,i  #aaith ,,congress  #b;d ,session    
,h4 ,r4 #igea  ,,in ,,the ,,house ,,of  
,,representatives  ,july #af1 #bjbf,ms4 
,lee of ,pennsylvania introduced the    
following bill2 which was referred to   
the ,committee on ,education and        
,workforce  ,a ,,bill  ,to amend the    
,employment ,retirement ,income         
,security ,act of #aigd to establish    
additional requirements relating to     
claims and appeals4  #a4 ,short title   
,this ,act may be cited as the ,consumer
 ,appeal ,rights ,enforcement ,act4  #b4
 ,enforcement of claims procedure and   
external review requirements  7a7       
,equitable relief and penalties ,section
 #ejb7;a7 of the ,employee ,retirement  
,income ,security ,act of #aigd 7#bi    
,u4,s4,c4 #aacb7;a77 is amended--  7#a7 
in paragraph 7#e71 by inserting before  
the semicolon the following3 or the     
terms of the plan2 and  7#b7 in         
paragraph 7#f71 to read as follows3     
7#f7 by the ,secretary to collect any   
civil penalty under this title2  4  7b7 

,penalty for claims procedure and       
external review requirement violations  
,section #ejb7;c7 of the ,employee      
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aacb7;c77 is      
amended by adding at the end the        
following3  7#ad7  7,a7 ,global and     
individual violations  7i7 ,in general  
,the ,secretary may assess a civil      
penalty under subparagraph 7,b7 against 
any person or entity 7other than a plan7
 that materially causes 7including      
through failure to perform required     
actions7 a global violation described in
 clause 7ii7 or individual violation    
described in clause 7iii74  7ii7 ,global
 violation ,it shall be deemed a global 
violation for a plan to fail to have--  
7,i7 a claims procedure that complies   
7in writing or in operation7 with-- 7aa7
 the terms of the plan2 or  7bb7 section
 #ejc 7including the requirements of    
section #befj4ejc-a of title #bi1 ,code 
of ,federal ,regulations1 as in effect  
on the date of enactment of the         

,consumer ,appeal ,rights ,enforcement  
,act72 or  7,,ii7 an external review    
process that complies 7in writing or in 
operation7 with--  7aa7 the terms of the
 plan2 or  7bb7 the requirements of     
section #beij4gae-bgai of title #bi1    
,code of ,federal ,regulations1 as in   
effect on the date of enactment of the  
,consumer ,appeal ,rights ,enforcement  
,act4  7iii7 ,individual violation ,it  
shall be deemed an individual violation 
for a plan to fail to-- 7,i7 provide a  
required notification or disclosure to a
 participant or beneficiary that        
includes all required content2  7,,ii7  
respond to or decide a participant's or 
beneficiary's claim1 appeal or request  
for external review in a timely manner2 
or  7,,iii7 respond to a participant's  
or beneficiary's communication or       
request for information with the        
requested information to which the      
participant or beneficiary is legally   
entitled2  in a manner that violates the
 plan's written claims procedure1       

section #ejc 7including the requirements
 of section #befj4ejc-a of title #bi1   
,code of ,federal ,regulations 7as in   
effect on the date of enactment of the  
,consumer ,appeal ,rights ,enforcement  
,act771 or the requirements of section  
#beij4gae-bgai of title #bi1 ,code of   
,federal ,regulations 7as in effect on  
the date of enactment of the ,consumer  
,appeal ,rights ,enforcement ,act74     
7iv7 ,separate violations ,each         
individual violation with respect to    
each participant or beneficiary shall be
 treated as a separate violation4  7,b7 
,penalty ,amounts  7i7 ,global violation
 ,the amount of the penalty imposed     
under this paragraph for a global       
violation shall be no greater than the  
product of--  7,i7 for each plan year in
 which such a violation occurs1 #a1jjj1 
multiplied by  7,,ii7 the number of     
participants and beneficiaries in the   
plan at the start of each such plan     
year4  7ii7 ,enhanced penalty for       
certain global violations ,a penalty for

 a global violation may be trebled if   
such violation is not corrected within  
#ij days after the ,secretary gives     
written notice of the ,secretary's      
intent to assess such penalty to the    
plan administrator and each person or   
entity that the ,secretary intends to   
hold liable for the penalty4  7iii7     
,individual violation ,the amount of the
 penalty imposed under this paragraph   
for an individual violation shall be no 
greater than #a1jjj for each day        
beginning on the date on which--  7,i7 a
 participant or beneficiary 7or such    
participant or beneficiary's authorized 
representative7 gives written notice of 
the violation to the administrator and  
the ,secretary of ,labor2 or  7,,ii7 if 
the ,secretary discovers an individual  
violation during the course of an       
investigation pursuant to section #ejd1 
the ,secretary provides written notice  
to the administrator of such violation4 
and ending on the date on which the     
violation is corrected4  7iv7 ,enhanced 

penalty for certain individual          
violations ,the civil penalty described 
in clause 7iii7 may be trebled with     
respect to each separate and distinct   
violation of subparagraph 7,a77iii7 that
 is not corrected within the following  
periods beginning on the date on which  
the plan administrator receives notice  
described in subclauses 7,i7 or 7,,ii7  
of clause 7iii73 7,i7 #ij-;day period   
with respect to a violation pertaining  
to a plan that is not a group health    
plan4  7,,ii7 #cj-;day period with      
respect to a violation pertaining to a  
group health plan4  7,,iii7 #c-;day     
period with respect to a violation of a 
claim involving urgent care as defined  
in section #befj4ejc-a7m77#a7 of title  
#bi1 ,code of ,federal ,regulations 7as 
in effect as of the date of enactment of
 the ,consumer ,appeal ,rights          
,enforcement ,act74  7v7 ,pattern or    
practice of individual violations ,in   
addition to the penalties under clauses 
7iii7 and 7iv71 in the case that the    

,secretary determines that a person or  
entity has engaged in a pattern or      
practice of individual violations1 the  
,secretary-- 7,i7 shall provide notice  
to the plan of the intent to assess a   
penalty with respect to each individual 
violation that occurred within the      
#c-year period ending on the date that  
such notice was provided1 unless each   
such individual violation has been      
corrected2  7,,ii7 with respect to each 
individual violation1 shall assess a    
penalty not less than #ajj and not      
greater than #a1jjj for each day each   
such violation during such period was   
not corrected following receipt of the  
notice by the ,secretary2 and  7,,iii7  
may waive some or all of the penalties  
if the plan corrects the violations     
within #abj days of receipt of the      
notice required under subclause 7,i74   
7,c7 ,joint and several liability ,any  
person or entity that materially causes 
7including through failure to perform   
required actions7 a violation described 

in subparagraph 7,a7 shall be jointly   
and severally liable for the payment of 
the appropriate penalty described in    
subparagraph 7,b74  4  7c7 ,additional  
penalty ,section #ejb7;g7 of the        
,employee ,retirement ,income ,security 
,act of #aigd 7#bi ,u4,s4,c4 #aacb7;g77 
is amended by adding at the end the     
following3  7#c7  7,a7 ,in any action   
brought under subsection 7a77#e7 with   
respect to a violation of section #ejc  
7including a violation of section       
#befj4ejc-a of title #bi1 ,code of      
,federal ,regulations1 as in effect on  
the date of enactment of the ,consumer  
,appeal ,rights ,enforcement ,act7 or a 
violation of section #beij4gae-bgai of  
title #bi1 ,code of ,federal            
,regulations 7as in effect on the date  
of enactment of the ,consumer ,appeal   
,rights ,enforcement ,act71 a court may 
impose against any defendant 7other than
 a plan71 as additional relief1 the     
penalties described under subsection    
7c77#ad74  7,b7 ,a court may not impose 

such penalties if the ,secretary has    
previously assessed a penalty under     
subsection 7c77#ad7 against such        
defendant for the same violation4  7,c7 
,the ,secretary may not assess any      
penalty under subsection 7c77#ad7       
against a person or entity if1 in an    
action brought under subsection 7a77#e71
 a court has imposed a penalty against  
such person or entity for the same      
violation4  4  7d7 ,effective date ,the 
amendments made by this section shall   
apply beginning on the date that is #ij 
days after the date of enactment of this
 ,act4  #c4 ,direct ,enforcement        
,authority  7a7 ,in general ,section    
#ejb7;b77#c7 of the ,employee           
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aacb7;b77#c77 is  
repealed4  7b7 ,effective date ,the     
amendment made by this section shall    
apply beginning on the date that is #ij 
days after the date of enactment of this
 ,act4