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Washington Labor & Employment Wire » House Passes Health Insurance Restrictions and Limitations Clarification Act of 2008

House Passes Health Insurance Restrictions and Limitations Clarification Act of 2008

On September 23, 2008, after forty minutes of debate, the House suspended the rules and passed the Health Insurance Restrictions and Limitations Clarification Act of 2008 (H.R. 6908).  This legislation was previously titled the Health Insurance Source of Injury Clarification Act of 2008.

This legislation would amend the provisions of the Employee Retirement Income Security Act, Public Health Service Act, and Internal Revenue Code permitting group health plans to establish limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the plan or coverage.  The new language would clarify that such limitations must be explicit and clear and disclosed to the plan sponsor in advance of the point of sale to the plan. The plan sponsor and issuer of the coverage would be required to make available to participants and beneficiaries prior to their enrollment and upon their enrollment a description of such limitations and restrictions in an easily understandable form.  The legislation was amended to clarify that providing such materials upon enrollment meant “at the earliest opportunity that other materials are provided.”