Improving Awareness of Health Coverage Options Act of 2022
Bill: H.R.6384 | Sponsor: Rep. Harder, Josh (D-CA)
Policy area: Health

Summary:
Improving Awareness of Health Coverage Options Act of 2022
This bill modifies the notification requirements with respect to eligibility for certain health coverage options due to a qualifying event (e.g., loss of coverage due to termination of employment).
For example, a health insurance plan must provide a clear explanation that an individual who is eligible for COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation coverage may be eligible to enroll instead, with financial assistance, in a qualified health plan offered through a health insurance exchange.

To amend the Employee Retirement Income Security Act of 1974, title 
XXII of the Public Health Service Act, and the Internal Revenue Code of 
      1986 to improve certain notifications provided to qualified 
  beneficiaries by group health plans in the case of COBRA qualifying 
                                events.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improving Awareness of Health 
Coverage Options Act of 2022''.

SEC. 2. IMPROVEMENT OF CERTAIN NOTIFICATIONS PROVIDED TO QUALIFIED 
              BENEFICIARIES BY GROUP HEALTH PLANS IN THE CASE OF COBRA 
              QUALIFYING EVENTS.

    (a) Employee Retirement Income Security Act of 1974.--
            (1) In general.--Section 606 of the Employee Retirement 
        Income Security Act of 1974 (29 U.S.C. 1166) is amended--
                    (A) in subsection (a)(4), in the matter following 
                subparagraph (B), by striking ``under this subsection'' 
                and inserting ``under this part in accordance with the 
                notification requirements under subsection (c)''; and
                    (B) in subsection (c)--
                            (i) by striking ``For purposes of 
                        subsection (a)(4), any notification'' and 
                        inserting ``For purposes of subsection (a)(4)--
            ``(1) any notification'';
                            (ii) by striking ``, whichever is 
                        applicable, and any such notification'' and 
                        inserting ``of subsection (a), whichever is 
                        applicable;
            ``(2) any such notification''; and
                            (iii) by striking ``such notification is 
                        made'' and inserting ``such notification is 
                        made; and
            ``(3) any such notification shall, with respect to each 
        qualified beneficiary with respect to whom such notification is 
        made, include information regarding any Exchange established 
        under title I of the Patient Protection and Affordable Care Act 
        through which such a qualified beneficiary may be eligible to 
        enroll in a qualified health plan (as defined in section 1301 
        of the Patient Protection and Affordable Care Act), including--
                    ``(A) the publicly accessible Internet website 
                address for such Exchange;
                    ``(B) the publicly accessible Internet website 
                address for the Find Local Help directory maintained by 
                the Department of Health and Human Services on the 
                healthcare.gov Internet website (or a successor 
                website);
                    ``(C) a clear explanation that--
                            ``(i) an individual who is eligible for 
                        continuation coverage may be eligible to enroll 
                        instead, with financial assistance, in a 
                        qualified health plan offered through such 
                        Exchange, but, in the case that such individual 
                        elects to enroll in such continuation coverage 
                        and subsequently elects to terminate such 
                        continuation coverage before the period of such 
                        continuation coverage expires, such individual 
                        may not be eligible to enroll in a qualified 
                        health plan offered through such Exchange 
                        during a special enrollment period if more than 
                        60 days have elapsed since the individual's 
                        loss of coverage as an employee;
                            ``(ii) an individual who elects to enroll 
                        in continuation coverage will remain eligible 
                        to enroll in a qualified health plan offered 
                        through such Exchange during an open enrollment 
                        period or another special enrollment period for 
                        which the individual is eligible and may be 
                        eligible for financial assistance with respect 
                        to enrolling in such a qualified health plan; 
                        and
                            ``(iii) an individual may apply for, and if 
                        eligible, enroll in Medicaid or the Children's 
                        Health Insurance Program (CHIP), at any time, 
                        with no special enrollment period required;
                    ``(D) information on consumer protections with 
                respect to enrolling in a qualified health plan offered 
                through such Exchange, including the requirement for 
                such a qualified health plan to provide coverage for 
                essential health benefits (as defined in section 
                1302(b) of the Patient Protection and Affordable Care 
                Act) and the requirements applicable to such a 
                qualified health plan under part A of title XXVII of 
                the Public Health Service Act; and
                    ``(E) information on the availability of financial 
                assistance with respect to enrolling in a qualified 
                health plan.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply with respect to qualifying events occurring on or 
        after the date that is 90 days after the date of the enactment 
        of this Act.
    (b) Public Health Service Act.--
            (1) In general.--Section 2206 of the Public Health Service 
        Act (42 U.S.C. 300bb-6) is amended--
                    (A) by striking ``In accordance'' and inserting the 
                following:
    ``(a) In General.--In accordance'';
                    (B) by striking ``of such beneficiary's rights 
                under this subsection'' and inserting ``of such 
                beneficiary's rights under this title in accordance 
                with the notification requirements under subsection 
                (b)''; and
                    (C) by striking ``For purposes of paragraph (4),'' 
                and all that follows through ``such notification is 
                made.'' and inserting the following:
    ``(b) Rules Relating to Notification of Qualified Beneficiaries by 
Plan Administrator.--For purposes of subsection (a)(4)--
            ``(1) any notification shall be made within 14 days of the 
        date on which the plan administrator is notified under 
        paragraph (2) or (3) of subsection (a), whichever is 
        applicable;
            ``(2) any such notification to an individual who is a 
        qualified beneficiary as the spouse of the covered employee 
        shall be treated as notification to all other qualified 
        beneficiaries residing with such spouse at the time such 
        notification is made; and
            ``(3) any such notification shall, with respect to each 
        qualified beneficiary with respect to whom such notification is 
        made, include information regarding any Exchange established 
        under title I of the Patient Protection and Affordable Care Act 
        through which such a qualified beneficiary may be eligible to 
        enroll in a qualified health plan (as defined in section 1301 
        of the Patient Protection and Affordable Care Act), including--
                    ``(A) the publicly accessible Internet website 
                address for such Exchange;
                    ``(B) the publicly accessible Internet website 
                address for the Find Local Help directory maintained by 
                the Department of Health and Human Services on the 
                healthcare.gov Internet website (or a successor 
                website);
                    ``(C) a clear explanation that--
                            ``(i) an individual who is eligible for 
                        continuation coverage may be eligible to enroll 
                        instead, with financial assistance, in a 
                        qualified health plan offered through such 
                        Exchange, but, in the case that such individual 
                        elects to enroll in such continuation coverage 
                        and subsequently elects to terminate such 
                        continuation coverage before the period of such 
                        continuation coverage expires, such individual 
                        may not be eligible to enroll in a qualified 
                        health plan offered through such Exchange 
                        during a special enrollment period if more than 
                        60 days have elapsed since the individual's 
                        loss of coverage as an employee;
                            ``(ii) an individual who elects to enroll 
                        in continuation coverage will remain eligible 
                        to enroll in a qualified health plan offered 
                        through such Exchange during an open enrollment 
                        period or another special enrollment period for 
                        which the individual is eligible and may be 
                        eligible for financial assistance with respect 
                        to enrolling in such a qualified health plan; 
                        and
                            ``(iii) an individual may apply for, and if 
                        eligible, enroll in Medicaid or the Children's 
                        Health Insurance Program (CHIP), at any time, 
                        with no special enrollment period required;
                    ``(D) information on consumer protections with 
                respect to enrolling in a qualified health plan offered 
                through such Exchange, including the requirement for 
                such a qualified health plan to provide coverage for 
                essential health benefits (as defined in section 
                1302(b) of the Patient Protection and Affordable Care 
                Act) and the requirements applicable to such a 
                qualified health plan under part A of title XXVII; and
                    ``(E) information on the availability of financial 
                assistance with respect to enrolling in a qualified 
                health plan.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply with respect to qualifying events occurring on or 
        after the date that is 90 days after the date of the enactment 
        of this Act.
    (c) Internal Revenue Code of 1986.--
            (1) In general.--Section 4980B(f)(6) of the Internal 
        Revenue Code of 1986 is amended--
                    (A) in subparagraph (D)--
                            (i) in clause (ii), by striking ``under 
                        subparagraph (C)'' and inserting ``under clause 
                        (iii)''; and
                            (ii) by redesignating clauses (i) and (ii) 
                        as subclauses (I) and (II), respectively, and 
                        moving the margin of each such subclause, as so 
                        redesignated, 2 ems to the right;
                    (B) by redesignating subparagraphs (A) through (D) 
                as clauses (i) through (iv), respectively, and moving 
                the margin of each such clause, as so redesignated, 2 
                ems to the right;
                    (C) by striking ``In accordance'' and inserting the 
                following:
                    ``(A) In general.--In accordance'';
                    (D) by inserting after ``of such beneficiary's 
                rights under this subsection'' the following: ``in 
                accordance with the notification requirements under 
                subparagraph (C)''; and
                    (E) by striking ``The requirements of subparagraph 
                (B)'' and all that follows through ``such notification 
                is made.'' and inserting the following:
                    ``(B) Alternative means of compliance with 
                requirement for notification of multiemployer plans by 
                employers.--The requirements of subparagraph (A)(ii) 
                shall be considered satisfied in the case of a 
                multiemployer plan in connection with a qualifying 
                event described in paragraph (3)(B) if the plan 
                provides that the determination of the occurrence of 
                such qualifying event will be made by the plan 
                administrator.
                    ``(C) Rules relating to notification of qualified 
                beneficiaries by plan administrator.--For purposes of 
                subparagraph (A)(iv)--
                            ``(i) any notification shall be made within 
                        14 days (or, in the case of a group health plan 
                        which is a multiemployer plan, such longer 
                        period of time as may be provided in the terms 
                        of the plan) of the date on which the plan 
                        administrator is notified under clause (ii) or 
                        (iii) of subparagraph (A), whichever is 
                        applicable;
                            ``(ii) any such notification to an 
                        individual who is a qualified beneficiary as 
                        the spouse of the covered employee shall be 
                        treated as notification to all other qualified 
                        beneficiaries residing with such spouse at the 
                        time such notification is made; and
                            ``(iii) any such notification shall, with 
                        respect to each qualified beneficiary with 
                        respect to whom such notification is made, 
                        include information regarding any Exchange 
                        established under title I of the Patient 
                        Protection and Affordable Care Act through 
                        which such a qualified beneficiary may be 
                        eligible to enroll in a qualified health plan 
                        (as defined in section 1301 of the Patient 
                        Protection and Affordable Care Act), 
                        including--
                                    ``(I) the publicly accessible 
                                Internet website address for such 
                                Exchange;
                                    ``(II) the publicly accessible 
                                Internet website address for the Find 
                                Local Help directory maintained by the 
                                Department of Health and Human Services 
                                on the healthcare.gov Internet website 
                                (or a successor website);
                                    ``(III) a clear explanation that--
                                            ``(aa) an individual who is 
                                        eligible for continuation 
                                        coverage may be eligible to 
                                        enroll instead, with financial 
                                        assistance, in a qualified 
                                        health plan offered through 
                                        such Exchange, but, in the case 
                                        that such individual elects to 
                                        enroll in such continuation 
                                        coverage and subsequently 
                                        elects to terminate such 
                                        continuation coverage before 
                                        the period of such continuation 
                                        coverage expires, such 
                                        individual may not be eligible 
                                        to enroll in a qualified health 
                                        plan offered through such 
                                        Exchange during a special 
                                        enrollment period if more than 
                                        60 days have elapsed since the 
                                        individual's loss of coverage 
                                        as an employee;
                                            ``(bb) an individual who 
                                        elects to enroll in 
                                        continuation coverage will 
                                        remain eligible to enroll in a 
                                        qualified health plan offered 
                                        through such Exchange during an 
                                        open enrollment period or 
                                        another special enrollment 
                                        period for which the individual 
                                        is eligible and may be eligible 
                                        for financial assistance with 
                                        respect to enrolling in such a 
                                        qualified health plan; and
                                            ``(cc) an individual may 
                                        apply for, and if eligible, 
                                        enroll in Medicaid or the 
                                        Children's Health Insurance 
                                        Program (CHIP), at any time, 
                                        with no special enrollment 
                                        period required;
                                    ``(IV) information on consumer 
                                protections with respect to enrolling 
                                in a qualified health plan offered 
                                through such Exchange, including the 
                                requirement for such a qualified health 
                                plan to provide coverage for essential 
                                health benefits (as defined in section 
                                1302(b) of the Patient Protection and 
                                Affordable Care Act) and the 
                                requirements applicable to such a 
                                qualified health plan under part A of 
                                title XXVII of the Public Health 
                                Service Act; and
                                    ``(V) information on the 
                                availability of financial assistance 
                                with respect to enrolling in a 
                                qualified health plan.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply with respect to qualifying events occurring on or 
        after the date that is 90 days after the date of the enactment 
        of this Act.
    (d) Model Notices.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of the Labor, in consultation with 
the Secretary of the Treasury and the Secretary of Health and Human 
Services, shall--
            (1) update the model Consolidated Omnibus Budget 
        Reconciliation Act of 1985 (referred to in this subsection as 
        ``COBRA'') continuation coverage general notice and the model 
        COBRA continuation coverage election notice developed by the 
        Secretary of Labor for purposes of facilitating compliance of 
        group health plans with the notification requirements under 
        section 606 of the Employee Retirement Income Security Act of 
        1974 (29 U.S.C. 1166) to include the information described in 
        paragraph (3) of subsection (c) of such section 606, as added 
        by subsection (a)(1);
            (2) provide an opportunity for consumer testing of each 
        such notice, as so updated, to ensure that each such notice is 
        clear and understandable to the average participant or 
        beneficiary of a group health plan; and
            (3) rename the model COBRA continuation coverage general 
        notice and the model COBRA continuation coverage election 
        notice as the ``model COBRA continuation coverage and 
        Affordable Care Act coverage general notice'' and the ``model 
        COBRA continuation coverage and Affordable Care Act coverage 
        election notice'', respectively.
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