Definition: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Children's Health Insurance for
Long-Term Development Act of 1996''.

SEC. 2. PURPOSE.

The purpose of this act is to provide health insurance coverage for
children during the Infant Neurological Risk Exposure Period (INREP).
The INREP extends through age 3 and encompasses the period of most
rapid neurological changes in young children. Health coverage will
improve children's health and, through routine health supervision,
promote parents' caregiving skills through these critical years.

SEC. 3. FINDINGS.

Congress finds that--
(1) 86 percent of children with private health insurance
are under-insured with respect to well-child care;
(2) because the human brain develops rapidly until the age
of 3, children need regular screenings and follow-up care to
detect neurological abnormalities and ensure normal
development;
(3) regular pediatric visits enable physicians to provide
guidance on parental activities, such as reading, that
stimulate the brain development of infants; and
(4) children deserve health care coverage that promotes
normal brain and nervous system development.

SEC. 4. DEFINITIONS.

As used in this Act:
(1) Beneficiary.--The term ''beneficiary'' has the meaning
given such term under section 3(8) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1002(8)).
(2) Child.--The term ''child'' means an individual who is
age 3 or younger.
(3) Employee health benefit plan.--
(A) In general.--The term ''employee health benefit
plan'' means any employee welfare benefit plan,
governmental plan, or church plan (as defined under paragraphs (1),
(32), and (33) of section 3 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1002 (1), (32), and (33))) that provides or pays
for health benefits (such as provider and hospital benefits) for
participants and beneficiaries whether--
(i) directly;
(ii) through a health plan offered by a
health plan issuer as defined in paragraph (6);
or
(iii) otherwise.
(B) Rule of construction.--An employee health
benefit plan shall not be construed to be a health plan
or a health plan issuer.
(C) Arrangements not included.--Such term does not
include the following, or any combination thereof:
(i) Coverage only for accident, or
disability income insurance, or any combination
thereof.
(ii) Medicare supplemental health insurance
(as defined under section 1882(g)(1) of the
Social Security Act (42 U.S.C. 1395ss(g)(1))).
(iii) Coverage issued as a supplement to
liability insurance.
(iv) Liability insurance, including general
liability insurance and automobile liability
insurance.
(v) Workers' compensation or similar
insurance.
(vi) Automobile medical payment insurance.
(vii) Coverage for a specified disease or
illness.
(viii) Hospital or fixed indemnity
insurance.
(ix) Short-term limited duration insurance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy providing
benefits only for long-term care, nursing home
care, home health care, community-based care, or any combination
thereof.
(4) Group purchaser.--The term ''group purchaser'' means
any person (as defined in section 3(9) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1002(9))) or
entity that purchases or pays for health benefits (such as
provider or hospital benefits) on behalf of participants or
beneficiaries in connection with an employee health benefit
plan.
(5) Health plan.--
(A) In general.--The term ''health plan'' means any
group health plan or individual health plan.
(B) Group health plan.--The term ''group health
plan'' means any contract, policy, certificate, or
other arrangement offered by a health plan issuer to a
group purchaser that provides or pays for health
benefits (such as provider and hospital benefits) in
connection with an employee health benefit plan.
(C) Individual health plan.--The term ''individual
health plan'' means any contract, policy, certificate,
or other arrangement offered by a health plan issuer to
individuals that provides or pays for health benefits
(such as provider and hospital benefits) and that is
not a group health plan.
(D) Arrangements not included.--Such term does not
include the following, or any combination thereof:
(i) Coverage only for accident, or
disability income insurance, or any combination
thereof.
(ii) Medicare supplemental health insurance
(as defined under section 1882(g)(1) of the
Social Security Act).
(iii) Coverage issued as a supplement to
liability insurance.
(iv) Liability insurance, including general
liability insurance and automobile liability
insurance.
(v) Workers' compensation or similar
insurance.
(vi) Automobile medical payment insurance.
(vii) Coverage for a specified disease or
illness.
(viii) Hospital or fixed indemnity
insurance.
(ix) Short-term limited duration insurance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy providing
benefits only for long-term care, nursing home
care, home health care, community-based care,
or any combination thereof.
(E) Certain plans included.--Such term includes any
plan or arrangement not described in any clause of
subparagraph (D) that provides for benefit payments, on
a periodic basis, for--
(i) a specified disease or illness; or
(ii) a period of hospitalization;
without regard to the costs incurred or services
rendered during the period to which the payments
relate.
(6) Health plan issuer.--The term ''health plan issuer''
means any entity that is licensed (prior to or after the date
of enactment of this Act) by a State to offer a health plan.
(7) Participant.--The term ''participant'' has the meaning
given such term under section 3(7) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1002(7)).
(8) Secretary.--The term ''Secretary'' unless otherwise
specified means the Secretary of Labor.

SEC. 5. REQUIRED HEALTH CARE COVERAGE FOR CHILDREN.

(a) In General.--Except as provided in subsection (b), a health
plan or an employee health benefit plan shall ensure that coverage is
provided with respect to a child who is a beneficiary under such plan
for all medically necessary health care and related services,
including--
(1) appropriate screening services at intervals that meet
reasonable standards of medical and dental practice;
(2) all appropriate immunizations;
(3) necessary case management, transportation, and
scheduling assistance; and
(4) such other necessary health care, diagnostic services,
treatment, and other measures to correct or ameliorate defects
and physical and mental illnesses and conditions discovered by
the screening services, whether or not such services are
covered for participants or policyholders under the plan.
(b) Exception.--Notwithstanding subsection (a), a health plan or an
employee health benefit plan shall not be required to provide coverage
for health care and related services that are not safe, are not
effective, or are experimental.

SEC. 6. PROHIBITIONS.

In implementing the requirements of this Act, a health plan or an
employee health benefit plan may not use a service limitation,
including a lifetime benefit limit, of the plan to deny medically
necessary health care and related services described in section 4 to a
child.

SEC. 7. NOTICE.

(a) Employee Health Benefit Plan.--An employee health benefit plan
shall provide conspicuous notice to each participant regarding coverage
required under this Act not later than 120 days after the date of
enactment of this Act, and as part of its summary plan description.
(b) Health Plan.--A health plan shall provide notice to each
policyholder regarding coverage required under this Act. Such notice
shall be in writing, prominently positioned, and be transmitted--
(1) in a mailing made within 120 days after the date of
enactment of this Act by such plan to the policyholder; and
(2) as part of the annual informational packet sent to the
policyholder.

SEC. 8. APPLICABILITY.

(a) Construction.--
(1) In general.--A requirement or standard imposed under
this Act on a health plan shall be deemed to be a requirement
or standard imposed on the health plan issuer. Such
requirements or standards shall be enforced by the State
insurance commissioner for the State involved or the official
or officials designated by the State to enforce the
requirements of this Act. In the case of a health plan offered
by a health plan issuer in connection with an employee health
benefit plan, the requirements or standards imposed under this
Act shall be enforced with respect to the health plan issuer by
the State insurance commissioner for the State involved or the
official or officials designated by the State to enforce the
requirements of this Act.
(2) Limitation.--Except as provided in section 8(c), the
Secretary shall not enforce the requirements or standards of
this Act as they relate to health plan issuers or health plans.
In no case shall a State enforce the requirements or standards
of this Act as they relate to employee health benefit plans.
(b) Rule of Construction.--Nothing in this Act shall be construed
to affect or modify the provisions of section 514 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1144).

SEC. 9. ENFORCEMENT.

(a) Health Plan Issuers.--Each State shall require that each health
plan issued, sold, renewed, offered for sale or operated in such State
by a health plan issuer meet the standards established under this Act.
A State shall submit such information as required by the Secretary
demonstrating effective implementation of the requirements of this Act.
(b) Employee Health Benefit Plans.--With respect to employee health
benefit plans, the standards established under this Act shall be
enforced in the same manner as provided for under sections 502, 504,
506, and 510 of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1132, 1134, 1136, and 1140). The civil penalties contained in
paragraphs (1) and (2) of section 502(c) of such Act (29 U.S.C. 1132(c)
(1) and (2)) shall apply to any information required by the Secretary
to be disclosed and reported under this section.
(c) Failure To Enforce.--In the case of the failure of a State to
substantially enforce the standards and requirements set forth in this
Act with respect to health plans, the Secretary, in consultation with
the Secretary of Health and Human Services, shall enforce the standards
of this Act in such State. In the case of a State that fails to
substantially enforce the standards set forth in this Act, each health
plan issuer operating in such State shall be subject to civil
enforcement as provided for under sections 502, 504, 506, and 510 of
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1132,
1134, 1136, and 1140). The civil penalties contained in paragraphs (1)
and (2) of section 502(c) of such Act (29 U.S.C. 1132(c)(1) and (2))
shall apply to any information required by the Secretary to be
disclosed and reported under this section.
(d) Regulations.--The Secretary, in consultation with the Secretary
of Health and Human Services, may promulgate such regulations as may be
necessary or appropriate to carry out this Act.

SEC. 10. PREEMPTION.

(a) In General.--The provisions of sections 4, 5, and 6 shall not
preempt a State law or regulation--
(1) that provides greater protections to patients or
policyholders than those required in this Act; or
(2) that requires health plans to provide coverage for
pediatric care in accordance with guidelines established by the
American Academy of Pediatrics or other established
professional medical associations.
(b) Employee Health Benefit Plans.--Nothing in this section affects
the application of this Act to employee health benefit plans, as
defined in section 2(3).

SEC. 11. EFFECTIVE DATE.

Except as otherwise provided for in this Act, the provisions of
this Act shall apply as follows:
(1) With respect to health plans, such provisions shall
apply to such plans on the first day of the contract year
beginning on or after June 1, 1997.
(2) With respect to employee health benefit plans, such
provisions shall apply to such plans on the first day of the
first plan year beginning on or after June 1, 1997.
Output:
Children's Health Insurance for Long-Term Development Act of 1996 - Requires health plans and employee health benefit plans to ensure coverage of all medically necessary health care and related services for children during the Infant Neurological Risk Exposure Period (INREP), which extends through age three and encompasses the period of most rapid neurological changes in young children. Prohibits health plans from using a service limitation, including a lifetime benefit limit, to deny medically necessary health care and related services to a child.
Sets forth enforcement provisions.