133 
such employee or of an employer of such em-
ployee’s spouse, 
‘‘(B) any employee who normally works 
less than 25 hours per week, 
‘‘(C) any employee who normally works 
during not more than 6 months during any 
year, 
‘‘(D) any employee who has not attained 
age 21, and 
‘‘(E) except to the extent provided in regu-
lations, any employee who is included in a unit 
of employees covered by an agreement which 
the Secretary of Labor finds to be a collective 
bargaining agreement between employee rep-
resentatives and the employer. 
‘‘(3) CONTROLLED GROUPS.—Rules similar to 
the rules of subclauses (II) and (III) of paragraph 
(4)(D)(iii) shall apply for purposes of paragraph 
(1)(A). 
‘‘(4) EMPLOYER
HEALTH
PLAN
CONTRIBU-
TION.—For purposes of this section— 
‘‘(A) IN
GENERAL.—The term ‘employer 
health plan contribution’ means the applicable 
premium for the employee reduced by the em-
ployee’s share of such premium.
134 
‘‘(B) APPLICABLE
PREMIUM.—Except as 
provided in subparagraph (D), the term ‘appli-
cable premium’ means an amount which is not 
less than 98 percent of— 
‘‘(i) the applicable premium (as de-
fined in section 4980B(f)(4)) for the em-
ployee, or 
‘‘(ii) if an election under subpara-
graph (D) is in effect with respect to an 
employee, the applicable premium deter-
mined under subparagraph (D). 
‘‘(C) EMPLOYEE’S SHARE.—The term ‘em-
ployee’s share’ means, with respect to the appli-
cable premium for any employee, the amount of 
the cost to the plan which is paid by the simi-
larly situated beneficiaries who are taken into 
account in determining such premium for such 
employee. 
‘‘(D) AUTHORITY TO USE AGE, SEX, AND 
GEOGRAPHY
IN
DETERMINING
CONTRIBU-
TION.— 
‘‘(i) IN GENERAL.—An employer may 
elect to determine the applicable premium 
for an employee on an actuarial basis tak-
ing into account age, sex, and geography of
135 
the employee and similarly situated bene-
ficiaries. 
‘‘(ii) DETERMINATION
OF
EMPLOY-
EE’S SHARE.—In the case of an employer 
who determines the applicable premium 
under clause (i), the employee’s share of 
such premium shall be the same percent-
age of such premium as the employee’s 
share of the applicable premium deter-
mined without regard to clause (i). 
‘‘(iii) CONSISTENCY REQUIRED.— 
‘‘(I) IN
GENERAL.—Except as 
provided in subclause (III), an em-
ployer may determine the applicable 
premium under this subparagraph for 
any employee only if such employer, 
and all other employers which are 
members of any controlled group 
which includes such employer, elect to 
determine the applicable premium 
under this subparagraph for all their 
employees. 
‘‘(II) CONTROLLED GROUP.—All 
persons treated as a single employer 
under subsection (a) or (b) of section
136 
52 or subsection (m) or (o) of section 
414 shall be treated as members of a 
controlled group for purposes of sub-
clause (I). 
‘‘(III) TREATMENT OF SEPARATE 
LINES OF BUSINESS.—If an employer 
is treated under section 414(r) as op-
erating separate lines of business dur-
ing any taxable year, subclause (I) 
shall not apply to employees employed 
in such separate lines of business. 
‘‘(f) SPECIAL
RULE
FOR
ARCHER
MSAS
AND 
HEALTH SAVINGS ACCOUNT CONTRIBUTIONS.—Sections 
220(b)(5) and 223(b)(4) shall not apply to an employer 
contribution which is excludable from gross income under 
subsection (a). 
‘‘(g) EXCLUSION APPLICABLE IN DETERMINING EM-
PLOYMENT TAX LIABILITY.—The exclusion under this 
section shall be treated for purposes of subtitle C in the 
same manner as the exclusion under section 106.’’ 
(b) EMPLOYER HEALTH PLAN CONTRIBUTION TO BE 
REPORTED ON W–2.—Subsection (a) of section 6051 of 
such Code (relating to receipts to employees) is amended 
by striking ‘‘and’’ at the end of paragraph (12), by strik-
ing the period at the end of paragraph (13) and inserting
137 
a comma, and by inserting after paragraph (13) the fol-
lowing new paragraphs: 
‘‘(14) the amount of the employer health plan 
contribution (as defined in section 139(c)(3)), and 
‘‘(15) the amount of compensating coverage 
payment (as defined in section 139(c)(1)).’’ 
(c) CLERICAL AMENDMENT.—The table of sections 
for such part III is amended by inserting after the item 
relating to section 139A the following new item: 
‘‘Sec. 139B. Treatment of compensating payments made for employees who elect 
not to participate in employer-subsidized health plans.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2005. 
TITLE VI—PATIENT ACCESS TO 
INFORMATION 
SEC. 601. PATIENT ACCESS TO INFORMATION REGARDING 
PLAN COVERAGE, MANAGED CARE PROCE-
DURES, 
HEALTH 
CARE 
PROVIDERS, 
AND 
QUALITY OF MEDICAL CARE. 
(a) IN GENERAL.—Subpart 2 of part A of title 
XXVII of the Public Health Service Act is amended by 
adding at the end the following new section:
138 
‘‘SEC. 2707. PATIENT ACCESS TO INFORMATION REGARD-
ING PLAN COVERAGE, MANAGED CARE PRO-
CEDURES, HEALTH CARE PROVIDERS, AND 
QUALITY OF MEDICAL CARE. 
‘‘(a) DISCLOSURE REQUIREMENT.—Each health in-
surance issuer offering health insurance coverage in con-
nection with a group health plan shall provide the adminis-
trator of such plan on a timely basis with the information 
necessary to enable the administrator to include in the 
summary plan description of the plan required under sec-
tion 102 of the Employee Retirement Income Security Act 
of 1974 (or each summary plan description in any case 
in which different summary plan descriptions are appro-
priate under part 1 of subtitle B of title I of such Act 
for different options of coverage) the information required 
under subsections (b), (c), (d), and (e)(2)(A). To the ex-
tent that any such issuer provides such information on a 
timely basis to plan participants and beneficiaries, the re-
quirements of this subsection shall be deemed satisfied in 
the case of such plan with respect to such information. 
‘‘(b) PLAN BENEFITS.—The information required 
under subsection (a) includes the following: 
‘‘(1) COVERED ITEMS AND SERVICES.— 
‘‘(A) CATEGORIZATION OF INCLUDED BEN-
EFITS.—A description of covered benefits, cat-
egorized by—
139 
‘‘(i) types of items and services (in-
cluding any special disease management 
program); and 
‘‘(ii) types of health care professionals 
providing such items and services. 
‘‘(B) EMERGENCY MEDICAL CARE.—A de-
scription of the extent to which the coverage in-
cludes emergency medical care (including the 
extent to which the coverage provides for access 
to urgent care centers), and any definitions pro-
vided under in connection with such coverage 
for the relevant coverage terminology referring 
to such care. 
‘‘(C) PREVENTATIVE
SERVICES.—A de-
scription of the extent to which the coverage in-
cludes benefits for preventative services. 
‘‘(D) DRUG FORMULARIES.—A description 
of the extent to which covered benefits are de-
termined by the use or application of a drug 
formulary and a summary of the process for de-
termining what is included in such formulary. 
‘‘(E) 
COBRA 
CONTINUATION
COV-
ERAGE.—A description of the benefits available 
under the coverage provided pursuant to part 6