,i #aaf? ,,congress #a/ ,session ,h4 ,r4 #fib ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,janu>y #ah1 #bjai,mr4 ,wald5 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,education & ,labor1 & ,ways & ,means1 = 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 ! ,public ,heal? ,s]vice ,act to prohibit application ( pre-exi/+ condition exclusions & to gu>antee availability ( heal? insurance cov]age 9 ! individual & gr\p m>ket1 cont+5t on ! enactm5t ( legislation repeal+ ! ,pati5t ,protection & ,af=dable ,c>e ,act1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,pre-exi/+ ,conditions ,protection ,act ( #bjai4 #b4 ,prohibition ( pre-exi/+ condition exclusions 7a7 ,gr\p m>ket ,subject to section #f7;a7 ( ?is ,act1 subp>t #a ( "p ,a ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg et seq471 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act1 is am5d$ by /rik+ section #bgja & ins]t+ ! foll[+3 #bgja4 ,prohibition ( pre-exi/+ condition exclusions 7a7 ,9 ,g5]al ,a gr\p heal? plan or a heal? insurance issu] (f]+ gr\p heal? insurance cov]age may n impose any pre-exi/+ condition exclusion ) respect to su* plan or cov]age4 7b7 ,def9itions ,= purposes ( ?is section3 7#a7 pre-exi/+ condition exclusion 7,a7 ,9 g5]al ,! t]m pre-exi/+ condition exclusion means1 ) respect to a gr\p heal? plan or heal? insurance cov]age1 a limitation or exclusion ( b5efits relat+ to a condition bas$ on ! fact t ! condition 0 pres5t be=e ! date ( enrollm5t 9 su* plan or = su* cov]age1 :e!r or n any m$ical advice1 diagnosis1 c>e1 or treatm5t 0 recomm5d$ or receiv$ be=e su* date4 7,b7 ,treatm5t ( g5etic in=mation ,g5etic in=mation %all n be treat$ z a pre-exi/+ condition 9 ! abs5ce ( a diagnosis ( ! condition relat$ to su* in=mation4 7#b7 ,date ( enrollm5t ,! t]m date ( enrollm5t means1 ) respect to an individual cov]$ "u a gr\p heal? plan or heal? insurance cov]age1 ! date ( enrollm5t ( ! individual 9 ! plan or cov]age or1 if e>li]1 ! fir/ day ( ! wait+ p]iod = su* enrollm5t4 7#c7 ,wait+ p]iod ,! t]m wait+ p]iod means1 ) respect to a gr\p heal? plan & an individual :o is a pot5tial p>ticipant or b5efici>y 9 ! plan1 ! p]iod t mu/ pass ) respect to ! individual be=e ! individual is eligible to be cov]$ = b5efits "u ! t]ms ( ! plan4 4 7b7 ,individual m>ket ,subject to section #f7;a7 ( ?is ,act1 subp>t #a ( "p ,b ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#da et seq471 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act1 is am5d$ by add+ at ! end ! foll[+3 #bgdf4 ,prohibition ( pre-exi/+ condition exclusions or o!r discrim9ation bas$ on heal? /atus ,! provisions ( section #bgja %all apply to heal? insurance cov]age (f]$ to individuals by a heal? insurance issu] 9 ! individual m>ket 9 ! same mann] z x applies to heal? insurance cov]age (f]$ by a heal? insurance issu] 9 ! gr\p m>ket4 4 #c4 ,gu>ante$ availability ( cov]age 7a7 ,gr\p m>ket ,subject to section #f7;a7 ( ?is ,act1 subp>t #c ( "p ,a ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act1 is am5d$ by /rik+ section #bgaa 7#db ,u4,s4,c4 #cjj;gg-#aa7 & ins]t+ ! foll[+3 #bgaa4 ,gu>ante$ availability ( cov]age 7a7 ,gu>ante$ issuance ( cov]age 9 ! gr\p m>ket ,subject to subsection 7b71 ea* heal? insurance issu] t (f]s heal? insurance cov]age 9 ! gr\p m>ket 9 a ,/ate %all accept e employ] & e individual 9 a gr\p 9 ! ,/ate t applies = su* cov]age4 7b7 ,enrollm5t 7#a7 ,re/riction ,a heal? insurance issu] describ$ 9 subsection 7a7 may re/rict enrollm5t 9 cov]age describ$ 9 su* subsection to op5 or special enrollm5t p]iods4 7#b7 ,e/abli%m5t ,a heal? insurance issu] describ$ 9 subsection 7a7 %all e/abli% special enrollm5t p]iods = qualify+ ev5ts 7z su* t]m is def9$ 9 section #fjc ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd74 4 7b7 ,individual m>ket ,subject to section #f7;a7 ( ?is ,act1 subp>t #a ( "p ,b ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act1 is am5d$ by /rik+ section #bgda ( su* ,act 7#db ,u4,s4,c4 #cjj;gg-#da7 & ins]t+ ! foll[+3 #bgda4 ,gu>ante$ availability ( cov]age ,! provisions ( section #bgaa %all apply to heal? insurance cov]age (f]$ to individuals by a heal? insurance issu] 9 ! individual m>ket 9 ! same mann] z su* provisions apply to heal? insurance cov]age (f]$ to employ]s by a heal? insurance issu] 9 connection ) heal? insurance cov]age 9 ! gr\p m>ket4 ,= purposes ( ?is section1 ! ,secret>y %all treat any ref]5ce ( ! ^w employ] 9 su* section z a ref]5ce to ! t]m individual4 4 #d4 ,prohibit+ discrim9ation aga9/ individual p>ticipants & b5efici>ies bas$ on heal? /atus 7a7 ,gr\p m>ket ,subject to section #f7;a7 ( ?is ,act1 section #bgjb ( ! ,public ,heal? ,s]vice ,act1 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act1 is am5d$ to read z foll[s3 #bgjb4 ,prohibit+ discrim9ation aga9/ individual p>ticipants & b5efici>ies bas$ on heal? /atus 7a7 ,9 ,g5]al ,a gr\p heal? plan & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age may n e/abli% rules = eligibility 7includ+ cont9u$ eligibility7 ( any individual to enroll "u ! t]ms ( ! plan or cov]age bas$ on any ( ! foll[+ heal? /atus-relat$ factors 9 relation to ! individual or a dep5d5t ( ! individual3 7#a7 ,heal? /atus4 7#b7 ,m$ical condition 7includ+ bo? physical & m5tal illnesses74 7#c7 ,claims exp]i5ce4 7#d7 ,receipt ( heal? c>e4 7#e7 ,m$ical hi/ory4 7#f7 ,g5etic in=mation4 7#g7 ,evid5ce ( insurability 7includ+ conditions aris+ out ( acts ( dome/ic viol5ce74 7#h7 ,disability4 7#i7 ,any o!r heal? /atus-relat$ factor det]m9$ appropriate by ! ,secret>y4 7b7 ,9 ,premium ,contributions 7#a7 ,9 g5]al ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age1 may n require any individual 7z a condition ( enrollm5t or cont9u$ enrollm5t "u ! plan7 to pay a premium or contribution :i* is great] ?an su* premium or contribution = a simil>ly situat$ individual enroll$ 9 ! plan on ! basis ( any heal? /atus-relat$ factor 9 relation to ! individual or to an individual enroll$ "u ! plan z a dep5d5t ( ! individual4 7#b7 ,con/ruction ,no?+ 9 p>agraph 7#a7 %all be con/ru$-- 7,a7 to re/rict ! am\nt t an employ] or individual may be *>g$ = cov]age "u a gr\p heal? plan except z provid$ 9 p>agraph 7#c72 or 7,b7 to prev5t a gr\p heal? plan1 & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age1 f e/abli%+ premium disc\nts or rebates or modify+ o!rwise applicable copaym5ts or d$uctibles 9 return = adh]5ce to programs ( heal? promotion & disease prev5tion4 7#c7 ,no gr\p-bas$ discrim9ation on basis ( g5etic in=mation 7,a7 ,9 g5]al ,= purposes ( ?is section1 a gr\p heal? plan1 & heal? insurance issu] (f]+ gr\p heal? insurance cov]age1 may n adju/ premium or contribution am\nts = ! gr\p cov]$ "u su* plan on ! basis ( g5etic in=mation4 7,b7 ,rule ( con/ruction ,no?+ 9 subp>agraph 7,a7 or 9 p>agraphs 7#a7 & 7#b7 ( subsection 7d7 %all be con/ru$ to limit ! ability ( a heal? insurance issu] (f]+ gr\p heal? insurance cov]age to increase ! premium = an employ] bas$ on ! manife/ation ( a disease or disord] ( an individual :o is enroll$ 9 ! plan4 ,9 su* case1 ! manife/ation ( a disease or disord] 9 "o individual _c also be us$ z g5etic in=mation ab\t o!r gr\p memb]s & to fur!r increase ! premium = ! employ]4 7c7 ,g5etic ,te/+ 7#a7 ,limitation on reque/+ or requir+ g5etic te/+ ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 %all n reque/ or require an individual or a family memb] ( su* individual to und]go a g5etic te/4 7#b7 ,rule ( con/ruction ,p>agraph 7#a7 %all n be con/ru$ to limit ! au?ority ( a heal? c>e pr(essional :o is provid+ heal? c>e s]vices to an individual to reque/ t su* individual und]go a g5etic te/4 7#c7 ,rule ( con/ruction reg>d+ paym5t 7,a7 ,9 g5]al ,no?+ 9 p>agraph 7#a7 %all be con/ru$ to preclude a gr\p heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 f obta9+ & us+ ! results ( a g5etic te/ 9 mak+ a det]m9ation reg>d+ paym5t 7z su* t]m is def9$ = ! purposes ( apply+ ! regulations promulgat$ by ! ,secret>y "u "p ,c ( title ,,xi ( ! ,social ,security ,act & section #bfd ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif1 z may be revis$ f "t to "t7 consi/5t ) subsection 7a74 7,b7 ,limitation ,= purposes ( subp>agraph 7,a71 a gr\p heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 may reque/ only ! m9imum am\nt ( in=mation necess>y to accompli% ! int5d$ purpose4 7#d7 ,rese>* exception ,not)/&+ p>agraph 7#a71 a gr\p heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 may reque/1 b n require1 t a p>ticipant or b5efici>y und]go a g5etic te/ if ea* ( ! foll[+ conditions is met3 7,a7 ,! reque/ is made pursuant to rese>* t complies ) "p #df ( title #de1 ,code ( ,f$]al ,regulations1 or equival5t ,f$]al regulations1 & any applicable ,/ate or local law or regulations = ! protection ( human subjects 9 rese>*4 7,b7 ,! plan or issu] cle>ly indicates to ea* p>ticipant or b5efici>y1 or 9 ! case ( a m9or *ild1 to ! legal gu>dian ( su* b5efici>y1 to :om ! reque/ is made t-- 7i7 compliance ) ! reque/ is volunt>y2 & 7ii7 non-compliance w h no effect on enrollm5t /atus or premium or contribution am\nts4 7,c7 ,no g5etic in=mation collect$ or acquir$ "u ?is p>agraph %all be us$ = und]writ+ purposes4 7,d7 ,! plan or issu] notifies ! ,secret>y 9 writ+ t ! plan or issu] is conduct+ activities pursuant to ! exception provid$ = "u ?is p>agraph1 includ+ a description ( ! activities conduct$4 7,e7 ,! plan or issu] complies ) su* o!r conditions z ! ,secret>y may by regulation require = activities conduct$ "u ?is p>agraph4 7d7 ,prohibition on ,collection ( ,g5etic ,in=mation 7#a7 ,9 g5]al ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 %all n reque/1 require1 or pur*ase g5etic in=mation = und]writ+ purposes 7z def9$ 9 section #bgia74 7#b7 ,prohibition on collection ( g5etic in=mation prior to enrollm5t ,a gr\p heal? plan1 & a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 %all n reque/1 require1 or pur*ase g5etic in=mation ) respect to any individual prior to su* individual's enrollm5t "u ! plan or cov]age 9 connection ) su* enrollm5t4 7#c7 ,incid5tal collection ,if a gr\p heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) a gr\p heal? plan1 obta9s g5etic in=mation incid5tal to ! reque/+1 requir+1 or pur*as+ ( o!r in=mation conc]n+ any individual1 su* reque/1 requirem5t1 or pur*ase %all n be consid]$ a violation ( p>agraph 7#b7 if su* reque/1 requirem5t1 or pur*ase is n 9 violation ( p>agraph 7#a74 7e7 ,g5etic ,in=mation ( a ,fetus or ,embryo ,any ref]5ce 9 ?is "p to g5etic in=mation conc]n+ an individual or family memb] ( an individual %all-- 7#a7 ) respect to su* an individual or family memb] ( an individual :o is a pregnant woman1 include g5etic in=mation ( any fetus c>ri$ by su* pregnant woman2 & 7#b7 ) respect to an individual or family memb] utiliz+ an assi/$ reproductive te*nology1 include g5etic in=mation ( any embryo legally held by ! individual or family memb]4 7f7 ,programs ( ,heal? ,promotion or ,disease ,prev5tion 7#a7 ,g5]al provisions 7,a7 ,g5]al rule ,= purposes ( subsection 7b77#b77;,b71 a program ( heal? promotion or disease prev5tion 7ref]r$ to 9 ?is subsection z a wellness program7 %all be a program (f]$ by an employ] t is design$ to promote heal? or prev5t disease t meets ! applicable requirem5ts ( ?is subsection4 7,b7 ,no conditions bas$ on heal? /atus factor ,if none ( ! conditions = obta9+ a premium disc\nt or rebate or o!r rew>d = p>ticipation 9 a wellness program is bas$ on an individual satisfy+ a /&>d t is relat$ to a heal? /atus factor1 su* wellness program %all n violate ?is section if p>ticipation 9 ! program is made available to all simil>ly situat$ individuals & ! requirem5ts ( p>agraph 7#b7 are compli$ )4 7,c7 ,conditions bas$ on heal? /atus factor ,if any ( ! conditions = obta9+ a premium disc\nt or rebate or o!r rew>d = p>ticipation 9 a wellness program is bas$ on an individual satisfy+ a /&>d t is relat$ to a heal? /atus factor1 su* wellness program %all n violate ?is section if ! requirem5ts ( p>agraph 7#c7 are compli$ )4 7#b7 ,wellness programs n subject to requirem5ts ,if none ( ! conditions = obta9+ a premium disc\nt or rebate or o!r rew>d "u a wellness program z describ$ 9 p>agraph 7#a77;,b7 are bas$ on an individual satisfy+ a /&>d t is relat$ to a heal? /atus factor 7or if su* a wellness program does n provide su* a rew>d71 ! wellness program %all n violate ?is section if p>ticipation 9 ! program is made available to all simil>ly situat$ individuals4 ,! foll[+ programs %all n h to comply ) ! requirem5ts ( p>agraph 7#c7 if p>ticipation 9 ! program is made available to all simil>ly situat$ individuals3 7,a7 ,a program t reimburses all or "p ( ! co/ = memb]%ips 9 a fitness c5t]4 7,b7 ,a diagno/ic te/+ program t provides a rew>d = p>ticipation & does n base any "p ( ! rew>d on outcomes4 7,c7 ,a program t enc\rages prev5tive c>e relat$ to a heal? condition ?r\gh ! waiv] ( ! copaym5t or d$uctible requirem5t "u gr\p heal? plan = ! co/s ( c]ta9 items or s]vices relat$ to a heal? condition 7su* z pr5atal c>e or well-baby visits74 7,d7 ,a program t reimburses individuals = ! co/s ( smok+ cessation programs )\t reg>d to :e!r ! individual quits smok+4 7,e7 ,a program t provides a rew>d to individuals = att5d+ a p]iodic heal? education sem9>4 7#c7 ,wellness programs subject to requirem5ts ,if any ( ! conditions = obta9+ a premium disc\nt1 rebate1 or rew>d "u a wellness program z describ$ 9 p>agraph 7#a77;,c7 is bas$ on an individual satisfy+ a /&>d t is relat$ to a heal? /atus factor1 ! wellness program %all n violate ?is section if ! foll[+ requirem5ts are compli$ )3 7,a7 ,! rew>d = ! wellness program1 toge!r ) ! rew>d = o!r wellness programs ) respect to ! plan t requires satisfaction ( a /&>d relat$ to a heal? /atus factor1 %all n exce$ #cj p]c5t ( ! co/ ( employee-only cov]age "u ! plan4 ,if1 9 addition to employees or individuals1 any class ( dep5d5ts 7su* z sp\ses or sp\ses & dep5d5t *ildr57 may p>ticipate fully 9 ! wellness program1 su* rew>d %all n exce$ #cj p]c5t ( ! co/ ( ! cov]age 9 :i* an employee or individual & any dep5d5ts are enroll$4 ,= purposes ( ?is p>agraph1 ! co/ ( cov]age %all be det]m9$ bas$ on ! total am\nt ( employ] & employee contributions = ! b5efit package "u :i* ! employee is 7or ! employee & any dep5d5ts are7 receiv+ cov]age4 ,a rew>d may be 9 ! =m ( a disc\nt or rebate ( a premium or contribution1 a waiv] ( all or "p ( a co/-%>+ me*anism 7su* z d$uctibles1 copaym5ts1 or co9surance71 ! abs5ce ( a sur*>ge1 or ! value ( a b5efit t w\ld o!rwise n be provid$ "u ! plan4 ,! ,secret>ies ( ,labor1 ,heal? & ,human ,s]vices1 & ! ,treasury may increase ! rew>d available "u ?is subp>agraph to up to #ej p]c5t ( ! co/ ( cov]age if ! ,secret>ies det]m9e t su* an increase is appropriate4 7,b7 ,! wellness program %all be reasonably design$ to promote heal? or prev5t disease4 ,a program complies ) ! prec$+ s5t5ce if ! program has a reasonable *ance ( improv+ ! heal? (1 or prev5t+ disease 91 p>ticipat+ individuals & x is n ov]ly burd5some1 is n a subt]fuge = discrim9at+ bas$ on a heal? /atus factor1 & is n highly suspect 9 ! me?od *os5 to promote heal? or prev5t disease4 7,c7 ,! plan %all give individuals eligible = ! program ! opportunity to qualify = ! rew>d "u ! program at lea/ once ea* ye>4 7,d7 ,! full rew>d "u ! wellness program %all be made available to all simil>ly situat$ individuals4 ,= su* purpose1 among o!r ?+s3 7i7 ,! rew>d is n available to all simil>ly situat$ individuals = a p]iod unless ! wellness program all[s-- 7,i7 = a reasonable alt]native /&>d 7or waiv] ( ! o!rwise applicable /&>d7 = obta9+ ! rew>d = any individual = :om1 = t p]iod1 x is unreasonably difficult due to a m$ical condition to satisfy ! o!rwise applicable /&>d2 & 7,,ii7 = a reasonable alt]native /&>d 7or waiv] ( ! o!rwise applicable /&>d7 = obta9+ ! rew>d = any individual = :om1 = t p]iod1 x is m$ically inadvisable to attempt to satisfy ! o!rwise applicable /&>d4 7ii7 ,if reasonable "u ! circum/ances1 ! plan or issu] may seek v]ification1 su* z a /atem5t f an individual's physician1 t a heal? /atus factor makes x unreasonably difficult or m$ically inadvisable = ! individual to satisfy or attempt to satisfy ! o!rwise applicable /&>d4 7,e7 ,! plan or issu] involv$ %all disclose 9 all plan mat]ials describ+ ! t]ms ( ! wellness program ! availability ( a reasonable alt]native /&>d 7or ! possibility ( waiv] ( ! o!rwise applicable /&>d7 requir$ "u subp>agraph 7,d74 ,if plan mat]ials disclose t su* a program is available1 )\t describ+ its t]ms1 ! disclosure "u ?is subp>agraph %all n be requir$4 7g7 ,exi/+ ,programs ,no?+ 9 ?is section %all prohibit a program ( heal? promotion or disease prev5tion t 0 e/abli%$ prior to ! date ( enactm5t ( ?is section & appli$ ) all applicable regulations1 & t is op]at+ on su* date1 f cont9u+ to be c>ri$ out = z long z su* regulations rema9 9 effect4 7h7 ,regulations ,no?+ 9 ?is section %all be con/ru$ z prohibit+ ! ,secret>ies ( ,labor1 ,heal? & ,human ,s]vices1 or ! ,treasury f promulgat+ regulations 9 connection ) ?is section4 4 7b7 ,individual m>ket ,subject to section #f7;a7 ( ?is ,act1 subp>t #a ( "p ,b ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 z re/or$ or reviv$ pursuant to ,,ppaca repeal legislation describ$ 9 section #f7;b7 ( ?is ,act & am5d$ by section #b7;b71 is fur!r am5d$ by add+ at ! end ! foll[+3 #bgdg4 ,prohibit+ discrim9ation aga9/ individual p>ticipants & b5efici>ies bas$ on heal? /atus ,! provisions ( section #bgjb 7o!r ?an subsections 7b77#b77;,b7 & 7f7 ( su* section7 %all apply to heal? insurance cov]age (f]$ to individuals by a heal? insurance issu] 9 ! individual m>ket 9 ! same mann] z su* provisions apply to heal? insurance cov]age (f]$ to employ]s by a heal? insurance issu] 9 connection ) heal? insurance cov]age 9 ! gr\p m>ket4 4 #e4 ,incorporation into ,,erisa & ,int]nal ,rev5ue ,code 7a7 ,,erisa ,subp>t ,b ( "p #g ( subtitle ,a ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaha et seq47 is am5d$ by add+ at ! end ! foll[+3 #gae4 ,additional m>ket re=ms ,sections #bgja1 #bgjb1 & #bgaa %all apply to gr\p heal? plans1 & heal? insurance issu]s provid+ heal? insurance cov]age 9 connection ) gr\p heal? plans1 z if includ$ 9 ?is subp>t1 & to ! ext5t t any provision ( ?is "p conflicts ) a provision ( su* a section ) respect to gr\p heal? plans1 or heal? insurance issu]s provid+ heal? insurance cov]age 9 connection ) gr\p heal? plans1 ! provisions ( su* section %all apply4 4 7b7 ,,irc ,sub*apt] ,b ( *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+3 #ihae4 ,additional m>ket re=ms ,sections #bgja1 #bgjb1 & #bgaa %all apply to gr\p heal? plans1 & heal? insurance issu]s provid+ heal? insurance cov]age 9 connection ) gr\p heal? plans1 z if includ$ 9 ?is sub*apt]1 & to ! ext5t t any provision ( ?is sub*apt] conflicts ) a provision ( su* a section ) respect to gr\p heal? plans1 or heal? insurance issu]s provid+ heal? insurance cov]age 9 connection ) gr\p heal? plans1 ! provisions ( su* section %all apply4 4 #f4 ,effective date cont+5t on repeal ( ,,ppaca 7a7 ,9 g5]al ,sections #b1 #c1 #d1 & #e & ! am5dm5ts made by su* sections %all take effect ^u ! enactm5t ( ,,ppaca repeal legislation describ$ 9 subsection 7b7 & su* sections & am5dm5ts %all h no =ce or effect if su* ,,ppaca repeal legislation is n enact$4 7b7 ,,ppaca repeal legislation describ$ ,= purposes ( subsection 7a71 ,,ppaca repeal legislation describ$ 9 ?is subsection is legislation t-- 7#a7 repeals ,public ,law #aaa-adh1 & re/ores or revives ! provisions ( law am5d$ or repeal$1 respectively1 by su* ,act z if su* ,act _h n be5 enact$ & )\t fur!r am5dm5t to su* provisions ( law2 & 7#b7 repeals title ,i & subtitle ,b ( title ,,ii ( ! ,heal? ,c>e & ,education ,reconciliation ,act ( #bjaj 7,public ,law #aaa-aeb71 & re/ores or revives ! provisions ( law am5d$ or repeal$1 respectively1 by su* title or subtitle1 respectively1 z if su* title & subtitle _h n be5 enact$ & )\t fur!r am5dm5t to su* provisions ( law4