I 
108TH CONGRESS 
1ST SESSION H. R. 3600
To amend the Public Health Service Act to require health insurance issuers 
to credit toward an annual deductible in case of subsequent issuance 
of similar health insurance policy by the same issuer to the same person. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 21, 2003
Mr. ENGEL introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to require health 
insurance issuers to credit toward an annual deductible 
in case of subsequent issuance of similar health insurance 
policy by the same issuer to the same person.
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 ‘‘Health Deductible In-
surance Fairness Act of 2003’’. 
SEC. 2. CREDITING TOWARD ANNUAL DEDUCTIBLE IN CASE 
OF SUBSEQUENT ISSUANCE BY SAME ISSUER. 
(a) GROUP HEALTH PLANS.—
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—(A) 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: 
‘‘SEC. 2707. STANDARD RELATING TO CREDITING TOWARD 
ANNUAL DEDUCTIBLE IN CASE OF SUBSE-
QUENT ISSUANCE BY SAME ISSUER. 
‘‘(a) REQUIREMENT.—If a health insurance issuer of-
fering group health insurance coverage imposes an annual 
deductible under such coverage with respect to an indi-
vidual and the individual changes the coverage obtained 
(including a change from family to individual coverage) 
from such issuer in a year to other health insurance cov-
erage that also imposes an annual deductible, the issuer 
shall credit toward the deductible for the latter coverage 
amounts that were credited toward the deductible under 
the former coverage during the same year. 
‘‘(b) NOTICE.—A group health plan under this part 
shall comply with the notice requirement under section 
714(b) of the Employee Retirement Income Security Act 
of 1974 with respect to the requirements of this section 
as if such section applied to such plan.’’.
(b) INDIVIDUAL HEALTH INSURANCE.—Part B of 
title XXVII of of such Act is amended by inserting after 
section 2752 the following new section:
‘‘SEC. 2753. STANDARD RELATING TO CREDITING TOWARD 
ANNUAL DEDUCTIBLE IN CASE OF SUBSE-
QUENT ISSUANCE BY SAME ISSUER. 
‘‘(a) IN
GENERAL.—The provisions of section 
2707(a) shall apply to health insurance coverage offered 
by a health insurance issuer in the individual market in 
the same manner as they apply to health insurance cov-
erage offered by a health insurance issuer in connection 
with a group health plan in the small or large group mar-
ket. 
‘‘(b) NOTICE.—A health insurance issuer under this 
part shall comply with the notice requirement under sec-
tion 714(b) of the Employee Retirement Income Security 
Act of 1974 with respect to the requirements referred to 
in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.’’. 
(c) EFFECTIVE DATES.—
(1) GROUP HEALTH INSURANCE COVERAGE.—
Subject to paragraph (3), the amendments made by 
subsection (a) apply with respect to group health 
plans for plan years beginning on or after a date 
specified by the Secretary of Health and Human 
Services that is not later than January 1, 2005. 
(2) INDIVIDUAL
HEALTH
INSURANCE
COV-
ERAGE.—The amendment made by subsection (b) 
shall apply with respect to health insurance coverage
offered, sold, issued, renewed, in effect, or operated 
in the individual market on or after such date.
Æ