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Washington Labor & Employment Wire » ERISA

Right to a Second Medical Opinion Act of 2009 (H.R. 2457)

Core Provisions:  This legislation would amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code to require group health plans and issuers of health insurance coverage to provide coverage for second medical opinions. Coverage for second opinions would have to be under the same terms as coverage for initial opinions. The bill contains an exception for group health plans maintained pursuant to collective bargaining agreements.

Status: H.R. 2457 was introduced by Rep. Davis (D-CA) on May 18, 2009 and referred to the Committees on Energy and Commerce; Education and Labor; and Ways and Means.


Savings Recovery Act of 2009 (H.R. 2021)

Core Provisions: The Savings Recovery Act is intended as a measure to help rebuild retirement, college, and personal savings. The legislation would increase the monthly exempt amount under the Social Security earnings test for individuals who have not reached retirement age. The bill also includes provisions that would exclude certain dividends and long-term capital gains of noncorporate taxpayers and increase the limitation on capital losses of noncorporate taxpayers. To increase opportunities for retirement savings, the bill would eliminate marriage penalties in income limitations with respect to individual retirement plan contributions; increase the amount that can be contributed to retirement plans; and increase the amount of allowed catch-up contributions to retirement plans, among other things. The legislation also targets savings for higher education by providing a credit for contributions to 529 plans.

Status: H.R. 2021 was introduced by Rep. Boehner (R-OH) on April 22, 2009 and referred to the Committees on Ways and Means and Education and Labor.


401(k) Fair Disclosure for Retirement Security Act of 2009 (H.R. 1984)

Core Provisions: The 401(k) Fair Disclosure for Retirement Security Act of 2009 (H.R. 1984) would amend ERISA to provide special reporting and disclosure rules for individual account plans. The bill would require clear and complete disclosure to plan participants of fees taken from 401(k) accounts.  The plan must provide each plan participant with the total sum of fees taken from his or her account, and participants also have the authority to request more detailed information from the plan administrator. The bill also requires that all 401(k) plans include at least one index fund as an option. The legislation gives the Department of Labor authority to review compliance with the disclosure requirements and to impose penalties for violations.

Status: H.R. 1984 was introduced by Rep. George Miller (D-CA) on April 21, 2009 and referred to the Committee on Education and Labor.  The Health, Employment, Labor, and Pensions Subcommittee held a hearing on the bill on April 22, 2009.  The committee approved a similar bill in the 110th Congress (H.R. 3185), but the bill was not acted upon thereafter.


House Passes Health Insurance Restrictions and Limitations Clarification Act of 2009 (H.R. 1253)

Core Provisions: This legislation would amend the provisions of the Employee Retirement Income Security Act, Public Health Service Act, and Internal Revenue Code that permit group health plans to establish limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for participants and beneficiaries of the plan. The new language would clarify that such limitations must be explicit and clear and must be disclosed to the plan sponsor before 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.

Status: H.R. 1253 was introduced by Rep. Burgess (R-TX) on March 3, 2009 and it passed the House on March 31, 2009.  The bill now moves to the Senate for consideration. The House passed identical legislation in the 110th Congress. 


Health Insurance Restrictions and Limitations Clarification Act of 2009 (H.R. 1253)

Core Provisions: This legislation would amend the provisions of the Employee Retirement Income Security Act, Public Health Service Act, and Internal Revenue Code that permit group health plans to establish limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for participants and beneficiaries of the plan. The new language would clarify that such limitations must be explicit and clear and must be disclosed to the plan sponsor before 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.

Status: H.R. 1253 was introduced by Rep. Burgess (R-TX) on March 3, 2009 and it passed the House on March 31, 2009.  The bill now moves to the Senate for consideration. The House passed identical legislation in the 110th Congress. 


Congress Passes Technical Correction to Mental Health Parity Law

Congress recently passed legislation (S. 3712) to correct a drafting error in the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.”

The mental health parity law requires health plans providing mental health coverage to provide mental health coverage in the same manner as other physical health conditions. The new legislation clarifies that the effective date for the law’s provisions covering collectively bargained plans is January 1, 2010, not January 1, 2009.

The Senate passed the technical correction legislation by unanimous consent on November 20, 2008, the House unanimously passed the bill on December 10, 2008, and the President is expected to sign the noncontroversial legislation.


Congress Temporarily Suspends Pension Rules To Address Economic Crisis


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Legislation to relax pension plan rules for senior citizens and employers was introduced and passed in Congress late last week.  The “Worker, Retiree and Employer Recovery Act” (H.R. 7327) would suspend for one year the 50 percent tax penalty otherwise imposed upon seniors who do not make the minimum withdrawal required by their defined contribution retirement plans. 

The bill would also temporarily delay the designation of multi-employer plans as in endangered or critical status.  The bill provides that, for the October 1, 2008 through September 30, 2009 period, sponsors may elect to retain the plan’s status designation for the previous plan year.  For plans that were in endangered or critical status for the preceding year, the plan sponsor would not be required to update its plan or schedules as otherwise required by the Employee Retirement Income Security Act (ERISA).  The bill would also extend funding improvement periods for plans in endangered or critical status from 10 to 13 years, and for plans in seriously endangered status from 15 to 18 years.

The Worker, Retiree and Employer Recovery Act was introduced by Rep. Rangel (D-NY) on December 10, 2008, and the House passed the bill without objection that same day.  The Senate passed the legislation on December 11, 2008 by unanimous consent.


House, Senate Pass Differing Mental Health Parity Bills

On September 23, the House and Senate each approved Mental Health Parity legislation, but did so via differing legislative vehicles.  The House passed H.R. 6983, a stand-alone mental health parity bill, by a solid bipartisan majority: 376-47. The Senate, which saw a previous stand-alone bill go down to defeat at the hands of a Republican filibuster on July 30, overwhelmingly passed (by a 93-2 margin) energy and tax legislation, H.R. 6049, that included identical mental health parity language.  Both bills require health plans providing mental health coverage to provide mental health coverage in the same manner as other physical health conditions.

The mental health parity provisions would amend ERISA to require group health plans to administer treatment limitations, beneficiary financial requirements and out-of-network coverage so that mental health benefits are no more restrictive than “substantially all medical and surgical benefits.”  The legislation would exempt group health plans of employers with fewer than 50 employees.

Unlike the Senate bill which does not directly offset the costs of the mental health parity provisions, the House bill is paid for by a delay in a tax benefit to multinational corporations.  According to the Senate Finance Committee, the parity provisions are expected to cost nearly $4 billion over the next decade.  It is unclear whether the House or the Senate will move first towards adopting the other house’s bill in an effort to reconcile the parity provisions.

The Bush administration released a statement expressing support for the Senate energy and tax bill which includes the mental health parity language, H.R. 6049.


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.”


Health Insurance Source of Injury Clarification Act of 2008 (H.R. 6908)

Core Provisions: 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.

Status: Rep. Burgess (R-TX ) introduced the Health Insurance Source of Injury Clarification Act on September 16, 2008, and it was referred to the House Committees on Energy and Commerce, Education and Labor, and Ways and Means.  On September 17, 2008, the House Energy and Commerce Committee held a mark-up session and ordered H.R. 6908 to be reported by a voice vote.