‘‘TITLE 
II—HEALTH 
BENEFITS 
FOR EMPLOYEES AND THEIR 
FAMILIES 
‘‘SEC. 201. HEALTH BENEFITS. 
‘‘(a) OFFER TO ENROLL.— 
‘‘(1) IN GENERAL.—Each large employer, in ac-
cordance with this title, shall offer to each of its em-
ployees the opportunity to enroll in a qualifying 
health benefit plan that provides coverage for the 
employee and the family of the employee. 
‘‘(2) QUALIFYING
HEALTH
BENEFIT
PLAN.— 
For purposes of this title, the term ‘qualifying 
health benefit plan’ means a plan that provides ben-
efits for health care items and services that are 
actuarily equivalent or greater in value than the ben-
efits offered as of January 1, 2006, under the Blue 
Cross/Blue Shield Standard Plan provided under the 
Federal Employees Health Benefit Program under 
chapter 89 of title 5, United States Code, and that 
meets the requirements of title XXVII of the Public 
Health Service Act applicable to the plan. 
‘‘(b) CONTRIBUTION AND WITHHOLDING.— 
‘‘(1) IN GENERAL.—Each large employer, in ac-
cordance with this title, shall—
‘‘(A) contribute to the cost of any quali-
fying health benefit plan offered to its employ-
ees under subsection (a); and 
‘‘(B) withhold from the wages of an em-
ployee, the employee share of the premium as-
sessed for coverage under the qualifying health 
benefit plan. 
‘‘(2) REQUIRED
CONTRIBUTION.—Except as 
provided in paragraphs (3) and (4), the portion of 
the total premium to be paid by a large employer 
under paragraph (1)(A) shall not be less than the 
portion of the total premium that the Federal Gov-
ernment contributes under the Blue Cross/Blue 
Shield Standard Plan provided under the Federal 
Employees Health Benefit Program under chapter 
89 of title 5, United States Code. 
‘‘(3) PART-TIME EMPLOYEES.—With respect to 
an employee who works less than 30 hours per week, 
the employer contribution required under paragraph 
(2) shall be equal to the product of— 
‘‘(A) the contribution required under para-
graph (2); and 
‘‘(B) the ratio of number of hours worked 
by the employee in a typical week to 30 hours.
‘‘(4) LIMITATION.—No employer contribution 
shall be required under this subsection with respect 
to an employee who works less than 10 hours per 
week. 
‘‘(c) EMPLOYEE OBLIGATION UNDER CERTAIN PRO-
GRAMS.— 
‘‘(1) IN
GENERAL.—With respect to an em-
ployee covered under a Federal health insurance pro-
gram (as defined in paragraph (3)), such employee 
shall accept an offer of health insurance coverage 
under subsection (a) and agree to the appropriate 
payroll withholdings under subsection (b)(1)(B) for 
such coverage or provide for the payment of the em-
ployee share of premiums under paragraph (2), ex-
cept that this subsection shall not apply— 
‘‘(A) with respect to an employee who is 
otherwise covered under an employment-based 
qualified health benefit plan; or 
‘‘(B) with respect to the coverage of a fam-
ily member of an employee if the employee does 
not elect coverage for such family member and 
the family member is otherwise covered under 
an employment-based qualified health benefit 
plan.
‘‘(2) PAYMENT OF PREMIUMS.—At the request 
of an employee to which paragraph (1) applies, the 
relevant Federal administrator of the Federal health 
insurance program involved shall provide for the 
payment of the employee share of the premium as-
sessed for coverage under the qualifying health ben-
efit plan involved. For purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.), the re-
quirement of this paragraph shall be deemed to be 
a requirement under the appropriate State plan 
under such title XIX. 
‘‘(3) FEDERAL
HEALTH
INSURANCE
PRO-
GRAM.—As used in this subsection, the term ‘Fed-
eral health insurance program’ means— 
‘‘(A) the medicare or medicaid program 
under title XVIII or XIX of the Social Security 
Act (42 U.S.C. 1395 or 1396 et seq.); 
‘‘(B) the Federal employee health benefit 
program under chapter 89 of title V, United 
States Code; or 
‘‘(C) the Civilian Health and Medical Pro-
gram of the Uniformed Services (CHAMPUS), 
as defined in section 1073(4) of title 10, United 
States Code. 
‘‘(d) LARGE EMPLOYERS.—
‘‘(1) IN GENERAL.—The provisions of this title 
shall only apply to large employers. 
‘‘(2) DEFINITION.— 
‘‘(A) IN GENERAL.—As used in paragraph 
(1), the term ‘large employer’ means, with re-
spect to a calendar year and plan year, an em-
ployer that employed an average of at least 50 
full-time employees on business days during the 
preceding calendar year and who employs not 
less than 50 employees on the first day of the 
plan year. 
‘‘(B) EXCEPTION.—The provisions of this 
title shall apply with respect to an employer 
that is not a large employer under subpara-
graph (A) if the majority of the services per-
formed by such employer consist of services per-
formed on behalf of a single large employer. 
‘‘(3) CONTRACT
WORKERS.—For purposes of 
this title, a contract worker of an employer shall be 
considered to be an employee of the employer. 
‘‘SEC. 202. REQUIREMENTS RELATING TO TIMING OF COV-
ERAGE AND WITHHOLDING. 
‘‘(a) DATE OF INITIAL COVERAGE.—In the case of 
an employee enrolled under a qualifying health benefit 
plan provided by a large employer, the coverage under the
plan must begin not later than 30 days after the day on 
which the employee first performs an hour of service as 
an employee of that employer. 
‘‘(b) WITHHOLDING PERMITTED.—No provision of 
State law shall prevent an employer of an employee en-
rolled under a qualifying health benefit plan established 
under this title from withholding the amount of any pre-
mium due by the employee from the payroll of the em-
ployee. 
‘‘SEC. 203. ENFORCEMENT. 
‘‘(a) CIVIL MONEY PENALTY AGAINST PRIVATE EM-
PLOYERS.—The provisions of section 502 of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1132)— 
‘‘(1) relating to the commencement of civil ac-
tions by the Secretary under subsection (a) of such 
section; 
‘‘(2) relating to civil money penalties under sub-
section (c)(2) of such section; and 
‘‘(3) relating to the procedures for assessing, 
collecting and the judicial review of such civil money 
penalties; 
shall apply with respect to any large employer that does 
not comply with this title.
‘‘(b) INJUNCTIVE RELIEF.—The provisions of section 
17 shall apply with respect to violations of this title. 
‘‘SEC. 204. PREEMPTION. 
‘‘Nothing in this title shall be construed to prevent 
a State from establishing, implementing, or continuing in 
effect standards and requirements relating to employer 
provided health insurance coverage unless such standards 
and requirements prevent the application of the require-
ments of this title. 
‘‘SEC. 205. DEFINITION AND EFFECTIVE DATE. 
‘‘(a) DEFINITION.—In this title the terms ‘family’ 
and ‘family member’ mean, with respect to an employee, 
the spouse and children (including adopted children) of 
the employee. 
‘‘(b) EFFECTIVE DATE.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), this title shall apply with respect to em-
ployers on January 1, 2006. 
‘‘(2) COLLECTIVE BARGAINING AGREEMENTS.— 
This title shall apply with respect to employees cov-
ered under a collective bargaining agreement on the 
first day of the first plan year beginning after the 
date of enactment of this Act, or January 1, 2006, 
whichever occurs later.’’. 
(b) CONFORMING AMENDMENTS.—