S.Amdt. 3905

1. Adds SEC. __. BENEFIT REVIEW PANEL ON HEALTH INSURANCE wherever appropriate

   Adds a section

   Inserted: SEC. __. BENEFIT REVIEW PANEL ON HEALTH INSURANCE.

   Inserted: (a) Benefit Review Panel.--

   Inserted: (1) Establishment.--The Secretary of Health and Human Services (referred to in this section as the "Secretary"), in consultation with the National Association of Insurance Commissioners, shall establish the Benefit Review Panel on Health Insurance (referred to in this section as the "Panel") to develop recommendations that a Federal floor of benefit mandates be established from the current array of inconsistent State health insurance laws and in accordance with the laws adopted in a plurality of the States.

   Inserted: (2) Composition.--The Panel shall be composed of the following individuals appointed by the Secretary:

   Inserted: (A) Two State insurance commissioners, of which--

   Inserted: (i) 1 shall be a Democrat and 1 shall be a Republican; and

   Inserted: (ii) 1 shall be designated as the chairperson and 1 shall be designated as the vice-chairperson.

   Inserted: (B) Two representatives of State government, of which--

   Inserted: (i) 1 shall be a governor of a State and 1 shall be a State legislator; and

   Inserted: (ii) 1 shall be a Democrat and 1 shall be a Republican.

   Inserted: (C) Two representatives of employers, of which 1 shall represent small employers and 1 shall represent large employers.

   Inserted: (D) Two representatives of health insurers, of which 1 shall represent insurers that offer coverage in all markets (including individual, small, and large markets), and 1 shall represent insurers that offer coverage in the small market.

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   Inserted: (E) Two representatives of consumer organizations.

   Inserted: (F) Two representatives of insurance agents and brokers.

   Inserted: (G) Two representatives of healthcare providers.

   Inserted: (H) Two independent representatives of the American Academy of Actuaries who have familiarity with the actuarial methods applicable to health insurance.

   Inserted: (I) One administrator of a qualified high risk pool.

   Inserted: (3) Terms.--The members of the Panel shall serve for the duration of the Panel. The Secretary shall fill vacancies in the Panel as needed and in a manner consistent with the composition described in paragraph (2).

   Inserted: (b) Development of a Federal Standard Benefit Package.--In accordance with the process described in subsection (c), the Panel shall identify and recommend a Federal standard benefit package of benefit mandates from among the current array of inconsistent State insurance laws.

   Inserted: (c) Process for Developing a Standard Federal Benefit Package.--

   Inserted: (1) In general.--In developing the standard benefit package recommendations described in subsection (b), the Panel shall--

   Inserted: (A) review all State laws that regulate insurance benefits; and

   Inserted: (B) develop recommendations to harmonize inconsistent State insurance laws with the laws adopted in a plurality of the States.

   Inserted: (2) Consultation.--The Panel shall consult with the National Association of Insurance Commissioners in identifying the benefit mandates of the States.

   Inserted: (d) Recommendations and Adoption by Secretary.--

   Inserted: (1) Recommendations.--Not later than 1 year after the date of enactment of this Act, the Panel shall recommend to the Secretary the adoption of the harmonized standards identified under subsection (c).

   Inserted: (2) Regulations.--Not later than 120 days after receipt of the Panel's recommendations under paragraph (1), the Secretary shall issue final regulations adopting such recommendations as the Federal standard benefit package. If the Secretary finds the recommended standards for an element of the standard benefit package to be arbitrary and inconsistent with the plurality requirements of this section, the Secretary may issue a unique standard only for such element, through a process similar to the process set forth in subsection (c) and through the issuance of proposed and final regulations.

   Inserted: (3) Effective date.--The regulations issued by the Secretary under paragraph (2) shall be effective on the date that is 2 years after the date on which such regulations were issued.

   Inserted: (e) Termination.--The Panel shall terminate and be dissolved after making the recommendations to the Secretary pursuant to subsection (d)(1).

   Inserted: (f) Updated Standard Benefit Package.--

   Inserted: (1) In general.--Not later than 2 years after the termination of the Panel under subsection (e), and every 2 years thereafter, the Secretary shall update the standard benefit package adopted under subsection (d)(2). Such updated standard benefit package shall be adopted in accordance with paragraph (2).

   Inserted: (2) Updated standard benefit package.--

   Inserted: (A) In general.--In order to update the standard benefit package in accordance with paragraph (1), the Secretary shall review all State laws that regulate insurance mandates and identify whether a plurality of States have adopted substantially similar requirements that differ from the standard benefit package adopted by the Secretary under subsection (d). In such case, the Secretary shall consider State laws that have been enacted with effective dates that are contingent upon adoption as a harmonized standard in the standard benefit package by the Secretary. Substantially similar requirements by different States shall be considered to be an updated harmonized standard.

   Inserted: (B) Report.--The Secretary shall request the National Association of Insurance Commissioners to issue a report to the Secretary every 2 years to assist the Secretary in identifying the updated benefit mandates of the States under this paragraph. Nothing in this subparagraph shall be construed to prohibit the Secretary from issuing updated standards in the absence of such a report.

   Inserted: (C) Regulations.--The Secretary shall issue regulations adopting the updated standard benefit package under this paragraph within 90 days of identifying the standards in need of updating. Such regulations shall be effective beginning on the date that is 2 years after the date on which such regulations are issued.

   Inserted: (g) Publication.--

   Inserted: (1) Listing.--The Secretary shall maintain an up-to-date listing of all harmonized standards in the standard benefit package adopted under this section on the Internet website of the Department of Health and Human Services.

   Inserted: (2) Sample contract language.--The Secretary shall publish, on the Internet website of the Department of Health and Human Services, sample contract language that incorporates the standard benefit package adopted under this section, which may be used by insurers seeking to qualify as an eligible insurer. The types of benefits that shall be included in such sample contract language are the standards that are relevant to the contractual bargain between the insurer and insured.

   Inserted: (h) State Adoption and Enforcement.--Not later than 2 years after the issuance by the Secretary of final regulations adopting the Federal standard benefit package under this section, the States may adopt such standard benefit package (and become an adopting State) and, in which case, shall enforce the harmonized standard benefit package pursuant to State law.

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As printed