,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #acid  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,febru>y #bg1         
#bjai,mr4 ,doggett introduc$ ! foll[+   
bill2 :i* 0 ref]r$ to ! ,committee on   
,ways & ,means1 & 9 addition to !       
,committee on ,en]gy & ,comm]ce1 = a    
p]iod to be subsequ5tly det]m9$ by !    
,speak]1 9 ea* case = consid]ation ( su*
 provisions z fall )9 ! jurisdiction ( !
 committee conc]n$  ,a ,,bill  ,to am5d 
title ,,xviii ( ! ,social ,security ,act
 to provide = c]ta9 re=ms ) respect to  
m$ic>e supplem5tal heal? insurance      
policies4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,m$igap ,consum]           
,protection ,act ( #bjai4  #b4 ,gu>ante$
 issue  7a7 ,gu>ante$ issue ( ,m$igap   
policies to all ,m$igap-,eligible       
,m$ic>e b5efici>ies  7#a7 ,9 g5]al      
,section #ahhb7s7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciess7s77 is      
am5d$--  7,a7 9 p>agraph 7#b77;,a71 by  
/rik+ #fe ye>s ( age or old] & is       
enroll$ = b5efits "u "p ,b & ins]t+     

entitl$ to1 or enroll$ =1 b5efits "u "p 
,a & enroll$ = b5efits "u "p ,b2  7,b7 9
 p>agraph 7#b77;,d71 by /rik+ :o is #fe 
ye>s ( age or old] z ( ! date ( issuance
 &2  7,c7 9 p>agraph 7#c77;,b77ii71 by  
/rik+ is #fe ye>s ( age or old] &2 &    
7,d7 9 p>agraph 7#c77;,b77vi71 by /rik+ 
at age #fe4  7#b7 ,effective date2      
phase-,9 au?ority  7,a7 ,effective date 
,subject to subp>agraph 7,b71 ! am5dm5ts
 made by p>agraph 7#a7 %all apply to    
m$ic>e supplem5tal policies effective on
 or aft] ,janu>y #a1 #bjbb4  7,b7       
,phase-,9 au?ority  7i7 ,9 g5]al        
,subject to clause 7ii71 ! ,secret>y (  
,heal? & ,human ,s]vices may phase 9 !  
implem5tation ( ! am5dm5ts made "u      
p>agraph 7#a7 7) su* phase-9 beg9n+ on  
or aft] ,janu>y #a1 #bjbb7 9 su* mann] z
 ! ,secret>y det]m9es appropriate 9 ord]
 to m9imize any adv]se impact on        
individuals enroll$ "u a m$ic>e         
supplem5tal policy4  7ii7 ,phase-,9     
p]iod may n exce$ #e ye>s ,! ,secret>y (
 ,heal? & ,human ,s]vices %all ensure t 

! am5dm5ts made by p>agraph 7#a7 are    
fully implem5t$ by n lat] ?an ,janu>y   
#a1 #bjbg4  7#c7 ,additional enrollm5t  
p]iod = c]ta9 individuals  7,a7 ,"o-"t  
enrollm5t p]iod  7i7 ,9 g5]al ,9 ! case 
( an individual describ$ 9 subp>agraph  
7,b71 ! ,secret>y %all e/abli% a "o-"t  
enrollm5t p]iod dur+ :i* su* an         
individual may enroll 9 any m$ic>e      
supplem5tal policy ( ! individual's     
*oos+4  7ii7 ,p]iod ,! enrollm5t p]iod  
e/abli%$ "u clause 7i7 %all beg9 on !   
date on :i* ! phase-9 p]iod "u p>agraph 
7#b7 is complet$ & end #f mon?s aft] su*
 date4  7,b7 ,individual describ$ ,an   
individual describ$ 9 ?is p>agraph is an
 individual :o-- 7i7 is entitl$ to      
hospital insurance b5efits "u "p ,a "u  
section #bbf7;b7 or section #bbf;,a ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#dbf7;b72 #dbf-a72  7ii7 is enroll$ =   
b5efits "u "p ,b ( su* ,act 7#db        
,u4,s4,c4 #acie;j et seq472 &  7iii7    
w\ld n1 b = ! provisions ( & am5dm5ts   
made by p>agraphs 7#a7 & 7#b71 be       

eligible = ! gu>ante$ issue ( a m$ic>e  
supplem5tal policy "u p>agraph 7#b7 or  
7#c7 ( section #ahhb7s7 ( su* ,act 7#db 
,u4,s4,c4 #aciess7s774  7,c7 ,outrea*   
plan  7i7 ,9 g5]al ,! ,secret>y %all    
develop an outrea* plan to notify       
individuals describ$ 9 subp>agraph 7,b7 
( ! "o-"t enrollm5t p]iod e/abli%$ "u   
subp>agraph 7,a74  7ii7 ,consultation ,9
 implem5t+ ! outrea* plan develop$ "u   
clause 7i71 ! ,secret>y %all consult )  
consum] advocates1 brok]s1 insur]s1 !   
,national ,association ( ,insurance     
,commission]s1 & ,/ate ,heal? ,insurance
 ,assi/ance ,programs4  7b7 ,gu>ante$   
issue ( ,m$igap policies = ,m$ic>e      
,advantage & ,m$icaid enrollees2        
,treatm5t ( individuals ) ,,cobra  7#a7 
,9 g5]al ,section #ahhb7s77#c7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciess7s77#c771 z am5d$ by subsection  
7a71 is fur!r am5d$--  7,a7 9           
subp>agraph 7,b71 by add+ at ! end !    
foll[+ new clauses3  7vii7 ,! individual
 0 enroll$ 9 a ,m$ic>e ,advantage plan  

"u "p ,c = n less ?an #ab mon?s &       
subsequ5tly dis5roll$ f su* plan &      
elects to receive b5efits "u ?is title  
?r\gh ! orig9al ,m$ic>e fee-=-s]vice    
program "u p>ts ,a & ,b4  7viii7 ,!     
individual-- 7,i7 is entitl$ to1 or     
enroll$ =1 b5efits "u "p ,a & enroll$ = 
b5efits "u "p ,b2 &  7,,ii7 ei!r-- 7aa7 
is eligible = m$ical assi/ance "u a     
,/ate plan or waiv] "u title ,,xix bas$ 
on a r$uction ( income ( ! individual   
bas$ on co/s incurr$ = m$ical or o!r    
rem$ial c>e & 0 enroll$ 9 su* plan or   
waiv]2 or  7bb7 0 o!rwise eligible =    
m$ical assi/ance "u a ,/ate plan or     
waiv] "u title ,,xix & subsequ5tly lo/  
eligibility = su* m$ical assi/ance4  2  
7,b7 by /rik+ subp>agraph 7,c77iii7 &   
ins]t+ ! foll[+3  7iii7 ,subject to     
subsection 7v77#a71 = purposes ( an     
individual describ$ 9 clause 7vi71      
7vii71 or 7viii7 ( subp>agraph 7,b71 a  
m$ic>e supplem5tal policy describ$ 9 ?is
 subp>agraph %all include any m$ic>e    
supplem5tal policy4  2 &  7,c7 9        

subp>agraph 7,e7-- 7i7 9 clause 7iv71 by
 /rik+ & at ! end2  7ii7 9 clause 7v71  
by /rik+ ! p]iod at ! end & ins]t+ a    
semicolon2 &  7iii7 by add+ at ! end !  
foll[+ new clauses--  7vi7 9 ! case ( an
 individual describ$ 9 subp>agraph      
7,b77vii71 ! annual1 coord9at$ election 
p]iod 7z def9$ 9 section                
#ahea7;e77#c77;,b77 or a cont9u\s op5   
enrollm5t p]iod 7z def9$ 9 section      
#ahea7;e77#b77 dur+ :i* ! individual    
dis5rolls f a ,m$ic>e ,advantage plan "u
 "p ,c2  7vii7 9 ! case ( an individual 
describ$ 9 subp>agraph 7,b77viii7 :o is 
eligible = m$ical assi/ance "u a ,/ate  
plan or waiv] "u title ,,xix = a reason 
describ$ 9 item 7aa71 su* p]iod z is    
specifi$ by ! ,secret>y2  7viii7 9 !    
case ( an individual describ$ 9         
subp>agraph 7,b77viii7 :o is eligible = 
m$ical assi/ance "u a ,/ate plan or     
waiv] "u title ,,xix = a reason describ$
 9 item 7bb71 ! p]iod beg9n+ on ! date t
 ! individual receives a notice (       
cessation ( su* individual's eligibility

 = m$ical assi/ance "u ! ,/ate plan or  
waiv] "u title ,,xix & end+ on ! date t 
is f\r mon?s aft] ! individual receives 
su* notice2 &  4  7#b7 ,treatm5t (      
individuals ) ,,cobra  7,a7 ,9 g5]al    
,section #ahhb7s77#c7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciess7s77#c771 z am5d$ by subsection  
7a7 & p>agraph 7#a71 is fur!r am5d$--   
7i7 9 subp>agraph 7,b77i7 by ins]t+ or1 
9 ! case ( an individual enroll$ 9 su*  
an employee welf>e b5efit plan pursuant 
to a ,,cobra cont9uation provision 7z   
def9$ 9 section #bgia7;d77#d7 ( !       
,public ,heal? ,s]vice ,act71 t !       
individual dis5rolls f su* plan &       
enrolls "u "p ,b be=e ! p]iod at ! end2 
&  7ii7 9 subp>agraph 7,e71 z am5d$ by  
p>agraph 7#a71 by add+ at ! end ! foll[+
 new clause3  7ix7 9 ! case ( an        
individual describ$ 9 subp>agraph       
7,b77i7 :o enroll$ 9 an employee welf>e 
b5efit plan describ$ 9 su* subp>agraph  
pursuant to a ,,cobra cont9uation       
provision 7z def9$ 9 section            

#bgia7;d77#d7 ( ! ,public ,heal? ,s]vice
 ,act7 & :o dis5rolls f su* plan &      
enrolls "u "p ,b1 ! p]iod beg9n+ on #fj 
days be=e ! effective date ( su*        
dis5rollm5t & end+ on ! date t is #fc   
days aft] su* effective date4  4  7,b7  
,te*nical correction ,section           
#ahhb7s77#b77;,d7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciess7s77#b77;,d77
 is am5d$-- 7i7 by /rik+ #bgja7;c7 &    
ins]t+ #bgjd7;c72 &  7ii7 by /rik+      
#bgja7;a77#c7 & ins]t+ #bgjd7;a77#c74   
7#c7 ,effective date ,! am5dm5ts made by
 p>agraphs 7#a7 & 7#b77;,a7 %all apply  
to m$ic>e supplem5tal policies effective
 on or aft] ,janu>y #a1 #bjbb4  #c4     
,m$ical loss ratio ,section             
#ahhb7r77#a77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciess7r77#a77;,a77
 is am5d$-- 7#a7 by ins]t+ & p]iodically
 review$ aft] develop$2 &  7#b7 by /rik+
 policy1 at lea/ #ge p]c5t ( ! aggregate
 am\nt ( premiums collect$ 9 ! case (   
gr\p policies & at lea/ #fe p]c5t 9 !   
case ( individual policies2 & & ins]t+ !

 foll[+3  policy-- 7i7 ) respect to     
p]iods beg9n+ be=e ,janu>y #a1 #bjbb1 at
 lea/ #ge p]c5t ( ! aggregate am\nt (   
premiums collect$ 9 ! case ( gr\p       
policies & at lea/ #fe p]c5t 9 ! case ( 
individual policies2 &  7ii7 ) respect  
to p]iods beg9n+ on or aft] ,janu>y #a1 
#bjbb1 a p]c5t ( ! aggregate am\nt (    
premiums collect$ t1 9 ! case ( gr\p    
policies or individual policies1 z      
applicable1 is equal to or great] ?an   
bo?--  7,i7 ! applicable p]c5t specifi$ 
9 clause 7i7 ) respect to su* policies2 
&  7,,ii7 su* p]c5t z ! ,national       
,association ( ,insurance ,commission]s 
may recomm5d to ! ,secret>y ) respect to
 su* policies = purposes ( ?is p>agraph2
 &  4  #d4 ,limitations on pric+        
discrim9ation  7a7 ,9 g5]al ,section    
#ahhb ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciess71 z am5d$ by section  
#f1 is fur!r am5d$ by add+ at ! end !   
foll[+ new subsection3  7aa7 ,developm5t
 ( new /&>ds relat+ to pric+            
discrim9ation  7#a7 ,9 g5]al ,!         

,secret>y %all reque/ ! ,national       
,association ( ,insurance ,commission]s 
to review & revise ! /&>ds = all b5efit 
packages "u subsection 7p77#a71 includ+ 
! core b5efit package1 9 ord] to provide
 cov]age consi/5t ) p>agraph 7#b74 ,su* 
revisions %all be made consi/5t ) !     
rules applicable "u subsection          
7p77#a77;,e7 7) ! ref]5ce to ! #aiia    
,,naic ,model ,regulation deem$ a       
ref]5ce to ! ,,naic ,model ,regulation z
 mo/ rec5tly updat$ by ! ,national      
,association ( ,insurance ,commission]s 
to reflect previ\s *anges 9 law & !     
ref]5ce to date ( enactm5t ( ?is        
subsection deem$ a ref]5ce to ! date (  
enactm5t ( ?is subsection74  7#b7       
,*anges 9 co/-%>+ describ$ ,"u ! revis$ 
/&>ds1 cov]age %all n be available "u a 
,m$ic>e supplem5tal insurance policy    
unless ! issu] ( ! policy1 9 addition to
 con=m+ to ! o!r applicable requirem5ts 
( ?is section--  7,a7 does n discrim9ate
 9 ! pric+ ( ! policy because ( ! age ( 
! individual to :om ! policy is issu$2  

7,b7 does n1 to an ext5t t jeop>dizes ! 
access to su* policy = individuals :o   
are eligible to p>ticipate 9 ! program  
"u ?is title because ! individuals are  
individuals describ$ 9 p>agraph 7#b7 or 
7#c7 ( section #ahaa1 discrim9ate 9 !   
pric+ ( ! policy because ! individual to
 :om ! policy is issu$ is s eligible to 
p>ticipate 9 su* program because !      
individual is an individual s describ$ 9
 su* a p>agraph2 &  7,c7 does n e/abli% 
premiums applicable "u su* policy on a  
basis t w\ld apply to a portion (1 b n !
 entirety (1 a c\nty or equival5t area  
specifi$ by ! ,secret>y4  7#c7          
,application date ,! revis$ /&>ds %all  
apply to b5efit packages sold1 issu$1 or
 r5ew$ "u ?is section to individuals :o 
fir/ become entitl$ to b5efits "u "p ,a 
or fir/ enrolls 9 "p ,b on or aft]      
,janu>y #a1 #bjbb4  4  7b7 ,con=m+      
am5dm5t ,section #ahhb7o77#a7 ( su* ,act
 7#db ,u4,s4,c4 #aciess7o77#a77 is am5d$
 by /rik+ 1 & 7y7 & ins]t+ 7y71 & 7aa74 
#e4 ,cl>ify+ b5efici>y options on !     

,m$ic>e plan f9d] website ,section #ahjd
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acie;b-#b7 is am5d$ by add+  
at ! end ! foll[+ new subsections3  7d7 
,9 ! case t ! ,secret>y provides = a    
,m$ic>e plan f9d] int]net website ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 7or 
a successor website71 ! ,secret>y %all1 
) respect to su* website & 9 accordance 
) subsection 7f7--  7#a7 make available 
on su* website-- 7,a7 access to provid] 
networks 9 ord] to provide to           
individuals entitl$ to b5efits "u "p ,a 
or enroll$ "u "p ,b in=mation to assi/  
su* individuals 9 und]/&+ ! re/rictions 
on provid]s & pot5tial co/s entail$ by  
_! decisions reg>d+ enrollm5t "u p>ts ,a
 & ,b1 "u "p ,c1 & 9 m$ic>e supplem5tal 
policies "u section #ahhb2  7,b7 a      
review ( out-(-pocket exp5ditures1      
includ+ d$uctibles1 copaym5ts1          
co9surance1 mon?ly premiums1 & e/imat$  
annual out-(-pocket co/s1 display$      
ov]all & by compon5ts1 bas$ on ! be/    
available in=mation z det]m9$ by !      

,secret>y2 &  7,c7 dur+ ! p]iod prior to
 ,janu>y #a1 #bjbe1 in=mation reg>d+ !  
rules t1 9 ea* ,/ate1 p]ta9 to gu>ante$ 
issue ( m$ic>e supplem5tal heal?        
insurance policies prior to             
implem5tation ( ! provisions ( ! ,m$igap
 ,consum] ,protection ,act ( #bjai &1 9 
! case t a ,/ate has no su* rules p]ta9+
 to gu>ante$ issue ( su* policies1 cle> 
language expla9+ ! implications ( su*   
lack ( rules = individuals ) pre-exi/+  
conditions2  7#b7 n lat] ?an ,janu>y #a1
 #bjbj1 & p]iodically !reaft]1 p]=m a   
review ( su* website 9 ord] to ensure t 
su* website makes available to          
individuals entitl$ to b5efits "u "p ,a 
or enroll$ "u "p ,b ! in=mation t !     
,secret>y det]m9es is necess>y = su*    
individuals to make in=m$ *oices reg>d+ 
_! options "u ! program "u ?is title2 & 
7#c7 n lat] ?an #ab mon?s aft] ! la/ day
 ( ea* p]iod = ! reque/ = in=mation "u  
subsection 7e71 update su* website1 tak+
 into consid]ation ! in=mation collect$ 
pursuant to su* subsection1 to cl>ify ! 

pres5tation ( consum] options = m$ic>e  
supplem5tal heal? insurance policy      
options1 includ+ by pres5t+ su*         
in=mation 9 a mann] calculat$ to be     
und]/ood by ! av]age consum] & 9 a mann]
 t--  7,a7 improves consum] access to   
in=mation reg>d+ ! applicable premiums  
"u su* policy options z ( ! date on :i* 
su* website is s updat$2  7,b7          
facilitates consum]s' ability to comp>e 
& sort policy options & premium         
in=mation across plan (f]+s 9 a giv5    
location2  7,c7 cl>ifies & expla9s      
diff]5ces 9 policy value2  7,d7 rates & 
expla9s ! f9ancial /ability ( issu]s (  
su* policies2  7,e7 provides data on !  
inflation rate ( diff]5t policies2  7,f7
 provides in=mation reg>d+ ! gu>ante$   
issue requirem5ts t apply to m$ic>e     
supplem5tal heal? insurance policies "u 
section #ahhb7s77#c72 &  7,g7 includes  
su* g5]al in=mation z is det]m9$ by !   
,secret>y to be necess>y = individuals  
entitl$ to b5efits "u "p ,a or enroll$  
"u "p ,b to und]/& co/s "u ,,ma plans   

available pursuant to "p ,c &           
prescription drug plans available       
pursuant to "p ,d4  7e7 ,n lat] ?an #f  
mon?s aft] ! date ( ! enactm5t ( ?is    
subsection & beg9n+ on ,decemb] #g ( ea*
 ye> !reaft]1 ! ,secret>y ( ,heal? &    
,human ,s]vices %all provide an         
opportunity = public comm5t dur+ :i* !  
,secret>y reque/s in=mation1 includ+    
recomm5dations1 f /akehold]s reg>d+     
pot5tial improvem5ts to ! pres5tation ( 
m$ic>e supplem5tal heal? insurance      
policy options "u section #ahhb on !    
,m$ic>e plan f9d] int]net website ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 7or 
a successor website74  7f7 ,) respect to
 any in=mation t ! ,secret>y makes      
available on ! ,m$ic>e plan f9d] int]net
 website ( ! ,c5t]s = ,m$ic>e  ,m$icaid 
,s]vices 7or a successor website7       
pursuant to subsection 7d71 ! ,secret>y 
%all1 prior to mak+ su* in=mation       
available--  7#a7 provide1 9            
consultation ) ! ,national ,association 
( ,insurance ,commission]s1 an          

opportunity = consum] te/+ ( su*        
in=mation2  7#b7 %>e ! results ( su*    
consum] te/+ ( su* in=mation ) int]e/$  
/akehold]s2 &  7#c7 provide a #fj-;day  
public comm5t p]iod ) respect to su*    
in=mation4  4  #f4 ,re/or+ access to    
fir/-doll> ,m$igap cov]age ,section     
#ahhb ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciess7 is am5d$ by /rik+    
subsection 7z74  #g4 ,brok] transp>5cy  
,section #aabh;,g ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acbj;a-#g;h7 is    
am5d$--  7#a7 9 subsection 7c77#a77;,a71
 by /rik+ #bjaa1 & ins]t+ #bjaa 7or1 )  
respect to in=mation requir$ to be      
submitt$ "u subsection 7f77#a71 n lat]  
?an six mon?s aft] ! date ( ! enactm5t (
 su* subsection712 &  7#b7 by add+ at ! 
end ! foll[+ new subsection3  7f7       
,application to ,m$igap insurance brok]s
  7#a7 ,9 g5]al ,beg9n+ n lat] ?an #ab  
mon?s aft] ! date ( enactm5t ( ?is      
subsection1 ea* issu] ( a m$ic>e        
supplem5tal heal? insurance policy %all 
annually submit to ! ,secret>y a report 

reg>d+ paym5ts or o!r transf]s ( value  
made dur+ ! previ\s ye> to ag5ts1       
brok]s1 & o!r ?ird p>ties repres5t+ su* 
policy4 ,ea* su* report %all include !  
foll[+ in=mation1 ) respect to su* a    
paym5t or o!r transf] ( value3  7,a7 ,! 
"n ( ! recipi5t ( ! paym5t or o!r       
transf] ( value4  7,b7 ,! bus9ess       
address ( ! recipi5t4  7,c7 ,! am\nt ( !
 paym5t or o!r transf] ( value4  7,d7 ,!
 dates on :i* ! paym5t or transf] (     
value 0 provid$4  7,e7 ,a description ( 
! =m ( ! paym5t or transf] ( value4     
7,f7 ,any o!r categories ( in=mation !  
,secret>y det]m9es appropriate4  7#b7   
,application ( transp>5cy sy/em ,!      
provisions ( subsections 7b7 ?r\gh 7d7  
%all apply to an issu] describ$ 9       
p>agraph 7#a71 in=mation requir$ to be  
report$ "u su* p>agraph1 & ag5ts1       
brok]s1 & o!r ?ird p>ties describ$ 9 su*
 p>agraph 9 ! same mann] & to ! same    
ext5t z su* provisions apply to an      
applicable manufactur]1 in=mation       
requir$ to be report$ "u subsection 7a71

 & a cov]$ recipi5t4  4