IB 
Union Calendar No. 22 
109TH CONGRESS 
1ST SESSION 
H. R. 525 
[Report No. 109–41] 
To amend title I of the Employee Retirement Income Security Act of 1974 
to improve access and choice for entrepreneurs with small businesses 
with respect to medical care for their employees. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 2, 2005 
Mr. SAM JOHNSON of Texas (for himself, Ms. VELA´ZQUEZ, Mr. BOEHNER, 
Mr. WYNN, Mr. KENNEDY of Minnesota, Mr. WESTMORELAND, Mr. 
BRADLEY of New Hampshire, Mr. SESSIONS, Mr. PLATTS, Mr. CARTER, 
Mr. MCINTYRE, Mr. SHAYS, Mr. DAVIS of Tennessee, Mrs. BONO, Mr. 
GRAVES, Mrs. MILLER of Michigan, Mr. TIBERI, Mr. WILSON of South 
Carolina, Mr. THORNBERRY, Mr. GILLMOR, Mr. BONILLA, Mr. 
MCHENRY, Mr. AKIN, Mr. MCHUGH, Mr. MARCHANT, Mr. FORTUN˜O, 
Mr. BRADY of Texas, Mrs. CUBIN, Mr. COX, Mr. NEUGEBAUER, Mr. PE-
TERSON of Pennsylvania, Mr. FITZPATRICK of Pennsylvania, Mr. COO-
PER, Mr. PETRI, Mrs. BIGGERT, Mr. SHADEGG, Mr. MANZULLO, Mr. 
MCCAUL of Texas, Mr. WELLER, Mr. JINDAL, Ms. FOXX, Mr. CANTOR, 
Mr. GERLACH, Mr. CULBERSON, Mr. KING of Iowa, Mrs. DRAKE, Mr. 
CHABOT, Mr. KLINE, Mr. CUNNINGHAM, Mrs. KELLY, Mr. RYAN of Wis-
consin, Mrs. EMERSON, Ms. PRYCE of Ohio, and Mr. CASE) introduced 
the following bill; which was referred to the Committee on Education and 
the Workforce 
APRIL 13, 2005 
Additional sponsors: Mr. DOOLITTLE, Mr. HERGER, Mr. ENGLISH of Pennsyl-
vania, Mr. MILLER of Florida, Mr. SENSENBRENNER, Mrs. NORTHUP, 
Mr. PENCE, Mr. BACHUS, Mr. FRANKS of Arizona, Mr. JONES of North 
Carolina, Mr. SHAW, Mr. ROGERS of Michigan, Mrs. MUSGRAVE, Mr. 
GARRETT of New Jersey, Mr. MCKEON, Ms. GINNY BROWN-WAITE of 
Florida, Ms. BORDALLO, Mr. GOHMERT, Mr. HYDE, Mr. KELLER, Mr. 
GARY G. MILLER of California, Mr. FLAKE, Mr. MURPHY, Mr. LAHOOD, 
Mrs. MYRICK, Mr. TANCREDO, Mr. HOSTETTLER, Mr. SODREL, Mr. 
BARTLETT of Maryland, Mr. ROGERS of Kentucky, Mrs. CAPITO, Mr.
HEFLEY, Mr. HENSARLING, Mr. RADANOVICH, Mr. EVERETT, Mr. 
THOMAS, Mrs. BLACKBURN, Mr. CONAWAY, Mr. BLUNT, Mr. ROGERS of 
Alabama, Mr. GINGREY, Mr. BARRETT
of South Carolina, Mr. 
BOUSTANY, Mr. BURTON of Indiana, Mr. KOLBE, Mr. OXLEY, Mr. 
CHOCOLA, Mr. FEENEY, Mr. TURNER, Mr. PEARCE, Mr. COLE of Okla-
homa, Ms. HART, Mr. DELAY, Mr. GOODLATTE, Mr. SHUSTER, Mr. 
KNOLLENBERG, Mr. ADERHOLT, Mr. BONNER, Mr. HALL, Mr. FORBES, 
Mr. FOSSELLA, Mr. WELDON of Florida, Mr. STEARNS, Mr. SULLIVAN, 
Mr. REHBERG, Mr. HOBSON, Mr. GALLEGLY, Mr. BEAUPREZ, Mr. KIRK, 
Mr. CANNON, Mr. WICKER, Mr. MACK, Mr. BARTON of Texas, Mr. 
JOHNSON of Illinois, Mr. LATHAM, Mr. SHIMKUS, Mr. CALVERT, Mr. 
GUTKNECHT, Mr. MARIO DIAZ-BALART of Florida, Ms. LEE, Mr. SMITH 
of Texas, and Mr. BURGESS 
Deleted sponsors: Mr. MEEKS of New York (added March 15, 2005; deleted 
March 16, 2005) and Mr. TOWNS (added April 12, 2005; deleted April 
13, 2005) 
APRIL 13, 2005 
Committed to the Committee of the Whole House on the State of the Union 
and ordered to be printed 
A BILL 
To amend title I of the Employee Retirement Income Secu-
rity Act of 1974 to improve access and choice for entre-
preneurs with small businesses with respect to medical 
care for their employees. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE AND TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Small Business Health Fairness Act of 2005’’. 
(b) TABLE OF CONTENTS.—The table of contents is 
as follows: 
Sec. 1. Short title and table of contents. 
Sec. 2. Rules governing association health plans. 
Sec. 3. Clarification of treatment of single employer arrangements.
Sec. 4. Enforcement provisions relating to association health plans. 
Sec. 5. Cooperation between Federal and State authorities. 
Sec. 6. Effective date and transitional and other rules.
SEC. 2. RULES GOVERNING ASSOCIATION HEALTH PLANS. 
(a) IN GENERAL.—Subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 is amend-
ed by adding after part 7 the following new part: 
‘‘PART 8—RULES GOVERNING ASSOCIATION 
HEALTH PLANS 
‘‘SEC. 801. ASSOCIATION HEALTH PLANS. 
‘‘(a) IN GENERAL.—For purposes of this part, the 
term ‘association health plan’ means a group health plan 
whose sponsor is (or is deemed under this part to be) de-
scribed in subsection (b). 
‘‘(b) SPONSORSHIP.—The sponsor of a group health 
plan is described in this subsection if such sponsor—
‘‘(1) is organized and maintained in good faith, 
with a constitution and bylaws specifically stating its 
purpose and providing for periodic meetings on at 
least an annual basis, as a bona fide trade associa-
tion, a bona fide industry association (including a 
rural electric cooperative association or a rural tele-
phone cooperative association), a bona fide profes-
sional association, or a bona fide chamber of com-
merce (or similar bona fide business association, in-
cluding a corporation or similar organization that 
operates on a cooperative basis (within the meaning