text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Genetic Fairness Act of 1996''.
  
  SEC. 2. DEFINITIONS.
  
      As used in this Act:
              (1) Family member.--The term ``family member'' means, with 
          respect to an individual, another individual related by blood 
          to that individual or a spouse or adopted child of the 
          individual.
              (2) Genetic information.--The term ``genetic information'' 
          means the information about genes, gene products or inherited 
          characteristics that may be derived from an individual or a 
          family member.
              (3) Genetic services.--The term ``genetic services'' means 
          health services provided to obtain, assess, and interpret 
          genetic information for diagnostic and therapeutic purposes, 
          and for genetic education and counseling.
              (4) Genetic test.--The term ``genetic test'' means a 
          procedure that is generally accepted in the scientific and 
          medical communities and that is performed for the purposes of 
          identifying the presence, absence, or alternation of any gene 
          or chromosome.
              (5) Health plan.--The term ``health plan'' means--
                      (A) a group health plan (as such term is defined in 
                  section 607 of the Employee Retirement Income Security 
                  Act of 1974 (29 U.S.C. 1167)), and a multiple employer 
                  welfare arrangement (as defined in section 3(40) of 
                  such Act) that provides health insurance coverage; or
                      (B) any contractual arrangement for the provision 
                  of a payment for health care, including any health 
                  insurance arrangement or any arrangement consisting of 
                  a hospital or medical expense incurred policy or 
                  certificate, hospital or medical service plan contract, 
                  or health maintenance organization subscriber contract.
              (6) Insurer.--The term ``insurer'' means--
                      (A) an insurance company, health care service 
                  contractor, fraternal benefit organization, insurance 
                  agent, third party administrator, insurance support 
                  organization or other person subject to regulation 
                  under State health insurance laws;
                      (B) a managed care organization; or
                      (C) an employee welfare benefit plan regulated 
                  under the Employee Retirement Income Security Act of 
                  1974 (29 U.S.C. 1001 et seq.).
              (7) Secretary.--The term ``Secretary'' means the Secretary 
          of Health and Human Services.
  
  SEC. 3. PROHIBITIONS.
  
      (a) Genetic Information.--An insurer offering a health plan may 
  not--
              (1) terminate, restrict, limit, or otherwise apply 
          conditions to coverage of an individual or family member under 
          the plan, or restrict the sale of the plan to an individual or 
          family member;
              (2) cancel or refuse to renew the coverage of an individual 
          or family member under the plan;
              (3) deny coverage or exclude an individual or family member 
          from coverage under the plan;
              (4) impose a rider that excludes coverage for certain 
          benefits and services under the plan;
              (5) establish differentials in premium rates or cost 
          sharing for coverage under the plan; or
              (6) otherwise discriminate against an individual or family 
          member in the provision of health care;
  on the basis of any genetic information concerning an individual or 
  family member or on the basis of an individual's or family member's 
  request for or receipt of genetic services.
      (b) Genetic Tests.--An insurer offering a health plan may not 
  require an applicant for coverage under the plan, or an individual or 
  family member who is presently covered under the plan, to be the 
  subject of a genetic test or to be subjected to questions relating to 
  genetic information.
      (c) Notice of Rights.--An insurer offering a health plan shall, in 
  the enrollment information provided by the insurer concerning such 
  plan, provide an enrollee with a written statement disclosing the 
  rights of the enrollee under this Act. Such statement shall be in a 
  form and manner that is noticeable to and understandable by an average 
  enrollee.
      (d) Enforcement.--
              (1)  Plans other than employee welfare benefit plans.--The 
          requirements established under subsections (a), (b), and (c) 
          shall be enforced by the State insurance commissioner for the 
          State involved or the official or officials designated by the 
          State, except that in no case shall a State enforce such 
          requirements as they relate to employee welfare benefit plans.
              (2) Employee welfare benefit plans.--With respect to 
          employee welfare benefit plans, the Secretary shall enforce the 
          requirements established under subsections (a), (b), and (c) in 
          the same manner as provided for under sections 502, 504, 506, 
          and 510 of the Employee Retirement Income Security Act of 1974 
          (29 U.S.C. 1132, 1134, 1136, and 1140).
              (3) Private right of action.--A person may, after that 
          person has exhausted all available administrative remedies, 
          bring a civil action--
                      (A) to enjoin any act or practice which violates 
                  subsection (a), (b), or (c);
                      (B) to obtain other appropriate equitable relief--
                              (i) to redress such violations; or
                              (ii) to require the Secretary of Health and 
                          Human Services to enforce any such subsections, 
                          or
                      (C) to obtain other legal relief, including 
                  monetary damages.
              (4) Jurisdiction.--State courts of competent jurisdiction 
          and district courts of the United States have concurrent 
          jurisdiction of actions under this subsection. The district 
          courts of the United States shall have jurisdiction, without 
          respect to the amount in controversy or the citizenship of the 
          parties, to grant the relief provided for in paragraph (3) in 
          any action.
              (5) Venue.--For purposes of this subsection the venue 
          provisions of section 1391 of title 28, United States Code, 
          shall apply.
              (6) Regulations.--The Secretary may promulgate such 
          regulations as may be necessary or appropriate to carry out 
          this section.
  
  SEC. 4. EFFECTIVE DATE.
  
      This Act shall apply to any health plan offered or renewed on or 
  after the end of the 90-day period beginning on the date of the 
  enactment of this Act.
target: Genetic Fairness Act of 1996 - Prohibits an insurer offering a health plan from:  (1) discriminating against an individual or family member on the basis of genetic information or on the basis of an individual's or family member's request for or receipt of genetic services; or (2) requiring a genetic test or questions relating to genetic information.  Requires insurers to disclose enrollee rights. Provides for enforcement by State insurance commissioners, the Secretary of Health and Human Services, and private actions.
feat_title: Genetic Fairness Act of 1996