Sec. 903. Prohibition of employee benefits duplicative of benefits under State health security programs; coordination in case of workers’ compensation
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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: Subject to subsection (b), no employee benefit plan may provide benefits which duplicate payment for any items or services for which payment may be made under a State health security program established pursuant to section 101(b) of the American Health Security Act of 2013 . Each workers compensation carrier that is liable for payment for workers compensation services furnished in a State shall reimburse the State health security plan for the State in which the services are furnished for the cost of such services.
In this subsection: The term workers compensation carrier means an insurance company that underwrites workers compensation medical benefits with respect to one or more employers and includes an employer or fund that is financially at risk for the provision of workers compensation medical benefits. The term workers compensation medical benefits means, with respect to an enrollee who is an employee subject to the workers compensation laws of a State, the comprehensive medical benefits for work-related injuries and illnesses provided for under such laws with respect to such an employee.
The term workers compensation services means items and services included in workers compensation medical benefits and includes items and services (including rehabilitation services and long-term-care services) commonly used for treatment of work-related injuries and illnesses. . Section 4(b) of such Act ( 29 U.S.C. 1003(b) ) is amended by adding at the end the following: Paragraph
(3)shall apply subject to section 522(b) (relating to reimbursement of State health security plans by workers compensation carriers). . The table of contents in section 1 of such Act is amended by inserting after the item relating to section 521 the following new items: Sec. 522. Prohibition of employee benefits duplicative of State health security program benefits; coordination in case of workers’ compensation. .
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Sec. 903
Prohibition of employee benefits duplicative of benefits under State health security programs; coordination in case of workers’ compensation
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