text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Insurance Disclosure Act of 1997''.
  
  SEC. 2. DEFINITIONS.
  
      As used in this Act:
              (1) Insurer.--The term ``insurer'' means any person, 
          reciprocal exchange, interinsurer, Lloyds insurer, fraternal 
          benefit society, or other legal entity engaged in the business 
          of insurance, including agents, brokers, adjusters, and third 
          party administrators. The term also includes health benefit 
          plans, health carriers, and life, disability, and property and 
          casualty insurers.
              (2) Health benefit plan.--The term ``health benefit plan'' 
          means any public or private entity or program that provides for 
          payments for health care, including--
                      (A) a group health plan (as defined in section 
                  2791(a)(1) of the Public Health Service Act (42 U.S.C. 
                  300gg-91(a)(1)), section 733(a)(1) of the Employee 
                  Retirement Income Security Act of 1974 (29 U.S.C. 
                  1191b(a)(1)), or section 5000(b)(1) of the Internal 
                  Revenue Code of 1986));
                      (B) a multiple employer welfare arrangement (as 
                  defined in section 3(40) of the Employee Retirement 
                  Income Security Act (29 U.S.C. 1002(40))) that provides 
                  benefits consisting of medical care (as defined in 
                  section 733(a)(2) of such Act (29 U.S.C. 1191b(a)(2))), 
                  including items and services paid for as medical care;
                      (C) any other health insurance arrangement, 
                  including 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;
                      (D) workers' compensation or similar insurance to 
                  the extent that it relates to workers' compensation 
                  medical benefits (as defined in regulations of the 
                  Secretary);
                      (E) automobile medical insurance to the extent that 
                  it relates to medical benefits (as defined in 
                  regulations of the Secretary); and
                      (F) any other insurance providing for enrollees 
                  medical benefits (as defined in regulations of the 
                  Secretary) in the event of sickness, accident, 
                  disability, death, or unemployment.
              (3) Health carrier.--The term ``health carrier'' means a 
          person that contracts or offers to contract on a risk-assuming 
          basis to provide, deliver, arrange for, pay for, or reimburse 
          any of the cost of health care services, including a sickness 
          and accident insurance company, a health maintenance 
          organization, a nonprofit hospital and health service 
          corporation, or any other entity providing a plan of health 
          insurance, health benefits, or health services.
              (4) Policy.--The term ``policy'' means a contract of 
          insurance, certificate, indemnity, suretyship, or annuity 
          issued, proposed for issuance, or intended for issuance by an 
          insurer, including endorsements or riders to an insurance 
          policy or contract.
              (5) Secretary.--The term ``Secretary'' means the Secretary 
          of Health and Human Services.
  
  SEC. 3. ACCESS BY EXAMINED INDIVIDUAL TO RESULTS OF MEDICAL 
                EXAMINATIONS.
  
      An insurer shall take such actions as are necessary to ensure that, 
  in any case in which--
              (1) a medical examination of an individual is required for 
          initial or continued enrollment under a policy issued by the 
          insurer, and
              (2) such medical examination is conducted by a person who 
          is in the employ of the insurer or whose services are procured 
          otherwise by the insurer,
  such individual (or the individual's legal guardian) is provided all 
  medical information obtained from such examination at the same time 
  that such information is made available to the insurer and is 
  encouraged to make such information available to such individual's own 
  physician.
  
  SEC. 4. ENFORCEMENT.
  
      (a) Applicability of Certain Public Health Service Act 
  Provisions.--
              (1) In general.--For purposes of sections 2722 and 2723 of 
          the Public Health Service Act (42 U.S.C. 300gg-22, 300gg-23), 
          the provisions of section 3 shall be deemed provisions of part 
          A of title XXVII of such Act. For purposes of sections 2761 and 
          2762 of such Act (42 U.S.C. 300gg-45, 300gg-46), the provisions 
          of section 3 shall be deemed provisions of part B of such title 
          XXVII.
              (2) Rules of construction.--In applying such sections 2722, 
          2723, 2761 and 2762, and section 2791(d) of such Act (42 U.S.C. 
          300gg-91(d)) pursuant to paragraph (1)--
                      (A) any reference to a ``health insurance issuer'' 
                  shall be deemed a reference to an insurer (as defined 
                  in section 2(1)));
                      (B) any reference to ``health insurance coverage'' 
                  (including any such coverage offered in connection with 
                  a group health plan) shall be deemed a reference to a 
                  policy (as defined in section 2(4));
                      (C) any reference to a ``group health plan'' shall 
                  be deemed a reference to a group insurance plan (as 
                  defined in section 111(b)(1) of the Employee Retirement 
                  Income Security Act of 1974, and subject to the same 
                  rules as apply with respect to group health plans under 
                  section 2721(a) of the Public Health Service Act (42 
                  U.S.C. 300gg-21(a))); and
                      (D) any reference to part A or part B of title 
                  XXVII of such Act shall be deemed a reference to 
                  sections 2 through 6 of this Act.
      (b) Private Cause of Action.--
              (1) In general.--An individual who believes that he or she 
          has been adversely affected by an act or practice of an insurer 
          in violation of section 3 may maintain an action against the 
          insurer in a Federal or State court of original jurisdiction. 
          Upon proof of such conduct by a preponderance of the evidence, 
          the court may award appropriate relief, including temporary, 
          preliminary, and permanent injunctive relief and compensatory 
          and punitive damages, as well as the costs of suit and 
          reasonable fees for the aggrieved individual's attorneys and 
          expert witnesses. With respect to compensatory damages, the 
          aggrieved individual may elect, at any time prior to the 
          rendering of final judgment, to recover in lieu of actual 
          damages, an award of statutory damages in the amount of $10,000 
          for each violation. It shall be the duty of the Federal courts 
          to advance on the docket and to expedite to the greatest 
          possible extent the disposition of any action for temporary or 
          preliminary injunctive relief considered under this paragraph.
              (2) Additional provisions relating to jurisdiction, venue, 
          attorney's fees, etc.--
                      (A) In general.--Subject to subparagraph (B), 
                  subsections (d), (e), (f), (g), (h), and (j) of section 
                  502 of the Employee Retirement Income Security Act of 
                  1974 (29 U.S.C. 1132(d), (e), (f), (g), (h), and (j)) 
                  shall apply with respect to a cause of action under 
                  paragraph (1) in the same manner and to the same extent 
                  as such subsections apply with respect to a cause of 
                  action under section 502(a)(1)(B) of such Act (29 
                  U.S.C. 1132(a)(1)(B)).
                      (B) Rules of construction.--In applying such 
                  subsections pursuant to subparagraph (A)--
                              (i) any reference to a ``participant'' or 
                          ``beneficiary'' shall be deemed a reference to 
                          the aggrieved individual referred to in 
                          paragraph (1);
                              (ii) any reference to an ``employee benefit 
                          plan'' shall be deemed a reference to an 
                          insurer (as defined in section (2)(A));
                              (iii) any reference to the Secretary of 
                          Labor or the Secretary of the Treasury shall be 
                          deemed a reference to the Secretary of Health 
                          and Human Services; and
                              (iv) any reference to title I of such Act 
                          shall be deemed a reference to sections 2 
                          through 6 of this Act.
  
  SEC. 5. EFFECT ON STATE LAW.
  
      (a) In General.--Section 3 supersedes any provision of State law 
  which is inconsistent with any provision of such section, in terms of 
  providing less protection to individuals than is provided by such 
  section, but only to the extent of such inconsistency. Nothing in 
  section 3 shall be construed to--
              (1) alter or relieve any insurer from the obligation to 
          comply with any State law with respect to insurers, policies, 
          and health benefit plans, except to the extent that such law is 
          inconsistent with any provision of section 3, or
              (2) preclude a State from enacting any law or regulation 
          that affords a greater level or broader range of protections to 
  individuals under policies or health benefit plans.
      (b) Definitions.--For purposes of this section, the terms ``State'' 
  and ``State law'' have the meanings provided such terms under section 
  514(c) of the Employee Retirement Income Security Act of 1974 (29 
  U.S.C. 1144(c)).
  
  SEC. 6. REGULATIONS.
  
      The Secretary (in consultation with the Secretary of Labor) shall 
  prescribe regulations to carry out the provisions of sections 2 through 
  5.
  
  SEC. 7. ERISA REQUIREMENTS FOR DISCLOSURE BY GROUP INSURANCE PLANS TO 
                PARTICIPANTS AND BENEFICIARIES OF THEIR MEDICAL CONDITION 
                LEARNED IN THE COURSE OF MEDICAL EXAMINATIONS REQUIRED 
                FOR COVERAGE UNDER SUCH PLANS.
  
      (a) In General.--Part 1 of subtitle B of title I of the Employee 
  Retirement Income Security Act of 1974 is amended--
              (1) by redesignating section 111 (29 U.S.C. 1031) as 
          section 112; and
              (2) by inserting after section 110 (29 U.S.C. 1030) the 
          following new section:
  
   ``disclosure to participants and beneficiaries of results of medical 
              examinations conducted by group insurance plans
  
      ``Sec. 111. (a) In General.--A group insurance plan, and any 
  insurer offering a policy in connection with such plan, shall take such 
  actions as are necessary to ensure that, in any case in which--
              ``(1) a medical examination of a participant or beneficiary 
          is required for initial or continued eligibility for benefits, 
          and
              ``(2) such medical examination is conducted by a person who 
          is in the employ of the plan or the insurer or whose services 
          are procured otherwise by the plan or the insurer,
  such participant or beneficiary (or his or her legal guardian) is 
  provided all medical information obtained from such examination at the 
  same time that such information is made available to the plan or 
  insurer and is encouraged to make such information available to his or 
  her own physician.
      ``(b) Definitions.--For purposes of this section--
              ``(1) Group insurance plan.--The term `group insurance 
          plan' means an employee welfare benefit plan established and 
          maintained for the purpose of providing for its participants or 
          their beneficiaries, through the purchase of insurance or 
          otherwise, medical, surgical, or hospital care or benefits, or 
          benefits in the event of sickness, accident, disability, death, 
          or unemployment.
              ``(2) Policy.--The term ``policy'' means a contract of 
          insurance, certificate, indemnity, suretyship, or annuity, 
          including endorsements or riders to an insurance policy or 
          contract.
      ``(c) Effect on State Law.--This section supersedes any provision 
  of State law which is inconsistent with any provision of this section, 
  in terms of providing less protection to participants and beneficiaries 
  than is provided by this section, but only to the extent of such 
  inconsistency. Nothing in this section shall be construed to--
              ``(1) alter or relieve any plan administrator from the 
          obligation to comply with the laws of any State with respect to 
          group insurance plans, except to the extent that such laws are 
          inconsistent with any provision of this section, or
              ``(2) preclude a State from enacting any law or regulation 
          that affords a greater level or broader range of protections to 
          participants and beneficiaries under group insurance plans.
      ``(d) Expedited Consideration.--It shall be the duty of the Federal 
  courts to advance on the docket and to expedite to the greatest 
  possible extent the disposition of any action under section 502 for 
  temporary or preliminary injunctive relief from violations of this 
  section.
      ``(e) Regulations.--The Secretary (in consultation with the 
  Secretary of Health and Human Services) shall prescribe regulations to 
  carry out the provisions of this section.''.
      (b) Penalties at $100 a Day for Failure to Disclose.--Section 
  502(c)(1)(A) of such Act (29 U.S.C. 1132(c)(1)(A)) is amended by 
  striking ``or section 101(e)(1)'' and inserting ``, section 101(e)(1), 
  or section 111(a)''.
      (c) Conforming Amendment.--The table of contents in section 1 is 
  amended by striking the item relating to section 111 and inserting the 
  following new items:
  
  ``Sec. 111. Disclosure to participants and beneficiaries of results of 
                              medical examinations conducted by group 
                              insurance plans.
  ``Sec. 112. Repeal and effective date.''.
  
  SEC. 8. EFFECTIVE DATE.
  
      Sections 2, 3, 4, 5, and 6 shall apply with respect to any action 
  taken on or after the date of the enactment of this Act. The amendments 
  made by section 7 shall apply with respect to plan years beginning on 
  or after such date.
target: Insurance Disclosure Act of 1997 - Requires insurers, if a medical exam (procured by the insurer) is required for initial or continued enrollment, to:  (1) provide the individual involved with all medical information obtained from the exam; and (2) encourage the individual to make the information available to the individual's physician. Deems the above requirements to be provisions of the Public Health Service Act for purposes of provisions relating to enforcement, preemption, State flexibility, and construction.  Provides for a private cause of action, including applying certain civil enforcement provisions of the Employee Retirement Income Security Act of 1974 (ERISA).  Supersedes any State law providing less protection to individuals. 
  (Sec. 7) Amends ERISA to require a group insurance plan, and any insurer offering a policy in connection with such plan, if a medical exam (procured by the insurer) is required for initial or continued eligibility for benefits, to:  (1) provide the individual involved with all medical information obtained from the exam; and (2) encourage the individual to make the information available to the individual's physician.  Supersedes any State law providing less protection to individuals.  Makes an administrator who fails or refuses to comply liable to the individual for up to $100 per day.  Allows other relief.
feat_title: Insurance Disclosure Act of 1997