119-s2086

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2086 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 2086

 To amend the Employee Retirement Income Security Act of 1974 to allow 
health marketplace pools to be deemed an employer under 

section 3

    (5) of 
 such Act for purposes of offering a group health plan or group health 
 insurance coverage, and for other purposes.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 June 17, 2025

 Mr. Paul introduced the following bill; which was read twice and 
 referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

 A BILL

 To amend the Employee Retirement Income Security Act of 1974 to allow 
health marketplace pools to be deemed an employer under 

section 3

    (5) of 
 such Act for purposes of offering a group health plan or group health 
 insurance coverage, 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 ``Health Marketplace for All Act of 
2025''.

SEC. 2. HEALTH MARKETPLACE POOLS DEEMED AN ``EMPLOYER'' FOR PURPOSES OF 
 OFFERING GROUP HEALTH PLANS OR GROUP HEALTH INSURANCE 
 COVERAGE.

    (a) Definition of Employer.--

Section 3

    (5) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1002

    (5) ) is amended 
by adding at the end the following: ``Such term shall be deemed to 
include, for purposes of offering a group health plan (as defined in 

section 733

    (a)

    (1) ) or group health insurance coverage (as defined in 

section 733

    (b)

    (4) ) (which, notwithstanding any other provision of law, 
may include such a plan or coverage covering prescription or 
nonprescription drugs as the only benefit offered by the plan or 
coverage in accordance with 

section 736

    (b)

    (5)
        (B) ), any entity that 
meets the requirements under 

section 736

    (b) .''.

    (b) Group Health Plans and Group Health Insurance Coverage.--Part 7 
of subtitle B of title I of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1181 et seq.) is amended by adding at the end the 
following:

``

SEC. 736. HEALTH MARKETPLACE POOLS DEEMED AN `EMPLOYER' FOR PURPOSES 
 OF OFFERING GROUP HEALTH PLANS OR GROUP HEALTH INSURANCE 
 COVERAGE.

 ``

    (a) In General.--An entity (referred to in this section as a 
`health marketplace pool') that meets the requirements under subsection

    (b) shall be deemed an employer under 

section 3

    (5) for purposes of 
offering a group health plan or group health insurance coverage (which, 
notwithstanding any other provision of law, may include such a plan or 
coverage covering prescription or nonprescription drugs as the only 
benefit offered by the plan or coverage in accordance with subsection

    (b)

    (5)
        (B) ).
 ``

    (b) Requirements for Health Marketplace Pools.--The requirements 
under this subsection are each of the following:
 ``

    (1) Organization.--The health marketplace pool shall--
 ``
        (A) be formed and maintained in good faith for a 
 purpose that includes the formation of a risk pool in 
 order to offer group health insurance coverage or a 
 group health plan to its members; and
 ``
        (B) not condition membership in the health 
 marketplace pool on any health status-related factor 
 relating to an individual (including an employee of an 
 employer or a dependent of an employee).
 ``

    (2) Offering group health plans and group health 
 insurance coverage.--
 ``
        (A) Different groups.--
 ``
            (i) In general.--The health marketplace 
 pool, which may be in conjunction with a health 
 insurance issuer that offers group health 
 insurance coverage through the health 
 marketplace pool, shall make available a group 
 health plan or group health insurance coverage 
 to all members of the health marketplace pool 
 (and, in the case of members that are 
 employers, employees of the employers) at rates 
 that--
 ``
            (I) are established by the health 
 marketplace pool, or a health insurance 
 issuer contracting with such health 
 marketplace pool, on a policy or 
 product specific basis; and
 ``
            (II) subject to sections 701 and 
 702, may vary for individuals covered 
 through the health marketplace pool.
 ``
            (ii) Permissible coverage for 
 dependents.--Such group health plan or group 
 health insurance coverage may be made available 
 under clause
            (i) to any dependents of members 
 of the health marketplace pool or dependents of 
 employees of employers that are such members.
 ``
        (B) Nondiscrimination in coverage offered.--
 ``
            (i) In general.--Subject to clause
            (ii) , 
 the health marketplace pool may not offer 
 coverage under a group health plan or group 
 health insurance coverage to a member of the 
 health marketplace pool unless the same 
 coverage is offered to all such members of the 
 health marketplace pool.
 ``
            (ii) Construction.--Nothing in this 
 subsection shall be construed as requiring a 
 health insurance issuer or group health plan to 
 provide coverage outside the service area of 
 the issuer or plan, or preventing a health 
 insurance issuer or group health plan from 
 underwriting or from excluding or limiting the 
 coverage on any individual, subject to the 
 requirements under sections 701 and 702.
 ``
            (C) Assumption of risk.--The health marketplace 
 pool may provide--
 ``
            (i) group health insurance coverage 
 through a contract with a health insurance 
 issuer; or
 ``
            (ii) a group health plan through self-
 insurance.
 ``

    (3) Geographic areas.--Nothing in this subsection shall 
 be construed as preventing the establishment and operation of 
 more than 1 health marketplace pool in a geographic area or as 
 limiting the number of health marketplace pools that may 
 operate in any area.
 ``

    (4) Provision of administrative services to purchasers.--
 The health marketplace pool may provide administrative services 
 for members. Such services may include accounting, billing, and 
 enrollment information.
 ``

    (5) Drug coverage.--The group health plan or group health 
 insurance coverage offered by the health marketplace pool may 
 offer--
 ``
        (A) drug coverage, including coverage of over-
 the-counter drugs, in combination with other benefits 
 covered by the group health plan or group health 
 insurance coverage; or
 ``
        (B) notwithstanding any other provision of law, 
 drug coverage, including coverage of over-the-counter 
 drugs, as the only benefit covered by the group health 
 plan or group health insurance coverage.
 ``

    (6) Members.--
 ``
        (A) In general.--With respect to an individual 
 who is a member of the health marketplace pool--
 ``
            (i) the individual may enroll for 
 coverage under the group health plan or group 
 health insurance coverage offered by the health 
 marketplace pool (including, if applicable, 
 enrollment for coverage for a dependent of such 
 individual); or
 ``
            (ii) the employer of the individual may 
 enroll the individual for coverage under the 
 group health plan or group health insurance 
 coverage offered by the health marketplace pool 
 (including, if applicable, enrollment for 
 coverage for a dependent of such individual).
 ``
        (B) Eligibility.--An individual shall be eligible 
 to be a member of the health marketplace pool if such 
 individual is--
 ``
            (i) a member of an entity that 
 establishes or joins the health marketplace 
 pool (or a dependent of such a member, as 
 applicable);
 ``
            (ii) an employee of a member of an entity 
 described in clause
            (i) (or a dependent of such 
 an employee, as applicable); or
 ``
            (iii) an employee of an entity (or a 
 dependant of such an employee, as applicable) 
 controlled by a member of an entity described 
 in clause
            (i) .
 ``
            (C) Rules for enrollment.--Nothing in this 
 paragraph shall preclude the health marketplace pool 
 from establishing rules of enrollment and reenrollment 
 of members. Such rules shall be applied consistently to 
 all members within the health marketplace pool and 
 shall not be based in any manner on health status-
 related factors in accordance with sections 701 and 
 702.
 ``
            (c) Determination of Employer and Joint Employer Status.--
Participating in or facilitating a group health plan or group health 
insurance coverage under this section shall not be construed as 
establishing under any Federal or State law--
 ``

    (1) an employer relationship for any purpose other than 
 offering the group health plan or group health insurance 
 coverage; or
 ``

    (2) a joint employer relationship for any purpose.
 ``
            (d) === Definition. ===
-In this section, the term `dependent', as 
applied to a group health plan or group health insurance coverage 
offered in a State, shall have the meaning applied to such term with 
respect to such plan or coverage under the State law applying to such 
plan or coverage. Such term may include the spouse and children of the 
individual involved in accordance with such State law.''.

SEC. 3. CONFORMING AMENDMENTS.

 

Section 3 of the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1002) is amended--

    (1) in paragraph

    (6) , by inserting before the period ``, 
 except (with respect to an entity meeting the requirements 
 under 

section 736

    (b) ) such term includes any member of such 
 entity'';

    (2) in paragraph

    (21) --
        (A) in subparagraph
        (A) , by striking ``subparagraph
        (B) '' and inserting ``subparagraphs
        (B) and
            (C) ''; and
        (B) by adding at the end the following:
 ``
            (C) With respect to a person that is a member of an entity 
(referred to in 

section 736 and this subparagraph as a `health 
marketplace pool') that meets the requirements of 

section 736

    (b) and 
offers a group health plan (as defined in 

section 733

    (a)

    (1) ) or group 
health insurance coverage (as defined in 

section 733

    (b)

    (4) ) (which, 
notwithstanding any other provision of law, may include such a plan or 
coverage covering prescription or nonprescription drugs as the only 
benefit offered by the plan or coverage), membership in the health 
marketplace pool shall not by itself cause the person to be a fiduciary 
with respect to the group health plan or group health insurance 
coverage.''; and

    (3) in paragraph

    (40)
        (A) --
        (A) in clause
            (ii) , by striking ``, or'' and 
 inserting ``,'';
        (B) in clause
            (iii) , by striking the period and 
 inserting ``, or''; and
            (C) by adding at the end the following:
 ``
            (iv) as a group health plan (as defined in 

section 733

    (a)

    (1) ), or group health insurance coverage (as defined in 
 

section 733

    (b)

    (4) ), offered by an entity meeting the 
 requirements under 

section 736

    (b) (which, notwithstanding any 
 other provision of law, may include such an entity offering 
 such a plan or coverage covering prescription or 
 nonprescription drugs as the only benefit offered by the plan 
 or coverage).''.
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