granted relief from the applicable requirements of
subsection (a), pursuant to an exemption procedure
which—
‘‘(A) shall be established by the Secretary
by regulation for purposes of this subsection,
and
‘‘(B) shall be subject to standards and pro-
cedures similar to those applicable under sec-
tion 408(a) with respect to exemptions granted
thereunder.’’.
(b) CLERICAL AMENDMENT.—The table of contents
in section 1 of such Act is amended by inserting after the
item relating to section 514 the following new items:
‘‘Sec. 515. Delinquent contributions.
‘‘Sec. 516. Discrimination in lifetime benefit coverage under group health plan.’’.
SEC. 4. REPORTING AND DISCLOSURE REQUIREMENTS.
(a) NOTICE OF MODIFICATIONS AND CHANGES.—
Section 104(b)(1) of the Employee Retirement Income Se-
curity Act of 1974 (29 U.S.C. 1024(b)) is amended by
adding at the end the following: ‘‘In the case of a group
health plan (as defined in section 607(1)), the adoption
of any material coverage restriction which constitutes such
a modification in the terms of the plan (including the ter-
mination of the plan), or which is represented by any such
change in the information required under section 102(b),
may not take effect until 60 days after such a summary
description of such modification or change is furnished to
each participant and to each spouse thereof who is a bene-
ficiary under the plan in language calculated to be easily
understood by the typical participant or beneficiary. For
purposes of the preceding sentence, the term ‘material cov-
erage restriction’ means any change in the terms of a
group health plan that results in elimination of, or in-
creased restrictions on, any form of benefit coverage which
was provided by the plan prior to the change, including,
but not limited to, the establishment of, or increases in
the amount of, deductibles or coinsurance payments re-
quired of participants and beneficiaries under the plan, ex-
cept that the Secretary may by regulation exclude from
such term any such change of a type which the Secretary
finds to be de minimis.’’.
(b) SPECIAL REQUIREMENTS
FOR SELF-INSURED
PLANS.—Section 102(b) of such Act (29 U.S.C. 1022(b))
is amended—
(1) by inserting ‘‘(1)’’ after ‘‘(b)’’; and
(2) by adding at the end the following new
paragraph:
‘‘(2)(A) In the case of a self-insured group health
plan, the plan description and summary plan description
shall also contain a statement—
‘‘(i) indicating that the plan is a self-insured
group health plan and is not a policy of insurance,
‘‘(ii) identifying the person who is responsible
for claim determinations and processing, and
‘‘(iii) indicating that the plan is not subject to
State guarantee fund protection and that, if the plan
does not pay all benefits for which participants or
beneficiaries are eligible under the plan, responsibil-
ity for payment for medical care may to some extent
remain with the participant or beneficiary.
‘‘(B) For purposes of this paragraph—
‘‘(i) The term ‘group health plan’ has the
meaning provided in section 607(1).
‘‘(ii) A group health plan is ‘self-insured’ unless
all benefits provided under the plan are provided
under a contract or policy of insurance issued by a
person licensed by a State to engage in the business
of insurance.’’.
SEC. 5. LEGAL RELIEF FROM DAMAGES FOR INTER-
FERENCE WITH RIGHTS UNDER PLAN.
(a) DAMAGES.—Section 502(c) of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1132(c))
is amended by adding at the end the following new para-
graph:
‘‘(4)(A) Any person who violates section 510 or 516
with respect to any participant or beneficiary under a
group health plan shall be liable to such participant or
beneficiary for actual damages. Subject to subparagraph
(B), damages for such violation shall not include punitive
damages.
‘‘(B) In any case in which the violation constitutes
willful, fraudulent, or malicious conduct, bad faith, or
gross negligence, each person liable under subparagraph
(A) may, in the court’s discretion, be liable to such partici-
pant or beneficiary for exemplary damages equal to not
more than the greater of—
‘‘(i) 200 percent of the amount of actual dam-
ages awarded, or
‘‘(ii) $10,000.
Any such exemplary damages shall be in addition to any
actual damages under subparagraph (A).
‘‘(C) For purposes of this paragraph, the term ‘group
health plan’ has the meaning provided in section 607(1).’’.
(b) ATTORNEY’S FEES.—Section 502(g) of such Act
(29 U.S.C. 1132(g)) is amended by adding at the end the
following new paragraph:
‘‘(3) In any action for damages under subsection
(c)(4) in which the plaintiff prevails or substantially pre-
vails, the court shall award the plaintiff reasonable attor-
ney’s fees and other costs of the action, including reason-
able expert witness fees and costs, to be paid by the de-
fendant. Fees awarded under this paragraph shall be at
generally prevailing hourly rates.’’.
SEC. 6. EFFECTIVE DATE.
The amendments made by this Act shall apply with
respect to changes in group health plan coverage adopted
on or after February 4, 1993.
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