A bill to amend the Public Health Service Act and the Fair Labor Standards Act of 1938 to provide minimum health benefits for all workers in the United States.
Minimum Health Benefits for All Workers Act of 1987 - Title I: Amendments to Public Health Service Act - Amends the Public Health Service Act to add provisions which require each employer to enroll each of its employees and their families in a health benefit plan. Makes State employers which do not so enroll their employees and their families ineligible to receive grants, contracts, loans, or loan guarantees under such Act.
Title II: Amendments to Fair Labor Standards Act of 1938 and Employee Retirement Income Security Act of 1974 - Amends the Fair Labor Standards Act of 1938 to add provisions which require each employer to enroll each of its employees and their families in a health benefit plan.
Amends the Employee Retirement Income Security Act of 1974 regarding supersedure of State laws relating to contracts or policies of insurance issued to or under a health benefit plan under title III of this Act.
Title III: Requirements for Health Benefit Plans for Employees and Their Families - Part A: Requirements and Definitions - Applies this title to employers required to enroll employees in health benefit plans under certain provisions of the Public Health Service Act or the Fair Labor Standards Act of 1938.
Requires each small and certain large employers to use a regional insurer, subject to certain exceptions and conditions.
Requires that enrollment of an employee in a health benefit plan under this title includes enrollment of the employee's family in the plan. Prohibits the employee from waiving personal or family enrollment. Provides exceptions to avoid duplicate family enrollment.
Prohibits employers from discriminating against any individual because such individual has a spouse or child required under this title to be enrolled in a health benefit plan.
Part B: Requirements for Health Benefit Plans - Sets forth general requirements for plans. Permits a health benefit plan to be considered as meeting such requirements provided the actuarial benefits under the plan are not less than would have applied if the plan met the requirements of this part.
Specifies benefits which a plan must provide, including inpatient and outpatient hospital care and physician services, tests, and prenatal and well-baby care.
Specifies requirements regarding the date of initial coverage and regarding interim coverage. Prohibits pre-existing condition provisions.
Allows a plan to require an employee to pay for premiums, deductibles, copayments, and coinsurance, not to exceed certain limits. Prohibits a plan from requiring a premium for an employee whose hourly wage is less than a specified amount. Sets limitations on deductibles.
Part C: Certification of Regional Insurers - Directs the Secretary of Health and Human Services (Secretary) to designate six to eight health insurance regions and to establish competitive procedures for the periodic certification of two to five insurers for each region. Specifies requirements for application for and consideration of applications for such certification. Directs the Secretary to periodically evaluate the performance of regional insurers and, under certain circumstances, to terminate the certification of the insurer.
Sets forth requirements regarding the types of plans each regional insurer must offer.
Requires each regional insurer to fix premiums under a community rating system. Prohibits adjustment of such premiums based on age, gender, or other factors relating to the projected or actual use of services.
Permits regional insurers to enter into subcontracts.
Directs the Secretary to encourage regional insurers to enter into arrangements with entities representing groups of small businesses for the provision of administrative services. Requires such insurers to reduce the premiums charged by an amount which reflects the value of such services.
Directs the Secretary to provide technical assistance to employers, utilizing to the maximum extent feasible entities with experience in providing health insurance services to small businesses.
Part D: Regulations and Enforcement - Directs the Secretary to promulgate rules to carry out this title by specified deadlines.
Provides for civil penalties for any nongovernmental employer who does not comply with certain provisions of this Act. Makes nongovernmental employers who knowingly fail to comply with certain provisions of this Act liable for damages, including health care costs incurred, to the employee or the employee's family. Allows any individual injured, adversely affected, or aggrieved by violation of certain requirements of this Act to bring an action for injunctive relief.
Title IV: Effective Date - Provides for the effective date of this Act and transition rules for certain circumstances.
Declares that no employer will be required under title III of this Act to provide any health benefit in addition to the benefits required to be provided by specified provisions of this Act unless: (1) such additional benefit is for a service which State Medicaid plans (under title XIX of the Social Security Act) are required to cover for certain individuals; and (2) before the enactment of such requirement, the benefits and costs of requiring the provision of such additional health benefit have been analyzed and considered by the Congress, according to certain procedures.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 691.
Introduced in House
Introduced in House
Referred to House Committee on Education and Labor.
Referred to House Committee on Energy and Commerce.
Referred to Subcommittee on Health and the Environment.
Referred to Subcommittee on Commerce, Consumer Protection, and Competitiveness.
Referred to Subcommittee on Labor-Management Relations.
Referred to Subcommittee on Labor Standards.
Subcommittee Hearings Held.
Subcommittee Hearings Held.
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