S1691-118

1. Short title This Act may be cited as the Healthcare Enrollment Reform Modernization And Navigation Act or the HERMAN Act.

2. Coordination of Medicare benefits with other health care insurance Section 1862(b)(1)(A) of the Social Security Act (42 U.S.C. 1395y(b)(1)(A)) is amended by adding at the end the following new clause: Notwithstanding any other provision of law, in the event that an individual is enrolled in an employer group health plan (including a multiemployer or multiple employer group health plan) by virtue of current employment status with an employer that does not have 20 or more individuals in current employment status for each working day in each of 20 or more calendar weeks in the current calendar year and the preceding calendar year and the individual is eligible but not enrolled in coverage under part B, such employer group health plan shall not reduce benefits under the plan with respect to the individual on the basis that the individual could have been enrolled in coverage under part B. Nothing in the preceding sentence shall require such employer group health plan to provide coverage to an individual who elects to enroll in coverage under part B or to prohibit such plan from terminating such coverage or reducing benefits if such individual makes such election. The amendment made by subsection (a) shall apply to items and services furnished on or after the date of the enactment of this Act. (vi)Coordination of benefits with other health care insuranceNotwithstanding any other provision of law, in the event that an individual is enrolled in an employer group health plan (including a multiemployer or multiple employer group health plan) by virtue of current employment status with an employer that does not have 20 or more individuals in current employment status for each working day in each of 20 or more calendar weeks in the current calendar year and the preceding calendar year and the individual is eligible but not enrolled in coverage under part B, such employer group health plan shall not reduce benefits under the plan with respect to the individual on the basis that the individual could have been enrolled in coverage under part B. Nothing in the preceding sentence shall require such employer group health plan to provide coverage to an individual who elects to enroll in coverage under part B or to prohibit such plan from terminating such coverage or reducing benefits if such individual makes such election..