after the first day of the first plan year in which such
requirements apply.’’.
(B) Section 731(c) of such Act (29 U.S.C.
1191(c)) is amended by striking ‘‘section 711’’ and
inserting ‘‘sections 711 and 714’’.
(C) Section 732(a) of such Act (29 U.S.C.
1191a(a)) is amended by striking ‘‘section 711’’ and
inserting ‘‘sections 711 and 714’’.
(D) The table of contents in section 1 of such
Act is amended by inserting after the item relating
to section 713 the following new item:
‘‘Sec. 714. Equity in provision of prescription drug coverage.’’.
(3) 
INTERNAL
REVENUE
CODE
AMEND-
MENTS.—Subchapter B of chapter 100 of the Inter-
nal Revenue Code of 1986 is amended—
(A) in the table of sections, by inserting
after the item relating to section 9812 the fol-
lowing new item:
‘‘Sec. 9813. Equity in provision of prescription drug coverage.’’;
and
(B) by inserting after section 9812 the fol-
lowing:
‘‘SEC. 9813. EQUITY IN PROVISION OF PRESCRIPTION DRUG
COVERAGE.
‘‘(a) EQUITY IN PROVISION OF PRESCRIPTION DRUG
COVERAGE.—
‘‘(1) IN GENERAL.—A group health plan that
provides for mail-order prescription drug coverage
(as defined in paragraph (3)(A)) shall also provide
non-mail-order prescription drug coverage consistent
with paragraph (2).
‘‘(2) EQUITABLE COVERAGE.—A plan provides
non-mail-order prescription drug coverage consistent
with this paragraph only if—
‘‘(A) benefits under the non-mail-order
prescription coverage are provided for in the
case of all drugs and all circumstances under
which benefits are provided under the mail-
order prescription drug coverage;
‘‘(B) no deductible or similar cost-sharing
is imposed with respect to benefits under the
non-mail-order prescription drug coverage un-
less such a deductible or similar cost-sharing is
imposed with respect to benefits under the mail-
order prescription drug coverage; and
‘‘(C) the benefits for the non-mail-order
coverage assures payments consistent with ei-
ther (or both) of the following clauses:
‘‘(i) The dollar amount of payment for
prescription drug coverage is not less than
the dollar amount of benefits provided with
respect to the mail-order coverage for that
same coverage.
‘‘(ii) 
The 
cost-sharing 
(including
deductibles, copayments, or coinsurance)
imposed with respect to non-mail-order
coverage is not greater (as a percentage of
charges or dollar amount, as specified
under the coverage) than the cost-sharing
imposed with respect to the mail-order cov-
erage.
‘‘(3) DEFINITIONS.—For purposes of this sub-
section:
‘‘(A) MAIL-ORDER
PRESCRIPTION
DRUG
COVERAGE.—The term ‘mail-order prescription
drug coverage’ means provision of benefits for
prescription drugs and biologicals that are de-
livered directly to participants and beneficiaries
through the mail or similar means.
‘‘(B) 
NON-MAIL-ORDER
PRESCRIPTION
DRUG
COVERAGE.—The term ‘non-mail-order
prescription drug coverage’ means the provision
of 
benefits 
for 
prescription 
drugs 
and
biologicals through one or more local phar-
macies.
‘‘(C) LOCAL PHARMACY.—The term ‘local
pharmacy’ means, with respect to a prescription
drug or biological and a participant or bene-
ficiary, an establishment that is authorized to
dispense such drug or biological and that is lo-
cated within such distance (not to exceed 5
miles in the case of a participant or beneficiary
residing in an urban area or 10 miles in the
case of a participant or beneficiary residing in
a non-urban area) of the residence of such par-
ticipant or beneficiary, as the Secretary of
Health and Human Services shall prescribe.
‘‘(b) PROHIBITIONS.—A group health plan may not
provide monetary payments or rebates to an individual to
encourage such individual to accept less than the min-
imum protections available under this section.
‘‘(c) CONSTRUCTION.—Nothing in this section shall
be construed as preventing a plan from—
‘‘(1) restricting the drugs for which benefits are
provided under the plan; or
‘‘(2) imposing a limitation on the amount of
benefits provided with respect to such coverage or
the cost-sharing that may be imposed with respect to
such coverage,
so long as such restrictions and limitations are consistent
with subsection (a).’’.
(b) INDIVIDUAL HEALTH INSURANCE.—(1) Part B
of title XXVII of the Public Health Service Act is amend-
ed by inserting after section 2752 the following new sec-
tion:
‘‘SEC. 2753. EQUITY IN PROVISION OF PRESCRIPTION DRUG
COVERAGE.
‘‘(a) IN GENERAL.—The provisions of section 2707
(other than subsection (d)) shall apply to health insurance
coverage offered by a health insurance issuer in the indi-
vidual market in the same manner as it applies to health
insurance coverage offered by a health insurance issuer
in connection with a group health plan in the small or
large group market.
‘‘(b) NOTICE.—A health insurance issuer under this
part shall comply with the notice requirement under sec-
tion 714(d) 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.’’.
(2) Section 2762(b)(2) of such Act (42 U.S.C.
300gg–62(b)(2)) is amended by striking ‘‘section 2751’’
and inserting ‘‘sections 2751 and 2753’’.