of this Act, or any application of such 17 provision to any person or

circumstance, is held to be un18 constitutional, the remainder of the

provisions of this Act 19 and the application of the provision to any other
person 20 or circumstance shall not be affected. 21 Subtitle G—Early
Investments 22 SEC. 161. ENSURING VALUE AND LOWER PREMIUMS. 23 (a) GROUP
HEALTH INSURANCE COVERAGE.—Title 24 XXVII of the Public Health Service
Act is amended by 25 inserting after section 2713 the following new section:
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(444390|2) 54 1 ‘‘SEC. 2714. ENSURING VALUE AND LOWER PREMIUMS. 2 ‘‘(a)
IN GENERAL.—Each health insurance issuer 3 that offers health insurance
coverage in the small or large 4 group market shall provide that for any
plan year in which 5 the coverage has a medical loss ratio below a level
specified 6 by the Secretary, the issuer shall provide in a manner 7
specified by the Secretary for rebates to enrollees of pay8 ment
sufficient to meet such loss ratio. Such methodology 9 shall be set at
the highest level medical loss ratio possible 10 that is designed to ensure
adequate participation by 11 issuers, competition in the health insurance
market, and 12 value for consumers so that their premiums are used for
13 services. 14 ‘‘(b) UNIFORM DEFINITIONS.—The Secretary shall 15
establish a uniform definition of medical loss ratio and 16 methodology
for determining how to calculate the medical 17 loss ratio. Such
methodology shall be designed to take into 18 account the special
circumstances of smaller plans, dif19 ferent types of plans, and newer
plans.’’. 20 (b) INDIVIDUAL HEALTH INSURANCE COVERAGE.— 21 Such title
is further amended by inserting after section 22 2753 the following new
section: 23 ‘‘SEC. 2754. ENSURING VALUE AND LOWER PREMIUMS. 24 ‘‘The
provisions of section 2714 shall apply to health 25 insurance coverage
offered in the individual market in the VerDate Nov 24 2008 12:51 Jul 14,
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f:\VHLC\071409\071409.140.xml (444390|2) 55 1 same manner as such
provisions apply to health insurance 2 coverage offered in the small or
large group market.’’. 3 (c) IMMEDIATE IMPLEMENTATION.—The amend4
ments made by this section shall apply in the group and 5 individual market
for plan years beginning on or after 6 January 1, 2011. 7 SEC. 162. ENDING
HEALTH INSURANCE RESCISSION ABUSE. 8 (a) CLARIFICATION REGARDING
APPLICATION OF 9 GUARANTEED RENEWABILITY OF INDIVIDUAL HEALTH 10
INSURANCE COVERAGE.—Section 2742 of the Public 11 Health Service Act (42
U.S.C. 300gg–42) is amended— 12 (1) in its heading, by inserting ‘‘AND
CON13 TINUATION IN FORCE, INCLUDING PROHIBI14 TION OF RESCISSION,’’
after ‘‘GUARANTEED RE15 NEWABILITY’’; and 16 (2) in subsection (a),
by inserting ‘‘, including 17 without rescission,’’ after