Worker Health Coverage Protection Act

II 116TH CONGRESS 2D SESSION S. 4714 To preserve health benefits for workers. IN THE SENATE OF THE UNITED STATES SEPTEMBER 24, 2020 Mr. DURBIN (for himself, Ms. CORTEZ MASTO, Mr. BROWN, Mrs. SHAHEEN, Ms. SMITH, Ms. KLOBUCHAR, Mrs. FEINSTEIN, Mr. BENNET, Mr. REED, Mr. MERKLEY, Mr. BLUMENTHAL, Ms. DUCKWORTH, Ms. STABENOW, Ms. ROSEN, and Mr. MENENDEZ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To preserve health benefits for workers. 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 ‘‘Worker Health Cov- 4 erage Protection Act’’. 5 SEC. 2. PRESERVING HEALTH BENEFITS FOR WORKERS. 6 (a) PREMIUM ASSISTANCE FOR COBRA CONTINU- 7 ATION COVERAGE AND FURLOUGHED CONTINUATION 8 COVERAGE FOR INDIVIDUALS AND THEIR FAMILIES.— 9 (1) PROVISION OF PREMIUM ASSISTANCE.— 10 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 2 •S 4714 IS (A) REDUCTION OF PREMIUMS PAY- 1 ABLE.— 2 (i) COBRA CONTINUATION COV- 3 ERAGE.—In the case of any premium for a 4 period of coverage during the period begin- 5 ning on March 1, 2020, and ending on 6 January 31, 2021, for COBRA continu- 7 ation coverage with respect to any assist- 8 ance eligible individual described in para- 9 graph (3)(A), such individual shall be 10 treated for purposes of any COBRA con- 11 tinuation provision as having paid the 12 amount of such premium if such individual 13 pays (and any person other than such indi- 14 vidual’s employer pays on behalf of such 15 individual) 0 percent of the amount of 16 such premium owed by such individual (as 17 determined without regard to this sub- 18 section). 19 (ii) FURLOUGHED CONTINUATION 20 COVERAGE.—In the case of any premium 21 for a period of coverage during the period 22 beginning on March 1, 2020, and ending 23 on January 31, 2021, for coverage under 24 a group health plan with respect to any as- 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 3 •S 4714 IS sistance eligible individual described in 1 paragraph (3)(B), such individual shall be 2 treated for purposes of coverage under the 3 plan offered by the plan sponsor in which 4 the individual is enrolled as having paid 5 the amount of such premium if such indi- 6 vidual pays (and any person other than 7 such individual’s employer pays on behalf 8 of such individual) 0 percent of the 9 amount of such premium owed by such in- 10 dividual (as determined without regard to 11 this subsection). 12 (B) PLAN ENROLLMENT OPTION.— 13 (i) IN GENERAL.—Notwithstanding 14 the COBRA continuation provisions, any 15 assistance eligible individual who is en- 16 rolled in a group health plan offered by a 17 plan sponsor, not later than 90 days after 18 the date of notice of the plan enrollment 19 option described in this subparagraph, may 20 elect to enroll in coverage under a plan of- 21 fered by such plan sponsor that is different 22 than coverage under the plan in which 23 such individual was enrolled at the time— 24 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 4 •S 4714 IS (I) in the case of any assistance 1 eligible individual described in para- 2 graph (3)(A), the qualifying event 3 specified in section 603(2) of the Em- 4 ployee Retirement Income Security 5 Act of 1974 (29 U.S.C. 1163(2)), sec- 6 tion 4980B(f)(3)(B) of the Internal 7 Revenue Code of 1986, section 8 2203(2) of the Public Health Service 9 Act (42 U.S.C. 300bb–3(2)), or sec- 10 tion 8905a of title 5, United States 11 Code (except for the voluntary termi- 12 nation of such individual’s employ- 13 ment by such individual), occurred, 14 and such coverage shall be treated as 15 COBRA continuation coverage for 16 purposes of the applicable COBRA 17 continuation coverage provision; or 18 (II) in the case of any assistance 19 eligible individual described in para- 20 graph (3)(B), the furlough period 21 began with respect to such individual. 22 (ii) REQUIREMENTS.—Any assistance 23 eligible individual may elect to enroll in 24 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 5 •S 4714 IS different coverage as described in clause (i) 1 only if— 2 (I) the employer involved has 3 made a determination that such em- 4 ployer will permit such assistance eli- 5 gible individual to enroll in different 6 coverage as provided under this sub- 7 paragraph; 8 (II) the premium for such dif- 9 ferent coverage does not exceed the 10 premium for coverage in which such 11 individual was enrolled at the time 12 such qualifying event occurred or im- 13 mediately before such furlough began; 14 (III) the different coverage in 15 which the individual elects to enroll is 16 coverage that is also offered to the ac- 17 tive employees of the employer, who 18 are not in a furlough period, at the 19 time at which such election is made; 20 and 21 (IV) the different coverage in 22 which the individual elects to enroll is 23 not— 24 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 6 •S 4714 IS (aa) coverage that provides 1 only dental, vision, counseling, or 2 referral services (or a combina- 3 tion of such services); 4 (bb) a qualified small em- 5 ployer health reimbursement ar- 6 rangement (as defined in section 7 9831(d)(2) of the Internal Rev- 8 enue Code of 1986); 9 (cc) a flexible spending ar- 10 rangement (as defined in section 11 106(c)(2) of the Internal Rev- 12 enue Code of 1986); or 13 (dd) benefits that provide 14 coverage for services or treat- 15 ments furnished in an on-site 16 medical facility maintained by 17 the employer and that consists 18 primarily of first-aid services, 19 prevention and wellness care, or 20 similar care (or a combination of 21 such care). 22 (C) PREMIUM REIMBURSEMENT.—For pro- 23 visions providing the payment of such premium, 24 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 7 •S 4714 IS see section 6432 of the Internal Revenue Code 1 of 1986, as added by paragraph (14). 2 (2) LIMITATION OF PERIOD OF PREMIUM AS- 3 SISTANCE.— 4 (A) ELIGIBILITY FOR ADDITIONAL COV- 5 ERAGE.—Paragraph (1)(A) shall not apply with 6 respect to— 7 (i) any assistance eligible individual 8 described in paragraph (3)(A) for months 9 of coverage beginning on or after the ear- 10 lier of— 11 (I) the first date that such indi- 12 vidual is eligible for coverage under 13 any other group health plan (other 14 than coverage consisting of only den- 15 tal, vision, counseling, or referral serv- 16 ices (or a combination thereof), cov- 17 erage under a flexible spending ar- 18 rangement (as defined in section 19 106(c)(2) of the Internal Revenue 20 Code of 1986), coverage of treatment 21 that is furnished in an on-site medical 22 facility maintained by the employer 23 and that consists primarily of first-aid 24 services, prevention and wellness care, 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 8 •S 4714 IS or similar care (or a combination 1 thereof)), or eligible for benefits under 2 the Medicare program under title 3 XVIII of the Social Security Act (42 4 U.S.C. 1395 et seq.); or 5 (II) the earlier of— 6 (aa) the date following the 7 expiration of the maximum pe- 8 riod of continuation coverage re- 9 quired under the applicable 10 COBRA continuation coverage 11 provision; or 12 (bb) the date following the 13 expiration of the period of con- 14 tinuation coverage allowed under 15 paragraph (4)(B)(ii); or 16 (ii) any assistance eligible individual 17 described in paragraph (3)(B) for months 18 of coverage beginning on or after the ear- 19 lier of— 20 (I) the first date that such indi- 21 vidual is eligible for coverage under 22 any other group health plan (other 23 than coverage consisting of only den- 24 tal, vision, counseling, or referral serv- 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 9 •S 4714 IS ices (or a combination thereof), cov- 1 erage under a flexible spending ar- 2 rangement (as defined in section 3 106(c)(2) of the Internal Revenue 4 Code of 1986), coverage of treatment 5 that is furnished in an on-site medical 6 facility maintained by the employer 7 and that consists primarily of first-aid 8 services, prevention and wellness care, 9 or similar care (or a combination 10 thereof)), or eligible for benefits under 11 the Medicare program under title 12 XVIII of the Social Security Act (42 13 U.S.C. 1395 et seq.); or 14 (II) the first date that such indi- 15 vidual is no longer in the furlough pe- 16 riod. 17 (B) NOTIFICATION REQUIREMENT.—Any 18 assistance eligible individual shall notify the 19 group health plan with respect to which para- 20 graph (1)(A) applies if such paragraph ceases 21 to apply by reason of clause (i)(I) or (ii)(I) of 22 subparagraph (A) (as applicable). Such notice 23 shall be provided to the group health plan in 24 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 10 •S 4714 IS such time and manner as may be specified by 1 the Secretary of Labor. 2 (C) SPECIAL ENROLLMENT PERIOD FOL- 3 LOWING EXPIRATION OF PREMIUM ASSIST- 4 ANCE.—Notwithstanding section 1311 of the 5 Patient Protection and Affordable Care Act (42 6 U.S.C. 18031), the expiration of premium as- 7 sistance pursuant to a limitation specified 8 under subparagraph (A) shall be treated as a 9 qualifying event for which any assistance eligi- 10 ble individual is eligible to enroll in a qualified 11 health plan offered through an Exchange under 12 title I of such Act (42 U.S.C. 18001 et seq.) 13 during a special enrollment period. 14 (3) ASSISTANCE ELIGIBLE INDIVIDUAL.—For 15 purposes of this section, the term ‘‘assistance eligible 16 individual’’ means, with respect to a period of cov- 17 erage during the period beginning on March 1, 18 2020, and ending on January 31, 2021— 19 (A) any individual that is a qualified bene- 20 ficiary that— 21 (i) is eligible for COBRA continuation 22 coverage by reason of a qualifying event 23 specified in section 603(2) of the Employee 24 Retirement Income Security Act of 1974 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 11 •S 4714 IS (29 U.S.C. 1163(2)), section 1 4980B(f)(3)(B) of the Internal Revenue 2 Code of 1986, section 2203(2) of the Pub- 3 lic Health Service Act (42 U.S.C. 300bb– 4 3(2)), or section 8905a of title 5, United 5 States Code (except for the voluntary ter- 6 mination of such individual’s employment 7 by such individual); and 8 (ii) elects such coverage; or 9 (B) any covered employee that is in a fur- 10 lough period that remains eligible for coverage 11 under a group health plan offered by the em- 12 ployer of such covered employee. 13 (4) EXTENSION OF ELECTION PERIOD AND EF- 14 FECT ON COVERAGE.— 15 (A) IN GENERAL.—For purposes of apply- 16 ing section 605(a) of the Employee Retirement 17 Income Security Act of 1974 (29 U.S.C. 18 1165(a)), section 4980B(f)(5)(A) of the Inter- 19 nal Revenue Code of 1986, section 2205(a) of 20 the Public Health Service Act (42 U.S.C. 21 300bb–5(a)), and section 8905a(c)(2) of title 5, 22 United States Code, in the case of— 23 (i) an individual who does not have an 24 election of COBRA continuation coverage 25 VerDate Sep 11 2014 00:08 Oct 20, 2020 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 12 •S 4714 IS in effect on the date of the enactment of 1 this Act but who would be an assistance el- 2 igible individual described in paragraph 3 (3)(A) if such election were so in effect; or 4 (ii) an individual who elected COBRA 5 continuation coverage on or after March 1, 6 2020, and discontinued from such coverage 7 before the date of the enactment of this 8 Act, 9 such individual may elect the COBRA continu- 10 ation coverage under the COBRA continuation 11 coverage provisions containing such provisions 12 during the period beginning on the date of the 13 enactment of this Act and ending 60 days after 14 the date on which the notification required 15 under paragraph (7)(C) is provided to such in- 16 dividual. 17 (B) COMMENCEMENT OF COBRA CONTINU- 18 ATION COVERAGE.—Any COBRA continuation 19 coverage elected by a qualified beneficiary dur- 20 ing an extended election period under subpara- 21 graph (A)— 22 (i) shall apply as if such qualified ben- 23 eficiary had been covered as of the date of 24 a qualifying event specified in section 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 13 •S 4714 IS 603(2) of the Employee Retirement In- 1 come Security Act of 1974 (29 U.S.C. 2 1163(2)), section 4980B(f)(3)(B) of the 3 Internal Revenue Code of 1986, section 4 2203(2) of the Public Health Service Act 5 (42 U.S.C. 300bb–3(2)), or section 8905a 6 of title 5, United States Code, except for 7 the voluntary termination of such bene- 8 ficiary’s employment by such beneficiary, 9 that occurs no earlier than March 1, 2020 10 (including the treatment of premium pay- 11 ments under paragraph (1)(A) and any 12 cost-sharing requirements for items and 13 services under a group health plan); and 14 (ii) shall not extend beyond the period 15 of COBRA continuation coverage that 16 would have been required under the appli- 17 cable COBRA continuation coverage provi- 18 sion if the coverage had been elected as re- 19 quired under such provision. 20 (5) EXPEDITED REVIEW OF DENIALS OF PRE- 21 MIUM ASSISTANCE.—In any case in which an indi- 22 vidual requests treatment as an assistance eligible 23 individual described in subparagraph (A) or (B) of 24 paragraph (3) and is denied such treatment by the 25 VerDate Sep 11 2014 04:25 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S4714.IS S4714 kjohnson on DSK79L0C42PROD with BILLS 14 •S 4714 IS group health plan, the Sec [Text truncated for display. 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