Continuous Health Coverage for Workers Act

II 116TH CONGRESS 2D SESSION S. 4329 To provide premium assistance for COBRA continuation coverage, church plan continuation coverage, and furloughed continuation coverage for individuals and their families. IN THE SENATE OF THE UNITED STATES JULY 27, 2020 Ms. MCSALLY (for herself, Mr. DAINES, Mr. CORNYN, and Mr. SULLIVAN) in- troduced the following bill; which was read twice and referred to the Com- mittee on Finance A BILL To provide premium assistance for COBRA continuation cov- erage, church plan continuation coverage, and furloughed continuation coverage for individuals and their families. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Continuous Health 4 Coverage for Workers Act’’. 5 SEC. 2. PRESERVING HEALTH BENEFITS FOR WORKERS. 6 (a) PROVISION OF PREMIUM ASSISTANCE.— 7 (1) REDUCTION OF PREMIUMS PAYABLE.— 8 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 4329 IS (A) COBRA CONTINUATION COVERAGE.— 1 In the case of any premium for a period of cov- 2 erage during the period beginning on the first 3 day of the first month that begins after the 4 date of enactment of this Act and ending on 5 December 31, 2020, for COBRA continuation 6 coverage with respect to any assistance eligible 7 individual described in subsection (c)(1), such 8 individual shall be treated for purposes of any 9 COBRA continuation provision as having paid 10 the amount of such premium if such individual 11 pays (and any person other than such individ- 12 ual’s employer pays on behalf of such indi- 13 vidual) the greater of 15 percent of the amount 14 of such premium owed by such individual (as 15 determined without regard to this subsection) 16 or the amount of the premium that a similarly 17 situated individual enrolled in the plan who is 18 not an assistance eligible individual is (or would 19 be, if so enrolled) required to pay with respect 20 to the plan (after any employer contribution). 21 (B) CHURCH PLANS.—In the case of any 22 premium for a period of coverage during the pe- 23 riod beginning on the first day of the first 24 month that begins after the date of enactment 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 4329 IS of this Act and ending on December 31, 2020, 1 for coverage under a church plan with respect 2 to any assistance eligible individual described in 3 subsection (c)(2), such individual shall be treat- 4 ed for purposes of the individual’s coverage 5 under such plan as having paid the amount of 6 such premium if such individual pays (and any 7 person other than such individual’s employer 8 pays on behalf of such individual) the greater of 9 15 percent of the amount of such premium 10 owed by such individual (as determined without 11 regard to this subsection) or the amount of the 12 premium that a similarly situated individual en- 13 rolled in the plan who is not an assistance eligi- 14 ble individual is (or would be, if so enrolled) re- 15 quired to pay with respect to the plan (after 16 any employer contribution). 17 (C) FURLOUGHED CONTINUATION COV- 18 ERAGE.—In the case of any premium for a pe- 19 riod of coverage during the period beginning on 20 the first day of the first month that begins 21 after the date of enactment of this Act and end- 22 ing on December 31, 2020, for coverage under 23 a group health plan with respect to any assist- 24 ance eligible individual described in subsection 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 4329 IS (c)(3), such individual shall be treated for pur- 1 poses of the individual’s coverage under such 2 plan as having paid the amount of such pre- 3 mium if such individual pays (and any person 4 other than such individual’s employer pays on 5 behalf of such individual) the greater of 15 per- 6 cent of the amount of such premium owed by 7 such individual (as determined without regard 8 to this subsection) or the amount of the pre- 9 mium that a similarly situated individual en- 10 rolled in the plan who is not an assistance eligi- 11 ble individual is (or would be, if so enrolled) re- 12 quired to pay with respect to the plan (after 13 any employer contribution). 14 (2) PLAN ENROLLMENT OPTION.— 15 (A) IN GENERAL.—Any assistance eligible 16 individual who is enrolled in a group health 17 plan offered by a plan sponsor may, not later 18 than 90 days after the date of notice of the 19 plan enrollment option described in this para- 20 graph, elect to enroll in coverage under a plan 21 offered by such plan sponsor that is different 22 than coverage under the plan in which such in- 23 dividual was enrolled at the time— 24 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 4329 IS (i) in the case of any assistance eligi- 1 ble individual described in subsection 2 (c)(1), the qualifying event specified in sec- 3 tion 603(2) of the Employee Retirement 4 Income Security Act of 1974, section 5 4980B(f)(3)(B) of the Internal Revenue 6 Code of 1986, section 2203(2) of the Pub- 7 lic Health Service Act, or section 8905a of 8 title 5, United States Code (except for the 9 voluntary termination of such individual’s 10 employment by such individual), occurred, 11 and such coverage shall be treated as 12 COBRA continuation coverage for pur- 13 poses of the applicable COBRA continu- 14 ation provision; 15 (ii) in the case of an assistance eligi- 16 ble individual described in subsection 17 (c)(2), the termination or reduction of 18 hours of employment of such individual oc- 19 curred; or 20 (iii) in the case of any assistance eligi- 21 ble individual described in subsection 22 (c)(3), the furlough period began with re- 23 spect to such individual. 24 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 4329 IS (B) REQUIREMENTS.—Any assistance eli- 1 gible individual may elect to enroll in different 2 coverage as described in subparagraph (A) only 3 if— 4 (i) the employer involved has made a 5 determination that such employer will per- 6 mit such assistance eligible individual to 7 enroll in different coverage as provided 8 under this paragraph; 9 (ii) the premium for such different 10 coverage does not exceed the premium for 11 coverage in which such individual was en- 12 rolled at the time such qualifying event oc- 13 curred or immediately before such furlough 14 began; 15 (iii) the different coverage in which 16 the individual elects to enroll is coverage 17 that is also offered to the active employees 18 of the employer, who are not in a furlough 19 period, at the time at which such election 20 is made; and 21 (iv) the different coverage in which 22 the individual elects to enroll is not— 23 (I) coverage that provides only 24 dental, vision, counseling, or referral 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 4329 IS services (or a combination of such 1 services); 2 (II) a qualified small employer 3 health reimbursement arrangement 4 (as defined in section 9831(d)(2) of 5 the Internal Revenue Code of 1986); 6 (III) a flexible spending arrange- 7 ment (as defined in section 106(c)(2) 8 of the Internal Revenue Code of 9 1986); or 10 (IV) benefits that provide cov- 11 erage for services or treatments fur- 12 nished in an on-site medical facility 13 maintained by the employer and that 14 consists primarily of first-aid services, 15 prevention and wellness care, or simi- 16 lar care (or a combination of such 17 care). 18 (3) PREMIUM REIMBURSEMENT.—For provi- 19 sions providing the payment of such premium, see 20 section 6432 of the Internal Revenue Code of 1986, 21 as added by section 3(a). 22 (b) LIMITATION OF PERIOD OF PREMIUM ASSIST- 23 ANCE.— 24 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 4329 IS (1) ELIGIBILITY FOR ADDITIONAL COV- 1 ERAGE.—Subsection (a)(1) shall not apply with re- 2 spect to— 3 (A) any assistance eligible individual de- 4 scribed in subsection (c)(1) for months of cov- 5 erage beginning on or after the earlier of— 6 (i) the first date that such individual 7 is eligible for coverage under any other 8 group health plan (other than coverage 9 consisting of only dental, vision, coun- 10 seling, or referral services (or a combina- 11 tion thereof), coverage under a flexible 12 spending arrangement (as defined in sec- 13 tion 106(c)(2) of the Internal Revenue 14 Code of 1986), coverage of treatment that 15 is furnished in an on-site medical facility 16 maintained by the employer and that con- 17 sists primarily of first-aid services, preven- 18 tion and wellness care, or similar care (or 19 a combination thereof)), or eligible for ben- 20 efits under the Medicare program under 21 title XVIII of the Social Security Act; or 22 (ii) the earlier of— 23 (I) the date following the expira- 24 tion of the maximum period of con- 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 4329 IS tinuation coverage required under the 1 applicable COBRA continuation cov- 2 erage provision; or 3 (II) the date following the expira- 4 tion of the period of continuation cov- 5 erage allowed under subsection 6 (d)(2)(B); 7 (B) any assistance eligible individual de- 8 scribed in subsection (c)(2) for months of cov- 9 erage beginning on or after the earlier of— 10 (i) the first date that such individual 11 is eligible for coverage under any other 12 group health plan (other than coverage 13 consisting of only dental, vision, coun- 14 seling, or referral services (or a combina- 15 tion thereof), coverage under a flexible 16 spending arrangement (as defined in sec- 17 tion 106(c)(2) of the Internal Revenue 18 Code of 1986), coverage of treatment that 19 is furnished in an on-site medical facility 20 maintained by the employer and that con- 21 sists primarily of first-aid services, preven- 22 tion and wellness care, or similar care (or 23 a combination thereof)), or eligible for ben- 24 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 4329 IS efits under the Medicare program under 1 title XVIII of the Social Security Act; or 2 (ii) the first date on which the church 3 plan is no longer available to such indi- 4 vidual; or 5 (C) any assistance eligible individual de- 6 scribed in paragraph (3)(C) for months of cov- 7 erage beginning on or after the earlier of— 8 (i) the first date that such individual 9 is eligible for coverage under any other 10 group health plan (other than coverage 11 consisting of only dental, vision, coun- 12 seling, or referral services (or a combina- 13 tion thereof), coverage under a flexible 14 spending arrangement (as defined in sec- 15 tion 106(c)(2) of the Internal Revenue 16 Code of 1986), coverage of treatment that 17 is furnished in an on-site medical facility 18 maintained by the employer and that con- 19 sists primarily of first-aid services, preven- 20 tion and wellness care, or similar care (or 21 a combination thereof)), or eligible for ben- 22 efits under the Medicare program under 23 title XVIII of the Social Security Act; or 24 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 4329 IS (ii) the first date that such individual 1 is no longer in the furlough period. 2 (2) NOTIFICATION REQUIREMENT.—Any assist- 3 ance eligible individual shall notify the group health 4 plan with respect to which subsection (a)(1) applies 5 if such paragraph ceases to apply by reason of sub- 6 paragraph (A)(i), (B)(i), or (C)(i) of paragraph (1) 7 (as applicable). Such notice shall be provided to the 8 group health plan in such time and manner as may 9 be specified by the Secretary of Labor. 10 (3) SPECIAL ENROLLMENT PERIOD FOLLOWING 11 EXPIRATION OF PREMIUM ASSISTANCE.—Notwith- 12 standing section 1311 of the Patient Protection and 13 Affordable Care Act (42 U.S.C. 18031), the expira- 14 tion of premium assistance pursuant to a limitation 15 specified under paragraph (1) shall be treated as a 16 qualifying event for which any assistance eligible in- 17 dividual is eligible to enroll in a qualified health plan 18 offered through an Exchange under title I of such 19 Act (42 U.S.C. 18001 et seq.) during a special en- 20 rollment period. 21 (c) ASSISTANCE ELIGIBLE INDIVIDUAL.—For pur- 22 poses of this section, the term ‘‘assistance eligible indi- 23 vidual’’ means, with respect to a period of coverage during 24 the period beginning on the first day of the first month 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 4329 IS that begins after the date of enactment of this Act and 1 ending on December 31, 2020— 2 (1) any individual that is a qualified beneficiary 3 that— 4 (A) is eligible for COBRA continuation 5 coverage by reason of a qualifying event speci- 6 fied in section 603(2) of the Employee Retire- 7 ment Income Security Act of 1974, section 8 4980B(f)(3)(B) of the Internal Revenue Code 9 of 1986, section 2203(2) of the Public Health 10 Service Act, or section 8905a of title 5, United 11 States Code (except for the voluntary termi- 12 nation of such individual’s employment by such 13 individual); and 14 (B) elects such coverage; 15 (2) any individual who— 16 (A) is terminated from (other than by rea- 17 son of such employee’s gross misconduct or vol- 18 untary termination), or is subject to a reduction 19 in hours with respect to, employment with an 20 employer who offers a church plan, if the em- 21 ployer voluntarily offers coverage under such 22 plan to such individual after the termination or 23 reduction of hours, or is a beneficiary of such 24 an individual who is terminated or subject to a 25 VerDate Sep 11 2014 17:59 Aug 11, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S4329.IS S4329 pamtmann on DSKBC07HB2PROD with BILLS 13 •S 4329 IS reduction [Text truncated for display. Full text available on Congress.gov.]