,i #aaith ,,congress #b;d ,session ,h4 ,r4 #igcg ,,in ,,the ,,house ,,of ,,representatives ,july #af1 #bjbf,mr4 ,de,saulnier introduced the following bill2 which was referred to the ,committee on ,education and ,workforce ,a ,,bill ,to amend the ,employment ,retirement ,income ,security ,act to establish a ,benefits ,assistance ,program to improve access to benefits under employee welfare benefit plans1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,consumer ,health ,claim ,assistance ,act4 #b4 ,benefits assistance program ,part #e of subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aaca et seq47 is amended by adding at the end the following new section3 #ebd4 ,benefits assistance program 7a7 ,establishment ,not later than ,january #a1 #bjbg1 the ,secretary shall establish1 within the ,employee ,benefits ,security ,administration of the ,department of ,labor1 a ,benefits ,assistance ,program 7in this section1 referred to as the ,program7 to improve access to benefits under employee welfare benefit plans4 7b7 ,duties ,the ,program shall-- 7#a7 establish a process for the receipt of inquiries or complaints from participants and beneficiaries1 and health care providers 7on behalf of participants and beneficiaries71 relating to-- 7,a7 adverse benefit determinations 7as defined under section #befj4ejc-a7m77#d7 of title #bi1 ,code of ,federal ,regulations1 as in effect on the date of enactment of the ,consumer ,health ,claim ,assistance ,act72 and 7,b7 alleged violations of-- 7i7 plan terms2 and 7ii7 any provision of this title2 7#b7 assist participants and beneficiaries in understanding their rights to benefits under their plan and the availability of internal appeals and external review 7as such terms are defined under sections #beij4gae-bgai7;a77#b7 of title #bi1 ,code of ,federal ,regulations1 as in effect on the date of enactment of the ,consumer ,health ,claim ,assistance ,act72 7#c7 directly assist participants and beneficiaries in filing appeals for denied benefits and navigating such appeals or reviews2 7#d7 make referrals to appropriate entities regarding any inquiries or complaints relating to adverse benefit determinations by a plan that may violate this title or any other law2 7#e7 provide additional training1 technical assistance1 and support to ,department staff1 including benefits advisors1 to address adverse benefit determinations or any violations of this title2 and 7#f7 if the inquiry or complaint was received as a result of a referral from a ,state office of health insurance consumer assistance1 health insurance ombudsman1 or other program that carries out the duties described in section #bgic7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ic7;c771 inform such office or program of the result of such inquiry or complaint4 7c7 ,annual report ,the ,secretary of ,labor shall1 on an annual basis1 submit to the ,committee on ,education and ,workforce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate a report1 with respect to the ,program1 on the following3 7#a7 ,the number of inquiries and complaints received 7disaggregated by type of plan1 size of plan1 and type of assistance provided74 7#b7 ,the number of participants and beneficiaries who received assistance 7disaggregated by type of plan1 size of plan1 and type of service provided74 7#c7 ,the dollar amounts of claims for benefits for which assistance was provided 7disaggregated by type of plan1 size of plan1 and type of service provided74 7#d7 ,the total dollar amount expended to operate the ,program and the number of full-time equivalents assigned by the ,secretary to operate the ,program4 7#e7 ,the number of referrals to appropriate entities and1 when available1 the disposition of such enforcement actions4 7#f7 ,the number and type of any non-monetary recoveries by participants and beneficiaries who received assistance4 7#g7 ,the average amount of time it takes to provide assistance4 7#h7 ,recommendations regarding any additional authority or resources needed to improve the ,program1 including recommendations on necessary increases in filing fees under section #ajd7;d74 7#i7 ,any other data determined appropriate by the ,secretary4 4 #c4 ,plan filing fees 7a7 ,fees on filings ,section #ajd of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajbd7 is amended by redesignating subsections 7d7 and 7e7 as subsections 7e7 and 7f71 respectively1 and by inserting after subsection 7c7 the following new subsection3 7d7 ,fees on filings with ,secretary of ,labor 7#a7 ,in general ,the administrator of any employee welfare benefit plan which is a single-employer plan shall pay to the ,secretary a filing fee in the amount determined under paragraph 7#b7 at the time of filing an annual report or a notice under subsection 7a77#a77;,a74 7#b7 ,amount of fee 7,a7 ,annual reports ,subject to subparagraph 7,b71 the amount of the fee under paragraph 7#a7 with respect to each report or notice shall be-- 7i7 #bej if the plan had fewer than #ajj participants as of the close of the plan year preceding the plan year in which such report or notice is filed2 7ii7 #ejj if the plan had #ajj or more but fewer than #ejj participants as of the close of such plan year2 and 7iii7 not less than #a1jjj in the case of any other plan4 7,b7 ,regulatory ,the ,secretary may by regulation require a fee that is higher than is otherwise required under this paragraph4 ,if the ,secretary requires a higher fee1 the ,secretary shall establish a fee scale that increases the fee charged to a plan as the number of participants in a plan increases4 7#c7 ,prohibition on use of plan assets ,payment of a filing fee under this subsection may not be made using any funds that are assets of the plan4 7#d7 ,use and availability of funds 7,a7 ,in general ,the ,secretary of ,labor shall expend the amounts received under this subsection for each fiscal year for enforcement of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd and to support operations of the ,benefits ,assistance ,program described in section #ebd4 ,such funds shall be available without fiscal year limitation4 7,b7 ,limitation ,at least #ej percent of the amounts described in subparagraph 7,a7 shall be used to support operations of the ,program4 4 7b7 ,effective date ,section #ajd7;d7 of the ,employee ,retirement ,income ,security ,act of #aigd1 as added by this section1 shall apply to reports1 descriptions1 notices1 and attestations filed after ,january #a1 #bjbg4 #d4 ,minimum notice 7a7 ,minimum notice ,section #ajd7;a7 of the ,employee ,retirement ,income ,security ,act 7#bi ,u4,s4,c4 #ajbd7;a77 is amended-- 7#a7 in paragraph 7#a71 by inserting after plan year the following3 7or1 if applicable1 file with the ,secretary a notice as described in paragraph 7#c77;,b7 for a plan year72 and 7#b7 in paragraph 7#c7-- 7,a7 by striking ,the ,secretary and inserting 7,a7 ,subject to subparagraph 7,b71 the ,secretary2 and 7,b7 by adding at the end the following3 7,b7 ,in the case of any employee welfare benefit plan which is a single-employer plan that is not required to file an annual report for any year1 the administrator of the plan shall file with the ,secretary a notice containing the following information in relation to such plan for such year3 7i7 ,the name of the employer maintaining such plan4 7ii7 ,the number of employees covered by such plan4 7iii7 ,the aggregate amount of benefits provided by such plan4 7iv7 ,the method of funding of such plan 7whether such plan is unfunded1 insured1 or a combination7 and1 if applicable1 the name of any issuers contracted to provide health insurance coverage in connection with such plan4 7v7 ,the name of any service providers that rendered services to the plan and received #e1jjj or more in compensation1 directly or indirectly1 from the plan4 4 7b7 ,effective dates ,the amendments made by this section shall apply with respect to plan years ending after ,january #a1 #bjbg4