Small Employers Health Benefits Program Act of 2004
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Small Employers Health Benefits Program Act of 2004 - 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. Permits rates and premiums to vary based on age but not on health status factors.
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.
Referred to the Subcommittee on Employer-Employee Relations.
- Introduced in House Formatted Text PDF Formatted XML
Cite this page
U.S. Congress. (2026). H.R. 4498: Small Employers Health Benefits Program Act of 2004. 108th Congress. Open America. https://openamerica.io/bill/108-HR-4498/
"H.R. 4498: Small Employers Health Benefits Program Act of 2004." 108th Congress, 2026, Open America, https://openamerica.io/bill/108-HR-4498/.
H.R. 4498, 108th Cong. (2026), https://openamerica.io/bill/108-HR-4498/.
[H.R. 4498: Small Employers Health Benefits Program Act of 2004](https://openamerica.io/bill/108-HR-4498/)