4 (1) in paragraph (1), by striking "25 percent of" and inserting "the applicable percentage of", 1 2 3 and (2) by adding at the end of paragraph (2) the 8 1995 or thereafter (b) EFFECTIVE DATE.-The amendment made by 9 subsection (a) shall apply to taxable years beginning after 14 Subtitle 15 16 17 A-Standards And Re quirements of Small Employer Health Insurance Reform 18 SEC. 201. STANDARDS AND REQUIREMENTS OF SMALL EM 19 20 PLOYER HEALTH INSURANCE. The Social Security Act is amended by adding at the 21 end the following new title: 5 "SEC. 2101. STANDARDS AND REQUIREMENTS OF SMALL EMPLOYER HEALTH INSURANCE. "(a) APPROVAL REQUIRED. "(1) IN GENERAL.-No health insurance plan (as defined in section 2103(a)) may be issued on or after the effective date specified in subsection (d) (and no new contract may be offered under such plan with respect to any small employer beginning on or after such effective date) unless the plan has been certified by the Secretary (in accordance with such procedures as the Secretary establishes) or approved by a State regulatory program (approved under subsection (b)) as meeting the standards es tablished under section 2102 by such effective date. "(2) PLAN DISAPPROVED.-If the Secretary determines that a health insurance plan does not meet the applicable requirements of this part on or after such effective date, no coverage may be provided under the plan to individuals not enrolled as of the date of the determination and the plan may not be continued for plan years beginning after the date of 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 222 23 6 such determination until the Secretary determines that such plan is in compliance with such require ments. "(b) CERTIFIED BY STATE APPROVED PROGRAMS. "(1) IN GENERAL.-If the Secretary determines that a State has in effect an effective regulatory pro gram for the application of the standards established under section 2102 to health insurance plans, the Secretary may approve such program for purposes of certification of health insurance plans under this part. "(2) ANNUAL REPORTS.-As a condition for the continued approval of such a regulatory program, the State shall report to the Secretary annually such information as the Secretary may require with respect to the performance of the program. Such information shall include the health insurance plans cer tified under the program, the compliance of such plans with the standards established under section. 2102, and enforcement actions taken to ensure such compliance. "(3) PERIODIC SECRETARIAL REVIEW OF STATE REGULATORY PROGRAMS.-The Secretary annually 24 shall review State regulatory programs approved 25 under paragraph (1) to determine if they continue to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 7 meet and enforce the standards for approval. If the Secretary initially determines that a State regulatory program no longer meets such standards, the Secretary shall provide the State an opportunity to adopt such a plan of correction that would bring such program into compliance with such standards. If the Secretary makes a final determination that the State regulatory program, fails to meet and enforce such standards after such an opportunity, the Secretary shall disapprove such program and reassume responsibility for certification of all health insurance plans in that State. "(3) GAO AUDITS.-The Comptroller General shall conduct periodic reviews on a sample of State regulatory programs approved under paragraph (1) to determine their compliance with the requirements of such paragraph. The Comptroller General shall report to the Secretary and Congress on the findings of such reviews. "(e) EXCISE TAX SANCTIONS.-For application of 21 excise tax in the case of a nonconforming plan, see section 22 5000A of the Internal Revenue Code of 1986. 23 "(d) EFFECTIVE DATE.-The effective date specified 24 in this subsection is January 1, 1993. 8 1 "SEC. 2102. ESTABLISHMENT OF STANDARDS. 2 "(a) ESTABLISHMENT OF STANDARDS.-The Sec 3 retary shall develop and publish, by not later than October 4 1, 1992, specific standards to implement the requirements 5 of this part and part B and to be applied under section 6 5000A of the Internal Revenue Code of 1986. 7 "(b) MORE STRINGENT STATE STANDARDS PER 8 MITTED. Except as provided in section 2113(g), a State may implement standards that are more stringent than 10 the standards established under this section to meet the 11 requirements under subpart II of this part. 12 "(c) TELEPHONE INFORMATION SYSTEM.-The Sec 13 retary shall provide for the establishment of a toll-free 14 telephone information and complaint system which pro15 vides for 16 17 18 19 20 21 22 23 “(1) a system for the receipt and disposition of consumer complaints or inquiries regarding compliance of health plans with the requirements of this title, and "(2) information to small employers about insurers that offer health insurance plans that meet the requirements of this title in the area of the em ployers. 24 "SEC. 2103. DEFINITIONS. 25 "(a) HEALTH INSURANCE PLAN.-As used in this 26 title, the term 'health insurance plan' means any hospital |