I
106TH CONGRESS
2D SESSION
H. R. 3631
To amend title XVIII of the Social Security Act, the Employee Retirement
Income Security Act of 1974, the Public Health Service Act, and the
Internal Revenue Code of 1986 to provide for an election for retirees
55-to-65 years of age who lose employer-based coverage to acquire health
care coverage under the Medicare Program or under COBRA continu-
ation benefits, and to amend the Employee Retirement Income Security
Act of 1974 to provide for advance notice of material reductions in
covered services under group health plans.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 10, 2000
Mr. KLECZKA introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committees on Com-
merce, and Education and the Workforce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act, the Em-
ployee Retirement Income Security Act of 1974, the Pub-
lic Health Service Act, and the Internal Revenue Code
of 1986 to provide for an election for retirees 55-to-
65 years of age who lose employer-based coverage to
acquire health care coverage under the Medicare Pro-
gram or under COBRA continuation benefits, and to
amend the Employee Retirement Income Security Act
of 1974 to provide for advance notice of material reduc-
tions in covered services under group health plans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Broken Promises Re-
tiree Health Coverage Act of 2000’’.
TITLE I—ACCESS TO MEDICARE
FOR 
INDIVIDUALS 
LOSING
RETIREE HEALTH COVERAGE
SEC. 101. ACCESS TO MEDICARE FOR INDIVIDUALS LOSING
RETIREE HEALTH COVERAGE.
(a) IN GENERAL.—Title XVIII of the Social Security
Act is amended by inserting after section 1818A the fol-
lowing new section:
‘‘MEDICARE BENEFITS FOR CERTAIN INDIVIDUALS WHO
ARE 55 TO 65 YEARS OF AGE
‘‘SEC. 1818B. (a) ELIGIBILITY TO ENROLL.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
an individual who meets the following requirements
with respect to a month is eligible to enroll in the
insurance program under this part with respect to
such month:
‘‘(A) AGE.—As of the last day of the
month, the individual has attained 55 years of
age, but has not attained 65 years of age.
‘‘(B) MEDICARE
ELIGIBILITY
(BUT
FOR
AGE).—The individual would be eligible for ben-
efits under this part for the month if the indi-
vidual were 65 years of age.
‘‘(C) 
NOT
ELIGIBLE
FOR
COVERAGE
UNDER
GROUP
HEALTH
PLANS
OR
FEDERAL
HEALTH
INSURANCE
PROGRAMS.—The indi-
vidual is not eligible for benefits or coverage
under a Federal health insurance program (as
defined in subsection (e)(2), other than under
this section) or under a group health plan (in-
cluding such eligibility merely through a Fed-
eral or State COBRA continuation provision) as
of the last day of the month involved.
‘‘(D) LOSS
OF
RETIREE
HEALTH
COV-
ERAGE.—The individual was covered under a
group health plan as a qualified retiree, but a
termination of such coverage occurred not more
than 90 days before the date the individual
seeks enrollment under this section.
‘‘(E) NOT IMPRISONED.—As of the first
day of such month, the individual is not impris-
oned under Federal, State, or local authority.
‘‘(2) LIMITATION
ON
ELIGIBILITY
IF
TERMI-
NATED ENROLLMENT.—If an individual described in
paragraph (1) enrolls under this section and cov-
erage of the individual is terminated under sub-
section (d) (other than because of age), the indi-
vidual is not again eligible to enroll under this sec-
tion unless the following requirements are met:
‘‘(A) NEW
COVERAGE
UNDER
GROUP
HEALTH
PLAN
OR
FEDERAL
HEALTH
INSUR-
ANCE PROGRAM.—After the date of termination
of coverage under such paragraph, the indi-
vidual obtains coverage under a group health
plan or under a Federal health insurance pro-
gram (other than under this section).
‘‘(B) SUBSEQUENT
LOSS
OF
NEW
COV-
ERAGE.—The individual subsequently loses eli-
gibility for the coverage described in subpara-
graph (A) and exhausts any eligibility the indi-
vidual may subsequently have for coverage
under a Federal or State COBRA continuation
provision.
‘‘(3) CHANGE
IN
HEALTH
PLAN
ELIGIBILITY
DOES NOT AFFECT COVERAGE.—In the case of an
individual who is eligible for and enrolls under this
section, the individual’s continued entitlement to
benefits under this part shall not be affected by the
individual’s subsequent eligibility for benefits or cov-
erage described in paragraph (1)(C), or entitlement
to such benefits or coverage.
‘‘(b) ENROLLMENT PROCESS.—
‘‘(1) IN GENERAL.—An individual may enroll
under this section only in such manner and form as
may be prescribed by regulations, and only during
an enrollment period prescribed by the Secretary
consistent with the provisions of this subsection.
Such regulations shall provide a process under which
individuals eligible to enroll as of a month are per-
mitted to pre-enroll during a prior month within an
enrollment period described in paragraph (2).
‘‘(2) ENROLLMENT PERIODS.—
‘‘(A) IN GENERAL.—
‘‘(i) INITIAL ENROLLMENT PERIOD.—
If the individual is eligible to enroll under
this section for October 1, 2000, the en-
rollment period shall begin on August 1,
2000, and shall end on December 31,
2000. Any such enrollment before October
1, 2000, is conditioned upon compliance
with the conditions of eligibility for Octo-
ber 1, 2000.
‘‘(ii) SUBSEQUENT PERIODS.—If the
individual is eligible to enroll under such
section for a month after October 2000,
the enrollment period shall begin on the
first day of the second month before the
month in which the individual first is eligi-
ble to so enroll and shall end four months
later. Any such enrollment before the first
day of the third month of such enrollment
period is conditioned upon compliance with
the conditions of eligibility for such third
month.
‘‘(B) AUTHORITY TO CORRECT FOR GOV-
ERNMENT ERRORS.—The provisions of section
1837(h) apply with respect to enrollment under
this part in the same manner as they apply to
enrollment under part B.
‘‘(c) DATE COVERAGE BEGINS.—
‘‘(1) IN GENERAL.—The period during which
an individual is entitled to benefits pursuant to an
enrollment under this section shall begin as follows,
but in no case earlier than October 1, 2000:
‘‘(A) In the case of an individual who en-
rolls (including pre-enrolls) before the month in
which the individual satisfies eligibility for en-
rollment under subsection (a), the first day of
such month of eligibility.
‘‘(B) In the case of an individual who en-
rolls during or after the month in which the in-
dividual first satisfies eligibility for enrollment
under such subsection, the first day of the fol-
lowing month.
‘‘(2) AUTHORITY
TO
PROVIDE
FOR
PARTIAL
MONTHS
OF
COVERAGE.—Under regulations, the
Secretary may, in the Secretary’s discretion, provide
for coverage periods that include portions of a
month in order to avoid lapses of coverage.
‘‘(3) LIMITATION ON PAYMENTS.—No payments
may be made under this title with respect to the ex-
penses of an individual enrolled under this section
unless such expenses were incurred by such indi-
vidual during a period which, with respect to the in-
dividual, is a coverage period under this subsection.
‘‘(d) TERMINATION OF COVERAGE.—
‘‘(1) IN
GENERAL.—An individual’s coverage
period under this section shall continue until the in-
dividual’s enrollment has been terminated at the ear-
liest of the following:
‘‘(A) GENERAL PROVISIONS.—
‘‘(i) NOTICE.—The individual files no-
tice (in a form and manner prescribed by
the Secretary) that the individual no
longer wishes to participate in the insur-
ance program under this part.
‘‘(ii) NONPAYMENT OF PREMIUMS.—
The individual fails to make payment of
premiums required for enrollment under
this part.
‘‘(iii) 
MEDICARE
ELIGIBILITY
ON
OTHER BASIS.—The individual becomes en-
titled to benefits under this part other
than by reason of this section.
‘‘(B) TERMINATION BASED ON AGE.—The
individual attains 65 years of age.
‘‘(2) EFFECTIVE DATE OF TERMINATION.—
‘‘(A) NOTICE.—The termination of a cov-
erage period under paragraph (1)(A)(i) shall
take effect at the close of the month following
for which the notice is filed.
‘‘(B) NONPAYMENT
OF
PREMIUM.—The
termination of a coverage period under para-
graph (1)(A)(ii) shall take effect on a date de-
termined under regulations, which may be de-
termined so as to provide a grace period in
which overdue premiums may be paid and cov-
erage continued. The grace period determined
under the preceding sentence shall not exceed
60 days; except that it may be extended for an
additional 30 days in any case where the Sec-
retary determines that there was good cause for
failure to pay the overdue premiums within
such 60-day period.
‘‘(C) AGE
OR
MEDICARE
ELIGIBILITY.—
The termination of a coverage period under
paragraph (1)(A)(iii) or (1)(B) shall take effect
as of the first day of the month in which the
individual attains 65 years of age or becomes
otherwise entitled to benefits under this part.
‘‘(e) PREMIUMS.—
‘‘(1) IN GENERAL.—Premiums for enrollment
under this section shall be paid to the Secretary in
an amount determined under paragraph (2). Such
premiums shall be paid at such times, and in such
manner, as the Secretary shall by regulations pre-
scribe, and shall be deposited in the Treasury to the
credit of the Federal Hospital Insurance Trust Fund
established under section 1817.
‘‘(2) AMOUNT OF PREMIUM.—The amount of
premium for a month occurring during—
‘‘(A) fiscal year 2001, is equal to $400;
and
‘‘(B) a succeeding fiscal year is the
amount specified under this paragraph for the
previous fiscal year increased by the percentage
increase in the consumer price index for all
urban consumers (all items; United States city
average) for the 12-month period ending with
July preceding the beginning of the fiscal year.
‘‘(3) PERIOD
OF
APPLICABILITY
OF
PRE-
MIUMS.—Such premiums shall be payable for the pe-
riod commencing with the first month of an individ-
ual’s coverage period and ending with the month in
which the individual dies or, if earlier, in which the
individual’s coverage period terminates under sub-
section (d).
‘‘(f) DEFINITIONS.—For purposes of this section:
‘‘(1) QUALIFIED RETIREE.—The term ‘qualified
retiree’ means an individual who, immediately before
the occurrence of the termination of coverage of
such individual under a group health plan—
‘‘(A) had attained 55 years of age; and
‘‘(B) was receiving such coverage by rea-
son of the retirement of the individual.
‘‘(2) FEDERAL
OR
STATE
COBRA
CONTINU-
ATION
PROVISION.—The term ‘Federal or State
COBRA continuation provision’ has the meaning