(d) ENFORCEMENT.—
(1) INSURERS.—
(A) ENFORCEMENT BY STATE INSURANCE
COMMISSIONER.—
(i) IN
GENERAL.—The requirements
established under subsections (a), (b), and
(c) insofar as they apply to insurers shall
be enforced by the State insurance com-
missioner for the State involved or the offi-
cial or officials designated by the State.
(ii) 
ENFORCEMENT
PLAN.—Each
State shall require that an insurer offering
or renewing health insurance coverage in
such State meet such requirements pursu-
ant to an enforcement plan filed by the
State with the Secretary.
(B) ENFORCEMENT
BY
SECRETARY.—In
the case of the failure of a State to file such a
plan or substantially enforce the plan, the Sec-
retary shall implement an enforcement plan in
such State. Under the Secretary’s enforcement
plan, each insurer operating in such State that
violates a requirement of subsection (a), (b), or
(c) shall be subject to civil enforcement under
sections 502, 504, 506, and 510 of the Em-
ployee Retirement Income Security Act of 1974.
For purposes of applying the previous sentence,
any reference in the sections referred to in such
sentence to the Secretary of Labor is deemed a
reference to the Secretary of Health and
Human Services.
(2) GROUP HEALTH PLANS.—With respect to
group health plans, the Secretary of Labor shall en-
force the requirements established under subsections
(a), (b), and (c) in the same manner as provided for
under sections 502, 504, 506, and 510 of the Em-
ployee Retirement Income Security Act of 1974.
(2) PRIVATE RIGHT OF ACTION.—A person may
bring a civil action—
(A) to enjoin any act or practice which vio-
lates subsection (a) or (b),
(B) to obtain other appropriate equitable
relief (i) to redress such violations, or (ii) to en-
force any such subsections, or
(C) to obtain other legal relief, including
monetary damages.
(3) JURISDICTION.—State courts of competent
jurisdiction and district courts of the United States
have concurrent jurisdiction of actions under this
subsection. The district courts of the United States
shall have jurisdiction, without respect to the
amount in controversy or the citizenship of the par-
ties, to grant the relief provided for in paragraph (2)
in any action.
(4) VENUE.—For purposes of this subsection
the venue provisions of section 1391 of title 28,
United States Code, shall apply.
(5) REGULATIONS.—The Secretary and the
Secretary of Labor (in consultation with the Sec-
retary in relation to the application of this section
with respect to group health plans) may promulgate
such regulations as may be necessary or appropriate
to carry out this section.
(e) APPLICABILITY.—
(1) PREEMPTION OF STATE LAW.—A State may
establish or enforce requirements for insurers or
health insurance coverage with respect to the subject
matter of this section, but only if such requirements
are not less restrictive than the requirements estab-
lished under subsections (a), (b), and (c).
(2) RULE OF CONSTRUCTION.—Nothing in this
section shall be construed to affect or modify the
provisions of section 514 of the Employee Retire-
ment Income Security Act of 1974.
(3) CONTINUATION.—Nothing in this section
shall be construed as requiring a group health plan
to provide benefits to a particular participant or
beneficiary.
(f) DEFINITIONS.—For purposes of this Act:
(1) GENETIC
INFORMATION.—The term ‘‘ge-
netic information’’ means the information about
genes, gene products, or inherited characteristics
that may derive from an individual or a blood-rel-
ative of the individual.
(2) GENETIC TEST.—The term ‘‘genetic test’’
means a test for determining the presence or ab-
sence of genetic characteristics in an individual.
(3) GROUP HEALTH PLAN.—The term ‘‘group
health plan means any employee welfare benefit
plan, governmental plan, or church plan (as defined
under paragraphs (1), (32), and (33) of section 3 of
the Employee Retirement Income Security Act of
1974) that provides or pays for medical benefits
whether directly, through insurance, or otherwise.
(4) HEALTH INSURANCE COVERAGE.—The term
‘‘health insurance coverage’’ means a contractual ar-
rangement for the provision of, or payment for,
health care, including any arrangement consisting of
a hospital or medical expense incurred policy or cer-
tificate, hospital or medical service plan contract, or
health maintenance organization subscriber contract
and including such an arrangement in connection
with a group health plan.
(5) INSURER.—The term ‘‘insurer’’ means an
insurance company, insurance service, or insurance
organization (including a health maintenance organi-
zation) which is licensed to engage in the business
of insurance in a State and which is subject to State
law which regulates insurance (within the meaning
of section 514(b)(2)) and which provides health in-
surance coverage. Such term does not include a
group health plan.
(6) PARTICIPANT; BENEFICIARY.—The terms
‘‘participant’’ and ‘‘beneficiary’’ have the meanings
given such terms in paragraphs (7) and (8), respec-
tively, of section 3 of the Employee Retirement In-
come Security Act of 1974.
(7) SECRETARY.—Except as specifically pro-
vided, the term ‘‘Secretary’’ means the Secretary of
Health and Human Services.
(8) STATE.—The term ‘‘State’’ includes the
District of Columbia, Puerto Rico, the Northern
Mariana Islands, the Virgin Islands, American
Samoa, and Guam.