Section 1 Short title
This Act may be cited as the “Coverage Protection Act of 2013”.
Coverage Protection Act of 2013
A BILL
To ensure that individuals who attempted to, or who are enrolled in, qualified health plans offered through an Exchange have continuity of coverage, and for other purposes.
Sec. 2 Authority to provide timely coverage for individuals who were unable to enroll in a qualified health plan
In general— In the case of an individual who enrolls in a qualified health plan offered through an Exchange established under title I of the Patient Protection and Affordable Care Act (Public Law 111–148) before February 1, 2014, the Secretary of Health and Human Services may require that the issuer of the plan treat such individual as enrolled in such plan as of December 23, 2013, if the following conditions are met:
Attempted timely enrollment— The individual submits, not later than January 31, 2014, an attestation (in such form and manner as the Secretary may require) that the individual—
made reasonable, good-faith attempts, but was unable, to successfully enroll in such a plan through an Exchange before December 23, 2013; or
was initially determined through an Exchange to be eligible to enroll in a Medicaid plan under title XIX of the Social Security Act but is not eligible to so enroll in such a Medicaid plan and, because of such incorrect eligibility determination, was subsequently unable to enroll in a qualified health plan before December 23, 2013.
Payment of premiums— The individual pays, not later than January 31, 2014, the amount of the applicable monthly premiums for the plan in which such individual enrolls for January and February of 2014, taking into account the amount of any premium assistance made available under section 36B of the Internal Revenue Code of 1986.
Application for purposes of premium assistance, reduced cost-Sharing, and individual responsibility— Coverage provided under a qualified health plan for January and February of 2014 under subsection (a) shall be counted as coverage under such a plan by or through an Exchange for such months for all purposes, including the following:
Premium assistance— Section 36B of the Internal Revenue Code of 1986.
Cost-sharing reductions— Section 1402 of the Patient Protection and Affordable Care Act (42 U.S.C. 18071).
Individual responsibility requirement— Section 5000A of the Internal Revenue Code of 1986.
Sec. 3 Transitional use of receipt of insurance payment as alternative to health insurance card for Exchange plans
In general— The Secretary of Health and Human Services shall require a health insurance issuer that offers a qualified health plan through an Exchange under title I of the Patient Protection and Affordable Care Act (Public Law 111–148)—
to allow in-network providers in such plan to treat, for purposes of coverage under the plan, a receipt of payment of premiums by an individual enrolled under the plan for January or February 2014 who has not received a health insurance card from the issuer in the same manner as if such receipt were such a health insurance card issued to such individual by the issuer for services furnished during such month; and
to notify such in-network providers of the policy under paragraph (1).
Rule of construction— Nothing in this section shall be construed as precluding a health care provider from directly seeking to verify the status of the enrollment of an individual in a qualified health plan offered through an Exchange by contacting the issuer of such plan.