HouseH.R. 9737119th Congress
Consumer Health Claim Assistance Act
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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9737 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 9737
To amend the Employment Retirement Income Security Act to establish a
Benefits Assistance Program to improve access to benefits under
employee welfare benefit plans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 16, 2026
Mr. DeSaulnier introduced the following bill; 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 plans, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Consumer Health Claim Assistance
Act''.
SEC. 2. BENEFITS ASSISTANCE PROGRAM.
Part 5 of subtitle B of title I of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1131 et seq.) is amended by adding at
the end the following new section:
``SEC. 524. BENEFITS ASSISTANCE PROGRAM.
``(a) Establishment.--Not later than January 1, 2027, the Secretary
shall establish, within the Employee Benefits Security Administration
of the Department of Labor, a Benefits Assistance Program (in this
section, referred to as the `Program') to improve access to benefits
under employee welfare benefit plans.
``(b) Duties.--The Program shall--
``(1) establish a process for the receipt of inquiries or
complaints from participants and beneficiaries, and health care
providers (on behalf of participants and beneficiaries),
relating to--
``(A) adverse benefit determinations (as defined
under section 2560.503-1(m)(4) of title 29, Code of
Federal Regulations, as in effect on the date of
enactment of the Consumer Health Claim Assistance Act);
and
``(B) alleged violations of--
``(i) plan terms; and
``(ii) any provision of this title;
``(2) assist participants and beneficiaries in
understanding their rights to benefits under their plan and the
availability of internal appeals and external review (as such
terms are defined under sections 2590.715-2719(a)(2) of title
29, Code of Federal Regulations, as in effect on the date of
enactment of the Consumer Health Claim Assistance Act);
``(3) directly assist participants and beneficiaries in
filing appeals for denied benefits and navigating such appeals
or reviews;
``(4) 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 law;
``(5) provide additional training, technical assistance,
and support to Department staff, including benefits advisors,
to address adverse benefit determinations or any violations of
this title; and
``(6) if the inquiry or complaint was received as a result
of a referral from a State office of health insurance consumer
assistance, health insurance ombudsman, or other program that
carries out the duties described in section 2793(c) of the
Public Health Service Act (42 U.S.C. 300gg-93(c)), inform such
office or program of the result of such inquiry or complaint.
``(c) Annual Report.--The Secretary of Labor shall, on an annual
basis, submit to the Committee on Education and Workforce of the House
of Representatives and the Committee on Health, Education, Labor, and
Pensions of the Senate a report, with respect to the Program, on the
following:
``(1) The number of inquiries and complaints received
(disaggregated by type of plan, size of plan, and type of
assistance provided).
``(2) The number of participants and beneficiaries who
received assistance (disaggregated by type of plan, size of
plan, and type of service provided).
``(3) The dollar amounts of claims for benefits for which
assistance was provided (disaggregated by type of plan, size of
plan, and type of service provided).
``(4) The total dollar amount expended to operate the
Program and the number of full-time equivalents assigned by the
Secretary to operate the Program.
``(5) The number of referrals to appropriate entities and,
when available, the disposition of such enforcement actions.
``(6) The number and type of any non-monetary recoveries by
participants and beneficiaries who received assistance.
``(7) The average amount of time it takes to provide
assistance.
``(8) Recommendations regarding any additional authority or
resources needed to improve the Program, including
recommendations on necessary increases in filing fees under
section 104(d).
``(9) Any other data determined appropriate by the
Secretary.''.
SEC. 3. PLAN FILING FEES.
(a) Fees on Filings.--Section 104 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1024) is amended by redesignating
subsections (d) and (e) as subsections (e) and (f), respectively, and
by inserting after subsection (c) the following new subsection:
``(d) Fees on Filings With Secretary of Labor.--
``(1) 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 (2) at the time of filing an annual report or a
notice under subsection (a)(1)(A).
``(2) Amount of fee.--
``(A) Annual reports.--Subject to subparagraph (B),
the amount of the fee under paragraph (1) with respect
to each report or notice shall be--
``(i) $250 if the plan had fewer than 100
participants as of the close of the plan year
preceding the plan year in which such report or
notice is filed;
``(ii) $500 if the plan had 100 or more but
fewer than 500 participants as of the close of
such plan year; and
``(iii) not less than $1,000 in the case of
any other plan.
``(B) Regulatory.--The Secretary may by regulation
require a fee that is higher than is otherwise required
under this paragraph. If the Secretary requires a
higher fee, the Secretary shall establish a fee scale
that increases the fee charged to a plan as the number
of participants in a plan increases.
``(3) 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 plan.
``(4) Use and availability of funds.--
``(A) 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 1974 and to
support operations of the Benefits Assistance Program
described in section 524. Such funds shall be available
without fiscal year limitation.
``(B) Limitation.--At least 50 percent of the
amounts described in subparagraph (A) shall be used to
support operations of the Program.''.
(b) Effective Date.--Section 104(d) of the Employee Retirement
Income Security Act of 1974, as added by this section, shall apply to
reports, descriptions, notices, and attestations filed after January 1,
2027.
SEC. 4. MINIMUM NOTICE.
(a) Minimum Notice.--Section 104(a) of the Employee Retirement
Income Security Act (29 U.S.C. 1024(a)) is amended--
(1) in paragraph (1), by inserting after ``plan year'' the
following: ``(or, if applicable, file with the Secretary a
notice as described in paragraph (3)(B) for a plan year)''; and
(2) in paragraph (3)--
(A) by striking ``The Secretary'' and inserting
``(A) Subject to subparagraph (B), the Secretary''; and
(B) by adding at the end the following:
``(B) 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 year, the administrator of the plan shall
file with the Secretary a notice containing the following
information in relation to such plan for such year:
``(i) The name of the employer maintaining such
plan.
``(ii) The number of employees covered by such
plan.
``(iii) The aggregate amount of benefits provided
by such plan.
``(iv) The method of funding of such plan (whether
such plan is unfunded, insured, or a combination) and,
if applicable, the name of any issuers contracted to
provide health insurance coverage in connection with
such plan.
``(v) The name of any service providers that
rendered services to the plan and received $5,000 or
more in compensation, directly or indirectly, from the
plan.''.
(b) Effective Dates.--The amendments made by this section shall
apply with respect to plan years ending after January 1, 2027.
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