cates, and others as deemed necessary by 
the Secretary; and 
‘‘(ii) based upon recognized clinical 
practice guidelines. 
‘‘(5) MANNER OF DISCLOSURE.— 
‘‘(A) IN GENERAL.—The standards under 
paragraph (1)(B) shall provide for health insur-
ance issuers to disclose the information under 
this subsection— 
‘‘(i) with all marketing materials; 
‘‘(ii) on the web site of the issuer; and 
‘‘(iii) at other times upon request. 
‘‘(B) CONTRACT LANGUAGE.—Such stand-
ards also shall require the disclosure of full pol-
icy contract language in printed form upon re-
quest. 
‘‘(c) APPLICATION OF ENFORCEMENT PROVISIONS.— 
The provisions of sections 2722 and 2671 shall apply to 
enforcement of the requirements of this section in the 
same manner as such provisions apply to the provisions 
of part A or part B, respectively. Under such provisions 
the States shall have initial (and primary) enforcement au-
thority with respect to such requirements, except that the 
Secretary under section 2793 may directly monitor compli-
ance with such provisions as well.’’. 
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(b) CONFORMING AMENDMENTS REGARDING DIS-
CLOSURE OF INFORMATION.— 
(1) REFERENCE IN THE GROUP MARKET.—Sec-
tion 2713 of the Public Health Service Act (42 
U.S.C. 300gg–13)) is amended by adding at the end 
the following new subsection: 
‘‘(c) REFERENCE
TO DISCLOSURE
OF INFORMA-
TION.—For provision requiring disclosure of information 
by health insurance issuers, see section 2794(d).’’. 
(2) REFERENCE
IN
THE
INDIVIDUAL
MAR-
KET.—Section 2761 of the Public Health Service 
Act is amended by adding at the end the following 
new subsection: 
‘‘(c) REFERENCE
TO DISCLOSURE
OF INFORMA-
TION.—For provision requiring disclosure of information 
by health insurance issuers, see section 2794(d).’’. 
SEC. 6. OFFICE OF HEALTH INSURANCE OVERSIGHT. 
(a) IN GENERAL.—Title XXVII of the Public Health 
Service Act, as amended by sections 3 and 4, is amended 
by adding at the end of part C the following new section: 
‘‘SEC. 2795. OFFICE OF HEALTH INSURANCE OVERSIGHT. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services an Office 
of Health Insurance Oversight (referred to in this section 
as the ‘Office’). The Office shall be headed by a Director 
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of Health Insurance Oversight (referred to in this section 
as the ‘Director’) who shall be appointed by and report 
directly to the Secretary. 
‘‘(b) DUTIES.— 
‘‘(1) PROMOTION
OF
ACCOUNTABILITY
IN 
HEALTH INSURANCE.— 
‘‘(A) IN GENERAL.—The Director shall im-
plement accountability initiatives under section 
2793. 
‘‘(B) 
CLEARINGHOUSE.—The 
Director 
shall provide, in consultation with the National 
Association of Insurance Commissioners, for a 
clearinghouse for State health insurance regu-
lators to share information concerning, and help 
them to enact and enforce, Federal health in-
surance requirements. 
‘‘(2) PROMOTE TRANSPARENCY IN HEALTH IN-
SURANCE.—The Director shall implement trans-
parency initiatives under section 2794. 
‘‘(3) CONSUMER INFORMATION, ASSISTANCE.— 
‘‘(A) IN
GENERAL.—The Director shall 
provide for consumer information assistance on 
health insurance coverage, and Federal health 
insurance consumer protections under this title, 
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including through carrying out activities under 
this paragraph. 
‘‘(B) INFORMATION RESOURCES.—The Di-
rector shall develop health insurance informa-
tion resources for consumers, including cov-
erage facts labels for patient claims scenarios 
developed under section 2794(b)(4) and web- 
based information on average price ranges for 
out-of-network services based on geography. 
‘‘(C) SERVICE.—The Director shall estab-
lish a consumer assistance service that, directly 
or in coordination with State health insurance 
regulators and consumer assistance organiza-
tions, receives and responds to inquiries and 
complaints concerning health insurance cov-
erage with respect to Federal health insurance 
requirements and under State law. 
‘‘(4) HEALTH INSURANCE CONSUMER ASSIST-
ANCE GRANTS.— 
‘‘(A) IN
GENERAL.—The Director shall 
provide for grants to public, private or not-for- 
profit consumer assistance organizations to de-
velop, support, and evaluate consumer assist-
ance programs related to selecting and navi-
gating health care coverage. Such a grant shall 
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only be made pursuant to an application made 
to the Director. In making such grants, the Di-
rector shall attempt to ensure regional and geo-
graphic equity. 
‘‘(B) GRANT REQUIREMENT.—As a condi-
tion of receiving such a grant, an organization 
shall be required to collect and report data to 
the Director on the types of problems and in-
quiries encountered by consumers they serve. 
Data shall be used by the Director to inform 
enforcement activities and be shared with State 
insurance regulators, the Department of Labor, 
and the Secretary of the Treasury. 
‘‘(C) APPROPRIATIONS
AND
AUTHORIZA-
TIONS.—There is hereby appropriated, out of 
any funds in the Treasury not otherwise appro-
priated for the first fiscal year in which this 
section is in effect, $30,000,000 for grants 
under this paragraph, to be available until ex-
pended. For each subsequent fiscal year there 
are authorized to be appropriated such sums as 
may be necessary for such grants. 
‘‘(5) ADMINISTRATION OF HIGH RISK POOL.— 
The Director shall administer the high risk pool pro-
gram under section 2745. 
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‘‘(6) ADMINISTRATION OF GRANTS TO STATE 
INSURANCE DEPARTMENTS.—The Director shall ad-
minister the program of grants to State insurance 
departments under section 2793(d). 
‘‘(c) PERIODIC REPORTS.—The Director shall submit 
periodic reports to Congress on the Office’s activities. 
‘‘(d) COORDINATION.— 
‘‘(1) FEDERAL OFFICIALS.—The Director shall 
coordinate, with the Secretaries of Labor and Treas-
ury, activities under this section with respect to re-
quirements that affect health insurance coverage of-
fered in connection with group health plans, includ-
ing coordination in — 
‘‘(A) development and dissemination of in-
formation; and 
‘‘(B) consumer inquiries and complaints 
relating to Federal health insurance require-
ments. 
‘‘(2) 
STATE
HEALTH
INSURANCE
REGU-
LATORS.—In carrying out the Office’s activities, the 
Director shall— 
‘‘(A) coordinate with State health insur-
ance regulators regarding data collection and 
disclosure and audit and enforcement activities 
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in order to avoid duplication and to use regu-
latory resources most efficiently; 
‘‘(B) monitor State efforts to implement 
and enforce consumer protections consistent 
with Federal health insurance requirements; 
‘‘(C) provide technical assistance to States 
seeking to implement and enforce consumer 
protections consistent with such requirements; 
and 
‘‘(D) provide for regular communication 
with such regulators to coordinate enforcement 
efforts and sharing of information 
‘‘(e) TRANSFER OF PERSONNEL AND RESOURCES.— 
The Secretary shall provide for the transfer to the Office 
of those personnel and resources within the Department 
of Health and Human Services that, as of the date of the 
enactment of this section, relate directly to the responsibil-
ities of the Director under this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—In addi-
tion to amounts made available under subsection 
(b)(4)(C), there are authorized to be appropriated to carry 
out this section $20,000,000 for the first fiscal year begin-
ning after the date of the enactment of this section and 
such sums as may be necessary for subsequent fiscal 
years.’’. 
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(b) CONFORMING AMENDMENTS REGARDING ADDI-
TIONAL AUTHORITY.— 
(1) GROUP MARKET.—Section 2722 of such Act 
(42 U.S.C. 300gg–22) is amended by adding at the 
end the following new subsection: 
‘‘(c) REFERENCE TO ADDITIONAL AUTHORITY.—For 
additional Secretarial authorities with respect to require-
ments under this part, see sections 2793 and 2794.’’. 
(2) INDIVIDUAL
MARKET.—Section 2761 of 
such Act (42 U.S.C. 300gg–61) is amended by add-
ing at the end the following new subsection: 
‘‘(c) REFERENCE TO ADDITIONAL AUTHORITY.—For 
additional Secretarial authorities with respect to require-
ments under this part, see sections 2793 and 2794.’’. 
SEC. 7. STANDARDS AND ACCOUNTABILITY AND TRANS-
PARENCY INITIATIVES FOR GROUP HEALTH 
PLANS THROUGH DEPARTMENTS OF LABOR 
AND THE TREASURY. 
(a) STANDARDS.—In coordination with the Secretary 
of Health and Human Services, the Secretaries of Labor 
and the Treasury shall establish for group health plans 
standards comparable to the standards developed by the 
Secretary of Health and Human Services for group health 
insurance coverage under section 2708 of the Public 
Health Service Act, as added by section 3(a), in order to 
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promote quality, fair marketing, and honesty in out-of-net-
work coverage under such plans and to permit participants 
to make an informed decision in cases where they are of-
fered a choice of coverage under such a plan. 
(b) ACCOUNTABILITY AND TRANSPARENCY INITIA-
TIVES.—In coordination with the Secretary of Health and 
Human Services, the Secretaries of Labor and the Treas-
ury shall jointly undertake accountability and trans-
parency initiatives with respect to group health plans simi-
lar to those undertaken by the Secretary of Health and 
Human Services with respect to group and individual 
health insurance coverage under sections 2793 and 2794 
of the Public Health Service Act, as added by sections 4 
and 5 of this Act. 
(c) GROUP HEALTH PLAN DEFINED.—In this sec-
tion, with respect to the Secretary of Labor and the Sec-
retary of the Treasury, the term ‘‘group health plan’’ has 
the meaning such term for purposes of part 7 of subtitle 
B of title I of the Employee Retirement Income Security 
Act of 1974 and chapter 100 of the Internal Revenue Code 
of 1986, respectively. 
Æ 
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