Skip to main content
S 1028 104th Congress Senate Health Accounting Administrative procedure Administrative responsibility Adopted children Alien labor Americans employed in foreign countries Americans in foreign countries Appropriations Bank loans Bank mergers Bank reserves Caregivers Charities Child health Chronically ill Citizenship Civil Rights and Liberties, Minority Issues Commerce Conflict of interests

Health Insurance Reform Act of 1995

Introduced: July 13, 1995 See on congress.gov
Sign in to write a letter Sign in to watch
 Everywhere this bill has been 13 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Apr 23, 1996
Senate passed companion measure H.R. 3103 in lieu of this measure by Yea-Nay Vote. 100-0. Record Vote No: 78.
Apr 19, 1996
Returned to the Calendar. Calendar No. 205. (consideration: CR S3742)
Apr 18, 1996
Senate incorporated this measure in H.R. 3103 as an amendment. (consideration: CR S3613)
Apr 18, 1996
The committee substitute as amended agreed to by Voice Vote.
Apr 18, 1996
Measure laid before Senate by unanimous consent. (consideration: CR S3503-3575, S3578-3613)
Oct 12, 1995
Committee on Labor and Human Resources. Reported to Senate by Senator Kassebaum with an amendment in the nature of a substitute. With written report No. 104-156.
Oct 12, 1995
Placed on Senate Legislative Calendar under General Orders. Calendar No. 205.
Aug 2, 1995
Committee on Labor and Human Resources. Ordered to be reported with an amendment in the nature of a substitute favorably.
Jul 28, 1995
Committee on Labor and Human Resources. Hearings held.
Jul 18, 1995
Committee on Labor and Human Resources. Hearings held.
Jul 13, 1995
Read twice and referred to the Committee on Labor and Human Resources.
Jul 13, 1995
Sponsor introductory remarks on measure. (CR S9905)
Jul 13, 1995
Introduced in Senate
 Plain-English summary Congressional Research Service

TABLE OF CONTENTS:

Title I: Health Care Access, Portability, and Renewability

Subtitle A: Group Health Plan Rules

Subtitle B: Individual Health Plan Rules

Subtitle C: COBRA Clarifications

Subtitle D: Private Health Plan Purchasing Coalitions

Title II: Application and Enforcement of Standards

Title III: Miscellaneous Provisions

Health Insurance Reform Act of 1995 - Title I: Health Care Access, Portability, and Renewability - Subtitle A: Group Health Plan Rules - Prohibits insurers from declining to provide coverage, and plans from establishing certain types of requirements, based on health status, medical condition, and similar factors.

(Sec. 102) Mandates plan renewability, except for nonpayment of premiums, termination of the plan, or other specified reasons.

(Sec. 103) Regulates the circumstances in which a plan may impose a benefit limitation or exclusion because of a preexisting condition. Allows State laws that limit preexisting conditions to shorter periods than the provisions of this paragraph.

(Sec. 104) Mandates special enrollment periods for individuals who have certain types of changes in family composition or employment status.

(Sec. 105) Regulates disclosures an insurer must make to a small employer (as defined in State law, or employers with not more than 50 employees if not defined in State law).

Subtitle B: Individual Health Plan Rules - Prohibits an insurer from establishing, for an individual in a period of previous qualifying coverage, eligibility, continuation, or enrollment requirements based on health status, medical condition, and similar factors.

(Sec. 111) Mandates renewability of coverage for individuals, except for nonpayment of premiums, misrepresentation of material fact, or termination of the plan.

(Sec. 112) Requires that State law in effect on, or enacted after, enactment of this Act apply in lieu of the standards above in this subtitle unless the Secretary of Health and Human Services determines that the State law is not as effective in providing access.

(Sec. 113) Mandates a study and report on ensuring the availability of health insurance to individuals, the need for Federal premium variation standards, and the effectiveness of this Act and State laws in stabilizing the small group health insurance market by providing for the broad pooling of risk.

Subtitle C: COBRA Clarifications - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to modify continuation coverage requirements.

Subtitle D: Private Health Plan Purchasing Coalitions - Requires a State to certify health plan purchasing coalitions (HPPCs) meeting the requirements of this paragraph. Provides for Federal certification if a State fails to do so. Regulates HPPC organization, duties, and activities. Preempts, for a HPPC meeting these requirements, State fictitious group laws, State rating requirement laws (subject to exception), and other State laws in direct conflict. Applies to HPPCs the requirements of ERISA provisions relating to fiduciary responsibility and administration and enforcement.

Title II: Application and Enforcement of Standards - Deems a requirement or standard under this Act imposed on: (1) a plan to be imposed on the insurer; and (2) a self-insured plan to be imposed on the plan sponsor.

(Sec. 202) Requires each State to mandate that each plan in the State meet the standards under this Act pursuant to an enforcement plan filed by the State with the Secretary of Labor.

Directs the Secretary, for self-insured health plans, to enforce the standards under this Act. Subjects failing plans to civil enforcement under specified ERISA provisions.

Provides for Federal enforcement if a State fails to do so.

Title III: Miscellaneous Provisions - Amends the Public Health Service Act to allow a health maintenance organization, if notified by a member that a medical savings account has been established for the member and if the member requests, to reduce the basic health services payment by requiring the payment of a deductible for basic health services.

Declares that it is the sense of the Senate that the Congress should take steps to further the purposes of this Act.

What's happening now April 23, 1996

Senate passed companion measure H.R. 3103 in lieu of this measure by Yea-Nay Vote. 100-0. Record Vote No: 78.

 Committees of jurisdiction 1
 Cosponsors 4
All 4 Democratic 2 Republican 2