,,ii  #aafth ,,congress  #b;d ,session  
,s4 #cecf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ai1    
#bjbj,mr4 ,casey 7for himself1 ,mr4     
,booker1 and ,mr4 ,reed7 introduced the 
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to provide for special      
enrollment periods during public health 
emergencies1 coverage of services       
related to public health emergencies1   
and for other purposes4  #a4 ,short     
title ,this ,act may be cited as the    
,ensuring ,coverage in ,public ,health  
,emergencies ,act of #bjbj4  #b4        
,special enrollment periods during      
public health emergencies  7a7 ,public  
,health ,service ,act ,title ,,xxvii of 
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #cjj;gg et seq47 is amended-- 
7#a7 in section #bgjb7;b77#b7 7#db      
,u4,s4,c4 #cjj;gg-#a7;b77#b771 by       
inserting 1 which shall include a       
special enrollment period of #cj days   
during a public health emergency        

declared under section #cai1 which      
period may be extended for such time as 
the ,secretary may require before the   
period at the end2 and  7#b7 in section 
#bgjd7;f7 7#db ,u4,s4,c4                
#cjj;gg-#c7;f771 by adding at the end   
the following3  7#d7 ,public health     
emergencies ,if the ,secretary declares 
a public health emergency under section 
#cai1 group health plan1 and a group    
health insurance issuer offering group  
health insurance coverage in connection 
with a group health plan1 shall permit  
an employee who is eligible1 but not    
enrolled1 for coverage under the terms  
of the plan or coverage 7or a dependent 
of such an employee if the dependent is 
eligible1 but not enrolled1 for coverage
 under such terms7 to enroll for        
coverage under the terms of the plan or 
coverage during the special enrollment  
period required under section           
#bgjb7;b77#b7 of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#a7;b77#b774  4  7b7 ,,erisa    

,section #gja7;f7 of the ,employee      
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aaha7;f77 is      
amended by adding at the end the        
following3  7#d7 ,public health         
emergencies ,if the ,secretary of       
,health and ,human ,services declares a 
public health emergency under section   
#cai of the ,public ,health ,service    
,act 7#db ,u4,s4,c4 #bdg;d71 a group    
health plan1 or a health insurance      
issuer offering group health insurance  
coverage in connection with such a plan1
 shall permit an employee who is        
eligible1 but not enrolled1 for coverage
 under the terms of the plan or coverage
 7or a dependent of such an employee if 
the dependent is eligible1 but not      
enrolled1 for coverage under such terms7
 to enroll for coverage under the terms 
of the plan or coverage during the      
special enrollment period required under
 section #bgjb7;b77#b7 of the ,public   
,health ,service ,act 7#db ,u4,s4,c4    
#cjj;gg-#a7;b77#b774  4  7c7 ,,irc      

,section #ihja7;f7 of the ,internal     
,revenue ,code of #aihf 7#bf ,u4,s4,c4  
#ihja7;f77 is amended by adding at the  
end the following new paragraph3  7#d7  
,public health emergencies ,if the      
,secretary of ,health and ,human        
,services declares a public health      
emergency under section #cai of the     
,public ,health ,service ,act 7#db      
,u4,s4,c4 #bdg;d71 a group health plan  
shall permit an employee who is         
eligible1 but not enrolled1 for coverage
 under the terms of the plan 7or a      
dependent of such an employee if the    
dependent is eligible1 but not enrolled1
 for coverage under such terms7 to      
enroll for coverage under the terms of  
the plan during the special enrollment  
period required under section           
#bgjb7;b77#b7 of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#a7;b77#b774  4  7d7 ,rule of   
construction ,nothing in the amendments 
made by subsections 7a7 and 7b7 shall be
 construed to prevent group health plan 

or health insurance issuer from offering
 a special enrollment period in addition
 to any such period required under      
,federal law4  #c4 ,coverage of         
prevention and treatment related to     
public health emergencies  7a7 ,required
 coverage  7#a7 ,in general ,subpart    
,,ii of part ,a of title ,,xxvii of the 
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;gg-#aa et seq47 is       
amended by adding at the end the        
following3  #bgbi;,a4 ,coverage of      
prevention and treatment related to     
public health emergencies  7a7 ,in      
general ,a group health plan or a health
 insurance issuer offering group or     
individual health insurance coverage    
shall provide coverage for such services
 related to a disease or condition      
relating to a public health emergency   
declared under section #cai1 which1 as  
applicable1 shall include any services  
for the prevention or treatment1 of the 
disease or condition4  7b7 ,scope of    
benefits ,the prevention and treatment  

measures for which coverage is required 
under subsection 7a7 shall-- 7#a7 be at 
the same level as benefits for the      
prevention or treatment of other similar
 or related diseases or conditions1 if  
applicable1 under the plan or coverage2 
and  7#b7 include1 with respect to the  
disease or condition reasonably related 
to the public health emergency1 even if 
no diagnosis has been made and even if  
the enrollee ultimately is determined   
not to have the disease or condition1 as
 applicable-- 7,a7 vaccines to prevent  
the disease or condition1 if applicable2
  7,b7 testing for diagnosis of the     
disease or condition1 if applicable2    
7,c7 care related to symptoms an        
enrollee may experience2 and  7,d7      
treatments for the disease or condition4
  7c7 ,cost-,sharing ,cost-sharing for  
services for which coverage is required 
under subsection 7a7 shall be comparable
 to similar such services that would be 
covered by the plan or coverage outside 
of a public health emergency4  7d7      

,waiver of restrictions  7#a7 ,in       
general ,a group health plan or health  
insurance issuer offering group or      
individual health insurance coverage    
shall waive any restriction 7including  
any prior authorization requirement1    
limitation on filling or refilling      
prescription drugs1 or other            
restrictions7 on access to covered      
benefits required under this section1 if
 the service is determined by a         
qualified health professional to be     
medically necessary by the provider and 
the ,secretary determines such          
restriction to be unduly burdensome in  
the context of the applicable public    
health emergency4  7#b7 ,term of waiver 
,any waiver of restrictions pursuant to 
paragraph 7#a7 shall apply only for the 
duration of the public health emergency1
 as declared under section #cai4  4     
7#b7 ,,erisa  7,a7 ,in general ,subpart 
,b of part #g of subtitle ,b of title ,i
 of the ,employee ,retirement ,income   
,security ,act of #aigd 7#bi ,u4,s4,c4  

#aaha et4 seq47 is amended by adding at 
the end the following3  #gaf4 ,coverage 
of prevention and treatment related to  
public health emergencies  7a7 ,in      
general ,a group health plan or a health
 insurance issuer offering group health 
insurance coverage1 shall provide       
coverage for such services related to a 
disease or condition relating to a      
public health emergency declared under  
section #cai of the ,public ,health     
,service ,act1 which1 as applicable1    
shall include any services for the      
prevention or treatment1 of the disease 
or condition4  7b7 ,scope of benefits   
,the prevention and treatment measures  
for which coverage is required under    
subsection 7a7 shall-- 7#a7 be at the   
same level as benefits for the          
prevention or treatment of other similar
 or related diseases or conditions1 if  
applicable1 under the plan or coverage2 
and  7#b7 include1 with respect to the  
disease or condition reasonably related 
to the public health emergency1 even if 

no diagnosis has been made and even if  
the enrollee ultimately is determined   
not to have the disease or condition1 as
 applicable-- 7,a7 vaccines to prevent  
the disease or condition1 if applicable2
  7,b7 testing for diagnosis of the     
disease or condition1 if applicable2    
7,c7 care related to symptoms an        
enrollee may experience2 and  7,d7      
treatments for the disease or condition4
  7c7 ,cost-,sharing ,cost-sharing for  
services for which coverage is required 
under subsection 7a7 shall be comparable
 to similar such services that would be 
covered by the plan or coverage outside 
of a public health emergency4  7d7      
,waiver of restrictions  7#a7 ,in       
general ,a group health plan or health  
insurance issuer offering group health  
insurance coverage shall waive any      
restriction 7including any prior        
authorization requirement1 limitation on
 filling or refilling prescription      
drugs1 or other restrictions7 on access 
to covered benefits required under this 

section1 if the service is determined by
 a qualified health professional to be  
medically necessary by the provider and 
the ,secretary determines such          
restriction to be unduly burdensome in  
the context of the applicable public    
health emergency4  7#b7 ,term of waiver 
,any waiver of restrictions pursuant to 
paragraph 7#a7 shall apply only for the 
duration of the public health emergency1
 as declared under section #cai of the  
,public ,health ,service ,act4  4  7,b7 
,clerical amendment ,the table of       
sections for subpart ,b of part #g of   
subtitle ,b of title ,i of the ,employee
 ,retirement ,income ,security ,act of  
#aigd is amended by adding at the end   
the following3  ,sec4 #gae4 ,additional 
market reforms4,sec4 #gaf4 ,coverage of 
prevention and treatment related to     
public health emergencies4  4  7#c7     
,,irc  7,a7 ,in general ,subchapter ,b  
of chapter #ajj of the ,internal        
,revenue ,code of #aihf is amended by   
adding at the end the following new     

section3  #ihaf4 ,coverage of prevention
 and treatment related to public health 
emergencies  7a7 ,in general ,a group   
health plan shall provide coverage for  
such services related to a disease or   
condition relating to a public health   
emergency declared under section #cai of
 the ,public ,health ,service ,act1     
which1 as applicable1 shall include any 
services for the prevention or          
treatment1 of the disease or condition4 
7b7 ,scope of benefits ,the prevention  
and treatment measures for which        
coverage is required under subsection   
7a7 shall-- 7#a7 be at the same level as
 benefits for the prevention or         
treatment of other similar or related   
diseases or conditions1 if applicable1  
under the plan2 and  7#b7 include1 with 
respect to the disease or condition     
reasonably related to the public health 
emergency1 even if no diagnosis has been
 made and even if the enrollee          
ultimately is determined not to have the
 disease or condition1 as applicable--  

7,a7 vaccines to prevent the disease or 
condition1 if applicable2  7,b7 testing 
for diagnosis of the disease or         
condition1 if applicable2  7,c7 care    
related to symptoms an enrollee may     
experience2 and  7,d7 treatments for the
 disease or condition4  7c7             
,cost-,sharing ,cost-sharing for        
services for which coverage is required 
under subsection 7a7 shall be comparable
 to similar such services that would be 
covered by the plan outside of a public 
health emergency4  7d7 ,waiver of       
restrictions  7#a7 ,in general ,a group 
health plan shall waive any restriction 
7including any prior authorization      
requirement1 limitation on filling or   
refilling prescription drugs1 or other  
restrictions7 on access to covered      
benefits required under this section1 if
 the service is determined by a         
qualified health professional to be     
medically necessary by the provider and 
the ,secretary determines such          
restriction to be unduly burdensome in  

the context of the applicable public    
health emergency4  7#b7 ,term of waiver 
,any waiver of restrictions pursuant to 
paragraph 7#a7 shall apply only for the 
duration of the public health emergency1
 as declared under section #cai of the  
,public ,health ,service ,act4  4  7,b7 
,clerical amendment ,the table of       
sections for subchapter ,b of chapter   
#ajj of such ,code is amended by adding 
at the end the following new item3      
,sec4 #ihaf4 ,coverage of prevention and
 treatment related to public health     
emergencies4  4  #d4 ,effective date2   
application ,the amendments made by this
 ,act shall take effect on the date of  
enactment of this ,act and shall apply  
with respect to plans years in effect on
 the date of enactment of this ,act1 and
 plan years beginning on or after such  
date4