Small Employers Health Benefits Program Act of 2005

Bill: 109-s-874
Sponsor: Sen. Durbin, Richard J. [D-IL]
Introduced: 2005-04-21 in the Senate
Policy area: Health
Subjects: Administrative procedure
Catastrophic health insurance
Civil Rights and Liberties, Minority Issues
Commerce
Competitive bidding
Congress
Congressional reporting requirements
Cost accounting
Discrimination in insurance
Discrimination in medical care
Economics and Public Finance
Electronic government information
Employee health benefits
Federal employees
Federal preemption
Finance and Financial Sector
Government Operations and Politics
Government contractors
Government employees' health insurance
Government paperwork
Government publicity
Health insurance
Health insurance continuation
Income tax
Indexing (Economic policy)
Insurance premiums
Internet
Labor and Employment
Law
Local laws
Medical economics
Medically uninsured
Medicare
Nonprofit organizations
Office of Personnel Management
Rebates
Reinsurance
Science, Technology, Communications
Self-employed
Small business
Social Welfare
State laws
Subsidies
Tax credits
Tax refunds
Taxation

Summary:
action_date: 2005-04-21
text: 
Small Employers Health Benefits Program Act of 2005 - Directs the Office of Personnel Management to administer a separate health insurance program for non-Federal employees who are either self-employed or employees of a small business with fewer than 100 employees.
 
Allows the Office to contract with carriers to provide health insurance under this Act. Requires rates charged to reasonably and equitably reflect the costs of the benefits provided. Requires a carrier to determine the amount of premiums to assess for coverage based on a community rate that may be annually adjusted based on geographic area, family status, and age.
 
Permits the Office to reimburse a carrier for costs that exceed premiums received by a specified percentage. Requires a carrier to make payments to a contingency reserve fund established by the Office if the carrier's costs are lower than expected by a specified percentage. Allows the Office to use such funds to provide assistance to carriers that experience unanticipated financial hardships.
 
 Requires the Office to establish a reinsurance fund to provide payments to carriers that experience a catastrophic claim (a claim over $50,000) for benefits provided to an individual enrolled under this Act.
 
Allows a participating employer to offer supplemental coverage options to employees for excepted benefits that are not subject to the Public Health Service Act requirements for health plans.
 
Authorizes the Office to contract with entities to administer this health program regionally.
 
Allows certain benefits to be offered to Medicare beneficiaries.
 
Requires the Office to implement a public education campaign regarding this health insurance program.
 
 Allows a refundable tax credit for health insurance expenses of small employers who pay a specific percentage of employee expenses under such a health plan.


Legislative actions:
action_date: 2005-04-22
text: Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 91.
action_date: 2005-04-21
text: Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time. (text of measure as introduced: CR S4114-4118)
action_date: 2005-04-21
text: Introduced in Senate