Labor, in consultation with the Secretary 
of the Treasury and the Secretary of 
Health and Human Services, shall, in con-
sultation with administrators of the group 
health plans (or other entities) that provide 
or administer the COBRA continuation 
coverage involved, provide rules requiring 
the provision of such notice. 
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437 
(iii) FORM.—The requirement of the 
additional notification under this subpara-
graph may be met by amendment of exist-
ing notice forms or by inclusion of a sepa-
rate document with the notice otherwise 
required. 
(B) SPECIFIC REQUIREMENTS.—Each ad-
ditional notification under subparagraph (A) 
shall include— 
(i) the forms necessary for estab-
lishing eligibility for premium assistance 
under this subsection; 
(ii) the name, address, and telephone 
number necessary to contact the plan ad-
ministrator and any other person main-
taining relevant information in connection 
with such premium assistance; 
(iii) a description of the extended elec-
tion period provided for in paragraph 
(4)(A); 
(iv) a description of the obligation of 
the qualified beneficiary under paragraph 
(2)(B) and the penalty provided under sec-
tion 6720C of the Internal Revenue Code 
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438 
of 1986 for failure to carry out the obliga-
tion; 
(v) a description, displayed in a 
prominent manner, of the qualified bene-
ficiary’s right to a reduced premium and 
any conditions on entitlement to the re-
duced premium; and 
(vi) a description of the option of the 
qualified beneficiary to enroll in different 
coverage if the employer permits such ben-
eficiary to elect to enroll in such different 
coverage under paragraph (1)(B). 
(C) NOTICE
IN
CONNECTION
WITH
EX-
TENDED ELECTION PERIODS.—In the case of 
any assistance eligible individual described in 
paragraph (3) (or any individual described in 
paragraph (4)(A)) who became entitled to elect 
COBRA continuation coverage before the first 
day of the first month beginning after the date 
of the enactment of this Act, the administrator 
of the applicable group health plan (or other 
entity) shall provide (within 60 days after such 
first day of such first month) for the additional 
notification required to be provided under sub-
paragraph (A) and failure to provide such no-
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pamtmann on DSKBC07HB2PROD with BILLS
439 
tice shall be treated as a failure to meet the no-
tice requirements under the applicable COBRA 
continuation provision. 
(D) MODEL NOTICES.—Not later than 30 
days after the date of enactment of this Act, 
with respect to any assistance eligible individual 
described in paragraph (3), the Secretary of 
Labor, in consultation with the Secretary of the 
Treasury and the Secretary of Health and 
Human Services, shall prescribe models for the 
additional notification required under this para-
graph. 
(7) NOTICE
OF
EXPIRATION
OF
PERIOD
OF 
PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—With respect to any as-
sistance eligible individual, subject to subpara-
graph 
(B), 
the 
requirements 
of 
section 
606(a)(4) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1166(4)), sec-
tion 4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the Public 
Health Service Act (42 U.S.C. 300bb–6(4)), 
shall not be treated as met unless the plan ad-
ministrator of the individual, during the period 
specified under subparagraph (C), provides to 
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440 
such individual a written notice in clear and un-
derstandable language— 
(i) that the premium assistance for 
such individual will expire soon and the 
prominent identification of the date of 
such expiration; and 
(ii) that such individual may be eligi-
ble for coverage without any premium as-
sistance through— 
(I) COBRA continuation cov-
erage; or 
(II) coverage under a group 
health plan. 
(B) EXCEPTION.—The requirement for the 
group health plan administrator to provide the 
written notice under subparagraph (A) shall be 
waived if the premium assistance for such indi-
vidual expires pursuant to clause (i) of para-
graph (2)(A). 
(C) PERIOD SPECIFIED.—For purposes of 
subparagraph (A), the period specified in this 
subparagraph is, with respect to the date of ex-
piration of premium assistance for any assist-
ance eligible individual pursuant to a limitation 
requiring a notice under this paragraph, the pe-
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441 
riod beginning on the day that is 45 days before 
the date of such expiration and ending on the 
day that is 15 days before the date of such ex-
piration. 
(D) MODEL NOTICES.—Not later than 45 
days after the date of enactment of this Act, 
with respect to any assistance eligible indi-
vidual, the Secretary of Labor, in consultation 
with the Secretary of the Treasury and the Sec-
retary of Health and Human Services, shall 
prescribe models for the notification required 
under this paragraph. 
(8) REGULATIONS.—The Secretary of the 
Treasury and the Secretary of Labor may jointly 
prescribe such regulations or other guidance as may 
be necessary or appropriate to carry out the provi-
sions of this subsection, including the prevention of 
fraud and abuse under this subsection, except that 
the Secretary of Labor and the Secretary of Health 
and Human Services may prescribe such regulations 
(including interim final regulations) or other guid-
ance as may be necessary or appropriate to carry 
out the provisions of paragraphs (5), (6), (7), and 
(9). 
(9) OUTREACH.— 
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442 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Labor, in consultation with the Secretary of the 
Treasury and the Secretary of Health and 
Human Services, shall provide outreach con-
sisting of public education and enrollment as-
sistance relating to premium assistance pro-
vided under this subsection. Such outreach shall 
target employers, group health plan administra-
tors, public assistance programs, States, insur-
ers, and other entities as determined appro-
priate by such Secretaries. Such outreach shall 
include an initial focus on those individuals 
electing continuation coverage who are referred 
to in paragraph (6)(C). Information on such 
premium assistance, including enrollment, shall 
also be made available on websites of the De-
partments of Labor, Treasury, and Health and 
Human Services. 
(B) ENROLLMENT
UNDER
MEDICARE.— 
The Secretary of Health and Human Services 
shall provide outreach consisting of public edu-
cation. Such outreach shall target individuals 
who lose health insurance coverage. Such out-
reach shall include information regarding en-
rollment for benefits under title XVIII of the 
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pamtmann on DSKBC07HB2PROD with BILLS
443 
Social Security Act (42 U.S.C. 1395 et seq.) for 
purposes of preventing mistaken delays of such 
enrollment by such individuals, including life-
time penalties for failure of timely enrollment. 
(10) DEFINITIONS.—For purposes of this sec-
tion: 
(A) ADMINISTRATOR.—The term ‘‘admin-
istrator’’ has the meaning given such term in 
section 3(16)(A) of the Employee Retirement 
Income Security Act of 1974. 
(B) COBRA
CONTINUATION
COVERAGE.— 
The term ‘‘COBRA continuation coverage’’ 
means continuation coverage provided pursuant 
to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 
(other than under section 609), title XXII of 
the Public Health Service Act, or section 
4980B of the Internal Revenue Code of 1986 
(other than subsection (f)(1) of such section in-
sofar as it relates to pediatric vaccines), or 
under a State program that provides com-
parable continuation coverage. Such term does 
not include coverage under a health flexible 
spending arrangement under a cafeteria plan 
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444 
within the meaning of section 125 of the Inter-
nal Revenue Code of 1986. 
(C) COBRA
CONTINUATION
PROVISION.— 
The term ‘‘COBRA continuation provision’’ 
means the provisions of law described in sub-
paragraph (B). 
(D) 
COVERED
EMPLOYEE.—The 
term 
‘‘covered employee’’ has the meaning given such 
term in section 607(2) of the Employee Retire-
ment Income Security Act of 1974. 
(E) QUALIFIED BENEFICIARY.—The term 
‘‘qualified beneficiary’’ has the meaning given 
such term in section 607(3) of the Employee 
Retirement Income Security Act of 1974. 
(F) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given 
such term in section 607(1) of the Employee 
Retirement Income Security Act of 1974. 
(G) STATE.—The term ‘‘State’’ includes 
the District of Columbia, the Commonwealth of 
Puerto Rico, the Virgin Islands, Guam, Amer-
ican Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(H) PERIOD
OF
COVERAGE.—Any ref-
erence in this subsection to a period of coverage 
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445 
shall be treated as a reference to a monthly or 
shorter period of coverage with respect to which 
premiums are charged with respect to such cov-
erage. 
(I) PLAN
SPONSOR.—The term ‘‘plan 
sponsor’’ has the meaning given such term in 
section 3(16)(B) of the Employee Retirement 
Income Security Act of 1974. 
(J) PREMIUM.—The term ‘‘premium’’ in-
cludes, with respect to COBRA continuation 
coverage, any administrative fee. 
(11) IMPLEMENTATION FUNDING.—In addition 
to amounts otherwise made available, out of any 
funds in the Treasury not otherwise appropriated, 
there are appropriated to the Secretary of Labor for 
fiscal year 2021, $10,000,000, to remain available 
until expended, for the Employee Benefits Security 
Administration to carry out the provisions of this 
subtitle. 
(b) COBRA PREMIUM ASSISTANCE.— 
(1) ALLOWANCE OF CREDIT.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 65 of the Internal Revenue Code of 1986 is 
amended by adding at the end the following 
new section: 
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